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Cataracts surgery restricted by unnecessary eye test thresholds

Sight-saving surgery is being wrongly restricted due to cost-cutting measures, it has been claimed.

People with cataracts who struggle to drive or even read are being refused surgery due to an unduly high threshold, according to the Royal College of Ophthalmologists (RCO) and other health bodies.

More than half (57%) of the 152 primary care trusts in England use eye test thresholds to determine whether a patient is eligible for surgery, it was revealed through Freedom of Information requests lodged by the Royal National Institute of Blind people (RNIB).

In some parts of the south-east a patient has to have difficulty in reading the third line down on a standard eye chart - which has very large letters - in order to be granted surgery.

As a result, the Royal College has joined forces with the College of Optometrists, Optical Confederation and Local Optical Committee Support Unit to issue an urgent warning statement about the situation.

Estimates suggest around half of people aged over 65 have cataracts in one or both eyes, with 720,000 people diagnosed with the condition each month.

Professor Harminder Dua, president of the RCO, said: “We understand the financial pressures the NHS faces but cataract surgery is a highly cost effective treatment that improves sight loss and preserves patients’ ability to live independent lives,” he said in the statement.

“Using visual acuity thresholds to impose limits on cataract surgery is economically counterproductive when it leads to higher health and social care costs because patients’ vision deteriorates.”


Readers' comments (13)

  • There has to be some sort of qualifying test, but I don't like this at all - it looks far too much like a version of age discrimination.

    Restoring reasonable vision to someone, surely isn't something that should be unduly restricted - it surely can't be near the top of cost-cutting measures ?

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  • oh this govt and their reforms...tip of the iceberg..will only get worse...roll on the general election and lets get rid of these idiots like lansley

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  • tinkerbell

    a reform is usually meant to improve something isn't it? These dickensian, draconian cuts in services, for something so vital as a persons vision, is shameless. Yes there are being cuts made to opthalmic care, it is not just a claim. One of our patients was rushed through quickly before the cuts hit us, i understand it, in november this year. The opthalmic consultant pushed his referral through to beat the cuts and try and improve his quality of life.

    We are re-entering the dark ages, literally.

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  • draconian cuts everywhere which seem rather willy-nilly affecting peoples' health and safety without reason. I thought the idea of reforms was to bring about improvements. what has happened to these current reforms have the gone into the archives yet to wait the next costly round of investigations, reports and recommendations?

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  • .../contd.

    in fact isn't it time that doctors and nurses got back into the driving seat again. tinkerbell's example well illustrates one of many more disasters which will continue to happen if they are not!

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  • frankly the whole system is abhorrent. no wonder the elderly become embittered and demented when their rights to their quality of life is denied them by the meanness of the NHS budget holders and decision makers who understand nothing of patient needs.

    why should a healthy independent individual suddenly become dependent on a system with their services of variable quality offered by strangers imposed on them because they are refused the medical/surgical treatment they need which would ensure their continued independence and even though they have paid for their healthcare through their taxes throughout their lives and may never have had any prior need for treatment so have cost the health service nothing yet willing paid for all others some of whose costs are extremely high.

    why should the elderly be pushed aside in this way so that some childless couples unable to have children of their own bring new life into the world through artificial means which takes the tax contributions from the elderly to pay for it? or abortions which are used as a means of birth control because others have failed to take reasonable precautions? how fair and moral is that?

    I couldn't careless about economy but since this is such a topic with the NHS and the government which comes before the care and quality of life of patients this is also a false economy as the elderly who cannot see, have accidents as a result and then further complications as a result of these which cost the health service and the tax payer far more in terms of treatment and care which can be very lengthy or even for the rest of their lives!

    and why in heaven's name, should somebody just because they have reached a certain age be condemned to the end of the road and have their quality of life ruined because if they are lucky enough to have a cataract done, the service will only do one eye. the elderly also have a life, with essential basic daily living activities to look after themselves and often others as well, as well as a right to their leisure and hobbies which they should be fit enough and free to enjoy. these should not be curtailed just because the NHS refuse to carry out two very common and relatively simple and cost effective procedures!

    what of those who drive and could be an added danger on the road. what of those who are keen and active sportsmen and women, some of whom still compete and many of whom could knock spots of many of the young and need some treatment and are refused it on account of their age which puts an end to what might be one of their few pleasures which keeps them active, healthy and out of doors. does the NHS prefer to spend far more to financially support increasing numbers of inactive and depressed patients instead?

    what of the many who live alone and are even more dependent on their fitness, mobility and vision to lead an independent, active and fulfilling life or is this no longer permitted on account of their age ?

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  • tinkerbell

    Anonymous | 13-Aug-2012 8:04 pm

    exactly. It is very shortsighted, (no pun intended) to think this is going to save money, when the consequences of losing ones independence through impaired vision which might easily have been corrected will cost so much more, emotionally, physically and financially.

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  • tinkerbell | 13-Aug-2012 9:13 pm

    and just add to the misery of peoples' lives unnecessarily. how cruel!

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  • The Buzz phrase of the government related to the NHS is "Patient Choice". Where is the patients' choice in all of this. They haven't even been asked!!

    Rhetoric does not translate into reality.

    In a radio interview today Simon Burns kept referring to NICE guidelines in relation to the arguments he put forward to claim that there is no evidence of arbitrary thresholds and bans related to cataract surgery.

    Does he not know that there are no NICE guidelines on Cataract surgery?

    He denies that this is happening - he should pull his head out of the sand and take a look around.

    When asked why have cataract surgery numbers reduced by almost a third, he had no explanation to offer - he refuses to accept the obvious.

    The reforms have come at a time when the government has asked the NHS to save 20 billion. This does not allow the NHS to deliver what the reform (and the politicians) promise. They are shooting themselves in the foot but it seems that we are dealing with millipedes.

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  • If you ask a millipede which leg it starts on when it gets up to walk it just collapses in a heap!

    It is difficult to understand how the NHS can save money when healthcare costs and the cost of living (requiring increases in salaries to keep up with inflation) are forever rising and at the same time provide the best level of service and care to patients.

    It don't make no sense at all!

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  • Its all about PRIORITIES !

    It costs the taxpayer some £750 to restore the sight of an elderly person.

    £Millions ++ of tax payers money is spent in support of a deviant's (who likes encourage the "killing of "non believers" ) multiple attempts to avoid deportation!

    Tax payers also have to support foreign countries with "AID". These are the countries with space and atomic weapon programs. We also support those with corrupt foreign governments where "AID" does not assist the people but does swell Swiss Bank accounts.

    Nearer home money has to be found to enable NHS trust executives and Bankers to receive their obscene bonuses.

    The EU has to be fed with £Billions with little resultant benefit to the UK

    Don't forget the ease with which we give in to blackmail. The unions threatened to bring the London underground rail system to a halt during the Olympics unless the staff were paid extra just to turn up for work. Yes!! they received extra pay !

    I could go on but I am sure to have grasped my train of thought.

    Having met our priorities we don't have £750 left in the kitty to restore an elderly persons sight.

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  • Jenny Jones | 14-Aug-2012 5:28 am

    most readers are well aware of all this. there is probably a lot which goes on that all but a privileged few are totally unaware of as well. The problem is what is going to be done about it to ensure that everybody gets the healthcare they need.

    currently we have the well trained and highly skilled resources qualified in the NHS to carry all of this work (and still probably have adequate financial resources too if they were sensibly distributed and managed) but if these resources are not utilised properly and continue to be over exploited there will be a serious drain as more staff are made redundant, retire, or leave and do not return such as those who seek jobs in the private sector or abroad. This will result, among other serious problems, in fewer clinical practitioners in the services to pass on their skills and experience to newer generations of staff and if future training does not match up to the changing needs and demands of the population (as well as understanding how to deliver basic care) and keep abreast with medical advances there will be far deeper and further trouble in providing adequate care and with a reduced workforce of human resources with the right skills and all other resources.

    Incidentally, managers, for better or worse, are probably easier to replace than highly qualified clinical staff and skills which have been lost altogether would take very long years to replace.

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  • tinkerbell

    perhaps these managers who are so short sighted about the 'impending doom' about to hit them and us should have gone to spec savers too.

    I got some glasses from there and have found that they have given me 'foresight'.

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