Optometrist Fails to Diagnose Retinal Detachment

Opthalmology Expert WitnessThis case takes place in Indiana and involves a female patient who presented to her optometrist with complaints of objects floating in her vision. She was examined by an optometrist who opined that the condition was self-limiting and did not require referral to a specialist. Shortly after leaving the facility the patient suffered a sudden loss of vision in the affected eye. It was later diagnosed that she had suffered retinal detachment. Despite surgical treatment the patient remains virtually blind in the affected eye.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients like the one described in this case?
  • 2. Have you ever had a patient develop this outcome?
  • 3. Based on this brief summary of the case, do you believe this patient might have had a better had the care rendered been different?

Expert Witness Response E-011072

It’s important to evaluate someone with flashes very carefully because this can sometimes be a sign of a retinal tear, that can lead to retinal detachment, and that can lead to loss of vision. This is what I do everyday and we work to avoid this outcome, however sometimes retinal detachment results in loss of vision even with proper treatment. This patient potentially could have had a better outcome if a tear was missed or if follow up was not appropriate.

Expert Witness Response E-009723

Expert-ID: E-009723

I most certainly do not treat my patients such as described in this case. Any patient with new onset of light flash, needs a retina specialists referral to check retina periphery for any evidence of a retinal hole. No I have never had a patient develop this outcome. If a patient was diagnosed in this stage, they would need a barrier retinal laser around the retinal hole. If the patient develops a RD, in acute state (less than one week from symptom), the surgery prognosis would be better than now. Base on the summary of the case, I believe that the patient might have had a better chance if the care rendered had been different.


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