We have recently settled damages of £2.5 million in a claim for negligence against a private consultant ophthalmic surgeon for laser eye surgery performed at Optegra in Guildford, Surrey.
Our client had a long-standing history of wearing contact lenses and of various problems affecting his eyes in the past. These included dry eye symptoms; episodes of conjunctivitis; and ocular surface disease. He also had a condition called meibomianitis, in which glands that secrete oil to provide a protective coating to the cornea at the surface of the eye become inflamed, in addition to blepharitis, where the edges of the eyelids become inflamed. He suffered a separate skin condition known as acne rosacea that aggravated his eye conditions.
None of these conditions affected his ability to wear contact lenses and did not cause him any particular problems. He was in his late forties when he saw an advert for laser eye surgery on his local high street. He was attracted – as many are – by the offer that laser eye surgery could improve his vision so that he would no longer need contact lenses. He made an appointment with a private eye clinic, Optegra, to find out more.
At Optegra, a nurse and then the surgeon asked him a series of standard questions before advising that he was a suitable candidate for laser eye surgery, in both eyes. He was offered LASIK, a procedure in which a laser or fine blade is used to create a flap in the top layer of the cornea. The flap is then lifted back and the cornea reshaped in order to change the angle of refraction of light into the eye. The objective is to improve the focus of light through the cornea onto the retinal cells at the back of the eye to enable clearer vision.
Our client was then given a long consent form to sign, which was not properly explained to him. In particular, the surgeon later admitted that he had not discussed with our client the fact that the laser eye surgery would make the flat corneas that our client had even flatter. This carried a very significant risk of causing him greater problems with refraction and making his vision worse, not better. Sadly, our client did experience a deterioration in his vision after that surgery. His visual acuities were worse and his dry eye was aggravated and became a noticeable problem, where before it had been well controlled.
Despite the decline in our client’s vision, the same surgeon advised further laser eye surgery was likely to improve things in the right eye. The surgeon offered LASEK surgery, where a laser is used to reshape the surface of the cornea, in another attempt to improve refraction and focus light more accurately on the retina. This was, however, completely inappropriate for our client because his cornea was already very flat. The LASEK procedure made his vision even worse in his right eye.
The same surgeon then went on to compound the problems he had already caused by advising our client that his vision could be improved by replacing the natural lenses in both eyes. Owing to a separate condition, our client was always likely to need the right lens replaced in later life, but the surgeon advised that multi-focal lens implants would be the best option. Multi-focal lenses depend on good refraction of light to enable focus. The surgeon’s advice in this case failed to take into account the damage the laser eye surgery had already caused and the highly variable refraction our client was experiencing. It was our expert’s evidence that multi-focal lenses were therefore wholly inappropriate for our client and the surgeon failed properly to assess or advise our client as to the risks of the approach he then took.
Following all these procedures, our client was left with very little vision. He could not see at all without contact lenses; spectacles could not correct the irregular surface of his eyes and were no help to him. He suffered very severe dry eye symptoms, which in turn limited how long he was able to tolerate wearing contact lenses. Some days, his eyes were so dry he could not wear contact lenses at all, even using artificial tear drops. He had to give up his work as an electrical engineer co-running a successful company he had founded.
In the course of investigating his claim, we instructed highly specialist experts in ophthalmic surgery and optometry who were able to make recommendations alongside the treating clinicians that did improve some of our client’s symptoms. By the time the claim concluded, our client was able to wear bespoke gas permeable contact lenses for longer than his previous lenses, but was still limited to only around four or five hours’ wear on a good day and without lenses had no useful vision at all.
In response to the claim, after prolonged delays it was eventually admitted on the surgeon’s behalf that the decisions to offer and proceed with laser eye surgery were inappropriate and that there was a failure to inform our client properly before proceeding with the lens replacements. It was admitted that implanting multi-focal lenses was highly likely to cause deterioration in our client’s vision, but argued that our client always would have needed lens replacement and would have chosen the multi-focal lens. This failed to acknowledge that our client’s situation would have been very different had he avoided the negligent laser surgery the surgeon had initially performed.
As a result, there was substantial dispute as to the extent to which our client’s vision would have been preserved but for the surgeon’s admitted negligence. This in turn affected each party’s position as to the function our client would have retained and therefore his ability to work, manage around the house and to continue enjoying hobbies, all of which were lost to him as a result of his impaired vision.
We secured an interim payment of £350,000 in damages for our client while the case was ongoing, given the continuing loss of earnings he was suffering.
Given the surgeon’s position, it was necessary to issue proceedings at the High Court, following which the parties served their respective witness, medical expert and quantum evidence. Significant and complex evidence, particularly in relation to earnings and pension arrangements, was needed to determine the value of the claim.
The case eventually settled at a meeting between the parties, for a total of £2.5 million, reflecting the extensive income our client had lost and the fact that he would not be able to return to the work he had previously been able to do.
The case was conducted throughout by Andrew Clayton, senior associate in our Guildford office, who leads a team with specialist interest in ophthalmic claims. This case particularly highlights that a decision to undergo laser eye surgery is not one to be taken lightly and requires proper and full exploration of the patient’s history and condition to determine whether refractive surgery is appropriate. Our client specifically chose a more expensive private surgeon over the many high street options that are now available, but even then suffered negligent care and a devastating, life-changing outcome that no amount of damages can reverse.