MR S PAGLIARINI/MD
30th September 2010
Mr J Williams c.c. Jane Kempton
Chairperson of LOC Senior Optometrist
143 Binley Road UHCW NHS Trust
COVENTRY
CV3 1HX
Dear Julian
Please find enclosed the Warwickshire PCT policy on low priority cataracts. The Coventry PCT has also accepted this policy. Essentially we are unable to receive reimbursements for cataract surgery in eyes with 6/12 or better visual acuity unless one of the exemption criteria listed below applies. Listing patients with one or more of the exemption criteria is expected by the PCT to be the absolute exception.
I have asked Jane Kempton to laminate the policy and place it in all clinical areas.
I would be most grateful if you could disseminate awareness amongst the Coventry and Warwickshire Optometrists in order not refer patients with 6/12 or better visual acuity unless strictly necessary with a clear justification.
Yours sincerely
MR S PAGLIARINI
CLINICAL DIRECTOR IN OPHTHALMOLOGY - SURGICAL DIVISION
Cataract Removal in adults / Cataract surgery will be commissioned for patients who, after correction (eg with glasses), have a visual acuity worse than 6/12 in their cataract affected eye· Referrals for cataract surgery should not be based simply on the presence of a cataract
· Cataract surgery will not be commissioned solely for the purpose of correcting longstanding pre-existing myopia and hypermetropia
· Cataract surgery will be commissioned for patients with a visual acuity of 6/12 or better, as an exception, for those patients whose livelihood would be effected if treatment was not undertaken, where glare disability is significant, where there is significant multiple vision and the condition interferes with day to day living/functioning
· Cataract surgery will be supported where there is binocular disparity/imbalance (anisometropia)
· Treatment will also be commissioned for the second eye where it is not 6/12 or worse but not treating would have a significant effect on the patient’s vision