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NICE releases NEW Cataract Surgery Guidelines

26 October 2017

The College welcomes the new NICE guideline for the management of cataracts in adults, which emphasises the importance of patient communication, shared decision making, minimising and managing risk to improve the quality and safety of patient care.

The NICE guidelines also demonstrate the cost effectiveness of cataract surgery through scientific and financial modelling, meaning that any arbitrary use of visual thresholds for referral or surgery which restricts access, creates inequitable care and is not justified. Cataract surgery is the most common operation, with over 400,000 performed per year in the UK2 and has immediate benefit for patients and their quality of life.

As demand for surgery is predicted to rise by 25% over the next 10 years and by 50% over the next 20 years1, it is crucial that patients, who will benefit from cataract surgery, are able to access it, whether for their first eye or second eye operation. Restrictions or delays to access cataract surgery can limit people’s ability to lead independent lives and care for others, they are twice as likely to have falls and can have significantly reduced quality of life, with increased levels of depression and anxiety1.  All have a long-term financial and resource impact on primary, social and community care systems.

Mike Burdon, RCOphth President and Chair of the NICE cataract guideline development committee said, ‘These new guidelines reinforce the message to commissioners and trusts that cataract surgery should be delivered at point of clinical need.  Cataract surgery is one of the most efficient procedures in the health service and the new guidelines will significantly improve the safety and quality of patient care.’

Where restrictions to access to cataract surgery are applied by some commissioning groups, the requirement for ophthalmologists to explain to patients about potential restrictions and the need to complete related administrative paperwork requesting permission for surgery, takes clinicians away from their main role in caring for and treating patients, putting further strain on already stretched ophthalmic clinical services.

The RCOphth will shortly release amended commissioning guidance for cataract surgery which reflect the new recommendations from NICE, and will actively work with commissioners at a local and national level to encourage understanding and implementation of the new NICE cataract guidelines.

Commissioners and hospital managers are encouraged to review the RCOphth’s The Way Forward documents which identify current examples of efficient and cost-effective pathways and multidisciplinary care models across primary and secondary care2.

Get in contact with the RCOphth to be alerted to the new commissioning guidance at


Notes to Editors

  1. The Three Step Plan: The hospital eye service is overwhelmed and patients are losing sight because of delayed treatment due to postponed hospital eye service appointments
  2. The Way Forward: Cataracts: identifies current methods of working and schemes devised by ophthalmology departments in the UK to help meet the increasing demand in ophthalmic services and is a useful resource for hospital managers, commissioners and medical and non-medical healthcare professional colleagues in the delivery of hospital eye services