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Assessment by optometrist (13HDC00696)
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(13HDC00696, 12 June
Optometrist ~ Prescription ~ Assessment ~ Information
~ Informed consent ~ Documentation ~ Rights 4(1), 4(2), 6(1),
A mother complained about the care provided to her
four-year-old son by an optometrist. The main reasons for their
first visit were that the boy had failed his B4 School Check, and
his mother had noticed that occasionally he had a "wandering
The optometrist carried out retinoscopy, an Ishihara
colour vision test, and pupil reactions to assess the boy's ocular
health. She also tested his eye alignment and arranged a further
appointment so that she could test further for amblyopia (lazy eye)
with the aid of cycloplegic drops.
At the second appointment, the optometrist re-examined his
eyes using cycloplegic drops to obtain a more accurate
prescription. The results, as documented in the notes, showed that
the boy was somewhat long sighted with a low degree of astigmatism.
The optometrist recommended that the boy wear single vision
distance spectacles full time and return for a review in six weeks'
time. Very little of this appointment is recorded in the notes,
including what was discussed or regarding any management
The boy's parents sought a second opinion with another
optometrist, who diagnosed an alternating exotropia (a divergent
squint, where the direction of the eye deviates), and advised that
glasses were unnecessary to treat the condition. This optometrist
then referred him to a consultant ophthalmic surgeon, who agreed
with this diagnosis.
By not carrying out a thorough and appropriate eye health
assessment at the first appointment, for not repeating the
measurements of vision, and for prescribing spectacles when they
were unnecessary, the optometrist breached Right 4(1).
The optometrist did not fully inform the boy's parents of
the diagnosis and prognosis, including the reasoning behind why
spectacles were prescribed, or of the plan to manage his condition.
Accordingly, the optometrist breached Right 6(1).
It was also held that the parents did not receive
sufficient information about the diagnosis and intended management
of their son's condition. Without this information, they were not
in a position to make an informed choice or give informed consent
for their son regarding an agreed course of management, including
the prescribing of spectacles. Accordingly, the optometrist
breached Right 7(1).
By not following the professional standards relating to
documentation, the optometrist breached Right 4(2).
The clinic was not found liable for the optometrist's
breaches of the Code.