Digital Cataract Referral With Direct Listing: Reducing Appointments, Cost And Environmental Impact
Published 2026 - 44th Congress of the ESCRS
Reference: POSUS010 | Type: Free paper | DOI: 10.82333/kyq0-rr90
Authors: Dr Wesley Kai-Xian McLoughlin* 1 , Dr Eve Corner 2 , Dr Sam Evans 2 , Dr Conor Ramsden 3 , Dr John Ellis 4
1School of Medicine,University of Dundee,Dundee,United Kingdom;Department of Ophthalmology,NHS Tayside,Dundee,United Kingdom, 2Lutra Health,London,United Kingdom, 3Department of Ophthalmology,Royal Devon & Exeter NHS Foundation Trust,Exeter,United Kingdom;Lutra Health,London,United Kingdom, 4Department of Ophthalmology,NHS Tayside,Dundee,United Kingdom;University of St Andrews,University of St Andrews,United Kingdom
Purpose
To evaluate the impact of a new digital, direct-listing cataract surgery referral pathway in a tertiary ophthalmology department.
Setting
Multiple referring optometry practices across NHS Tayside (serving Dundee, Angus, Perth & Kinross, parts of Fife & Aberdeenshire) and a single operating site (Department of Ophthalmology, NHS Tayside).
Methods
This was a single centre retrospective, non-randomised, observational study analysing the efficacy of a new digital, direct-listing from referral (DLR, Lutra Health) pathway for cataract surgery in NHS Tayside.
We analysed all referrals (n=1570) received from 51 optometrists from participating practices (n=11) via the new referral pathway between July 2023 to October 2025. We selected 209 patients within this cohort to analyse, with randomly-selected matched traditional referral (TR) pathway control patients (n=209). We also used the patient’s listed postcode to estimate direct line travelled health miles spent attending appointments.
Results
Most patients referred by the new pathway were directly listed from referral (85.6%), mostly for bilateral cataract surgery (58.5%. Few patients needed telephone (7.5%) or face-to-face appointments (6.8%) pre-listing. This represented £202,642 saved via direct listing and appointment avoidance across a 2-year period. Just 8 patients (0.51%) did not have access to an email or mobile phone.
In the 18 months prior to surgery, DLR patients had 72.4% less non-biometry appointments than TR. DLR patients had a shorter average waiting time from referral to listing (63 vs. 168 days, 62.6% reduction) and referral to procedure (327 vs. 434 days, 24.6% reduction). DLR referral was associated with 8729 miles saved (82.3% reduction) across 209 patients.
Conclusions
Direct-listing for cataract surgery supported by digital platforms can offer significant savings in cost, appointments and environmental impact. Contrary to public perception, digital literacy did not constitute a barrier; Almost all users in our analysis had access to a mobile phone or email address.