Royal College of Ophthalmologists | RCOphth

12 May: Letter from Bernard Chang, RCOphth Vice President Chair of Professional Standards, to surgeons who had unsuccessfully applied to be on the Working Group.

Bad news for OE and others for me to be involved in revising the RCOphth guidelines I'm calling for the Government to enforce!

"1. The Royal College of Ophthalmologists guidelines and Standards to be tightened and enforced as the basis of a legal requirement."
www.opticalexpressruinedmylife.co.uk/ind...rgery-epetition.html

I was apparently the first to be appointed to the Working Group, and Kathy Evans asked me not to publish the news until the RCOphth were ready to do so.

As is now obvious, frustrating though it was, I obliged

"• Lay Representative (nomination by the Lay Advisory Group)"


www.rcophth.ac.uk/wp-content/uploads/201...urgery-standards.pdf

16 April ’15: I attended an interview to join the RCOphth Lay Advisory Group.

I had no idea this group existed until a surgeon told me they were looking for a new member! Strangely no-one had ever mentioned it to me previously!

The interview panel consisted of RCOphth President Professor Carrie MacEwen, Chief Executive Kathy Evans, and LAG Chairman Tom Brembridge.

The next day I was asked to supply the name of two referees - both commended me so highly that I was almost embarrassed!

29 April: I received this email from Kathy Evans

Poppy

You probably have no case with regards your refractive correction. Over and undercorrection and part and parcel of Laser eye surgery. Accuracy really depends on the evaluation process and the person doing the evaluation.

Dry eye is a serious one and you may have a case if you can absolutely prove that you had prior dry eye. If in spite of indicating you had dry eye, there was no Schirmer's test and Tear Break up time documented, then perhaps they have been negligent in proceeding to surgery.

The most important factor in all this is having a surgeon evaluate you well before you proceed to surgery and take responsibility for your care through to completion. They would make pretty sure they evaluated you correctly and avoided you if they had documented dry eye. Hired guns make the £30.00 per case no matter what happens. OE are left to pick up the pieces.

Sorry you are having such a problem. Your dry eye is evaporative - there are solutions and suggest you search well and get treated by someone well versed in the area

Doubt under/over correction can be classed as negligence, but I reckon blepharitis likely. Its on the FDA list of 'no no' patients.

IntheBusiness, thank you for your reply.

My solicitor told me it is quite usual for an expert to produce a cause & liability report without an examination!
My complications are that one eye was over corrected & the other under corrected.
An independent Ophthalmic surgeon I'm receiving treatment from (not medico legal) believes this is partly due to them being unable to get an accurate measurement due to my poor tear film.
He has diagnosed that I have blepharitis and told me an experienced optometrist or surgeon should have been able to see this.
On the day of surgery the optometrist It was recorded that I had a poor tear film but I do not believe that the surgeon saw this note. I was unaware that I had blepharitis (I'd never heard of it) or that I had a poor tear film until I requested my notes post op from OE.
My vision now is cloudy as if my glasses are smeared, dry eyes with a tear film break up time of 1-2 seconds. Corneal erosion regularly.
I now apply eye drops hourly or more frequently. I have to get up every night to apply ointment to ease the pain. I can no longer drive in the dark.
The poor vision is bad enough but the constant discomfort or pain from the dry eyes is at times intolerable. I feel that at least I should have been made aware prior to surgery that I had an increased risk of these complications.
Patients are criticised for not asking questions but even if we DID have time and opportunity how the hell are we expected to KNOW what to ask?
How would I have known to ask do I have a good quality tear film? Or blepharitis? I truly was unaware what 'DRY EYES' actually involved.
Do you think I have a case for lack of informed consent?
Thanks for your time and input.

Poppy, how would you say your surgery was negligent? You were over / under corrected? Can you prove something else has gone wrong? That the assessment was incorrect?

Hi Poppy

Without all the details I cannot provide a thorough response.

Who was your expert witness ?

Based on what you state, I would have to agree that you have cause to protest / complain / reject the report.

What are your complications ?

There is no such thing as "reasonable complications" nor is there anything reasonable about competence. Either the surgeon was competent or not. If is unclear how an expert witness can state that you had enough time with your surgeon preoperatively without speaking to you. More appropriately, was your care to the standards suggested by the Royal College of Ophthalmologlists ? If not then the words "reasonable" can be chucked out altogether. Anything less than these standards must be considered "unreasonable".

Suggest you refuse to pay as the report does not appear to be fit for purpose.

Read all Terms and conditions from your lawyers clearly and make your intentions clear to them in writing when it comes to your expectations of them.

Finally you only have a case if your complications are a result of "causation and liability" as a result of medical negligence.

Dear InthebusinessnotOE, can you help me?

I received a medico legal report which, despite my request for an examination, was produced and submitted with an excessive invoice without examination or even a communication to say that the experts intention was to proceed without examining me.

The report states that "I had plenty of time to discuss matters with the surgeon prior to surgery"

I definitely did NOT and this was mentioned in my sworn statement.

The report states that I "have suffered reasonably acceptable complications from the surgery".
Then states that there is "no evidence that the surgery was in any way lower of a reasonably competent Opthalmic Surgeon". These are direct quotes.

I did NOT select OE to have surgery performed by a "reasonably competent surgeon"

Do you think I have cause challenge this report?

I am enraged that this surgeon appears to have got it so wrong and how can a report be produced without an examination?

Thank you