Would Your Eye Surgeon Choose the Treatment They Recommend to You?
- Posted
- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: September 23, 2026
- Last Updated: September 23, 2026
TL;DR: Every recommendation a surgeon makes carries a judgement about what is worth doing. In an interview with Ophthalmology Times Europe at ESCRS London 2026, Mr Mfazo Hove argued that surgeons should be willing to have the treatments they recommend. This essay sets out the question that standard asks, “Would I choose this if I had your eyes, your work and your priorities?”, and shows what it looks like in practice.
Read the interview: ESCRS 2026: Why surgeons should be willing to use what they prescribe to patients, Ophthalmology Times, 22 September 2026.
Watch The Ophthalmology Times Interview
The accompanying Ophthalmology Times video covers:
- Should surgeons have the treatments they prescribe?
- Why would you give it to your patients?
- The Cleveland Clinic comparison begins.
- How hospitals test doctors for smoking.
- The parallel with ophthalmology.
The Question Behind Every Recommendation
When a surgeon recommends a lens or a laser procedure, a patient hears two things. The first is information: what the treatment is, what it can do, and what it involves. The second is quieter and often matters more. It is a signal of confidence, the sense that this surgeon believes this option is right.
Patients reasonably assume the two are aligned. The standard I want to argue for is a way of making sure they are. Before recommending any treatment, a surgeon should be able to answer one question honestly:
Would I choose this if I had your eyes, your work and your priorities?
During the 44th Congress of the European Society of Cataract and Refractive Surgeons in London this September, I told Ophthalmology Times Europe that surgeons who recommend premium lenses or laser vision correction should be willing to have those treatments themselves if they ever needed them.¹ The question above is how that principle becomes useful in a consultation room. It turns a statement about professional integrity into a test that can be applied to one patient, one pair of eyes and one decision at a time.
What the Principle Asks, and What It Does Not
The principle is easy to misstate, so it is worth being precise.
It is not a requirement that every surgeon must have undergone every procedure they perform. A surgeon in their thirties has no cataract to remove. A surgeon with thin corneas may be unsuitable for laser vision correction. An ophthalmologist with early macular disease might rightly be advised against a multifocal lens. Nor is it a judgement about any individual colleague. A surgeon who wears glasses may have eyes that are unsuitable for treatment, may be content with glasses, or may simply have made a different personal choice. None of that tells us anything about their confidence in the treatments they offer.
The principle is willingness. If my eyes and circumstances made this treatment appropriate, would I choose it? If the honest answer is yes, I can stand behind the option, but I must still establish that it suits this patient. If the honest answer is no, I owe the patient an explanation. Sometimes there will be a good one: a reason specific to me that I can state plainly. If there is not, then the recommendation may be resting on something other than clinical judgement, whether habit, convenience, or a sense of what the patient hopes to hear.
The question, in other words, is not “have you had it?” It is “would you choose it, if you were in my position?”
Why the Question Is Worth Asking Out Loud
It might seem that any conscientious surgeon asks this silently already. There is some reason to think that deciding for oneself and advising someone else do not always follow the same reasoning.
In a study published in 2011, Ubel and colleagues presented physicians with hypothetical scenarios from other areas of medicine and asked them to choose between two treatments, either for themselves or for a patient. Their choices often differed depending on whose decision it was.² That study cannot tell us anything about ophthalmic surgeons or their private choices, and I do not use it that way. What it does suggest is narrower: the perspective we take when choosing for ourselves can differ from the one we take when advising others. Asking the question explicitly brings the two perspectives together.
In the interview, I used an analogy from outside ophthalmology. Cleveland Clinic in the United States has declined to hire people who use nicotine since 2007, while funding support to help applicants stop.³ I mentioned it not because surgery and smoking are comparable, but because it illustrates a principle of professional consistency: an institution that advises people how to protect their health should be willing to live by that advice. I also admitted that I advise patients about weight while still working on my own.
Standards like this are aspirations. The point is not that doctors must be perfect, but that the direction of travel should be towards practising what we recommend.
What the Standard Looks Like in a Lens Consultation
Being willing to choose a treatment for myself does not mean recommending it to everyone. It means the opposite. The question only works because it is about your eyes, your work and your priorities, not mine.
Consider how differently it plays out across patients considering lens surgery:
A keen reader in their sixties with healthy retinas, who wants to reduce their reliance on glasses and accepts that they may notice rings around lights at night, may be exactly the person for whom I would choose a trifocal lens if I were in their position.
A patient who drives professionally at night, or who places a very high value on crisp night vision, faces a different balance. For them, a monofocal or extended depth of focus lens may be what I would choose in their place, even though it means using glasses for some tasks.
A patient with early changes at the macula may not be well served by a multifocal lens at all, however much they would like to be free of glasses. Recommending one would fail the test.
For a younger patient with high short-sightedness and thin corneas, the right answer may not be a lens exchange or laser treatment, but an implantable contact lens: an honest alternative, not a consolation prize.
And for some patients, the right recommendation is not to operate yet, or at all.
This is why compromise must be discussed as openly as benefit. A Cochrane review found that multifocal lenses reduce dependence on glasses but are associated with more glare and halos than monofocal lenses.⁴
Neither lens is better in the abstract. One suits some lives and the other suits others. A surgeon who describes only the benefits has told you half of what you need to know.
UK law and professional guidance point in the same direction. Patients are entitled to know about material risks and reasonable alternatives, including the option of no treatment,⁵ ⁶ and decisions should be shared between clinician and patient rather than handed down.⁷ The question “would I choose this in your position?” is a way of honouring that duty in practice. It forces the surgeon to weigh the options through the patient’s life rather than through the surgeon’s preferences.
It also implies something uncomfortable. A credible assessment must be capable of saying no. If every consultation ends with the same recommendation, the question is not really being asked.
My Own Lens Choice
In April 2024 I had cataract surgery in both eyes and chose a ZEISS trifocal lens, one I had implanted in patients for years. I applied the same question to myself. Given my eyes, my work and my priorities, it was the lens I would have recommended to a patient in my position. My result is one result, and it is not a promise for anyone else. I have written about the experience in an earlier article.
In an essay about trust, you should also know that I am a ZEISS Key Opinion Leader. That role followed my own surgery and the patient film made about it; it did not come before my choice of lens. You are entitled to weigh that when you read what I say about lenses.
Questions Worth Asking Your Surgeon
Wherever you are treated, these questions can help you understand the confidence behind a recommendation:
“If you had my eyes and my priorities, what would you choose, and why?”
“Why this option for my eyes, rather than the alternatives?”
“What would make you advise against it?”
“Which trade-offs are most likely to matter to me in daily life?”
“Is there a simpler option that would serve me nearly as well?”
“What happens if the result is not what we planned?”
Good answers are specific to you. They should mention your eyes, your work and the things you told the surgeon matter most. A surgeon who welcomes these questions is showing you something important about how they practise.
The Standard Behind a Recommendation
Medicine asks patients to trust their doctors with decisions they cannot fully check for themselves. A patient cannot inspect a surgeon’s reasoning, audit their experience, or see what they would choose in private. What a patient can reasonably expect is that the recommendation in front of them would survive the question this essay began with.
That standard does not require surgeons to have had every treatment they offer, or to recommend the same option to everyone. It does not remove the patient’s right to choose differently, or to choose nothing at all. It asks something simpler and more demanding: that every recommendation be one the surgeon would be willing to accept if the patient’s eyes, work and priorities were their own.
It is the standard I try to hold myself to at Blue Fin Vision®. I believe it is one the whole profession should aspire to, and one every patient is entitled to ask about.
Disclosure: Mr Hove is a ZEISS Key Opinion Leader. He has ZEISS trifocal intraocular lenses in both eyes, implanted in April 2024, before that appointment.
References
- Hove M, Harp MD. ESCRS 2026: why surgeons should be willing to use what they prescribe to patients [Internet]. Cranbury (NJ): Ophthalmology Times, MJH Life Sciences; 2026 Sep 22 [cited 2026 Sep 22]. Available from: https://www.ophthalmologytimes.com/view/escrs-2026-why-surgeons-should-be-willing-to-use-what-they-prescribe-to-patients
- Ubel PA, Angott AM, Zikmund-Fisher BJ. Physicians recommend different treatments for patients than they would choose for themselves. Arch Intern Med. 2011;171(7):630-4.
- Cleveland Clinic. New nonsmoking hiring policy at Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; 2007 [cited 2026 Sep 22]. Available from: https://my.clevelandclinic.org/-/scassets/files/org/imaging/non-smoking_hiring_statement.pdf
- de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016;12(12):CD003169.
- Montgomery v Lanarkshire Health Board [2015] UKSC 11.
- General Medical Council. Decision making and consent. London: General Medical Council; 2020.
- National Institute for Health and Care Excellence. Shared decision making. NICE guideline NG197. London: National Institute for Health and Care Excellence; 2021.
ABOUT THE AUTHOR
Mr Mfazo Hove
Consultant Ophthalmic Surgeon
MBChB MD FRCOphth CertLRS
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with experience spanning more than 57,000 procedures. He completed 6.5 years of specialist training at Moorfields Eye Hospital and served for five years as a consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust. He is the founder of Blue Fin Vision®, a consultant-led private ophthalmology practice operating across London, Essex, and Hertfordshire. His clinical expertise encompasses advanced cataract surgery, refractive lens replacement, laser vision correction, and implantable Collamer lenses (ICL).
A ZEISS Key Opinion Leader, Mr Hove is a respected international speaker with five invited engagements across seven cities in 2026:
- ZEISS China tour (Changsha, Shanghai, and Hangzhou, April – ZEISS APAC User Meeting)
- RCOphth Annual Congress – May – Manchester
- ZEISS EMEA User Meeting (Istanbul)
- ZEISS Lausanne User Meeting (Lausanne)
- European Society of Cataract and Refractive Surgeons Annual Congress (ESCRS, London)
