Referrals for cataract surgery: variations between different geographic areas within a Welsh Health Authority

The aim of the study was to identify variations in cataract presentation within three different eye units in a single health authority and to identify any correlation between cataract presentation and social deprivation indices. We also compared our patient profile and results with the UK National Cataract Audit Statistics.

It was a prospective multicentre questionnaire-based project involving three hospitals: Cardiff Eye Unit--University Hospital of Wales (UHW), Royal Glamorgan Hospital--Llantristant (RGH), and Prince Charles Hospital--Merthyr Tydfil (PCH). Demographic, clinical, and socioeconomic data were collected in patients undergoing cataract surgery. Patients were also asked to fill in the questionnaire based on Berth-Petersen Visual Function Index (VF-14) indicating difficulty in performing daily living activities.

A total of 112 patients were recruited in the study. Demographics were similar to National Cataract Audit. However, the percentage of patients with poor visual acuity (less than 6/60) at the time of surgery was greater at all the three hospitals compared to the national statistics. Among the three hospitals at South Wales, PCH had the lowest visual acuity in both listed and fellow eye and the lowest VF-index. Both the outpatient and surgery waiting times were longest at PCH. The population at PCH also visited their optician least frequently.

Our results show significant variation in cataract presentation between the three eye units within a single Health Authority. These variations correlate well with social deprivation indices and poor use of Optometric services. Local policies are needed to redress these inequalities and raise public and professional awareness of causes of poor sight in the elderly population.