Eye doctor raises alarm as Manitoba's cataract surgery wait times balloon due to pandemic response

A plunge in the number of cataract and lens surgeries done in Manitoba during the pandemic is worse than at least eight other provinces, and eye surgeons say patients in the province are suffering as the delayed procedures become more complicated.

"There was a significant backlog before the pandemic and now it has gotten significantly worse," Dr. Jennifer Rahman said during a virtual news conference held by Doctors Manitoba Friday morning.

"The backlog is creating more complicated cataract procedures due to the lengthy wait times, and this will prolong patients' suffering."

The pandemic cataract backlog stood at about 5,000 as of October, Doctors Manitoba said, not including a wait-list that existed pre-pandemic.

Data collected by the Canadian Institute for Health Information suggests the number of cataract and other eye lens surgeries done from March 2020 to June 2021 was down 44 per cent from pre-pandemic. Manitoba's percentage decrease in those surgeries was the worst among nine provinces.

The number of those surgeries done at the Misericordia Health Centre during the pandemic is about 8,900 below normal levels, according to Doctors Manitoba. Roughly 400 fewer were done at centres in Brandon, Minnedosa, Swan Valley and Portage la Prairie during the pandemic, the advocacy organization estimates.

Wilson Anderson is among those waiting for surgery.

He said during Friday's news conference that about two years after learning he needed a cataract procedure, he still has no surgery date.

He learned in a January 2020 followup with his ophthalmologist that he would need surgery due to the deteriorating condition of his eyes, which have gotten progressively worse since then.

"My independence has been severely impacted," said Anderson, who served as director of information services with Manitoba's department of sport, culture and heritage before retiring in late 2019.

"I find walking, cooking, taking medications, navigating stairs and steps safely are very difficult for me."

Anderson recently injured his lip and face after suffering a serious fall due to his impaired vision. He can't take his two dogs for nearly as many walks as he used to.

His plans in retirement, which included volunteering for non-profits and taking university courses, have been significantly hampered due to his worsening eyesight.

"He gives a snapshot of what a lot of patients are going through right now," Rahman said.

The longer patients like Anderson wait, the more complicated surgery can be, she said. Daily tasks, driving and working can become progressively more difficult, too. 

Pre-pandemic, the national benchmark was to have a patient receive cataract surgery within 16 weeks of being added to the wait list, Rahman said. But in Manitoba, people were waiting close to a year, which Rahman said was a result of a "deficit of surgeons" in the province.

Developed countries should have about eight ophthalmologists for every 100,000 people, Rahman said. Manitoba has just over two per 100,0000, placing Manitoba in the bottom three provinces, she said.

Despite that, some capacity is there — there are 29 eye surgeons who perform surgeries out of the Misericordia Health Centre — but caps on surgery volumes have long made eliminating the backlog a challenge, Rahman said.

Increase surgery cap: doctor

The annual cap on cataract surgeries is around 9,000 at the Misericordia, and about 1,500 at facilities in western Manitoba, she said. 

"If we compare ourselves to the other provinces, we should be doing around 15,000 cases a year, which we are not doing," Rahman said. "We may need to do more than that to get down the backlog."

Manitoba set aside $50 million in the first part of 2021 to help chip away at backlogs and wait times. Late last year, Health Minister Audrey Gordon said about $8.8 million had already been spent on cataract surgeries, echocardiograms and other procedures done through private service providers.

The private sector plays an important role but cannot do more complex cataract, retinal and glaucoma surgeries that require sedation or carry higher risks, Rahman said.

Need to be proactive: advocate

Retired nurse and longtime seniors' advocate Trish Rawsthorne wants the province to consider increasing surgery volumes before the effects of vision impairment land more seniors in hospital.

"If you want to decrease the health-care costs, then you need to be proactive and preventative, and we're not doing that right now," she said.

Rawthorne, 71, learned in September she needs cataract surgery. 

She has been referred to two ophthalmologists since then but still hasn't received a consult or surgery date.

Because of a fuzziness in her field of view, walking can present challenges, as she tends to drift to the left as she goes. 

Rawthorne lives on her own and worries about what could happen if she fell due to vision issues.

"I would not want to enter into a hospital situation of any kind during this pandemic right now," she said.

"The things created because I can't see as well as I used to impact all avenues of my life."

Are you or someone you know facing long waits for surgeries, procedures or diagnostic tests? Email bryce.hoye@cbc.ca.