Cataract Surgery and the NHS
Discussion
I had my annual eye test today.
My Opthalmologist had previously noted the gradual development of Cataracts which is not unusual for someone of my age.
The Surgery itself is very low risk.
Apparently the NHS will not put someone on the waiting list until their eyesight is too poor for them to drive. The current wait in my area (SW England) for surgery via the NHS is 9 months.
The cost of surgery in my area is around £3000 per eye if undertaken privately.
This would seem to be an absurd situation. My Opthalmologist has seen a few patients over the years who find out at examination that they require this surgery and whom he has had to tell that their eyesight is not good enough to drive.
Apparently it is possible to insert a different lens to improve vision when the surgery is performed. The NHS will only insert a lens which maintains the current prescription.
Has anyone experienced a similar situation or did you get NHS surgery before being unable to drive?
My Opthalmologist had previously noted the gradual development of Cataracts which is not unusual for someone of my age.
The Surgery itself is very low risk.
Apparently the NHS will not put someone on the waiting list until their eyesight is too poor for them to drive. The current wait in my area (SW England) for surgery via the NHS is 9 months.
The cost of surgery in my area is around £3000 per eye if undertaken privately.
This would seem to be an absurd situation. My Opthalmologist has seen a few patients over the years who find out at examination that they require this surgery and whom he has had to tell that their eyesight is not good enough to drive.
Apparently it is possible to insert a different lens to improve vision when the surgery is performed. The NHS will only insert a lens which maintains the current prescription.
Has anyone experienced a similar situation or did you get NHS surgery before being unable to drive?
Paid to have mine done two weeks or, or rather the private medical did, because again the GP said they'd have to fight for funding. My left eye was completely blurred and I wasn't driving.
You get a choice of 3 lenses. The NHS/basic one paid for by private is the one to correct long distance only, you will still need reading glasses after although this may be a different prescription.
They also do a bifocal, distance and reading and another more expensive that does distance, mid range and reading at even more money. I had the basic.
Mostly it's ok. There's bits of the op that are unpleasent but that really doesn't last long. No issues afterwards with my eyes, but everything at first feels like it's turned upto 11, brightness contract and colours. I had both eyes so suffered a little disorientation/motion sickness? for about a week, close stuff, like looking at a pattened floor.
Lots of drops, 4 times a day...
You get a choice of 3 lenses. The NHS/basic one paid for by private is the one to correct long distance only, you will still need reading glasses after although this may be a different prescription.
They also do a bifocal, distance and reading and another more expensive that does distance, mid range and reading at even more money. I had the basic.
Mostly it's ok. There's bits of the op that are unpleasent but that really doesn't last long. No issues afterwards with my eyes, but everything at first feels like it's turned upto 11, brightness contract and colours. I had both eyes so suffered a little disorientation/motion sickness? for about a week, close stuff, like looking at a pattened floor.
Lots of drops, 4 times a day...
jmn said:
Apparently it is possible to insert a different lens to improve vision when the surgery is performed. The NHS will only insert a lens which maintains the current prescription.
This part at least isn't correct. The NHS will only offer a standard monofocal lens which will correct you to (usually) slightly under perfect distance vision. There are other bi-focal & tri-focal lenses available if done privately but these come with much greater risk of issues with the quality of the vision afterwards.As said you would still need reading glasses so one option (which may be available under the NHS) is to correct your dominant eye for distance & the other eye for reading, which can work well as long as the difference is not too great.
It is true that the waiting list is long but you may get somewhere if you start claiming that the issue is affecting your quality of life. The squeaky wheel gets the oil.
Classic post code lottery with the NHS
2022 my wife started developing cataracts. Not so bad she couldn't drive but noticeable to her. Two weeks later at an appointment at a privately run hospital paid for by the NHS they booked her in for the first eye in 3 weeks. It could of been sooner but we were on holiday. Whilst there they offered to correct her eyesight FOC with the insertion of lenses.
Three months later the other eye was done and she's now glasses free for the first time in her adult life.
Generally things are better in Surrey
2022 my wife started developing cataracts. Not so bad she couldn't drive but noticeable to her. Two weeks later at an appointment at a privately run hospital paid for by the NHS they booked her in for the first eye in 3 weeks. It could of been sooner but we were on holiday. Whilst there they offered to correct her eyesight FOC with the insertion of lenses.
Three months later the other eye was done and she's now glasses free for the first time in her adult life.
Generally things are better in Surrey
My poor Mum in Northern Ireland had a cateract issue in one of her eyes. She loves reading and when using her Kindle, it was about 4 words to a page - it was ridiculous and somethign which really upset me to see.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
redrabbit29 said:
My poor Mum in Northern Ireland had a cateract issue in one of her eyes. She loves reading and when using her Kindle, it was about 4 words to a page - it was ridiculous and somethign which really upset me to see.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
The way you speak about her it sounds like she's 97 not 67.
Harry H said:
redrabbit29 said:
My poor Mum in Northern Ireland had a cateract issue in one of her eyes. She loves reading and when using her Kindle, it was about 4 words to a page - it was ridiculous and somethign which really upset me to see.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
She went through the NHS and was told it would be at least two years of waiting. She's 67 and no idea how long she has left. Feels so heartless to just let someone of that age live with virtually no usable sight in one eye.
Anyway, my Brother and I paid for private treatement and it cost £3k for one eye. She had it done in around 4 weeks from initial appointment.
The way you speak about her it sounds like she's 97 not 67.
She hasn't got much money, is on state pension and so I am often helping her by sending her the odd £50-100 to help her have a nicer quality of life, e.g. buying a coffee when out with her sisters, or saving for a new mobile phone.
I often feel worried about her - especially since she retired from full time work and has a very inactive lifestyle.
I ended up going privately. It was 2019 and I think both eyes were £2500.
I then got PCO (secondary cataracts) and covid happened, and I had to wait over nine months for the laser treatment which was done in a private hospital via the NHS. Luckily I walked to work at the time as my eyesight deteriorated bad enough for me to make the registered blind list according to the consultant.
Little hint. Once you make the list, find your local Spire Hospital that does eye surgery. You can chose to go there rather than your local NHS and their waiting lists are a lot shorter.
Are you still working or retired?
And with anything NHS related, the squeaky gate gets the most oil.
I then got PCO (secondary cataracts) and covid happened, and I had to wait over nine months for the laser treatment which was done in a private hospital via the NHS. Luckily I walked to work at the time as my eyesight deteriorated bad enough for me to make the registered blind list according to the consultant.
Little hint. Once you make the list, find your local Spire Hospital that does eye surgery. You can chose to go there rather than your local NHS and their waiting lists are a lot shorter.
Are you still working or retired?
And with anything NHS related, the squeaky gate gets the most oil.
Slow.Patrol said:
I ended up going privately. It was 2019 and I think both eyes were £2500.
I then got PCO (secondary cataracts) and covid happened, and I had to wait over nine months for the laser treatment which was done in a private hospital via the NHS. Luckily I walked to work at the time as my eyesight deteriorated bad enough for me to make the registered blind list according to the consultant.
Little hint. Once you make the list, find your local Spire Hospital that does eye surgery. You can chose to go there rather than your local NHS and their waiting lists are a lot shorter.
Are you still working or retired?
And with anything NHS related, the squeaky gate gets the most oil.
I then got PCO (secondary cataracts) and covid happened, and I had to wait over nine months for the laser treatment which was done in a private hospital via the NHS. Luckily I walked to work at the time as my eyesight deteriorated bad enough for me to make the registered blind list according to the consultant.
Little hint. Once you make the list, find your local Spire Hospital that does eye surgery. You can chose to go there rather than your local NHS and their waiting lists are a lot shorter.
Are you still working or retired?
And with anything NHS related, the squeaky gate gets the most oil.
Assuming you are in England (and not Wales, Scotland or Ireland)
NICE guidance and the National EBI (Evidence Based Interventions) Guidance differs from what your optometrist is telling you:
https://ebi.aomrc.org.uk/interventions/shared-deci...
You also have the legal right, through the NHS Constitution, to choose where you have your treatment. There are independent sector providers (SpaMedica, New Medica, Optegra, CHECs plus a number of Private Hospital groups, Spire, Circle etc) who are contracted by the NHS to deliver cataract surgery. Their outcomes are excellent and their waiting times are very short.
In short: You should make it clear you want surgery, your quality of life is impacted and you understand NICE Guidance states surgery shouldn't be restricted by visual acuity. Remind your optom you would like to exercise your legal right to choice.
NICE guidance and the National EBI (Evidence Based Interventions) Guidance differs from what your optometrist is telling you:
https://ebi.aomrc.org.uk/interventions/shared-deci...
EBI said:
This guidance applies to those 18 years and over.
Cataract referrals should not be accepted unless a formally documented shared decision making process has been performed by their referring primary care optometrist with the patient (and their family members or carers, as appropriate) as part of a referral. This includes but is not limited to:
How the cataract affects the person’s vision and quality of life
Whether one or both eyes are affected
What cataract surgery involves, including possible risks and benefits
How the person’s quality of life may be affected if they choose not to have cataract surgery
Whether the person wants to have cataract surgery.
In line with NICE guidance, do not restrict access to cataract surgery on the basis of visual acuity.
Please note that this guidance is intended as a standard threshold for access. However, if you/ your patient falls outside of these criteria, the option to apply for an Individual Funding Request is still available to you.
The key statement being: "do not restrict access to cataract surgery on the basis of visual acuity".Cataract referrals should not be accepted unless a formally documented shared decision making process has been performed by their referring primary care optometrist with the patient (and their family members or carers, as appropriate) as part of a referral. This includes but is not limited to:
How the cataract affects the person’s vision and quality of life
Whether one or both eyes are affected
What cataract surgery involves, including possible risks and benefits
How the person’s quality of life may be affected if they choose not to have cataract surgery
Whether the person wants to have cataract surgery.
In line with NICE guidance, do not restrict access to cataract surgery on the basis of visual acuity.
Please note that this guidance is intended as a standard threshold for access. However, if you/ your patient falls outside of these criteria, the option to apply for an Individual Funding Request is still available to you.
You also have the legal right, through the NHS Constitution, to choose where you have your treatment. There are independent sector providers (SpaMedica, New Medica, Optegra, CHECs plus a number of Private Hospital groups, Spire, Circle etc) who are contracted by the NHS to deliver cataract surgery. Their outcomes are excellent and their waiting times are very short.
In short: You should make it clear you want surgery, your quality of life is impacted and you understand NICE Guidance states surgery shouldn't be restricted by visual acuity. Remind your optom you would like to exercise your legal right to choice.
Edited by AlfaPapa on Tuesday 5th November 16:32
Dixy said:
Paid to have mine done at Parkside in Taunton a few years ago, cost about a grand, was worth every penny.
Had mine done at Nuffield Taunton last year ! (only 55, I paid)OP: Some key points
1) NHS WILL give you a nice new correct prescription - just not fancy multifocals.
2) The surgery is called RLE and is not without risks but they odds are what they are. They key (my surgeon told me) is to keep the buggers clean and apply the antibiotic drops 4 times a day as instructed - he told me that after a week you are pretty much out of the woods (you use them for around 4 weeks). A year later I developed a few more "floaters" in my right eye, which can be a sign of retinal detachment. I had them checked at the opticians last week. All is good. PCO is a common after effect (where the bag that contained your lens gets a calcium like coating) and is treated by the smae surgeon with a laser and takes a couple fo minutes. I have not had to have either done but its quite common - 50/50 and no big deal at all. Once lasered , it's gone for good.
RLE and cataract surgery are identical. They empty the bag/sack that is your eyeball lense. They do this with an ultrasonic wand/needle. You now have no lense to see through / focus with. This bag is the thing your cataract grows in. They scrape if off - it all goes out with the lense contents. Then, they insert a new lense made of plastic. This lense prescription is chosen before hand - they'd not insert one that made your eyes blurry! :-) What they do is measure your prescription before surgery, and then pick suitable "in eyeball" lenses to insert in you!
3) The NHS will make you wait until you are old and blind. Do NOT underestimate the improvement of doing them now if you can afford it. Seriously. The 1st thing you notice is the return of vibrant colours, not to mention seeing the pixels on your TV!. My god the greens blew me away! (cataracts dull colour perception). My opticians, who referred me to the clinic, said that everyone they see who had them done on the NHS said they wish they'd paid and enjoyed the benefit of perfect eye sight decades before. They told me they hear it ALL the time. Don't be that person. Don't leave it until it's free unless you can't afford it. I paid £3200 per eye.
4) The operation is easy, and kind of fun in a weird way. They do it while you are awake and watching. It's all over in 10 mins. You can see immediately, but they patch your eye for hygeine reasons. I removed mine the next morning and was shocked at how good it is. I got the othe reye done shortly after (only my left was developing a cataract)
5) You don't necessarily NEED reading glasses after. I had my surgeon / optometrist chat at length about what I wanted to achieve. I was a +2.75 /+3.00 lense wearer, and then used +2 ready readers over them to read (I could not read at all without the readers, and I could not see anything without the conatcts!). I have previously tried multifocal contacts and didn't like them, so no way was I going to risk having them literally inserted in my eyes. My mum has them and thinks they are great. My surgeon brought my prescription "in" a little. I can see perfectly without any lenses now, and I can also read without any readers! I can read my phone crystal clear at a little under half arms length. I apparently sacrificed a small amount of far distance to gain short. I can't notice tbh. This was all discussed and agreed before the surgery.
If you have the money, and also are fed up with glasses / readers etc - do it.
Edited by Griffith4ever on Tuesday 5th November 17:46
My wife requires bilateral cataract surgery.
One eye requires a Toric lens because of astigmatism (the other eye only a standard lens).
The NHS will only give her standard lenses.
We are privately medically insured and are going down this route,
however the insurers say that they will not pay for the extra cost of supplying and fitting a Toric lens.
Does anybody have a 'view'
on this restriction?
One eye requires a Toric lens because of astigmatism (the other eye only a standard lens).
The NHS will only give her standard lenses.
We are privately medically insured and are going down this route,
however the insurers say that they will not pay for the extra cost of supplying and fitting a Toric lens.
Does anybody have a 'view'
on this restriction?NHS referral time from eye examination to secondary provider surgery in Wiltshire is about 14 weeks, sometimes quicker. It would be very rare to be as bad as not being able to drive before you get referred.
Unless you want multifocals, personally I wouldn't, or torics, less scope for issues, then there isn't a huge advantage going private.
Going rates from one secondary provider are monofocal £2295 per eye, toric £ 2795 and multi £3195.
I send people all the time and it's almost (but never entirely) always successful.
Despite what the surgeons say unless you go for multifocals you will need near vision glasses and 85% have a meaningful distance prescription too.
It's reasonable to expect to wear glasses as you do beforehand but see much better. You may get lucky or tolerate the blur without but don't count on it.
Unless you want multifocals, personally I wouldn't, or torics, less scope for issues, then there isn't a huge advantage going private.
Going rates from one secondary provider are monofocal £2295 per eye, toric £ 2795 and multi £3195.
I send people all the time and it's almost (but never entirely) always successful.
Despite what the surgeons say unless you go for multifocals you will need near vision glasses and 85% have a meaningful distance prescription too.
It's reasonable to expect to wear glasses as you do beforehand but see much better. You may get lucky or tolerate the blur without but don't count on it.
Elderly said:
My wife requires bilateral cataract surgery.
One eye requires a Toric lens because of astigmatism (the other eye only a standard lens).
The NHS will only give her standard lenses.
We are privately medically insured and are going down this route,
however the insurers say that they will not pay for the extra cost of supplying and fitting a Toric lens.
Does anybody have a 'view' on this restriction?
It's normal in my experience. You can always pay the additional sum yourself or not have a toric lens & wear glasses for correction.One eye requires a Toric lens because of astigmatism (the other eye only a standard lens).
The NHS will only give her standard lenses.
We are privately medically insured and are going down this route,
however the insurers say that they will not pay for the extra cost of supplying and fitting a Toric lens.
Does anybody have a 'view'
on this restriction?DKL said:
Going rates from one secondary provider are monofocal £2295 per eye, toric £ 2795 and multi £3195.
As Astigmatism is a medical condition, I don’t understand why an insurer won’t cover the extra cost of a toric lens to correct it in the one eye that in any case requires cataract surgery?Gassing Station | Health Matters | Top of Page | What's New | My Stuff