DELAY IN DIAGNOSING GLAUCOMA

Plaintiff had been seeing a local optometrist for over 20 years and has a family history of Glaucoma. The defendant told him they’d monitor it. Doctor never indicated pt had glaucoma – just that he was suspicious. He never dilated pt’s eyes to check his optic nerves until an associate did. Pt asked to be referred to a specialist, then discovered that he had advanced glaucoma and was told that without immediate treatment he would go blind.

Laser surgery was not a viable option because patients condition was too advanced.

Issue: Did the optometrist fail to timely diagnose the glaucoma thereby impacting the outcome?

MEDQUEST EXPERT RESPONSES

Sounds like clear negligence care by the optometrist. Dr. S.H. – Optometrist

There is differing opinions as to what constitutes “advanced” glaucoma. There could also a bit of “gotcha” medicine going on with the glaucoma specialist. The phrase “without immediate treatment you will go blind” is frequently used as a scare tactic. Its difficult to acertain the severity and speed at which glaucoma is advancing without proper testing over a very long period of time. You dont have to dilate the pupil to get a good look at the optic nerve in all cases. It is standard of care to dilate if there is possible pathology present. Dr. B.L. – Optometrist

What is in question here is failure to properly diagnose and initiate treatment in a timely manner. Everything there after is up for discussion. If there were no IOP measurements taken, no visual fields done, no nerve fiber layer assessments done, than it looks likely that the optometrist in question may have a problem on his hands. This does appear to be a deviation both for lack of dilation and visual fields being performed over the years Dr. B.S. – Opthamologist