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Cataract restrictions ‘clinically unsound’

Eye experts have issued an urgent warning that restrictions on cataract surgery are ‘clinically unsound'.

The Royal College of Ophthalmologists (RCO) has said restrictions should not be based on the basis of visual acuity tests alone and that patients should be offered treatment if the cataract is ‘adversely affecting their daily living'.

The call comes after commissioning leaders said cataract surgery was being restricted by using assessment methods that are ‘not fit for purpose' and should instead be based on a patient's reduction in quality of life.

The RCO said patients with cataract could experience other serious symptoms, such as double vision or disabling glare from lights, even though their visual acuity is relatively unaffected.

It also warned of reports that patients with cataracts in both eyes were being told their PCT will only treat one eye, despite substantial evidence in favour of treating both eyes.

Professor Harminder Dua, RCO president, said: ‘We strongly advise that it is clinically unsound to determine access to cataract surgery on the basis of visual acuity alone. Patients should be offered treatment for a cataract if the cataract is adversely affecting their daily living, they fully understand the risks and benefits of surgery and if they want to have – and are fit enough to have – surgery.

‘We urge commissioners, clinicians and patient groups to work together to implement this advice as a matter of urgency.'

But Elizabeth Wade, head of commissioning policy for the NHS Confederation's PCT Network, said the NHS had to 'live within its means'.

She said: 'Visual acuity is just one aspect of visual performance, and there are other important elements which need to be taken into account when determining whether a patient should be treated. However, we must remember that the NHS is facing an unprecedented financial challenge and commissioners must live within their means while providing high quality care.'

'It is right that commissioners work with local communities and clinicians to determine the priorities for ensuring patients have access to the right care to meet their health needs.'

A Cochrane review into further evidence for second eye cataract surgery is under way and should report by the end of 2012.