It was with great sadness that we read the about the case of Vincent Barker (8) who died in 2012 following the missed diagnosis of bilateral papilloedema which was a sign of a buildup of fluid on his brain. A court concluded that the swollen optic nerves, should have been picked up in a routine eye examination and would have prevented his death. We want to take the opportunity to reassure all patients that this is exactly the kind of thing we are looking out for when we perform an eye examination. Although very rare, the reason we perform such a thorough range of tests and scans is to identify conditions like these which may have no obvious signs.
Our team are amongst the most highly trained in the country and our technology is the most advanced available. These two factors, combined with the fact that we take our responsibility as eye care professionals incredibly seriously, mean that these signs would have simply not been missed.
We also want to take this opportunity to remind parents of the importance of regular eye examinations for children. From pre-school (or earlier if you have any concerns regarding your child’s vision or eye health) children must have their eyes examined every two years. We aren’t just checking for vision issues, eye examinations pick up so much more, including signs of serious conditions like papilloedema, childhood eye cancer and more.
A comprehensive eye examination should last around 30 minutes and will include a wide range of tests, as well as discussions with both you the parent and your child. This allows the optometrist to gain a thorough picture of your child’s eye health and should provide parents with reassurance regarding your child’s eye health.
Please also be assured that this case was the first of its kind. It is an uncommon condition, especially in children, and is treatable. Although it can result in a loss of sight, it is incredibly rare for it to result in death (see more information on the papilloedema below). Never before has an optometrist failed to pick up this condition which ultimately resulted in a child’s death.
If you have any concerns or would like further information on eye care for children, please contact us at [email protected] or on 0131 225 2235.
Further information on papilloedema from the College of Optometrists
What is papilloedema?
Papilloedema is a swelling of the optic disc (the area of the optic nerve that enters the eye). It is typically seen in both eyes and is most commonly due to increased intracranial pressure. There are many possible causes of raised intracranial pressure. It is often accompanied by symptoms such as headaches, transient visual loss, double vision and sickness, although not always. When an optometrist detects papilloedema, they will normally make an emergency referral, which means the patient will be seen by an ophthalmologist within 24 hours.
How common/unusual is it?
Papilloedema is a rare condition. However the most common cause of papilloedema, idiopathic intracranial hypertension, is increasing due to the rising prevalence of obesity. Although papilloedema is most common in women, it can affect children and adults of any age.
Can it be treated?
In most cases it can be treated. Treatment will be directed at the underlying cause of the increased intracranial pressure. It is normally treated by a neurologist, with input from an ophthalmologist.
Should parents ensure their optometrist checks their child’s eyes for it?
At every eye examination an optometrist will assess the optic nerve, by looking at the back of the eye with a slit-lamp microscope or an ophthalmoscope. Increasingly, in addition to this, optometrists may use retinal cameras in to assess the back of the eye, including the optic nerve.