Glaucoma is the leading cause of preventable blindness in the UK. Most cases are primary open angle glaucoma (POAG), which progresses slowly and asymptomatically until significant peripheral vision is lost. Intraocular pressure measurement, optic disc examination, and visual field testing in routine optometry and ophthalmology appointments are the key tools for early diagnosis. When these tests are not performed, not properly interpreted, or when abnormal results are not followed up, glaucoma can progress to the point of irreversible vision loss before diagnosis and treatment begin. When that failure falls below the required clinical standard, a claim may be available.
Who has a duty to diagnose glaucoma?
Optometrists (community opticians)
Optometrists who perform a routine eye examination owe a duty to check intraocular pressure, examine the optic disc, and assess the visual field. Failure to identify features suggesting glaucoma, failure to refer appropriately to an ophthalmologist, or failure to follow up on abnormal results may give rise to a claim.
GPs
A GP who receives a referral letter from an optometrist noting elevated intraocular pressure or optic disc changes has a duty to ensure the referral is processed. Failure to refer, or failure to chase an outstanding ophthalmology appointment in a patient with documented glaucoma risk, may contribute to a claim.
Ophthalmologists
A hospital ophthalmologist who fails to diagnose glaucoma from clinic findings, fails to arrange visual field testing, or discharges a patient with undiagnosed elevated intraocular pressure may be below the required standard.
What harm results from delayed glaucoma diagnosis?
Glaucoma causes irreversible loss of peripheral visual field. The optic nerve fibres that are lost cannot regenerate. A delay in diagnosis allows the field loss to progress further than it would have with timely diagnosis and treatment (eyedrops to lower intraocular pressure, or laser/surgical procedures). While treatment cannot restore lost vision, it can halt progression. The harm in a delayed diagnosis claim is the additional field loss that occurred during the diagnostic delay.
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Frequently asked questions
Can I claim if an optometrist missed signs of glaucoma?
Yes — if the signs were present at the examination and a competent optometrist would have identified them and referred appropriately.
Can I claim if an NHS ophthalmology follow-up appointment was cancelled and my glaucoma progressed?
Possibly — if the cancellation resulted in a delay that fell below the required standard, and the delay caused measurable progression of field loss.
How is causation proven in a glaucoma claim?
Expert optometric and ophthalmological evidence will identify what the visual field loss was at the point of diagnosis, estimate the rate of progression, and calculate what additional field loss occurred during the delay compared to what would have been expected with prompt treatment.