Cataract surgery on the NHS: cost, criteria and waiting

What it costs on the NHS

Nothing to you. Cataract surgery is a standard NHS operation, and the NHS describes it as an operation to replace a cloudy lens in your eye with an artificial one (nhs.uk). The NHS also notes that surgery is the only way to get rid of a cataract, that it is usually done under local anaesthetic, that it normally takes 20 to 45 minutes, and that if both eyes are affected they are treated on separate days.

Who gets referred

NICE guideline NG77 tells clinicians to base the referral decision on a discussion with the person about how the cataract affects their vision and quality of life, whether one or both eyes are affected, what surgery involves, and whether the person wants it. NG77 then says in terms: 'Do not restrict access to cataract surgery on the basis of visual acuity.' It also says second-eye surgery should be offered on the same criteria as the first (NICE NG77, published 26 October 2017).

NICE guidance is not the same thing as local commissioning. Integrated care boards and health boards set their own referral thresholds and some have been stricter than NG77 in practice. If you have been told you do not qualify, ask which criteria were applied and on what basis, and ask your optometrist or GP to explain the decision.

How long the wait is

There is no single national number worth quoting here, because the wait for cataract surgery differs sharply between hospitals. What does apply in England is a legal right: the NHS states that the maximum waiting time for non-urgent, consultant-led treatment is 18 weeks from referral, that the right does not apply in certain situations such as choosing to wait longer, and that if you are likely to wait longer than the maximum you have the right to ask to be seen by a different provider (nhs.uk guide to NHS waiting times in England).

1. Look up the hospital you have been referred to on My Planned Care, the NHS site that publishes waiting information by hospital and is updated weekly.
2. If the wait is long, ask the referring clinician whether another NHS provider in your area is quicker, since you can usually choose where you are treated.
3. Only then weigh a private price against it, using the published figures rather than a headline range.

If you go private, you do not leave the NHS

• Paying for one eye privately does not forfeit NHS care for the other, and you can be referred back into NHS care afterwards.
• Waiting-time rights and referral routes differ across England, Wales, Scotland and Northern Ireland, so check the position where you live rather than assuming the England rules apply.
• The NHS advises taking your usual eye drops for around four weeks after surgery to help healing and prevent infection, whoever operates.