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Evaluation of the quality of cataract surgery referrals at a District General Hospital in the United Kingdom

Poster Details

First Author: J.Doyle UK

Co Author(s):    K. Rahman                    

Abstract Details


Recent guidance in the United Kingdom has called for the streamlining of access to cataract surgery. This allows direct referral from optometrists in addition to General Practitioners (GPs) and has introduced the cataract “one-stop” clinic model that condenses pre-assessment to a single hospital visit. The quality of referrals is important in ensuring appropriate referral and resource utilisation. Guidance suggests referral should not be based on the presence of cataract alone but also impairment of lifestyle and willingness for surgery. We aim to assess the quality of referrals to determine whether appropriate patients are referred and whether relevant information is provided.


Patients were seen in the “One-Stop” Cataract clinic at Stoke Mandeville Hospital in Buckinghamshire, UK. Stoke Mandeville is a large district general hospital serving a population of over half a million people.


The referrals of 53 patients to the “One-Stop Cataract Clinic” at Stoke Mandeville Hospital were analysed. Details of information recorded in the referral were recorded as well as the source of the referral.


Optometrist referrals were more likely than GP referrals to include information on the effect on lifestyle (57% vs. 44%), willingness for surgery (90% vs. 22%) and consent for referral (90% vs. 22%). Referrals from the diabetic screening service were also poor in recording effect on these areas (0%, 17%, and 17% respectively).


The referral form utilised by optometrists in Buckinghamshire primary care trust meets guidelines, ensuring only suitable patients willing to undergo surgery are referred. GP referrals come in letter form and omit key information. We suggest a proforma for GPs is introduced, including at a minimum; recent visual acuity, patient’s willingness for surgery, effect on lifestyle and consent for referral. Referrals from diabetic screening often omit key information. Whilst the importance of fundal view for screening is appreciated, the patient must be willing to undergo surgery and this should be discussed prior to referral.

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