Download Symptoms caused by the presence of cataract SPECIALTY

St. Richard’s Hospital
SPECIALTY: OPHTHALMOLOGY
CLINICAL PROBLEM: CATARACT
DEFINITION: An opacity of the crystalline lens
Symptoms caused by the presence of cataract
Blurred Vision
Glare
Change in colour appreciation
Monocular diplopia or distortion
Rapid change in refraction or differences of refraction
between the two eyes
Threshold for Cataract Surgery
When vision compromises the normal daily activity and it is considered that the
operation would benefit the patient to an extent that outweighs the risk (e.g.
infection and haemorrhage). It does not depend on the degree of development
of the cataract or whether it is unilateral or bilateral, or on any specific level
of vision.
Clinical criteria for cataract surgery
•
The presence of cataract interfering with visual function and the
reasonable expectation on the part of the surgeon and patient of
improvement of visual function and enhanced quality of life when visual
rehabilitation is completed.
•
To permit examination and treatment of lesions affecting the posterior
segment of the cataractous eye (e.g. diabetes).
•
To avoid lens-induced ocular disease (rare).
Specific indications for cataract surgery
•
•
When, in the presence of a cataract, the standard of vision is inadequate
for the patient's needs.
When, in the presence of a cataract, the patient is unable to see well
enough either to work safely or to obtain a driving licence. If a unilateral
cataract is present, loss of binocular vision can occur or be a problem for
drivers, for those people who work at heights or require binocular vision for
their occupation or pastimes.
: Refer if
‘Do Not
•
•
•
•
The patient does not want surgery.
The patient’s lifestyle is not affected by the presence of cataract.
Spectacles or other visual aids provide satisfactory functional vision.
The patient’s medical condition is such that the risks of anaesthesia and
surgery outweigh the potential benefits.
Day Surgery
The majority of cataract surgery is performed under local anaesthesia as a day
case.
PRACTICE POINTS
All referrals for cataract surgery must be accompanied by
• a copy of a recent optometrist’s refraction and findings with any
referral for cataract surgery. (GOS18)
• a drug history and details of the patient’s general health.
Cataracts do not need to be ‘ripe’ or mature to be removed.
Patient’s with early cataract do not need referral to assess the maculae.
SOURCE : The Royal College of Ophthalmologists, Guidelines for Cataract Surgery,
2007
AUTHOR: Mr Peter Fox, Consultant Ophthalmologist, Western Sussex Hospitals NHS
Trust.
OTHERS INVOLVED: Mr. Sal Rassam and Mr Thisara Niyadurupola, Consultant
Opthalmologists; Mr C. Walsh & Mr R. Tildesley, Ophthalmic Opticians and all LRMG
Committee Members, St Richards Hospital Chichester.
PUBLISHED: 3/96
REVIEWED: 10/00 08/06 03/09
NEXT REVIEW: 03/11