Additional guidance on referring patients for cataract surgery has been issued by the Optical Confederation to ensure the maximum number of patients are considered for treatment.
Following last week's alarm over blanket visual acuity thresholds (News 17.08.12) the Confederation issued a supplement saying clinicians and practices had a professional duty to regard the circumstances of individual patients.
Practitioners were told it would not be sensible to refer a patient who was 'obviously outside locally agreed referral guidelines' unless there was an exceptional reason for intervention, but recommended to refer on the basis of 'functionality and impairment to tasks of daily living' and 'the patient's fitness and willingness for surgery'.
'In a clinically led and patient-focused NHS as the government intends, it is good practice for referral guidelines to be agreed locally between hospital clinicians, community optometrists and optical practices via the local optical committee and commissioners,' the Confederation said.
Referring optometrists were advised to abide by local guidelines unless there were exceptional circumstances, such as when vision cannot be improved by vision correction and quality of life is affected. Such a reason should be noted by the optometrist in the referral letter, according to the guidance.
'If the receiving ophthalmologist then considers that the patients should not undergo surgery, that is a legitimate clinical decision. However, this should be on the basis of the patient's individual circumstances and clinical need, not on the basis of a blanket threshold,' the Confederation added.
