Evaluation Of Urgent Cataract Referrals During Covid-19 Pandemic In West Of Scotland

The aim of our study is to evaluate whether "urgent cataract" referrals made by community opticians meet the criteria set out by the Royal College of Opphthalmologists in the West of Scotland region.

Cataract surgery is the most common elective operation worldwide. The Covid-19 Pandemic has resulted in suspension of theatres and resulted in increased waiting times for the operation. The RCOPhth has set out guidelines for urgent referrals into secondary care. The aim of our study is to evaluate whether referrals meet those criteria in the West of Scotland region.

This was a retrospective cohort study. The electronic database was used to identify all “urgent cataract” referrals received by the ophthalmology department in NHS Greater Glasgow and Clyde between 01/10/2020 to 31/07/2022. The referral letter was reviewed to determine the reason for urgency of referral.

609 referrals were included in the study (mean age 69 years; 55% female). 173 patients (28.4%) had Best corrected visual acuity (BCVA) ≤6/18, of which 68 (11.2%) had BCVA ≤6/60 Snellen. 162 patients (26.6%) met the RCOPhth criteria for “urgent cataract” referral. Most common reasons for incorrect referral included falls risk (11.4%), unable to work (38.9%); Unable to drive (30.9%), and poor fundal view (8.1%).

The RCOPhth categorised two main groups for “urgent cataract” referrals into secondary care in May 2020 in response to the COVID-19 pandemic in order to prioritise patients at greatest risk of harm. This study demonstrated considerable variability in clinical assessment of urgent referrals by opticians in West of Scotland. The study suggests the need for further education among opticians in West of Scotland regarding the change in RCOPhth guidance in order to prioritise patients at risk of greatest harm.