The globally aging population presents a unique challenge: an increasing number of patients need specialised healthcare, while the number of physicians that can offer such remains low. This is particularly true for eye surgeries, including some of the most common ones like cataract surgery.
According to the Royal College of Ophthalmologists, globally over 10.8 million people present as fully blind, and 35.1 million are visually impaired due to a cataract. In the UK, these figures are similar—35% of the elderly, aged 65 years or more, have a visually significant or operated cataract. Current projections are that these numbers will continue to grow, with an anticipated increase of 50% between 2015 and 2035.
A cataract is a vision defect that presents as a clouding of the naturally clear lens in the pupil and the iris. It’s most prominent in elderly patients and blurred vision is usually the first and most common symptom. It may affect one eye at a time but mostly, both eyes will start presenting a cataract at the same time.
The good news is that cataract surgery is a relatively common and straightforward procedure. In Scotland alone, there are around 42,000 procedures performed annually (according to 2019 BBC data). The cataract surgery takes around 30-45 minutes and is carried under local anaesthetic, meaning you can go home on the same day. It carries a low risk and the majority of patients return to have the second eye fixed as well.
While cataract surgery is common, the increasingly aging population puts it at a growing demand, which contributes to increasing wait times as well. Health boards across Scotland and the UK are struggling to reduce the waiting times for patients.
According to a 2013 study, the mean waiting time for cataract surgery in England is 18 days, on par with other European countries, and significantly lower than others. In Canada, the wait time for eye surgery ranges from 2 to 88 days, depending on the province, while in Sweden and France patients wait for an average of 31-60 and 66 days, respectively(Viberg et al., 2013).
However, further evidence suggests that these wait times might be too good to be true. According to the Guardian, the NHS has seen an unprecedented surge in cataract surgeries over the past decade – from 284,897 in 2007-2008 to 377,397 in 2017-2018.
Naturally, the increasing demand has contributed to longer waiting times as well. Statista Research Department reports that between 2010 and 2015, the average wait time for cataract surgery has increased from 63.7 days to 92.5 days. Official figures cited by the Guardian suggest that patients in Herefordshire face a wait time of 168 days (almost 6 months). NHS Digital reports that waiting times in Great Yarmouth and Waveney in Norfolk aren’t much better, with 173 days and 154 days on average.
The waiting times depend on location, so for a precise number, it’s always best to check your local NHS website.
Cataract surgery is usually offered on the NHS. To be eligible for it, you need to show that the cataracts are affecting your eyesight and your quality of life. The decision doesn’t depend solely on the visual acuity – an eye test – results, but other factors are taken into account.
Prior to scheduling the surgery, your eye doctor will conduct an assessment to measure your eyes’ health and your eyesight. During the assessment, you can discuss your preferences, including near-sight or long-sight lens, as well as ask questions such as whether you’ll need glasses after the surgery, what the standard recovery time is, or the risks and benefits of the cataract surgery.
With wait times averaging 3 months (90 days), with some areas reporting wait times for cataract surgery as high as 6 months, you might be worried about your prospects of getting cataract surgery. It’s possible to schedule an elective eye surgery in a private eye clinic (not on the NHS). The NHS is also working on solutions on how to reduce the wait times for cataract surgery and provide patients with affordable, round-the-clock healthcare. In 2019, NHS Fife came up with an ingenious solution, the so-called “Jack and Jill” model. The large operating theatres have been split in half and are used alternately by one surgeon and two nursing teams. This has increased capacity dramatically and the hospital successfully met its patient targets within 12 weeks.
Currently, due to the COVID-19 crisis, elective surgeries (including cataract surgery) have been suspended across the UK. According to the BBC, over 1 million operations have been cancelled, including hip replacement, cataract surgeries and more to cope with the demands from coronavirus patients. As a consequence, an increasing number of people deal with extremely long waiting lists, with no end in sight. Doctors are working on ways to remedy that, but solutions are unclear as we don’t yet have any certainty about how the pandemic will proceed.