Glaucoma Negligence - Client Case Study

The Claimant had a family history of glaucoma with a raised intraocular pressure. They were a regular attender at the local hospital. As a result of increasing pressures in the eye, the claimant was referred to the glaucoma service. It was considered the pressure was high due to the use of steroids prescribed for the condition. The treatment was continued but not changed. Arrangements were made to review the Claimant 5 months later. The Claimant's vision deteriorated further. They were seen in the Emergency Eye Clinic where the pressures were recorded as raised at 30mmhg. The Claimant was referred for a Trabeculectomy on an urgent basis. The procedure was scheduled but had to be cancelled and rescheduled. Unfortunately, there was a failure to reschedule the procedure as urgent and the claimants name was placed on the next available list.

In the meantime, the Claimants vision deteriorated further resulting in almost total loss of useful vision. Despite further treatment and surgery the Claimant failed to recover any useful vision in the eye.

The Defendants admitted their failure to relist the surgical procedure as urgent was negligent which led to continued uncontrolled intraocular pressures which led to irreversible damage to visual function in the eye.

The Claimant was no longer able to drive and had to surrender their license. They had to be careful when crossing busy roads, pavements or public areas. It was likely to impact on their future career and there was risk their sight could deteriorate in the good eye, rendering the Claimant totally blind.

The claim settled the day after an unsuccessful joint settlement meeting for the sum £850,000.

The settlement was roughly broken down as follows:

Glaucoma is caused by the death of cells causing visual field pattern loss. It is the cause of blindness, particularly with age. It is a major cause of blindness across the world. There is no cure, but it can be controlled. Patients must have regular eye examinations. The NHS recommends an eye test at least every 2 years, if at a higher risk of glaucoma, for example, if a close relative suffers from it. The tests should include the following:

• Pressure tests. This is often referred to as interocular pressure test. The test is relatively straight forward. A instrument is used to puff air against the eye, or the optometrist may apply some an aesthetic and dye to the surface of the eye. A light will be shone into the eye and a tonometer will touch the eye to test the pressure.

• They eye should be examined using a Gonioscopy to check how fluid drains out of your eye, which will help identify the type of glaucoma.

• A Visual field test should be carried out to assess the edges of vision, sometimes by the use of light spots being displayed with the patient being asked to press a button to indicate which ones can be seen. Peripheral vision is often the first area to be affected.

• Optic nerve assessment. Eyedrops will be used to enlarge the pupils so the eyes can be examined using a slit lamp (a microscope with a bright light)

If the readings are abnormal or there is cause for concern there should be a referral to a specialist eye doctor, an ophthalmologist for further tests who can then advise on treatment.

Any delay in checkups, failing to follow up, or failing to recognise the signs of glaucoma can have a devastating effect on an individual's sight. The optic nerve can be damaged by prolonged high pressures in the eye.

Find out more about ophthalmic misdiagnosis here.