My Dad needs to see an opthalmic surgeon re cataract how do I ensure this happens

[Mrsdavidcaruso]

History my dad is 65 and in August last year was told by his optician that he had a cataract in one eye, nothing was mooted except to say he would need to go back in a year for another test and that both eyes would need to be affected before he could have surgery.

Since then it has got worse, he cant read, he volunteers in my charity shop and has difficulty seeing the till and reading labels and when I asked him to write on a dark blue label with a black pen he couldn't see to do it he is also now getting headaches.

Today I went with him to the opticians to ask for another test and they refused to do it on the NHS saying its too early and he would need to get a letter from his GP or pay £25 for a private eye exam (he is a pensioner and cant afford that type of money)

Tomorrow he sees the nurse for his regular test as he has type 2 diabetes, He did on my insistence ask his surgery to put down the opticians diagnosis on his medical records but as far as I am aware the optician has not contacted his GP so I have told him to ask for a letter to be sent to his optician for a free NHS eye test, can a nurse arrange this?

Looking at both the NHS and the RNIB web sites it does state that a cataract operation can be done at any stage if it affects a persons daily life however some NHS trusts ration these type of ops, so the optician was incorrect when they said he would need to be nearly blind to get an operation

How can I ensure my Dad gets the treatment he needs would it be best to get an appointment with an eye surgeon and bypass the opticians.

I work in an opticians and what they are telling you is wrong. If your dad feels his prescription has changed or his eyes have gone worse the nhs will pay for his eyetest. Explain again to the opticians that he feels his cataracts have gone worse. It might also help if you say that he needs just a sight test and not a diabetic screening as they are two different things.

I can't figure out how long it is since your dad had a test from your post but he can have one every 12 months normally because of his diabeties but the optician can put a code down on their sight test form that states earlier test needed due to "patient presenting with problems" or "prescription changed" etc etc.

Hope this helps. [Thanks]

All primary care trusts work slightly different but the general rule is
Sight test > referral from Optician to GP > GP to hospital.
Some pcts skip the GP and refer straight to the hospital.
So your dad will have to have a sight test to get his cataracts done.

Most opticians I know don't inform Gp's of cataracts until they are having surgery as most people over 60 has a certain amount of cataracts that don't affect their vision.

The nurse doesn't need to arrange a letter to the opticians. The optician you spoke to was mis informed or in my opinion a jobsworth

If you're not happy with that optician you can use any, it doesn't make any difference like using an Nhs dentist would.
I think i'm done. Excuse the mistakes, i'm trying to rock my newborn to sleep and type!

Thanks have same problems with my new born

Hope your dad gets sorted. :)

Bloody hell ,your poor dad . Thank goodness he's got you fighting his corner !

Is he under the hospital for eye screening for his diabetes? In my region all diabetics are under ophthalmology for eye screening but I know is different in other regions.

He should definitely ask the nurse at the diabetic clinic. She may have some idea of how things work locally, since the conditions are connected.

My mother had it done a few years ago, when they were trying to clear a back log, so had it done (and the other one) very quickly and it was life changing/enhancing :D

He is not under the hospital for his eyes but goes to a mobile clinic for a retina scan once a year

He didn't go to the clinic today as he forgot to pee in a pot when he woke up so they have rescheduled

The rules have changed with regards to sight tests - but as long as you DF goes in and says he thinks his eyes have changed, they will see him on the NHS. (The practice aren't actually wrong - but the new guidelines are ridiculous). I would suggest that he doesn't actually mention cataracts etc until he is seen.

There are also strict criteria with regards to cataract referral - usually they will not operate until the eye sees less than 6/12 (which is approx driving standards), so generally we can't refer until then.

Sometimes cataracts can worsen due to poorly controlled diabetes.

Korolean that's not what the NHS choice website and the RNIB websites say both sites say that a cataract operation CAN be done at any time if it affects peoples lives, my Dad does not drive however before he retired he was a designer and still gets a chance of free lance he cant do the free lance now so that affects his livelihood and earning capabilities he also volunteers in my shop and cant do some of the tasks very well he has difficulty with the till and some tagging work, therefore that means that if he was employed as a shop assistant for wages he would have to give up the job.

That's is how I am going to push it after all even at age 65 he should be able to work if he wants to therefore it is affecting his life.

The only thing that might stop him is if the Health Authority ration these types of ops, and certainly in 2012 the IOW HA was one of eight who did not ration them.

As I understand it every area is slightly different on their referral criteria and pathways, but of course the affect on living and needs should affect individual referral, even if there are strict criteria. 65 is still young! As your father is diabetic and has noticed reduction in vision, he should get a further exam on those grounds alone. If all else fails (and the PCT or whatever its called now do not allow a further eye examination) the GP should be able to refer to the local ophthalmology clinic for an opinion on the reduced vision. If the vision has deteriorated significantly very quickly (last day or two) then referral needs to be urgent . Cataracts can give difficulty with seeing similar dark colours such as you mention (and in particularly blue can look black with some types of age related cataract), so using greater contrast (black on white for instance) and extra light (task light) may help in the meantime in the shop. Its not usual to wait for the second eye to deteriorate unless there is a good reason to delay surgery - such as a greater risk of complications with surgery for a medical reason. Diabetic retinal screening can be difficult if there is dense cataract so there is even an argument for not waiting too long. Good luck