There is grave concern for people’s eyesight as large numbers of cataract operations are turned down across the Hywel Dda region.

The issue has been raised by optometrists in Pembrokeshire who are concerned by the level of referrals not receiving follow-up appointments at Carmarthen General Hospital’s ophthalmology department.

One optometrist, who does not wish to be named, said that the issue had begun around April this year when Hywel Dda Health Board sent letters to optometrists stating that a referral letter has been assessed and returned “as the patient’s condition has been deemed not bad enough, at the moment, to warrant a hospital appointment”.

It added that demand for the service had risen but despite increases in capacity, potentially blinding conditions will be prioritised.

“We have a clinical duty if we detect a problem to refer patients,” said an optometrist.

“An arbitrary decision about who will or will not be seen is being made, when it was introduced we were promised every referral would be looked at properly but I do not believe that is happening.

“They are looking at two numbers, visual acuity in each eye, and saying one eye can see so that’s good enough, but many people can’t cope with the difference in prescription and everything is off balance.

“Patients have a right to expect good vision,” he added.

One case highlighted by the optometrist was a 49-year-old diabetic with significant dimming in one eye due to a cataract, making it difficult to drive in low light, who was refused treatment.

He was also worried that other eye problems could be overlooked as a cataract restricts vision of the back of the eye.

Another concerned optometrist said he had one patient caring for a disabled wife whose eyesight was now outside the legal limit and could no longer drive, but was still not seen at Carmarthen.

“We are referring in the usual way and are getting a few sent back because their eyesight is not bad enough, a few years ago referring the same patients, they would be seen.”

A Hywel Dda spokesman said: “Should a patient’s cataract condition render them unable to drive in accordance with the Driver and Vehicle Licensing Authority, and the GP or optometrist makes reference to this in the referral letter, they will be assessed by the health board.

“The health board has increased availability of ophthalmology services recently with the appointment of a new doctor. Demand continues to rise and we are currently advertising for two additional surgeons to further increase this capacity.

“In the interim, consultant teams are assessing referrals based on the severity of the condition, in particular those conditions that cause permanent blindness and are irreversibly sight threatening or painful. We regret that some patients are disappointed, but we need to ensure that those with the highest clinical need are given treatment at the earliest opportunity. We urge all patients to regularly see their GP or optometrist in order that their condition can be closely monitored.”

Optometry Wales, the body representing the primary care eye health profession in Wales, is also concerned.Spokesman Sali Davies told the Western Telegraph: “We are very concerned about the number of patients in the Hywel Dda area who have been refused surgery. “We hope that we can work with Hywel Dda to ensure that those patients who are in need of surgery will be treated. It should not be the case in a modern health care service that patients who are referred are not allowed access to treatment.

“Cataract surgery can improve a patient’s quality of life and it should be available to those who need it.”

Ceri Jackson, Head of Sight Loss Prevention at RNIB Cymru added:"We appreciate that the eye clinics are facing capacity issues but we are concerned that cataract patients are being referred back to their local optometrist with no idea of when they can have their cataracts removed.

"Although loss of vision through cataracts is usually reversible, sight loss is very distressing and can have a huge impact on someone's life, even if it is temporary. One person who contacted us about this problem in West Wales is too frightened to drive and is having trouble with simple tasks like completing forms.

"If cataracts are not treated it can result in someone losing their job or be in danger of falling or having an accident."