How do I determine the appropriate timing for referral to ophthalmology for cataract surgery?

The decision to refer a person with a cataract for surgery should be based on a discussion that includes how the cataract affects their vision and quality of life, whether one or both eyes are affected, and what surgery involves, including risks and benefits ¹.

Referral should not be restricted on the basis of visual acuity alone, but local arrangements may specify certain visual acuity thresholds, such as a monocular visual acuity of 6/18 or worse, or binocular visual acuity of 6/12 or worse for non-drivers, or 6/9 or worse for drivers, especially in some CCG protocols ¹.

Consideration of the impact on quality of life and specific symptoms like glare or double vision is also important, even if visual acuity is relatively unaffected ¹.

In addition, advice on fitness to drive should be provided, with specific standards for visual acuity and the need to notify the DVLA if these are not met ¹.