Audit of referrals for cataract extraction: are they appropriate?

Objective: To investigate the correlation between community cataract referral information and hospital ophthalmic opinion in order to assess if the referrals for cataract extraction are appropriate. The secondary aim is to identify if any streamlining of the service is indicated.

Methods: Patients referred from the community with a cataract were assessed with regard to the given referral data against the hospital ophthalmic opinion at their first outpatient assessment.

Results: Twenty-three (76.7%) patients referred with cataract were listed for a cataract extraction. The reason for not listing patients was due to lifestyle issues in 86% (n = 7) of cases. There proved to be no association (P = 0.62) between an indication of a compromised lifestyle on the referral letter and being listed for cataract surgery.

Conclusions: Community cataract referral data only appears lacking in their consideration of patients' quality of life, which needs to be clarified prior to a hospital visit--either by better communication with the community optometrists or by contact with the patient. A nurse-led service receiving cataract referrals direct from the community is warranted if current practice uses multiple preoperative hospital visits.