Tackling cataracts early is one of the best and most cost effective things we can do to improve the health and wellbeing of our communities

As the different political parties vie for our vote as we write this, we can’t stress enough how important it is for eyecare professionals in Aotearoa New Zealand to work together to maintain and increase pressure on whoever’s in government and leading our health service to ensure timely and affordable cataract surgery for our patients.

A recent publication reported that cataract surgery reduces the risk of dementia by 30% over 10 years¹. This is highly relevant and has global implications for healthcare. Given the importance of this study’s finding, a team from the University of Otago examined the health implications of low vision, commonly related to cataracts, to help raise awareness among health professionals working with older patients about the benefits of cataract surgery for reducing dementia risk, morbidity, falls, injuries and depression². It is indisputable that early cataract surgery has positive implications for a range of important health, social and economic outcomes. This is not a research result or an opinion, it is a fact. It is more important than any new glasses or lenses, any new surgical technique, drug or future technological development that can take years to become reality (if, indeed, it ever does).

Prior to the election, following pressure from the media – driven in large part by our sector – Labour’s health minister Dr Ayesha Verrall promised to introduce a nationally consistent Clinical Priority Assessment Criteria (CPAC) threshold to end the cataract ‘postcode lottery’. With the help of the private sector and by allocating resources better, including utilising better care in the community via optometrists, approximately 3,500 more cataract surgeries should be delivered in New Zealand over the next 18 months. However, all sides admit this is just a fraction of what’s needed, with cataract surgery waiting lists exceeding 7,800 people pre-election. At the time of writing, however, Te Whatu Ora had not announced details of how a nationally consistent CPAC score of 46 would be implemented. 

Health policy must adapt to provide evidence-based vision care for older people and ensure we get the 'best bang for our buck' to maximise benefits for the community. It is therefore vital all eyecare professionals work together to make sure cataract surgery is prioritised, independent of the socioeconomic status of our patients. We must educate the public and we must continue to call for more resources for more efficient and equitable public cataract surgery to improve health outcomes across Aotearoa.

Cataract surgery changes people's lives. We see it every day, which is why our jobs, our voices and our commitment to continue to make a difference are so important. 

References

1. Lee C, Gibbons L, Lee A, Yanagihara R, Blazes M, Lee M, McCurry S, Bowen J, McCormick W, Crane P, Larson E. Association between cataract extraction and development of dementia. JAMA Intern Med. 2021 Dec 6:e216990.
2. March de Ribot F, de Ribot A, Walker X, Jamieson H, Cheung G. Dementia and cataract surgery in Australia and New Zealand. Australas J Ageing. 2023; 42: 450-454.
   
   
   

Dr Francesc March de Ribot is an ophthalmologist at Dunedin Hospital and a member of the research team at the University of Otago.

Callum Milburn is NZAO president and optometrist-director at Milburn and Neill Optometrists in Dunedin.

Dr Peter Hadden is former chair of RANZCO NZ and an ophthalmologist at Eye Institute and Greenlane Clinical Centre in Auckland. 

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