I read with interest 'Clouds on the horizon' (Managers & Medicine , pages 2-3, 28 October). Optometrists have an essential role in the delivery of cataract services, and we are more optimistic for the future than this article's author.

The days are gone when optometrists thought a cataract had to be 'ripe' before it could be treated. What optometrists can do is hold patients in the community until the appropriate time for surgery, and then carry out postoperative assessments.

For example, in Ayrshire and Arran Acute Hospitals trust's cataract project, patient appointments have been reduced from seven to three and the waiting time from 12 months to one - an impressive service improvement based on the multidisciplinary approach encouraged by the government.

We agree that assessment for the need for cataract surgery should be based on impact on lifestyle as well as visual acuity. The lifestyle of a young patient with visual acuity of 6/12 who needs to drive, go to work, etc may be more affected by their condition than that of an older patient with lower visual acuity but a less demanding lifestyle.

Optometrists are an example of primary care professionals whose role in the community makes them well placed to provide support to the NHS in its drive for quality primary care services and a shift away from the secondary sector.

GJ Morgan President The College of Optometrists London WC2