Questions to ask your consultant ophthalmologist April/May 2009 edition

Find out the best questions to ask your consultant ophthalmologist with Dr Foster Health

If you have been referred by your GP to hospital for an operation or other treatment on your eyes, Dr Foster Health's Questions to Ask Your Consultant Ophthalmologist series will help you get the most out of your consultation experience.

Introduction

What are the risk and benefits of eye surgery?

Talk over with your consultant whether surgery is the right option for you. With a condition such as cataracts, for example, the main treatment is surgery. Most cases of glaucoma do not require surgery, and milder cases of corneal disease can be treated with eye drops, tablets, and specialised contact lens ⁽¹⁾. Surgery to improve your eyesight can have a very positive impact on your daily life and your ability to read or work. However, all operations also carry a risk of a worsening of vision.

How long will I have to wait for treatment?

If you are told that you will have a long wait for surgery, you may wish to ask your GP or specialist whether you could go to a different unit with a shorter waiting time. It may not be in your local area and you may need to travel further.

Can I be treated as a day case?

You will normally not have to stay overnight in hospital before or after your operation. For cataract and glaucoma operations, it is regarded as "best practice" to perform cataract surgery as day cases ⁽²⁾ unless the patient has other complex medical conditions. People who need surgery for corneal disease generally have to stay in overnight ⁽³⁾.

Do you perform this operation regularly?

A number of studies have shown that undertaking an operation regularly improves the outcome ⁽⁴⁾. This applies to cataract surgery, for example, which is one of the most commonly performed operations in NHS hospitals ⁽⁵⁾.

To find out which hospitals carry out most cataract operations visit Dr Foster Health's Hospital Guide.

Do you have a special interest in this type of surgery?

If a surgeon says they have a special interest they are more likely to undertake this type of surgery regularly. If your case is complex you may wish to ask to see a surgeon with a special interest in your condition. In most hospitals each eye surgeon develops a special interest of their own as well as carrying out a range of common surgical procedures.

What is the local complication rate as compared with the rate elsewhere?

Hospitals should record complication rates and your surgeon should be able to tell you how they compare with the national average for each procedure. With cataract surgery, complications occur in fewer than two per cent of cases according to the Royal College of Ophthalmologists, but it occasionally results in a thickening of the lens capsule ⁽⁵⁾. If there have been high complication rates locally, you may wish to ask them to explain what they were and why they occurred. With surgery for glaucoma, one way of measuring complication rates is to look at the proportion of patients that have to be readmitted to hospital following surgery.