Page 63 - NAME OF CONDITION: REFRACTIVE ERRORS

Standard Operating procedure

a. In Patient
i. Patients coming from a long distance
ii. Traumatic cataracts

iii. Cataracts with intraoperative complications:
iv. Pediatric patients requiring anesthesia.
v. Mono ocular patients.

b. Out Patient
Pre operative investigations
Follow up

C. Day Care
Cataract surgery is ideally done as a day care procedure.

d) Referral criteria:

Cases needing specialized investigations before surgery (Specular microscopy)
Cases not manageable by the facilities available
Seeking second opinion
Complications needing specialized intervention (e.g. posterior vitrectomy)

Detection of posterior segment disorder after cataract removal
*Situation 2: At Super Specialty Facility in Metro location where higher-

end technology is available

a) Clinical Diagnosis: Same as situation 1

b) Investigations: Same as situation 1. Some additional investigations help in explaining

prognosis and planning the surgery.
b. Corneal topography, corneal pachymetry and , specular microscopy for associated
corneal disease. Specular microscopy is helpful for planning surgery in hard
cataracts and in patients with suspected compromised corneas.
c. Fluorescein angiography is helpful in vascular retinopathies and maculopathies if
clarity of media permits.
d. An automated field analyzer evaluation may be helpful in preoperative diagnosis of

co-existing glaucoma.
e. Conjunctival swab culture for suspected infections
f. Additional investigations for paediatric cataracts according to systemic conditions.

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