Ophthalmologist Dr P receives a claim alleging poor consent and technique – but is that the real cause?

Mr M, a 45-year-old lawyer with a substantial income, consulted Dr L, an ophthalmologist, for the management of deteriorating keratoconus. He had become intolerant of contact lenses and was experiencing visual difficulties.

Mr Q, 40 years old, consulted Miss A, a consultant ophthalmologist, with lesions affecting his eyelids. Mr Q’s complex medical history included antiphospholipid syndrome and his drug therapy included anticoagulant and antiplatelet agents, oral corticosteroids and ocular surface lubricants.

Mrs B, 40 years old, was referred by her optician to see an ophthalmologist, Mr F, because of concerns about possible raised intraocular pressure and right-sided amblyopia. Mr F confirmed the diagnosis of right-sided amblyopia, found her to have normal intraocular pressure and documented some visual field loss in both eyes, which he considered was performance-related. He advised reassessment in six months but the patient did not attend for follow-up.

Mrs X gave birth to J, a healthy baby boy. J was discharged, with a note in the records stating he was a “normal healthy infant”; a further note stated that, on examination, there was a bilateral red reflex.

Complaints in health and social care: standards and guidelines for resolution and learning (2009) aims to provide a simple, consistent approach for staff who handle complaints, and for patients who raise complaints across all health and social care services.

Mr P, a 40-year-old office worker, had a long history of sino-nasal problems, and had even had a previous septoplasty operation. Soon after returning from a holiday, he consulted his GP, Dr A, with worsening blockage in the left side of his nose.

Ms M, a 38-year-woman, consulted Mr F, an ophthalmologist, for surgical correction of high hypermetropia.

Mr M, a 51-year-old primary school teacher, was referred to ophthalmologist Mrs C, following a letter sent by an optometrist to his GP. The optometrist had found Mr M to have an abnormal right optic disc, slightly raised intraocular pressures and significant defects in the visual fields of his right eye with suspected glaucoma.

Mr T, an 85-year-old retired accountant, went to see his GP, Dr L, because he had felt unwell for a couple of days with a severe left-sided headache. The pain was worse on eating and Mr T had noticed transient loss of vision and flashing lights. Mr T had also lost some weight. Dr L prescribed co-dydramol.

Mrs O, a 54-year-old secretary with a history of migraine, developed a severe frontal headache, noticing flashing lights and cloudiness in her field of vision. These symptoms came on over about 24 hours. She was visited at home by Dr R, who was working for an out-of-hours GP co-operative. Dr R noted the symptoms of headache, ‘misty’ vision and red eye. Dr R diagnosed conjunctivitis, prescribing topical fusidic acid ointment.

Mrs D, a 79-year-old retired haberdasher, went to her GP practice as she’d developed a rash on her forehead and face with puffy eyes. She saw Dr Y who suspected an allergic reaction to a new perfume that Mrs D had just started using.

Miss Y was a healthy, happy schoolgirl until the age of 15 when she started getting headaches. She saw a locum at her GP practice, giving a six-month history of persistent headaches with vomiting and a stiff, twisted neck. She mentioned a family history of migraines. The doctor diagnosed migraine and prescribed analgesia and pizotifen.

Miss T was three years old when she injured her right eye whilst playing with a stick. Six hours after the injury she was seen by Mr F, consultant ophthalmologist.