18 January 2023

College responds to consultation on standards for cataract surgery

We have submitted our response to Healthcare Improvement Scotland's cataract surgery standards scoping consultation.


We welcomed the development of these standards, as they will support national consistency and drive improvements in the delivery of cataract services. We highlighted the important role primary care optometrists play in providing safe care for cataract patients (pre and post treatment) closer to home. We also called for better use of all primary care optometrists’ skills to reduce the backlog of delayed outpatient appointments. 

Find out more about the consultation.

Our response

1. Are the proposed areas detailed in the scope the right areas to be covered by the cataract surgery standards?

No. We suggest adding 'Post-operative assessment' to the list of the proposed areas to be covered by the cataract surgery standards. This should clarify whether discharge would be to primary care optometrists and if so, who would retain the overall responsibility of care.

2. Are there any key points or areas that are not covered?

Yes. Please see our response to question 1 above.

3. Are there any additional references or evidence that we should include?

Yes. We suggest adding the following references:

  1. The College of Optometrists and The Royal College of Ophthalmologists joint statement on our vision for safe and sustainable patient eye care services.

    Our vision for the future is to provide pathways that ensure patients are prioritised based on their clinical need and to receive care that is appropriate and accessible.

    Multidisciplinary professionals will provide that care working collaboratively in primary care, community and hospital settings.
  2. The College of Optometrists' Guidance for Professional Practice.

    The Guidance provides the support and guidance optometrists working in all settings need to make the right clinical and professional decisions in a range of situations, and to put their patient’s interests first.

4. Are there any gaps in the proposed cataract surgery standards development group membership?

Yes. We suggest adding Primary care optometrists to the list of proposed membership of the standards development group.

In addition, we welcome the inclusion of hospital optometrists to this list, but would recommend to specify hospital optometrists with pre/post operative and biometry experience.

5. Do you have any additional comments or suggestions you would like to make about the scope report, including timelines proposed for this work?

Yes. Cataract surgery represents a significant workload for ophthalmologists. Primary care optometrists are well-placed to provide safe care for cataract patients (pre and post treatment) closer to home, and reduce the backlog of delayed outpatient appointments. The current lack of capacity in hospital eye services must be addressed through effective eye care pathways into and out of hospital, ensuring that available capacity in primary care is used as appropriate. These pathways should maximise the professional skills currently available including those of primary care optometrists.

Submitted: 16 January 2023

Related further reading

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Optometrists can play a crucial role in highlighting the red flags of intraoperative floppy iris syndrome before cataract surgery, says Rima Evans.