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Jury decides against optometrist, awards $9.2 million for missed tumor diagnosis
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FT. LAUDERDALE, Fla. — A six-member jury here awarded a $9.2 million judgment to a teen-age girl and her family after deciding an optometrist's diagnosis of amblyopia delayed treatment of a brain tumor near the girl's optic nerve.
The patient, now age 16, underwent two operations for the tumor and was left totally blind, according to Andrew B. Yaffa, an attorney for the family. "This case stands for taking a full and adequate patient history, doing a complete exam and learning what the patient's problems are before settling on a benign diagnosis of amblyopia," Mr. Yaffa said.
According to the complaint filed by the patient and her family, Louis Wasserman, OD, reached the duty of care by not taking a complete history and not performing a complete exam to rule out other ocular and neurological disease before diagnosing amblyopia. At press time, Primary Care Optometry News was unable to reach Dr. Wasserman for comment.
In this case, a complete exam should have included a baseline screening visual field test, according to Jerome Sherman, OD, a Distinguished Teaching Professor at the State University of New York, who has testified as an expert witness in several malpractice trials.
"The bottom line is to never consider a diagnosis of amblyopia without a constant unilateral strabismus or significant anisometropia, and this patient had neither," Dr. Sherman said. "Also, don't rely entirely on pupillary testing, color vision testing and visual field confrontations. The experts in this case said if a screening visual field was performed on the first visit, it is far more likely than not that a defect would have been uncovered that would have put in doubt a diagnosis of amblyopia."
The girl first presented to the optometrist with a complaint of blurry vision in the right eye only. The optometrist recorded normal pupils, normal color vision, normal intraocular pressure and biomicroscopy, and normal results of a dilated fundus examination and visual field confrontations. He then diagnosed amblyopia and told the patient to return in 1 year.
Eleven months later, the girl noticed colored flashing lights in her right eye followed by dim vision. She returned to the optometrist 2 days later, who recorded that she had bare light perception in the right eye. He referred her to an ophthalmologist, who ordered a computed tomography scan and magnetic resonance imaging, which revealed a large brain tumor on the optic nerve.
She was seen by a pediatric neurosurgeon who performed two operations, one to remove the tumor and a second to relieve high intracranial pressure. Following both operations, the girl was left with no light perception in either eye.