Hi all
My 13 son went for his 1st ever routine free eye test yesterday at spec savers.
The lady said he may have blurred disc/nerve behind his eye and told me to get him to the local
Eye hospital in coventry.
I’m worried now and will be taking him over today. Anyone else had this situation ?
He has no pain or head aches and the lady said his eyes are working fine
Cheers Andy
This happens all the time now since an optometrist in Ipswich was convicted for manslaughter by failing to spot a brain condition because a patient had swollen optic discs. Consequently every child +/- adult with unusual appearing optic discs is referred to a hospital due to optometrists fear of litigation.
Short version is that it is 99%+ likely to be perfectly normal or nothing to worry about especially if he has no symptoms but only way to find out now is to go and get it checked!
CheersOriginally Posted by mmgg1988
The Opthalmology Dept at UHCW, (Coventry) is first class.
I had a retinal detachment in April, diagnosed immediately and operation the following day.
The same thing happened to the other eye five weeks later, again immediately diagnosed and operated on the following day
I really cannot speak too highly of the staff. Without their expertise and professionalism, undoubtedly, I would be blind by now.
Your son is in safe hands.
Last edited by JeremyO; 20th July 2018 at 17:25.
Spent 5 hours at the walsgrave hospital in coventry today
Found some swelling on the discs at the back of my sons eyes.
His eye sight is excellent though
Got to have a mri scan just to rule all the bad stuff out now
Fingers crossed!
It's just a matter of time...
Sorry but no it doesn't happen all the time. Yes there was a well publicised case but there were lots of other factors as to why that reached a criminal court and the conviction was quashed anyway.
This case needed referring and I'm glad all seems well but the optom in case took the correct course of action. Had the practice had an OCT they may have chosen to monitor in store if they were happy with the results. Equally they won't have an MRI scanner.
That case hasn't become the issue it first seemed, the perfect storm if you like and the combination of circumstances shouldn't have happened and almost certainly won't again.
Folks you may have faith in your local optometrist
Where I work, an extra clinic has been set up to see only paediatric patients referred with swollen discs such was the increased demand following that case. Referral rates were audited before and after and there was a significant rise.
Good optometrists (like the OP’s!) only refer patients with disc swelling. Others, at least around here refer people who have been seen for years with small discs, tilted discs hyperaemic discs or anything which does not look like a textbook photo AND lots of people with headaches and normal discs.
These utilise a vast amount of resource and detract this from patient with or potentially with pathological swollen discs hence my displeasure!
Last edited by mmgg1988; 21st July 2018 at 12:32.
The honey rose case hasn't changed how I'd refer, but a new patient with swollen discs (that haven't been previously investigated), it's going to get referred.
It's a shame if that case has led to pointless referrals, that doesn't benefit anyone.
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If the audit figures are there then so be it but I'm still surprised. As I understand it one of the given reasons that poor child wasn't referred is that she didn't see his images but another set, incorrectly labelled. Still her error ultimately. One assumes some sort of internal examination was undertaken which should have been sufficient.
You're lucky you have the capacity to add a clinic, I don't think our area would. Waiting times are interesting...
Referrals should be evidence based; perhaps I'd be slightly concerned what happens in a large multiple. Not somewhere I've been for over a decade.
It's area dependent. Some of them operate internal audits due to the volume of patients seen, and are very efficient. But ultimately it comes down to the individual practitioner.
I can't see how discs obviously swollen on a photo could be missed even with a cursory look with an ophthalmoscope. But that's another topic.
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My wife has been suffering from this since March of this year. Her problem was spotted during an eye exam when her vision started to become blurred. She's had various bloods taken, brain scans and all have come back clear however the swelling is getting worse.
She is now on 20mg steroids to reduce the swelling but this is giving her further issues such as palatations! Somewhen in the next few weeks she has to have further bloods taken to see if they can identify the reason for the swelling. Hopefully the OPs lad will be sorted quickly
My understanding with that case is that it was not the missed disc swelling on clinical exam so much (as I don't think the child was that co-operative) it was that fundus photos of said discs which were taken were not reviewed and so not only was there evidence of the discs actually being swollen at the exam which would be otherwise hard to prove, she couldnt use the reasoning of being unable to adequately assess the fundus at the time. I still feel that manslaughter conviction was not justified and so did the appeal court!
It is a large unit which was at the time having new consultants/other staff join and hence there was capacity. As a business thing, it is quite good as these children often need several payable investigations to exclude any disc pathology.
This however takes resource away from other things as I said previously. Patients with genuinely swollen discs particularly those causing symptoms do require an urgent review. I have seen many and all were appropriate. However I have seen far more patients who definately do not have swollen discs but due to the litigeous nature of practice these days, end up having loads of tests to prove what everyone thought was the case anyway.
Even worse are those patients without symptoms and who have normal discs being genuniely scared into presenting somewhere as an emergency to be seen. This happens countless times. I am fully aware that not all practices have OCT and other equipment and so some cases are borderline. Many of these patients can be seen in an elective clinic and not miss birthdays/evenings of their lives waiting to be seen and told that they are of course fine, as they knew themselves!
Anecdotally, chains seem to be worse at this but independants are at fault occasionally too. On the upside, we can't forget that many referrals for this and other things are very perceptive and patients would have come to significant harm should things not have been detected.
Hopefully the OP's son turns out to have nothing sinister-lack of symptoms is generally a positive thing!
I shall descent my hobby horse now and say no more on the subject!
Hopefully all in hand and positive FFF.
I had swollen discs for around 18-24 months. Vision and balance problems. I had lots of tests, lumbar puncture, mri, various blood tests, and regular check up at a couple of hospitals with both nuero and opthalmic staff. Thankfully it just settled down.
It's just a matter of time...
Well it's encouraging to hear that it can settle down ny itself as she really doesn't want to be on steroids for ever. It's getting her down now as it makes driving especially at night very difficult.
The manslaughter conviction was daft as they then gave her a suspended sentence; she's not going to do it again is she. Its almost as though they thought err maybe that wasn't a great idea so we'll mitigate with a lenient sentence.
It was quashed as the appeal judge said gross negligence manslaughter could only be upheld if you knowingly withheld a test which, if positive, would inevitably lead to the death of the patient. You didn't cause it but you didn't check either, with overwhelming evidence. That clearly wasn't the case here; the chances of this boy dying were small but sadly the odds played against him. Medics aren't automatically disbarred for this but this optom was struck off. Fortunately the opportunity for GNM in optics is very small.
Quick update on this thread
My son had the mri about 6 weeks ago
Follow up appointment today. His mum took him. Waiting on the news now.
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