April 16, 2019
Why can't every New Zealander receive fair and equal access to life-changing cataracts treatment? Unfortunately, access to publicly-funded cataract surgery has been likened to "postcode healthcare". So, what's the problem? The twenty District Health Boards in our country each have different thresholds that determine whether people qualify for publicly funded cataract surgery, and we don't believe that's right.
Doctor Trevor Gray, one of our eye surgeons and a major advocate for equal access to cataract surgery, has said that there is a "big need in the public sector to provide care for those who most need it". Along with the Auckland Regional Charity Hospital (ARCH), he is taking steps to make cataract treatment accessible to the people who desperately need it but aren't being granted public hospital access. Today we want to take the time to talk about why this is so important.
Cataracts are a creeping clouding of the visual lens in the eye, usually coming on over a period of months or years - it makes sufferers see the world as if from behind frosted glass. Cataracts are responsible for 51% of the world's blindness, which is an indicator of how prevalent it is, and also how important it is to treat it. Ophthalmologists (eye surgeons) remedy this condition with a pain-free twenty-minute surgery, wherein they remove the clouded lens and replace it with a clear artificial lens. The procedure is quick and painless and , we believe, should be available to anyone who needs it.
One of the biggest reasons why patients with cataracts need better access to lens replacement surgery in New Zealand is because the presence of cataracts in one's life can have a massive effect on day-to-day life - from how they can drive on the road to how well they can do their jobs. Having cataracts makes it extremely difficult for people to continue functioning as they usually do. It often results in their drivers' licenses being taken away, and doing the simplest things like reading or trying to navigate your way around the house can become an incredible chore.
While this is a very difficult condition for anyone, it is particularly worse for anyone who is a primary caregiver or breadwinner who relies on their vision to take care of their family. When someone is the main provider for the home it becomes a much larger issue than just cloudy vision.
In order to get access to cataract surgery through the public hospital system, patients are first evaluated and given a priority score on a scale of 0 to 100. Optometrists calculate this by using nationwide clinical priority assessment criteria (CPAC) and is based on the patient's clinical and social need for treatment. The closer the score is to 100, the worse the cataracts are. Then, depending on what the "threshold" established by their local District Health Board is, they will either be placed onto the system for treatment or denied public access. Each DHB sets its own threshold, so whether or not you get treated will depend on where you live in NZ.
Someone with cataracts severe enough to warrant a score of even 50 would be experiencing a very significant impairment in their vision, possibly already being forced to lose their driver's licence and independence. However, in many places in New Zealand they would be denied access to surgery by their DHB.
Ophthalmologists like our Dr Gray believe that this is an unfair system, as boards like the Bay of Plenty, Nelson Marlborough, and Southern DHBs all have thresholds above 58. People living in these places are forced to seek private cataract surgery if they wanted to keep their driver's licence. While this is understandable given the severity of their cataracts, the $4,000 price tag is often too high a bar for many Kiwis.
We believe that people feeling the impact of cataracts should have access to clear vision (and keep driving safely!), especially when the procedure is so fast and painless. In a recent article with the New Zealand Herald, Dr Gray outlined his work with ARCH where he (and other colleagues) volunteer to carry out cataract surgeries free of charge for patients in need. He's also encouraging other ophthalmologists to support the scheme and set aside time for twenty-minute free cataract surgery in their own cataract theatres once a fortnight or once a month.
"This is one aspect in which there are definitely people falling through the cracks", says Dr Gray, and this could not be more accurate. People should be able to live their lives and care for their families with clear vision, and both Dr Gray and Dr Mo of Re:Vision Sight Correction Centre are encouraging ophthalmologists around the country to sue their time for good. Whether it is once a week or once a month, such a short amount of time can change someone's entire life for the better!
Take back your eyes today
At Re:Vision, your team of premier eye specialists in Auckland and around the country, we believe that everyone should have visual freedom in their lives. If you've been struggling with cataracts or any other problems with your eyes, start your journey to recovery with us today!