25/10/2026
‼️👁️ Cataract referral: a practical guide for optometrists. Save it, or share with a colleague whose patients it will help.
Visual acuity is a poor sole criterion for referral. Two patients recording 6/6 may differ entirely in function — one untroubled, the other limited by contrast loss and glare disability.
The other relevant clinical picture is dysfunctional lens syndrome: glare, halos, starbursts and streaks, difficulty in dim illumination, and the persistent sense that spectacles are smudged when they are clean. These symptoms commonly precede measurable acuity loss.
Driving merits specific attention. Referral is better timed while the patient still holds a licence than at the point where it must be withdrawn.
Three items materially accelerate triage:
• Refraction and BCVA, each eye
• The patient’s own account of activities they have ceased or struggle with
• Coexisting pathology in either eye that limits the achievable outcome
Documented macular or glaucomatous disease at the point of referral allows expectations to be set accurately at the first consultation.
