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Optometrists in Northampton, agreed that every optometrist should have a good link to their local hospital. He commented: ‘Invite the consultant into the practice and visit them at their workplace to get a better understanding of how you both work and how you can help each other. Ensure your referrals are on point, avoiding any unnecessary referrals, which end up wasting everybody’s time.’

It is useful to have the resources to provide pre-management of cataracts and aftercare. Tompkins said that its technology has allowed the practice to help with any pre- or post-operative care, removing the need for certain hospital appointments.

Regarding the most important part of management and aftercare, Tompkins added: ‘Regular appointments help massively, and we like to see patients for weekly, monthly or three-monthly reviews, plus a six-month review. Prescriptions can change and it’s important to let the patient know those changes are not set in stone and may change again. As with everything, communication is key.

‘It’s also worth checking the retinal structure rather than simply looking at the front of the eye and assuming everything is OK. If you are thorough you can pick up on other potential problems at an earlier stage.’

COMMUNICATION ENDS STIGMA Many patients were well-informed about cataract surgery already, as it was the most commonly performed operation in the UK, said Hamid. However, ophthalmologists should try to provide information to the patient before they come in for clinic appointments so they are not starting at square one during the hospital appointment. This could be in the form of patient information booklets, emailed, posted or ¬ if it is a referral from a shared care partner ¬ provided to patients at the time of diagnosis, and then subsequent referral, as well as animations, posters and diagrams on site.

Tompkins explained that early communication and preparation

Discussing cataracts should be part of the eye examination

with patients, such as on aspects like diagnosis, addressing fears, and long wait times, is key: ‘Discussing cataracts should be part and parcel of the eye examination. It is vital to begin the conversation as early as possible and reassure patients that cataracts are really nothing to worry about. Normalising them is important, we

dementia we have systems in place to ensure that we are doing the right things for the patient, such as obtaining consent in the appropriate way. Similarly, for patients that don’t speak English, we have to ensure that they understand the information provided to them – either through appropriate literature or by using a translator.’

“Patients should know it’s one of those operations where the visual rehabilitation can leave people much better off postsurgery than they were even before they developed the cataract.”

talk about it in a way that equates developing cataracts to getting grey hair.

‘It allays fears and makes them aware of what is coming further down the line, so there are no nasty shocks. By getting in early, plans can be made in advance for operations and the management of the cataract before it becomes an emergency.’ When communicating specifically with dementia, special needs, or non-English speaking patients, Hamid said: ‘We have various policies and procedures in place to help in different situations like these, and ensure you have a safe and effective service. For example, for

He outlined that health providers should regularly monitor data of cataract surgeries to understand and collect surgery results that could be used to reassure and educate patients beforehand.

‘We regularly audit our results, and we are in excess of the benchmark, meaning there are quality results in terms of visual performance post-operatively, and very low complication rates – that’s a useful resource to have to hand.’

Hamid highlighted that: ‘Patients should know it’s one of those operations where the visual rehabilitation can leave people much better off post-surgery than

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they were even before they developed the cataract. Although it’s not guaranteed, we try and make people as spectacle-independent as possible.’

WHAT DOES THE FUTURE HOLD? When addressing professionals on best practices, Hamid advised that ECPs must practice differently to how they did before the pandemic. ‘We have to be as efficient as possible in terms of how long we want patients to be in hospital for (eg pre- and post-surgery). If we can reduce their transit time within our hospital while maintaining high quality and a good experience for our patients, then that’s what we need to aim for.’ With the establishment of advances in technology and new research, cataract management and surgery options have room to grow and improve. Hamid told Optician there are lots of exciting developments coming in the next few years, including even safer ways of doing surgery, more robotic involvement in the surgery, the use of lasers, and then, eventually, preventing cataracts from developing in the first place.

‘There’s lots of research going on into pharmacological agents currently in the form of injections that can stop the process of cataract development occurring, or even eyedrops that can stop the development of cataracts,’ he added. •

10 June 2022 OPTICIAN 7