The waiting game: natural history of a cataract waiting list in New Zealand

Clin Exp Ophthalmol. 2001 Dec;29(6):376-80. doi: 10.1046/j.1442-9071.2001.d01-25.x.


Aims: To identify the demographic and visual function of patients on the reserve waiting list for cataract surgery at a large public hospital within New Zealand and to determine the ultimate outcome of those on a priority-based, rationed, health-care waiting list.

Methods: Patients from a defined geographical population, placed on a reserve waiting list for possible cataract surgery, during the period January 1997 to March 2000, were invited to attend for further clinical assessment and asked to complete a visual assessment questionnaire.

Results: Of 193 patients in the pilot study group who had been on the reserve waiting list for a mean of 18.2 +/- 11.6 months (range 0.1-62.7 months), only 94 (49%) were deemed suitable for, and subsequently underwent, surgery in the public sector. Forty-nine (25%) had undergone surgery earlier, the majority of these (84%) in the private sector. A further 23 (12%) patients were deceased, four (2%) declined surgery and in six (3%) cataract surgery was no longer indicated. The remaining 11 (6%) patients could not be traced. Patients still awaiting surgery had a mean age of 77.2 years (range 48-95 years). Fifty-four were women. Vision had deteriorated by a mean of 0.05 LogMAR units, from Snellen equivalent 6/30 at listing to 6/36, over this time.

Conclusions: Current methods of prioritization for cataract surgery are imperfect, as are the resources for performing adequate levels of cataract surgery. Analysis of a residual waiting list for cataract surgery highlights that the majority (51%) do not ultimately progress to cataract surgery in the public sector for a variety of reasons. During a mean waiting time of 1.5 years vision further deteriorates in this predominantly older population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract / diagnosis*
  • Cataract Extraction / trends
  • Female
  • Health Care Rationing / organization & administration
  • Health Priorities / organization & administration
  • Health Resources / organization & administration
  • Hospitals, Public / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Pilot Projects
  • State Medicine / organization & administration
  • Vision Tests
  • Waiting Lists*