Pre operative HIV testing in all cataract surgeries


We operate about 1600 cataracts every year. Up till now we never sreened any patients pre operatively in last 15-20 years. Does the guidelines suggests to do so or only take universal precautions? DR Diwan


Hello Dr. Diwan,

I'm not sure where your medical practice is, so understand that I'll answer your question from the perspective of an American doctor (though one that works a lot in developing countries).

Firstly, universal precautions should be used at all times, with all patients and all procedures. This clearly isn't just to prevent HIV infection, but multiple blood-borne pathogens.

Current US guidelines strongly suggest that all persons age 13-64 should have HIV screening tests performed; it matters not what medical setting, it also matters not what demographic or risk group the patient may come from; only if the person had recent testing. So for your patients, I'd suggest asking if they had testing in the recent past. If not, then HIV testing should be done (with option out for the patient).

I hope this helps.