Three in four NHS trusts deny life-changing cataract surgery finds Mail probe

  • 73% of hospitals have guidelines which see only worst-affected treated
  • Patients are refused surgery unless unable to read big letters with glasses
  • In some cases, they have to fill out a form, ticking if they have fallen over
  • Half of hospitals will do worst-affected eye, saying patients only need one
  • Waiting times for those who are allowed operation are up to year and a half

Sophie Borland

Josh White For The Daily Mail



Three quarters of hospitals are denying the elderly life-changing cataract operations until they have all but lost their sight, a Mail investigation reveals today.

Health trusts are refusing to offer the surgery unless a patient’s vision is so poor they cannot read large letters displayed on a wall – with glasses.

Even then, some trusts only refer patients for surgery if they have fallen twice in the last year, also have hearing problems, care for a loved one, or live alone.

Campaigners say thousands of patients are losing their sight and being condemned to misery because the NHS won’t treat them until they are nearly blind (file photo)

The life-transforming procedure costs less than £1,000 per eye – yet it is being rationed by NHS managers so that even those in direst need are being subjected to humiliating tests and form-filling exercises.

More than half of over-65s, some 4.5million individuals, suffer from cataracts to some degree. They occur when the lens in the eye becomes cloudy with age.

But campaigners say thousands of patients are now losing their sight and being condemned to misery because the NHS won’t treat them until they are nearly blind.

To make matters worse, it has emerged that some foreign health tourists have been able to jump the queue for the surgery. An investigation using Freedom of Information requests today reveals:

  • Seventy-three per cent of hospitals have imposed strict guidelines which determine only those worst-affected by the condition are treated,
  • Patients must fail a sight test when wearing glasses and sometimes also prove they cannot work, read or recognise loved ones,
  • In some instances, they have to fill out a form, ticking whether they have fallen over, live alone or care for a loved one,
  • Half of hospitals will only do the worst-affected eye. Patients are told they only need to see out of one,
  • Waiting times for those who are allowed the operation are up to a year and a half.

Cataracts get worse with time and some victims are so severely affected they cannot read, watch TV, recognise faces or drive.

But the condition is easily treatable with a 30-minute operation to remove the cloudy lens and replace it with a plastic implant.

The Mail used Freedom of Information requests to ask all 150 hospital trusts whether they imposed ‘eligibility criteria’ to determine who was allowed cataract surgery.

A Mail investigation reveals health trusts are refusing to offer the surgery unless a patient’s vision is so poor they cannot read large letters displayed on a wall – with glasses (file photo)


Helen Heraty had her cataract treatment privately at the London Eye Hospital

Helen Heraty was told that the NHS would treat only one eye even though she was struggling to see.

The 55-year-old, who runs a boutique hotel in York, ended up borrowing from her son to pay for the treatment privately.

She said doctors told her they would do her right eye but wait until her left had got sufficiently bad before treating it.

Mrs Heraty, who has seven children aged 11 to 27, said she became increasingly reliant on her family to help her with everyday tasks.

‘I couldn’t function,’ she added. ‘It was a very difficult time. It was like looking through a Vaseline-coated lens.

‘One eye was completely gone and the left eye was down to 50 per cent vision.

‘Had I been 70 or 80, I wouldn’t have been so fussed about it. But I was 55, I knew I was going to be working for a lot of years. I need to be able to see.’

Mrs Heraty had her cataract treatment privately at the London Eye Hospital.

She ended up opting for a far more hi-tech lens than those offered by the NHS which cost £8,000 an eye.

These have corrected her vision so well she no longer needs to wear glasses to read or see long distances. ‘I’m very, very happy with the results,’ she said.

‘I’m sat here looking at the distance and I’m able to read a book. That’s all I wanted.’ 

A total of 91 responded, of whom 66 confirmed they did indeed enforce such criteria. Most trusts who supplied details said patients had to score six out of 12 in sight test or lower – when wearing glasses – for them to qualify for cataracts operations. This means their vision with glasses must be half as good or worse than someone with normal eyesight.

But some trusts went further by insisting that even when patients did have this low score, they must still demonstrate their lives are severely impaired. They ask doctors to complete a form, ticking whether patients have fallen twice in the last year, live alone, also have hearing problems or care for a loved one.

These strict policies fly in the face of the advice from the Royal National Institute for the Blind, that cataracts must be treated as soon as they start to affect quality of life.

Health Secretary Jeremy Hunt said: ‘Any patient who needs cataract treatment should get it without delay. Decisions about who gets treatment should always be clinically-led, and patients can pursue their right to ask for an alternative provider if they haven’t started treatment within 18 weeks of referral.’

Some trusts only refer patients for surgery if they have fallen twice in the last year, also have hearing problems, care for a loved one, or live alone (file photo)

Earlier this month an investigation by this newspaper exposed how health tourists were jumping the queue for cataract operations because their condition was deemed more urgent

Hundreds of patients from countries including Zimbabwe and Nigeria have flown in for treatment, and returned home without paying the cost of the operation.

Holly Heath of the Royal National Institute of the Blind said: ‘We have shown again and again that cataract operations are being restricted, forcing patients to live with unnecessary sight loss and a reduced quality of life. ‘NHS ‘efficiency savings’ achieved by cutting cataract operations are a false economy.

Denying treatment leaves patients at risk of depression, social isolation and fall-related hip fractures which are more costly to treat in the long-term.’ There are no NHS guidelines on who should be referred for cataract surgery so managers are left to set their own rules and many trusts deem it a ‘low priority’.


Even mild sight loss can lead to depression, loneliness and worse overall health, a major study has found.

Researchers from University College London say millions of adults with early stage cataracts and other problems with their vision are being overlooked by the NHS.

Their study of 112,300 men and women found that people suffering from mild sight problems were 12 per cent more likely to say their health was poor.

They also had a 14 per cent chance of being under the care of a psychiatrist for depression, anxiety or other mental health problems.

The authors say even relatively mild vision impairment can affect people’s eating habits, their activity levels and social life and can lead to them having accidents in the home.

UCL professor of Ophthalmic Epidemiology Jugnoo Rahi looked at the medical records of adults aged 40 to 74, many of whom had cataracts or other sight problems including glaucoma and macular degeneration. She said that even slight visual impairment – not serious enough to affect driving, for instance – could lead to serious long term effects on peoples’ quality of life.

‘It could be that you start to change the lifestyle, be more sedentary, eat differently and it could also impact social structures,’ she said. ‘There is also a sense you feel less in control of your life.

Professor Rahi, whose study is published in JAMA Ophthalmology, said basic eye tests should be incorporated into health MOTs. ‘In the care of older people, vision should be a priority,’ she added. ‘It’s a mistake to think its ok to remove the cataracts in one eye, for example, and think that someone who [previously] had good vision in two eyes is going to function just as well.’ 

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