PATIENTS in Ayrshire are being refused cataract surgery on a second eye under new restrictions designed to cut waiting times.

Opticians are said to be frustrated over the move, which was described as a “false economy” by sight loss campaigners.

It is understood that the new rules have been implemented to ease pressure on ophthalmology, amid a shortage of surgeons and theatre space to cope with demand.

NHS Ayrshire and Arran was previously accused of rationing treatment when it introduced a strict threshold for cataracts surgery in 2017, meaning patients’ vision had to deteriorate below the legal standard for driving before they could be referred for surgery.

Now opticians are being told not to refer patients for the operation on a second eye if they still have adequate vision in the first.

Samantha Watson, chair of Optometry Scotland, said: “There is some frustration amongst our colleagues in Ayrshire and Arran about this change in policy.

"Opticians in the area are at the frontline of care and have to manage patient expectations, which can be challenging in this situation.

“We would stress that, regardless of any policy change, an optometrist should be patients’ absolute first port of call for any eye issues. They are the ‘GPs of eyes’ and are best placed to assess eye health and decide on the path of care.”

The move contradicts guidelines recently issued by the National Institute for Health and Care Excellence (NICE) which concluded that second eye cataract surgery is highly cost effective and should be offered using the same criteria as for first eye surgery. It also said access to cataract surgery should not be restricted on the basis of visual acuity.

It followed concerns that patients in some parts of England and Wales were being left to go virtually blind before being eligible for treatment.

However, NICE does not cover Scotland and NHS Ayrshire and Arran is believed to be the first health board to impose similar restrictions.

David Stubley, 68, from Prestwick has cataracts in both eyes. He was told by his optician that he does not qualify for referral because his sight is not yet poor enough, even though he experiences other debilitating side effects such as migraines, sensitivity to light, and milky vision.

He said: “I think it is most unfair, not just for myself but the rest of the population of Ayrshire, that we are being arbitrarily made to accept approaching blindness or at least very restricted vision just on the basis that they decide this operation shouldn’t be done.

"If I was living in Inverclyde I would be able to say to my optician ‘can I get my cataracts done?’ and they would say ‘yes’. But because I live in Prestwick, I’m told I’ve just got to suffer it.”

Mr Stubley, a retired insurance broker, said he was particularly concerned because his sister had developed glaucoma and his mother had suffered a burst blood vessel in her eye, which prevented her from undergoing cataract surgery.

He fears that if he delays the operation he is at risk of similar complications that would make cataracts treatment impossible, and lead to him becoming blind.

He has considered seeking treatment privately but, because he also has astigmatism, the operation would cost him around £3000 per eye.

Mr Stubley said: "My optician told me that NHS Ayrshire only have the surgeons and facilities for 75% of the patients they're getting.

"Therefore they've just make an arbitrary rule to eliminate a number of people who would normally need it, which I find absolutely shocking.

"If you got back to the setting up of the NHS, it was the idea of providing a service to all the population, regardless of where they lived."

Cataract surgery is the most common procedure performed on the NHS, with more than 40,000 operations carried out every year in Scotland.

Cataracts cause blurry vision and sight loss but can be easily treated by replacing the cloudy lens with an artificial one.

However, waiting times have been deteriorating amid increasing demand as the population ages.

In 2017, a quarter of patients waited longer than 12 weeks for an outpatient appointment and in extreme cases some patients had waited up to 78 weeks.

Studies have shown that patients with cataracts have more hip fractures, falls and motor vehicle crashes, especially when they have extended waits for treatment.

A spokesman for the Royal National Institute for the Blind (RNIB) said: "Cataract surgery is a very successful and cost-effective treatment. Denying this to people who need it is a false economy as people with sight loss are at greater risk of falls, depression and isolation which can result in more costs to the public purse.”

John Burns, chief executive of NHS A&A said each patient “receives individualised care according to their needs”.

He added: “We currently accept referrals for consideration of cataract surgery for patients who meet the referral criteria.

“We also accept referrals for consideration of cataract surgery on the patient’s second eye if they meet the second eye referral criteria. Where there are exceptional clinical circumstances patients may be offered surgery outwith the referral criteria.”