Optometrist fails to provide services of an appropriate standard - 21HDC01773

In a report released today, Deputy Health and Disability Commissioner Deborah James found the standard of services provided by an optometrist breached a woman’s rights under the Code of Health and Disability Services Consumers’ Rights (the Code).

The woman, in her mid-seventies, had a history of cataracts in both eyes and bilateral retinoschisis (1) and had regular eye checks at the clinic. Concerned that her cataract was getting worse, she saw an optometrist who conducted an eye examination and prescribed new glasses.

Around a year later, the woman saw an ophthalmologist who diagnosed a long-standing retinal detachment of her right eye. At that stage, the condition was beyond treatment and resulted in partial blindness.

Ms James accepted the advice of her clinical advisor that a dilated pupil examination was clinically indicated in the circumstances. In addition, she said that a check of visual fields and visual reflexes are part of the comprehensive eye examination that was expected by the optometrist’s employer and the Optometrists and Dispensing Opticians Board (ODOB) standards.

While Ms James was unable to make a finding about whether the woman’s retinal detachment was present at the time of the examination, she concluded that failure to detect the detachment was made more likely due to the lack of dilated pupil examination.

Ms James was critical that the optometrist did not provide a dilated pupil examination, as the accepted standard of care for someone in the woman’s clinical circumstances. Accordingly, she found the optometrist breached the Code for failing to provide services of an appropriate standard | Tautikanga.

Since the event, the optometrist has reviewed her practice, including the ODOB and New Zealand Association of Optometrists (NZAO) clinical standards and guidelines to ensure that she will carry out a dilated pupil examination when appropriate in the future.

Ms James made several further recommendations for the optometrist, outlined in the report.

1: An area of retina separated into two layers.