--- title: What Should a Proper Consultation Before Cataract Surgery Include? description: "![review cataract surgery 9](https://bluefinvision.com/wp-content/uploads/2026/10/review-cataract-surgery-9-338x1024.webp) ## Patient Experience “I recently had bilateral cateract surgery with Zeiss trifocal lenses performed by Mr Mfazo Hove at Weymouth Street Hospital in London. The initial consultation was at One Hatfield Hospital and took 45 minutes.…" url: "https://bluefinvision.com/knowledge-base/topics/patient-experience/what-should-a-proper-consultation-before-cataract-surgery-include/" updated: "2026-10-30" category: Patient Experience tags: - Cataract Surgery Reviews - Lens Replacement Surgery Reviews --- # What Should a Proper Consultation Before Cataract Surgery Include? ![review cataract surgery 9](https://bluefinvision.com/wp-content/uploads/2026/10/review-cataract-surgery-9-338x1024.webp) ## Patient Experience “I recently had bilateral cateract surgery with Zeiss trifocal lenses performed by Mr Mfazo Hove at Weymouth Street Hospital in London. The initial consultation was at One Hatfield Hospital and took 45 minutes. Mr Hove explained the surgery including a video demonstrating the procedure. Having taken precise eye measurements and determined I was suitable, I was booked in for the operation. I had intended to compare other providers but having paid the £500 for the BlueFin consultation, and being comepletely satisfied with the outcome, I didn't bother. My experience at Weymouth Hospital was very good. The staff were welcoming, caring, and professional. The facilities are excellent. The pre-surgery preparation to dilate the pupils was probably the most uncomfortable point of the entire process. Four lots of drops which sting the eyes. I elected not to be sedated which worked fine for me. Each eye took about ten minutes with a five minute gap between, so less than half an hour. Post surgery I was shown back to a private room and monitored for about an hour. Within an hour my sight was recovering quickly and after 90 minutes I felt confident enough to leave the hospital and travel home. Being driven home at night with dilated pupils and blurry vision was interesting. My eyes felt a little "gritty" for the next 48 hours which I treated with eye drops. I used eye drops for about a month maybe three of four times a week to alleviate what felt like dryness. My vision was actually very good the morning after the operation, and within a couple of days the results were remarkably good. Transitioning from varifocal glasses to trifocal lenses you have to accept there are fixed focal lengths so, for me, a book needs to be 38cm away to be sharply in focus. 3cm either way and you notice the blurriness. A computer screen, again for me, is best at 70cm +/- 5cm. Overall I am very pleased with the results, very happy I had this done, and very impressed with Mr Hove and his team.” Verified patient review, Doctify, 22 October 2026. Same-day bilateral cataract surgery, meaning surgery on both eyes on the same day, at Weymouth Street Hospital, London, following consultation at One Hatfield Hospital, Hertfordshire. The patient received trifocal intraocular lenses, artificial lenses placed inside the eyes that are designed to focus at near, intermediate and far distances. The fee and eye drops mentioned are as reported by the patient and are not current pricing or prescribing advice. ## Clinical Explanation The operation this patient describes took less than half an hour for both eyes. The 45-minute consultation that came before it is where the foundations of that result were laid. At Blue Fin Vision®, surgical consultations are booked for 45 minutes to allow time for the three jobs a consultation before [cataract surgery](https://bluefinvision.com/cataract-surgery/) has to do: diagnosis, measurement and understanding. The first is diagnosis. Before any lens is chosen, the surgeon needs to confirm that the cataract explains the symptoms and that the rest of the eye is healthy enough for the lens being considered. A cataract can hide disease at the back of the eye during a standard examination, and a scan of the macula, the central part of the retina responsible for detailed vision, can identify abnormalities that are not apparent on examination.¹ ² Every Blue Fin Vision® cataract assessment includes a macular optical coherence tomography (OCT) scan, which uses light to produce detailed cross-sectional images of this part of the retina. Where a trifocal or other multifocal lens, a lens with more than one focal point, is under discussion, this matters even more, because macular disease can reduce the quality of vision these lenses are designed to provide.³ The second is measurement. The power of the replacement lens is calculated from the length of the eye and the curvature of the cornea, the clear front surface of the eye, and small measurement errors become visible as blur after surgery.⁴ At One Hatfield Hospital, Blue Fin Vision® assessments use: - Lenstar optical biometry, which measures the eye to help calculate replacement lens power. - REVO FC OCT, which provides detailed scans of the eye. - Nidek autorefraction, which automatically measures the eye’s focusing error. Every scan is reviewed by the consultant. The patient summarises this step as having precise measurements taken and being found suitable. Suitability is a clinical finding, not a formality: a credible assessment must be capable of concluding that a particular lens, or surgery itself, is not the right choice. The third is understanding. This patient was shown a video of the procedure, and well-designed preoperative videos can improve understanding and satisfaction and reduce anxiety.⁵ Understanding also covers the patient's own priorities, such as reading, screens, night driving and how much freedom from glasses they want. It includes the trade-offs of each lens option, including halos or glare around lights at night and the possibility of still needing glasses for some tasks.³ ⁴ It extends to life after surgery. The patient's precise description of his reading distance (38 cm, give or take 3 cm) and his computer distance (70 cm, give or take 5 cm) is his own experience of a trifocal lens, which gives sharp vision at set focal points rather than continuously at every distance; how noticeably focus falls away between those points varies from one patient to another. His overall satisfaction shows a result he has accepted and is pleased with. Good counselling aims for exactly that: not the promise of perfect vision at every distance, but realistic expectations of the chosen lens. Finally, the decision to proceed is shared. The patient needs to understand their individual risks, recovery and aftercare, and the benefits.⁴ They also need to understand the reasonable alternatives, including lenses or options not offered at that hospital or by that surgeon, postponing surgery, or not proceeding at all.⁷ ⁸ Who delivers the consultation matters as much as how long it lasts. At Blue Fin Vision®, scans are performed by the clinical team, but the consultation itself, the examination, the explanation, the lens discussion and the consent conversation, is conducted in full by the consultant surgeon who will perform the operation. Answers come directly from the person who will choose the lens and do the surgery, not relayed through someone else. The aim is to align expectations with the likely result and reduce misunderstandings after surgery. ## Structured Context Applies to: anyone considering cataract or lens replacement surgery, particularly where a trifocal, multifocal or extended depth of focus lens, designed to provide a continuous range of focus, is being discussed. It also applies to anyone comparing providers who wants to know what a thorough consultation should contain. Does not apply to: consultation length as a measure of quality in itself. Time alone does not make an assessment thorough. What matters is whether diagnosis, measurement and understanding have all been completed properly. Nor is it a criticism of pathways that share counselling with optometrists or other clinical colleagues, who play valuable roles across eye care; it describes the model Blue Fin Vision® has chosen. A consultation also commits no one to surgery: a good assessment may end with a different lens, a different procedure, or advice to wait. ## Published Evidence Swept-source OCT, a type of OCT scan, performed before routine cataract surgery identified macular abnormalities that were not apparent on standard examination in around one in ten eyes.¹ A later review found that OCT detected additional macular pathology, meaning disease or abnormalities affecting the macula, in 13.7% of eyes judged normal on fundus examination, an examination of the back of the eye.² The American Society of Cataract and Refractive Surgery's clinical committee lists macular disease among the relative contraindications to multifocal lenses, meaning reasons why these lenses may be unsuitable rather than an automatic exclusion in every case. It emphasises careful patient selection and counselling.³ National guidance recommends optical biometry for lens power calculation and sets out the information patients should receive before surgery, including what it involves, its possible risks and benefits, and the person's individual risks and refractive implications, meaning how the operation may affect their focus and need for glasses.⁴ In a randomised trial of 141 patients, a preoperative video showing what to expect increased understanding and satisfaction and reduced anxiety, even among patients who felt they already had enough information.⁵ Studies of patients dissatisfied after multifocal lens implantation identify residual refractive error, a remaining focusing error, dry eye and posterior capsule opacification, clouding of the thin capsule behind the replacement lens, as leading causes. This underlines the value of careful counselling before surgery and a clear plan for managing these problems if they arise.⁶ In UK law, valid consent requires disclosure of material risks, meaning risks a reasonable person in the patient's position would consider significant or that matter to that particular patient, and reasonable alternatives.⁷ Professional guidance describes decision making as a shared dialogue rather than a signature, in which the options discussed include taking no action.⁸ ## Surgeon Interpretation The operation takes about ten minutes an eye. The consultation is where the foundations of the outcome are laid, which is why we book 45 minutes for it. The measurements choose the lens power, the retinal scan tells me whether a trifocal is a sensible idea at all, and the conversation tells me what the patient actually needs to see, at what distance, and what they are prepared to accept. This patient can tell you his reading distance to the centimetre and is still very pleased with his result. His account illustrates why working distances belong in the consultation: patients need to understand how their chosen lens may fit their everyday activities. A consultation that cannot end in “no”, or in “a different lens”, is not an assessment. It is a booking. Here, patients hear everything from the surgeon who will operate, and in my case from someone who lives with trifocal lenses in his own eyes every day. Realistic expectations are one part of satisfaction; the right lens, an accurate result and good aftercare are the others. Mr Mfazo Hove, Consultant Ophthalmic Surgeon. ## Clinical Takeaway The surgery takes minutes; the consultation lays the foundations for the result. A proper consultation before cataract surgery combines precise measurements, a scan of the retina, a clear explanation of the procedure, its risks and its alternatives, and an honest discussion of what your chosen lens will and will not do. At Blue Fin Vision®, the operating consultant personally reviews the measurements and scans and conducts the examination, lens discussion and consent conversation. **References** 1. Zafar S, Siddiqui MAR, Shahzad R, Shahzad MH. Swept-source optical coherence tomography to screen for macular pathology in eyes having routine cataract surgery. J Cataract Refract Surg. 2017;43(3):324-327. doi:10.1016/j.jcrs.2016.12.022 2. Ahmed TM, Siddiqui MAR, Hussain B. Optical coherence tomography as a diagnostic intervention before cataract surgery: a review. Eye (Lond). 2023;37(11):2176-2182. doi:10.1038/s41433-022-02320-y 3. Braga-Mele R, Chang D, Dewey S, Foster G, Henderson BA, Hill W, Hoffman R, Little B, Mamalis N, Oetting T, Serafano D, Talley-Rostov A, Vasavada A, Yoo S; ASCRS Cataract Clinical Committee. Multifocal intraocular lenses: relative indications and contraindications for implantation. J Cataract Refract Surg. 2014;40(2):313-322. doi:10.1016/j.jcrs.2013.12.011 4. National Institute for Health and Care Excellence. Cataracts in adults: management. NICE guideline NG77. London: NICE; 2017 (last reviewed 2025). 5. Pager CK. Randomised controlled trial of preoperative information to improve satisfaction with cataract surgery. Br J Ophthalmol. 2005;89(1):10-13. doi:10.1136/bjo.2004.048637 6. Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009;35(6):992-997. doi:10.1016/j.jcrs.2009.01.031 7. Montgomery v Lanarkshire Health Board [2015] UKSC 11. United Kingdom Supreme Court. 8. General Medical Council. Decision making and consent. London: GMC; 2020.