Investigation Of Reduced Vision Caused By "floater"

Deputy Health and Disability Commissioner Kevin Allan today released a report finding an optometrist in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to adequately investigate the cause of a "floater" in a woman’s eye.

The woman was away on holiday when the floater suddenly appeared. Her usual optometrist recommended that she get her eye checked immediately rather than waiting until she returned home. She made an appointment with an optometrist, who undertook a visual acuity test, which showed significantly reduced vision in the woman’s right eye. The optometrist also performed a dilated retinal examination, and diagnosed a posterior vitreous detachment.

The optometrist did not document all her assessment findings, including that she dilated the woman’s eyes, nor did she record the method of examination used. The woman was later diagnosed with a posterior vitreous attachment and a macular hole.

Mr Allan considered that the optometrist should have taken further diagnostic steps to investigate the cause of the woman’s reduced vision, including Amsler grid testing (a test used to detect vision problems resulting from damage to the macula) and an optical coherence tomography scan (a non-invasive imaging test).

"As a result [of the failure to investigate], the cause of [the woman’s] symptoms were not identified, and surgery to address her degenerating sight was delayed," Mr Allan said.

Mr Allan was also critical of the fact that that the optometrist did not fully document her assessment findings or method of examination.

He recommended that the optometrist undertake a documentation audit to confirm that all clinical assessments have been documented fully, and provide a written apology to the woman. Mr Allan also recommended that the Optometrists and Dispensing Opticians Board of New Zealand consider whether a review of the optometrist’s competence is warranted.

The full report for case 19HDC00346 is available on the HDC website.

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