Abstract
Cataract, the clouding and eventual opacification of the crystalline lens, is primarily anage-related condition, affecting most individuals during their lifetime. The prevalence of cataracts in Europe has risen due to increasing life expectancy, placing a significant burden on the NHS. The primary aim of this thesis was to assess the cataract pathway in the UK, focusing particularly on the value that the application of imaging technologies could bring, the role of optometrists and the benefits of expanding responsibilities against the backdrop of the ageing population and constraints on NHS capacity.This was addressed through the following studies: (1) an audit of cataract referrals and surgical listing in a leading UK Eye Hospital, (2) a realist review of the literature focusing on the current and evolving role of optometrists in cataract care, (3) how optometrists use structural imaging and visual function information in clinical decisions with cataract, (4) considerations about how imaging technology is utilised in cases of complex biometry, and (5) how imaging data from the anterior segment of the eye can supplement conventional clinical visual function measures and patient related outcome measures with cataract.
This thesis demonstrates that the efficiency of the cataract pathway can be improved by standardising optometric referrals through guidelines, training, and the integration of quality of life and visual function assessments. The realist review highlights the expanding role of optometrists in cataract care, with their responsibilities growing as services adapt to the ageing population. The clinical vignette study emphasises the importance of combining imaging and visual function data for more comprehensive assessments. The research also reveals challenges in peripheral anterior chamber depth measurements, particularly in advanced keratoconus, indicating a need to optimise anterior chamber depth use in complex biometry and the potential of binocular-OCT for lens thickness assessment and within the cataract pathway.
| Date of Award | May 2025 |
|---|---|
| Original language | English |
| Sponsors | College of Optometrists |
| Supervisor | Padraig Mulholland (Supervisor), Julie-Anne Little (Supervisor) & Pearse A Keane (Supervisor) |
Keywords
- cataract
- shared-care
- optometrist
- lens opacity
- optometry