Visus writes: Are the optometrist’s measures of vision taken seriously?

Many, or most, clinical commissioning groups have criteria for cataract referral. Many adopt a three-way check; is it a cataract causing visual loss, is it interfering with quality of life and are they willing to undergo surgery? Laudable, but then topped off with Snellen VA worse than 6/12! How many times have you referred a symptomatic patient who returns because the HES won’t list them? Why does this happen and what should you do about it?

After you have checked your chart calibration, you can, if you are lucky enough to have received a reply, start by wondering about their 6/9 and ignoring the patient’s symptoms. First there is natural variability between tests and a phenomenon called ‘regression to the mean’ which usually rears its head in IOP measures. Measure again.