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Acquired Cataract F023

Last amended 
10 November 2016
Current RMA Instruments
Reasonable Hypothesis SOP
87 of 2016
Balance of Probabilities SOP
88 of 2016
Changes from previous Instruments

SOP bulletin 193

ICD Coding
  • ICD-9-CM Codes: 366.00-366.10,366.12-366.53,366.8,366.9
  • ICD-10-AM code H25, H26, H28.1 or H28.2
Brief desciption

A cataract is a clouding in the lens of the eye that affects vision.  It can involve one or both eyes.  It generally develops slowly.  It is a very common condition in older people.

Confirming the diagnosis

The diagnosis is made clinically based on (i) examination of the lens of the eye using an ophthalmoscope or slit lamp and (ii) visual acuity testing.  The SOP definition requires impairment of vision due to cataract to be present and not just (early) evidence of lens opacification without visual loss. 

The relevant medical specialist is an ophthalmologist.

Additional diagnoses covered by the SOP
  • Nuclear sclerosis
Conditions not covered by the SOP
  • Congenital cataract - revoked SOP - can't be related to service.
Clinical onset

Date of clinical onset will generally correspond with the date of confirmation of diagnosis.  It may be possible to backdate onset to an earlier time if there are convincing vision symptoms due to cataract and not due to another of the many causes of visual impairment.

Clinical worsening

The natural history of cataracts is for slow progression over time.  The course of the condition can be accelerated by a range of factors, as listed in the SOP.  Treatment of cataract generally involves surgery to remove the lens and replace it with an artifical one.  Inability to obtain appropriate treatment for cataract will not generally cause a worsening of a cataract, but may prevent the improvement in vision that typically occurs with surgery.