66 year old female had a standard eye exam with an optometrist for rule out cataract. Primary doctor had sent her for evaluation.
Attached you will find the photocopy of the examination report made by the optometrist. The redacted portions are handwritten notes by the potential client and also removing names associated with the case. I apologize if its difficult to read.
Approximately 24 hours after this examination, the PC had an acute retinal detachment. The PC believes that this was caused by the autofluorescence imaging that was performed at the initial exam. Documentation shows that a XyCAM RI was used in this procedure. There is contention that the light was “way too bright” than it was supposedly a “calibration” problem. We have no evidence of this claim.
Follow up treatments confirm that detachment which required surgical intervention. **The operative note is attached**.
The first post operative appointment, MD stated that "corneal transplant was not indicated as it will not improve the vision." It was reported that the eye "may ultimately become phthisical and require enucleation."
That provider stated she was NOT legally blind: "does not meet the definition" That was approx 6 months ago.
**Her latest acuity and eye exam from March 2024 is attached for reference**
We are looking to ensure that this procedure could not cause a delayed retinal detachment/damage or this was just a coincidence and the two events are unrelated.
We appreciate your time and opinions in advance.
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No questions yet!
Do you believe there might have been medical error?
The only possible medical error here would be "Failure to Diagnose", as it would be unlikely for a patient to develop an acute retinal detachment one day after a comprehensive eye examination. However, the doctor did follow the standard of care with a dilated examination of the peripheral retina which was described as "normal"
Do you believe there might have been causation (i.e. the medical error resulted in an injury)?
An FAF is a photograph. The image obtained is the result of the normal autofluorescence of the human fundus. To suggest that this could cause a retinal detachment is frankly preposterous.
What makes you a good expert for this case?
I'v been a comprehensive medical eye practice for 40+ years. I am board certified in optometry and in the subspecialty of Glaucoma. I am one of 8 Glaucoma Diplomates of the American Academy of Optometry.
How often do you encounter cases similar to this one in your practice?
Rhegmatogenous retinal detachment (RRD) is not a rare occurrence in general practice. It is more commonly seen in older and more myopic patients. It is not caused by FAF.
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