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Retinal tear missed by optometrist who did not dilate pupils (00HDC09842)

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(00HDC09842, 24 September 2002)

Optometrist ~ Standard of care ~ Information about treatment options ~ Dilatation ~ Retinal tear and detachment ~ Rights 4(1), 6(1)(a), 6(1)(b)

A man consulted an optometrist when he noticed a grey "part-disc" shape in his peripheral vision. He complained that the optometrist incorrectly diagnosed a floater, when in fact retinal detachment had occurred some time previously, and did not refer him to an opthalmologist for assessment  or a second opinion. The patient also complained that the optometrist examined his eyes without dilatation drops, and did not mention that flashes of light are a symptom of retinal detachment.

The Commissioner noted that given the patient's history of floaters, as well as a large part-disc shaped disturbance in his vision, the optometrist should have performed a dilatation examination to assist in making an accurate diagnosis. However, it was held that the failure to use dilatation drops did not amount to a breach of Right 4(1) as at the time dilatation was not common practice among optometrists, and the diagnosis of a floater was reasonable on the evidence. Nor did the optometrist breach Right 6(1)(a) or Right 6(1)(b) because the clinical notes clearly documented that she discussed the symptoms of retinal detachment and offered the patient the option of referral for a second opinion.