NICE proposes new guidance on improving NHS cataract treatment process

Posted: 27/10/2017

The National Institute for Health and Care Excellence (NICE) has warned that restricting cataract surgery until people are virtually blind cannot be justified. Its proposed new guidance will advise the NHS to send more patients with cataracts for treatment.

Cataracts, which generally affect the eyesight of elderly patients, form when the lens of the eye becomes cloudy, resulting in blurred vision, spots and glare from bright lights.

Surgery to replace the affected lens is the most common operation carried out by the NHS, with more than 300,000 procedures taking place each year. But more recently, treatment has been rationed and offered only to those patients who have significant visual impairment and can barely read an eye chart. Patients in certain areas have had to wait an average of a year and a half for treatment and in some cases have had to plead for operations and demonstrate that they have experienced multiple falls because of their poor vision.

NICE has concluded that such restrictions are not clinically valid. The new guidance will insist that patients presenting with cataracts which impair their quality of life should be referred for treatment and it will specifically advise doctors not to rely on visual acuity scores as a measure of the impact on that patient’s quality of life.

Arran Macleod, a solicitor in the clinical negligence team at Penningtons Manches, said: "There is no justification for delaying a patient who needs treatment the opportunity to have their cataracts removed. If an individual’s vision is so impaired that their quality of life is affected, and they are at risk of injuring themselves, they should be offered, and referred for, treatment.

"Patients who develop cataracts will require treatment at some point, and NICE also argues that referring more patients for treatment will save money in the long run. It is claimed that earlier treatment will reduce the NHS’s exposure to costs associated with treating patients who have fallen down and suffered bony and soft-tissue injuries.

"NHS officials maintain that the additional number of procedures taking place because of NICE’s guidance is unaffordable. They have stated that unless the NHS gets a meaningful funding increase, patients will continue having to wait for treatment.

"If you or a loved one develop cataracts which impact on your daily living, we recommend you get in touch with your GP or optician. We would be happy to speak with anyone who has concerns about the treatment received for their cataracts and provide advice on your options."

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