CATARACT SURGERY PATHWAY

Example Patient Journey​

Referral and Assessment

DAY 1

Referral agreed during sight test at your opticians, which is sent on to the Cataract Referral Service.

The referral request is triaged by the Central Norfolk Cataract Referral Service (click here for the details of this process).
If appropriate the referral will be sent on to us (N2S). You will receive a letter with a booking reference from the Cataract Referral Service, usually giving you a date to contact us on if you haven’t heard from us in two weeks.  
DAY 7-14 (APPROX)

Your referral is received and registered on the N2S waiting list.
Patients with a mobile number/email address will receive an acknowledgement and an indication of waiting times at this point (wait times are on the homepage and updated when necessary).

CURRENT WAIT – 14 WEEKS
A letter will be sent out with an assessment appointment when you get nearer to the top of the list. This letter will come with information regarding the procedure and a questionnaire for you to fill out and bring with you to your appointment.
Due to the amount of patients waiting we can only reschedule your appointment once, so please do try and make any necessary arrangements to attend. Only you (the patient) will be allowed to enter the practice, unless agreed prior due to care needs.
At your appointment you will see a health care assistant/nurse, who will go through preliminary checks and measure your visual acuity using a Snellen chart, as you will have had done at your opticians.
An OCT scan of the back of your eye will be performed. They will put some drops into your eyes to dilate your pupil, which will allow our optometrist to get a good view of your cataracts and retina.

You will then go through and see the optometrist/ophthalmic nurse, who will check the condition of your cataracts and eye health in general. The purpose of this check is to make sure your cataracts meet the NHS Clinical Commissioning Group (CCG) criteria and confirm that there isn’t anything else potentially affecting your vision. At this point your eyes will be measured for a new lens, and a surgery date will be set (usually within 2-4 weeks, depending on surgeon availability). If your cataracts are not ready for extraction, or should they not be the reason for your limited vision, we will write to both your GP and optician to let them know.

You will be given some eye drops to take away, which are to be used on the day of your procedure to start dilating your pupil one hour before you are due to attend. Instructions are provided.

Procedure

ASSESSMENT TO SURGERY – 2-4 WEEKS

You will receive a letter in the lead up to your surgery (approx. one week beforehand) with the instructions for the day.

On the day of surgery you will be given an arrival time. We are monitoring the amount of patients we have in the practice carefully, so please do not arrive any earlier than 10 minutes before your stated arrival time as you will be turned away. Your temperature will be checked, and at this point you may be asked to leave should your temperature be above 37.5°C.

You will be escorted upstairs to the waiting area, where a member of the theatre team will check how dilated your pupil is and put in some more drops in preparation for the procedure. They will mark your eye and ensure anything of note (allergies, relevant health issues etc) is made clear for the surgeon. You will have another OCT scan before surgery.

Once your eye is ready you will be brought through to theatre, where the procedure will take place. The procedure usually takes less than 30 minutes, often nearer 15-20 minutes. If you’re interested in what happens in the theatre during the procedure, more information can be found here.

Afterwards a member of the theatre team will collect you and perform a post-operative check to make sure everything seems to be okay. You will be given eye drops and several documents to take away with you: a guide for post-operative care with a diary to keep track of your drops, a certificate of exemption for wearing a face mask for two weeks after surgery (to avoid your breath going into your healing eye – example not provided to avoid abuse), and a form to take to your optician once you’ve healed and are ready for a new prescription which is usually six weeks after surgery. You are then free to go home.

Post-op

You will receive a phone call the day after surgery to check how you’re feeling. You will also receive a phone call the following week (usually eight days later – the date will be provided on the day of surgery). This second call is your formal post-operative review, so it is very important you make the time to take this call. You will either be put forward to have your second eye done, or be discharged back to your opticians. If you do not answer the call we would expect you to call us back during our opening hours (09:00–12:00 Mon-Fri), and if we do not hear from you within two weeks we will assume everything is okay with your eye and discharge you.

Some patients will be offered a face-to-face post-op appointment; those with certain medical issues, complex procedures or memory problems. This will be discussed on the day of your procedure and a time and date agreed.

If put forward for your second eye, you will receive a date and time during your post-op call/appointment. If needed, more dilating drops will be posted to you. The process as above would start again.
If discharged you will be asked to visit your optician in about six weeks, as this should be long enough for your prescription to have settled. Please take the form you were given after your surgery with you, as they will then complete this and send it back to us for our records.