We prize our vision more than any other sense — but we don’t always look after it. Sight problems can creep up on us with few symptoms so it’s important that we have an eye test every two years. A recent study showed that a third of us aren’t doing that.

For some people, eye surgery becomes a necessity if they want to maintain their sight and quality of life. For others, the advent of private laser surgery, as an alternative to spectacles and contact lenses, means surgery is becoming a matter of choice. Whatever your reason for deciding on eye surgery, you need to know more about the procedures and who performs it than ever before. From this month, people needing cataract surgery on the NHS will be offered at least two options as to where to have it and from December 2005 people needing all types of non-urgent surgery will be offered four to five choices.

What’s more, a parliamentary enquiry last month concluded that doctors and clinics carrying out private laser surgery should be subject to far stricter rules and sanctions — currently medics can, in theory, conduct private laser surgery without any ophthalmic training. This follows an NHS review which decided laser surgery should not be available on the NHS because there was not enough evidence that it was safe long term (www.nice.org.uk). The consequences of things going wrong can be frightening, so there are important questions that you should put to your doctors before you decide.

KEY QUESTIONS
How long will I have to wait for treatment? The average wait for an ophthalmic operation was 96 days last year. All hospitals should now ensure that you do not wait longer than three months for a cataract operation. The shortest average waiting time is just 13 days.

Can I be treated as a day case? It suits everyone if you don’t have to stay overnight in hospital. For cataract and glaucoma operations, it is regarded as best to perform them as day cases. Dr Foster statistics show that the best hospitals perform all their cataract operations as day cases. The worst hospitals only treat a fifth of their cataract patients this way. People who need surgery for corneal disease generally stay in overnight.

How many operations has the surgeon done? Practice makes perfect. Studies show that the more procedures a surgeon carries out, the better the outcome. Cataract surgery is one of the most commonly performed operations in NHS hospitals, with some non-specialist hospital trusts conducting up to 6,515 operations a year. Others carry out as few as 18. To find out which hospitals carry out most operations and the predicted waiting time for an appointment click here. (NB waiting times listed do not apply for private procedures such as laser eye surgery.)

Is the surgeon a specialist in the procedure? If a consultant says they specialise in one type of surgery, it is an indication that they have some expertise. This is particularly important if the case is complex. More than 40 per cent of the 1,101 ophthalmologists in the Dr Foster database specify a special interest in cataract surgery, 206 ophthalmologists say they have a special interest in glaucoma, and 109 have an interest in laser refractive surgery. Click here for more information. The non-inclusion of a consultant on the database does not mean that he or she does not have the necessary experience to carry out surgery. However, in complex cases you should try to see someone who specialises in the surgery you are undergoing.

What is the complication rate? Hospitals should record complication rates and your surgeon should be able to tell you how they compare to the national average for each procedure. If there have been problems, ask them to explain what they were and why they occurred. With surgery for glaucoma, one way of measuring success is to look at how often patients have to return to hospital following surgery. The Dr Foster data show that the average readmission rate is less than 7 per cent, with the majority of hospitals having no readmissions after this procedure.

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club