The NHS must adopt a fairer, 'patient-centred approach' to recommendations about when and how to treat cataracts, according to new guidance from the National Institute for Clinical Excellence.
Cataracts are a common eye problem leading to nearly 400,000 operations in 2015/16, where the lens in the eye becomes cloudy. They cause blurry, misty vision and sight loss. Cataracts can develop in one or both eyes and they normally happen as part of getting older. Cataracts can be treated by replacing the cloudy lens with an artificial one.
The guideline contains advice for patients and ophthalmologists on how to decide when surgery is appropriate, taking into account how the condition is affecting a patient’s sight and their quality of life, the benefits and harms of the operation and whether the patient feels that it is the right time to consider having surgery.
Other recommendations cover pre-operative assessment, choice of lens implant, and the prevention and management of surgical complications.
According to the guidance, the clinical threshold used to access cataract surgery currently varies across NHS trusts in England. This has resulted in differences in access to cataract surgery, because policies vary in scope and content and are not necessarily consistent with research evidence or guidance provided by the Department of Health in Action on cataracts and the Royal College of Ophthalmologists' Cataract surgery guidelines.
Sir Andrew Dillon, chief executive of NICE, said: “Cataract surgery is one of the ways in which the NHS can transform our lives. Our guideline will help patients with cataracts and those treating them to make choices about the treatment they should have.
“We are asking NHS organisations to compare their current practice with our recommendations and to consider what changes may need to be made to put them into practice. In considering any changes, they will need to take into account any extra costs they may incur. The speed at which these recommendations are adopted by local NHS services will depend on the resources they have available and the other priorities they are dealing with.”
