Eye surgery: cataract, retina, glaucoma and children's operations, funding and documents

What does eye surgery include and who makes the decision?

"Eye surgery" covers several entirely different procedures. In cataract, the eye's natural lens becomes cloudy and is replaced with an artificial lens during surgery. Retinal surgery deals with retinal detachment, complications of diabetic retinopathy and disorders of the vitreous body, and often requires specialised equipment. Glaucoma is damage to the optic nerve caused by intraocular pressure; it is managed with drops, laser or surgery. Children form a separate group: congenital cataract, retinopathy of prematurity, strabismus and eye tumours.

This page does not contain medical advice. Which procedure is needed, when and by what method is decided only by the treating ophthalmologist; we explain how their prescription is funded and which documents that route requires. If you have doubts about the diagnosis or the need for surgery, you will find how to obtain another specialist's opinion in the second opinion guide.

Timing also depends on the diagnosis. Cataract surgery is usually scheduled as a planned operation, and waiting for the approval letter is possible, whereas some retinal conditions cannot wait, in the doctor's judgement. If the treating ophthalmologist considers the procedure urgent, ask them to justify this in Form IV-100/a or in a separate letter: such a record will serve you equally well with the Agency, City Hall and the commission when you ask for a faster decision.

What does Universal Healthcare cover for eye surgery?

In the basic Universal Healthcare package, the ophthalmologist is on the list of specialists you see on referral from your family, village or district doctor. In the standard package such a visit carries a 30% co-payment, while protected groups pay no co-payment. The first step, therefore, is often a referral from the family doctor rather than going straight to a clinic.

The operation itself falls under the planned surgery component: the annual limit is GEL 15,000, and the co-payment depends on the category. In the standard package it is 30%, up to a maximum of GEL 1,500, and lower for pensioners and other protected groups. The full table of categories and shares is in the Universal Healthcare guide; here we cover only what concerns the eyes.

What is expressly excluded

The basic package, which covers children aged 6-17, families with a score of 70,001 to 100,000 and most of the uninsured population, names four eye procedures as non-reimbursable. The same entry also appears in the veterans' package:

• refractive surgery, that is, vision correction instead of glasses or contact lenses;
• surgical treatment of strabismus, including in children;
• laser eye surgery, except for the diabetic eye: laser treatment of diabetic retinopathy is not part of this exclusion;
• corneal transplantation.

Notably, the exclusion list in Annex 1.3, which applies to families with a score of up to 70,000, children aged 0-5, pensioners, students and persons with disabilities, does not name these four procedures separately. This may mean that for these groups, for example for strabismus surgery for a child with disabilities, the application is assessed under the general rule for planned surgery, but confirm the answer for your specific case in writing with the National Health Agency.

All other planned eye operations are assessed under the general rule: with the Agency's approval letter and the clinic's cost estimate. The programme usually covers the cost of the operation as set by the rules, but a particular clinic may offer a type of artificial lens or extra materials at the patient's expense. Before signing, ask for a written cost estimate that shows the programme's share, your co-payment and any extra charge separately.

Eye injuries

Penetrating wounds of the eye and orbit, foreign bodies and injuries to the eyeball are on the programme's list of emergency conditions. In such cases you do not need an advance approval letter: the clinic notifies the Agency of the case itself, and you provide your identity details as early as possible.

Eye surgery for children: what should parents know?

Screening for retinopathy of prematurity

The 2026 state programme “Early Detection and Screening of Diseases” funds screening for retinopathy of prematurity in premature newborns under the national protocol. Under the programme's criteria, every newborn born before 34 weeks of gestation or weighing less than 2,001 grams is examined, and babies born at 34-36 weeks are examined at the neonatologist's discretion if the history is complicated or they needed oxygen for more than 48 hours. The timing of the first examination depends on gestational age; if it is postponed, the reason must be recorded in the child's medical record and the examination carried out within one week.

The practical conclusion for parents is simple: if your baby is in this group, ask before discharge whether the screening was done and take a copy of the result. If retinopathy is confirmed, the ophthalmologist and the neonatologist decide on the treatment approach together.

Funding surgery for a child

Children aged 0-5 are in a protected Universal Healthcare group, where the co-payment for planned surgery is lower than standard; children aged 6-17 receive the standard package. The main risk is strabismus: its surgical treatment is expressly excluded from the standard package, so the family of a child aged 6-17, unless they fall into another category, turns to municipal programmes and the referral commission. For a child aged 0-5 or a child with disability status, first request a written answer from the Agency. A malignant eye tumour is an oncological diagnosis and follows a different route: treatment abroad for patients under 18 is a separate strand of the Solidarity Fund's work, described in the guide to children's treatment.

For a child with diabetes, the state “Diabetes Management” programme provides for fundus monitoring twice a year. Do not skip this examination: early signs of retinopathy often develop without symptoms.

Glaucoma and long-term treatment: drops, monitoring, surgery

Glaucoma management often lasts for years and relies on daily drops. The programme for medicines for chronic diseases lists glaucoma as a separate diagnosis and covers socially vulnerable families with a rating score of up to 100,000, pensioners, children with disabilities and persons with a severe or significant disability status. How the medicine is prescribed under the programme and what co-payment applies is explained in the guide to funding for medicines.

Glaucoma surgery, as a planned surgical procedure, follows the general rule, but laser methods fall within the exclusion list unless the procedure concerns the diabetic eye. This means that for the same diagnosis the method the doctor chooses directly changes the funding route. If the doctor recommends a laser procedure, ask whether there is a programme-funded alternative in your case, but do not base the choice on financial considerations: the method is determined by the medical indication.

For a long-term patient, an orderly history is especially important: intraocular pressure records, visual field tests and OCT results arranged by date. It is exactly this progression that both a second opinion doctor and the commission need. You can use Universal Healthcare for regular follow-up visits if you see the ophthalmologist on referral from your family doctor, so get the referral in advance each time. How to request documents is described in the guide to obtaining your medical history.

When do families go abroad and what changed in May 2026?

Families mainly consider eye treatment abroad in three situations: complex retinal or vitreoretinal surgery when a procedure at home has not succeeded; a rare congenital condition in a child; and eye tumours. Frequently considered destinations are Turkey, Germany, Israel and Spain; each has its own guide.

The referral commission funds treatment abroad only when it has been shown that the same service is not available in Georgia. For ophthalmology, this rule has applied through a specific procedure since 1 May 2026: the commission's documentation is sent to every Georgian provider registered in the electronic system that is licensed to provide surgical ophthalmology services, so that they can confirm whether they can provide the same service. By decision of the commission, the documents may also be sent to a sectoral expert at the Ministry.

In practice this means that a doctor's opinion that "it is better abroad" is no longer enough. Form IV-100/a and the accompanying letter must show which method, equipment or expertise local clinics lack and why it is critical in your case. The commission's full rules are in the guide to the Referral Services Programme, and all channels for funding treatment abroad are in a separate guide.

What a foreign clinic asks for

Before giving a cost estimate, an eye clinic usually asks for recent objective data: visual acuity with and without correction, intraocular pressure, OCT, fundus photos, ultrasound where needed, visual field and, for children, electrophysiological tests. Added to this are the reports of previous operations, a list of the drops used and any other conditions, especially diabetes. Send images as original files, not just the text of the report. Our clinic search service can help you choose a clinic.

When planning the trip, take the post-operative period into account as well. A foreign clinic usually schedules follow-up visits after the operation, and after some retinal operations flying is temporarily not allowed. So do not buy a return ticket before the doctor confirms it, and ask who will continue the follow-up in Georgia. That doctor will need the operation report and the discharge recommendations translated into Georgian.

Which mistakes hold up funding for eye surgery?

Eye-related applications are often held up not because of the diagnosis but because of a formal gap. Below are the situations we meet most often in practice and which can be avoided in advance:

1. The operation took place before the approval letter. Planned surgery is funded on the basis of the Agency's approval letter, so you need the letter first and the operation date afterwards. An emergency injury is an exception to this rule.
2. The certificate states only the diagnosis. If Form IV-100/a does not include the procedure code, or does not clearly distinguish between a laser and a surgical method, the application may end up in the wrong category.
3. A price difference for the lens or materials was agreed verbally. If the clinic offers a more expensive lens or extra materials, ask for the price and the reason in writing: this is exactly the document you will later need for City Hall or a dispute.
4. You applied to City Hall without the Agency's answer. A municipality usually calculates co-funding on the basis of the state programme's decision or refusal.
5. The request for treatment abroad does not show what Georgia lacks. Since May 2026 this is the weakest point, because the confirmation from Georgian clinics directly determines the commission's decision.

If you are refused anyway, first ask for the written reasons. The deadline and structure of an appeal are in the guide to appealing a refusal.

Which documents should you prepare?

The core of the package is the same whether you apply to the Agency, City Hall, the commission or a foreign clinic. Only the language and the form of certification differ.

• Form IV-100/a with the ICD-10 diagnosis and the code of the planned procedure; for a request abroad, with the doctor's recommendation. How to obtain it is explained in the Form 100 guide, and the translation is on the Form 100 translation page.
• Discharge summary from previous operations or hospital stays; for a doctor abroad, with a translation of the discharge summary.
• Test reports and images: OCT, fundus photos, ultrasound, visual field, as original files and with a translation of the reports.
• Cost estimate with itemised entries; for the commission, a foreign invoice must be translated and notarised, for which we provide translation of financial documents.
• A copy of the ID card or birth certificate and, where needed, a document confirming social or disability status.
• A written answer from another source: the Agency's refusal or approval letter, which City Hall and the commission will ask for.

The Translation price calculator will show you an indicative cost of translation. A step-by-step checklist is in the guide to documents for treatment abroad.

Funding sources in one table

The sources complement each other rather than replace one another: the municipality and the commission usually ask for the written answer of the previous link in the chain. The logic of the sequence is in the guide to funding for surgery.

How we can help

The most common problem in eye cases is technical: the test report is in one language, the images in another format and the cost estimate is a single lump sum. We translate eye test reports, discharge summaries and financial documents, check that the figures for visual acuity, intraocular pressure and lens parameters carry over into the translation exactly, arrange notarisation and send the package to the foreign clinic. If you need state or municipal funding, Advocat.Ge lawyers prepare the application through our funding search service, and when you travel abroad we also put together the documents for a medical visa. We do not make medical decisions at any stage: they are the prerogative of your treating doctor.

Frequently asked questions about eye surgery