Cataract referral: when to refer a patient for surgery
The short answer
Refer a cataract when it is affecting the person's sight and daily life and they want to consider surgery. NICE advises against using a visual acuity cut-off alone: the decision rests on a conversation about how the cataract affects them, whether one or both eyes are affected, and the risks and benefits of surgery.
Refer a patientMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Who to refer
- Adults whose cataract is affecting reading, driving, work, glare at night or confidence on stairs, and who want to discuss surgery.
- People with a cataract in both eyes who have had one eye done: the second eye is offered on the same criteria as the first.
- Anyone whose cataract stops you seeing the fundus well enough to rule out other disease, such as diabetic retinopathy or glaucoma.
- A cataract in a child, which is never routine: refer the same week, because sight development is at stake.
How urgently
Same day
A sudden, painful loss of vision or a red, painful eye after recent cataract surgery. This is not a routine cataract; use the red eye or retinal detachment page.
Soon
A cataract in a child, or rapid progression over weeks, or a cataract with a coexisting condition that cannot be monitored through it.
Routine
Most age-related cataracts affecting daily life.
What to send with the referral
- Best corrected visual acuity for each eye, and the refraction.
- How the cataract affects the person day to day, in their words, and that they want to discuss surgery.
- Any other eye findings: intraocular pressure, the fundus view, previous eye surgery or injury.
- General health that matters for surgery: diabetes and its control, blood pressure, anticoagulants, and any tamsulosin or similar alpha blocker.
- Whether the person has had the other eye operated on, and where.
Before you refer
Check the refraction is up to date. A change of glasses sometimes restores enough vision that the person chooses to wait, and that is a reasonable choice when they have the facts.
Tell the person what surgery involves, so the referral is for someone who wants to discuss it rather than someone surprised by the letter.
What you get back
- An acknowledgement email with the referral reference as soon as you submit.
- A loop-back letter from the receiving clinician once the patient has been seen: what was found, what was done and the plan.
- The patient returned to you for ongoing care, with the plan in the letter, so you keep the person you looked after.
- A named specialist and a care coordinator who calls the patient, so the referral does not sit unanswered.
Mezo pays nothing for referrals: no fee, credit, points or discount per patient, to anyone. You refer because it is the right place for the patient, and you hear back how it went.
Refer a patient
For cataract surgery or an assessment. No Mezo account needed. The receiving specialist and a care coordinator take it from here.
Common questions
Is there a visual acuity level below which I should refer?
No. NICE recommends not restricting access to cataract surgery on the basis of visual acuity. Refer when the cataract is affecting the person's life and they want to consider surgery.
Will the patient come back to me afterwards?
Yes. After surgery and the post-operative checks, the patient is returned to you for their refraction and ongoing eye care, with a letter setting out what was done.
Does Mezo pay referrers?
Mezo pays nothing for referrals: no fee, credit, points or discount per patient, to anyone. You refer because it is the right place for the patient, and you hear back how it went.
Guides to send your patient
Patient health guides
The treatment
More referral guidance
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Cataracts in adults: management (NG77). National Institute for Health and Care Excellence, 2017. Clinical guideline.
- Cataract in the Adult Eye Preferred Practice Pattern. American Academy of Ophthalmology, 2021. Clinical guideline.
- Understanding cataracts. The Royal College of Ophthalmologists. Patient information.
Links last checked 23 October 2026.