Monday February 20, 2017
Here is a brief explanation from an ophthalmologist:
The score for the CPAC is calculated from a 5 or 6 variable patient questionnaire and a few clinical variables. The patient impact questionnaire is the same as the one used for all these prioritisation tools I believe (hips, cardiac, bariatric etc) The clinical variables are best corrected VA in the surgery eye, best corrected binocular acuity, presence of axial opacity, and the likely post-operative acuity if surgery is routine.
Each variable is weighted differently in the “black box” ministry calculator and a score is derived. In theory any clinician would be able to calculate the score if they had access to the ministry calculator but it would require a confident refractive assessment (ie what would the best glasses be?) and a slit lamp exam looking at the type of cataract and a good assessment of other possible ocular pathologies that might affect the vision.
The local optometrists obviously all have this training and do calculate the scores so that they don’t send in people who won’t make the threshold. The calculator pathway is for routine cataracts. If we feel there is a medical need to do the cataract in spite of relatively good vision (compared to others) then we override the score.
For most people I think the most practical way to manage this in General Practice is to get patients to see the optometrist for an assessment of the cataract first.
Acceptance details can be found on our elective services page- http://baynav.bopdhb.govt.nz/ophthalmology/elective-services/