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Cataract referral thresholds

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In October 2017 NICE published Cataracts in adults: management, which validated our longstanding policy position that access to cataract surgery should not be restricted based on visual acuity alone [1].  

Unfortunately, despite independent guidelines, commissioners occasionally seek to impose non-evidence-based eligibility criteria for cataract surgery. If this is happening where you practise, then you should be mindful of your professional duty to patients and the General Optical Council's Standards of Practice for Optometrists and Dispensing Opticians, including:

  • "Making the care of your patients your first and overriding concern"
  • "Provide effective patient care and treatments based on current good practice." [2]

Members who feel that local referral criteria are inconsistent with good practice and/or evidence-based guidelines should contact us at [email protected].


Originally published:  August 2012

Reviewed: November 2019

Next review date: November 2022

Info: We, as part of Optical Confederation, originally published 'Cataract referrals and professional liability guidance' in August 2012 when some Primary Care Trusts in England imposed blanket visual acuity thresholds on referrals for cataract surgery despite a Ministerial Statement that such bans should be discontinued from March 2012 [3]. In November 2019 we reviewed that guidance as part of our website upgrade and simplified it further to reflect NICE guideline NG77, cataracts in adults: management [1] and the GOC's latest Standards for Optometrists and Dispensing Opticians [2].

References and notes

[1] NICE, 2017, Cataracts in adults: management, NG77. Recommendation 1.2.2, referral for cataract surgery "Do not restrict access to cataract surgery on the basis of visual acuity"

[2] GOC, 2016, Standards of Practice for Optometrists and Dispensing Opticians, pages 3 and 12

[3] For example, Optical Confederation, 2011, Cataract referrals and professional liability guidance.