Sir,

We would like to thank Dinah et al for their helpful discussion in relation to our cataract referral study.1 We were most interested to find that in Frimley Park Hospital, in agreement with our Bristol study, traditional cataract referrals are more likely to detail the past medical history than direct cataract referrals, emphasising yet again on the importance of collaboration between the patient's general practitioner and hospital eye service (HES).

We agree that at the time of cataract referral review by the HES it is most useful to have the past medical history, drug history and social history, which is used to identify patients that need more urgent surgery or have special needs in relation to their surgery, such as an in-patient stay or need of a senior surgeon because of anticipated surgical hurdles. To ensure this, in Bristol we have devised a combined, direct referral form, which combines the requisite information from both the GP and community optometrist onto a single, unified form. Initially, this will be in paper format, and in due course be managed electronically.

We hope to re-audit our outcomes (and in particular assess the rates of conversion to surgery and reasons for not proceeding to surgery) to see if this combined, direct referral form further improves the standard of care.

Conflict of interest

The authors declare no conflict of interest.