A patient complaint - failure to identify signs of glaucoma

What happened

Anna (not her real name) had been qualified and practising for almost a decade when she received a letter from the GOC about a complaint from 73 year old patient who had developed glaucoma, following an eye test Anna conducted.

The GOC had opened an investigation into Anna’s conduct, and informed her of allegations that she had failed to identify the signs of glaucoma, failed to refer the patient for further investigation or treatment of glaucoma, and failed to take adequate steps to ensure that the patient’s visual field test would be repeated upon collection of her spectacles.

Anna realised that she had made an error by assuming that the patient’s disc appearance was likely to be physiological, rather than pathological. She had asked for the patient’s visual fields to be repeated when she collected her glasses, but did not follow up to ensure that this was done. 

Sadly the patient’s vision had become significantly poorer as a result of this error, which could have been prevented. 

How we helped

Anna contacted the AOP legal team for advice and was assigned a solicitor in the Professional Discipline team who reviewed all of the evidence in her case and explained the GOC’s process and procedures. Her solicitor explained to Anna that the GOC case examiners have different options when deciding how to progress a case which include referring the matter for a hearing before a Fitness to Practise committee, closing a case with advice, issuing a warning, or taking no further action.  

Anna’s AOP solicitor explained that whilst Anna had made a mistake, this did not necessarily mean that she was no longer fit to practise or that she should be sent to a hearing, if she could demonstrate that she had learned from her mistake and there was a low risk of repetition.  

We advised that she should accept all the allegations made against her based on our analysis of the evidence. We helped her build a programme of CPD courses she could take to help her reflect on her examination of the patient, why it is important she ensures that all aspects of sight tests are conducted adequately, and why patient follow up care is ultimately each individual optometrists’ responsibility. 

Anna’s solicitor drafted legal representations on her behalf which argued that minimum action, if any, should be taken against her. She also worked with Anna to draft a reflective statement which highlighted areas of her practice she would focus and improve upon, and explained that with future tests Anna would ensure follow up tests are carried out. 

The outcome 

The GOC case examiners decided that there was no realistic prospect of finding that Anna’s fitness to practice was impaired to a degree which justified an action being taken against her registration. They decided to give Anna a warning regarding her future conduct. 

Anna was very upset that she had been involved in causing harm to a patient, but was happy with the outcome and very grateful for the support and guidance provided by the AOP legal team.