Cataracts

Question 1

How do you manage a suspected cataract?

Answer 1

Refer to an optometrist for examination and visual acuity assessment

Counselling on how will affect vision + QoL + what surgery involves/risks/benefits

Surgery indications:

• Person wants to keep driving but does not meet DVLA minimum sight requirements
• Significant impact on QoL/ADLs

Question 2

Why would you suspect and how do you manage a suspected cataract in paediatrics?

Answer 2

Urgent same day call to ophthalmology if:

• Opacity or absence of red reflex
• White pupillary reflex (Leukocoria)

Urgent written referral to ophthalmologist if:

• Inequality in colour, clarity or reflection
• No detectable abnormality but parent describes Hx suspicious of leukocoria e.g. in a photo (though this often a reflection of the optic disc in flash photography when off axis to camera)