PubMed Health⌕ Search

Biomedical subjects

J G Classé

Publications and source records attributed to J G Classé.

70 records · Page 4Linked to original sources

A review of 50 malpractice claims.

A study of 50 malpractice claims reveals that, although claims against optometrists have increased in number over the past two decades, the relative cost of professional liability insurance coverage has remained stable. The most common cause of claims is misdiagnosis of intraocular disease, principally retinal detachment, open-angle glaucoma, and tumors. Corneal disease and complications of contact lens wear also contribute to errors of diagnosis. The great majority of claims alleging misdiagnosis involve optometrists who have failed to use diagnostic drugs for dilation of the pupil; few claims are due to adverse responses to ophthalmic drugs. Failure to prescribe polycarbonate plastic as the spectacle lens material for patients at risk for ocular injury constitutes another cause of claims. A small number of claims allege failure to offer binocular vision therapy to amblyopic children.

Amblyopia↗

Contact lens prescriptions: a clinicolegal view.

The release of contact lens prescriptions is regulated by a variety of laws, and optometrists need to be familiar with these requirements to determine when prescriptions must be provided to patients or third parties. We recommend that contact lens prescriptions include the refractive data, lens parameters, lens manufacturer, expiration date, number of permissible refills, the notation "for daily wear only" if the lenses are not intended for extended wear, and other appropriate information intended to ensure that the patient will obtain the lenses prescribed if the prescription is presented to a dispenser.

Contact Lenses↗

A review of five recent cases of significance for optometrists.

The standard of care expected of optometrists continues to be defined by the courts. Misdiagnosis of ocular disease and liability for injuries caused by ophthalmic products remain the leading causes of litigation. Documentation of findings, warnings, and key management decisions is an essential aspect of clinical practice and must not be neglected by clinicians.

Accidents, Occupational↗

Clinical and legal issues in the management of patients with diabetes.

Retinopathy is a likely complication of diabetes mellitus, and optometrists who manage patients with diabetes must be prepared to recognize the disease, educate the patient, communicate with the physician treating the disease, and follow up as appropriate to minimize the opportunity for undiagnosed complications. Liability most often results from failure to diagnose diabetic retinopathy, failure to monitor retinopathy adequately, and failure to refer or obtain consultation in a timely manner. Care for patients with diabetes should include appropriate record-keeping and documentation.

Diabetic Retinopathy↗

Clinicolegal considerations of monovision.

Patients who wear monovision contact lenses must be carefully selected, properly fitted, and adequately informed of the risks of reduced visual acuity and stereopsis. A demonstration of the visual effects of monovision should be used to determine the adaptability of patients to this form of lens wear, and patients should be advised to undergo a gradual adaptation to their lenses. Negligence in the prescribing, fitting, follow-up of these patients can create liability for the contact lens practitioner. Patients must be warned of the risks of monovision lens wear, as required by the doctrine of informed consent, and these warnings should be documented, either by making entries in the patient's record or through the use of forms. Contact lens prescriptions should include all the information necessary to ensure that replacement lenses are the same parameters as those prescribed.

Contact Lenses↗

Liability and extended wear contact lenses.

The fitting and dispensing of extended wear contact lenses places special clinical and legal demands upon optometrists. These patients must be monitored on a regular basis to minimize the risk of complications. To promote better understanding and compliance, the use of printed agreements is recommended. Failure to observe these factors--and to document patient care--may lead to professional liability claims based on allegations of negligence or product liability.

Contact Lenses, Extended-Wear↗

Helling revisited: how the "tale" wagged the dog.

Failure to test for glaucoma is a leading cause of malpractice claims against optometrists. The standard of care expected of optometrists has been influenced by legal decisions involving ophthalmologists, beginning with Helling v. Carey, and has resulted in the routine use of tonometry as a fundamental aspect of glaucoma detection by optometric clinicians.

Glaucoma, Open-Angle↗

Legal aspects of prescribing for athletes and sportsmen.

Eyewear for athletes and sportsmen must meet legally-recognized standards for impact-resistance. Negligence and product liability claims may result from a failure to observe these standards, which are intended to minimize the risk of ocular injury. Optometrists have a legal duty to warn athletes of the relative impact-resistance of ophthalmic materials, to dispense materials that offer adequate protection, and to verify all materials dispensed to ensure they meet the necessary standards.

Contact Lenses↗

Contractual considerations in contact lens practice.

The use of forms in contact lens practice can save time, promote patient education, and reduce the opportunity for legal or economic disputes. The most commonly employed forms are those for contact lens fitting agreements, instructions for care and maintenance of lenses, prepaid service agreements, clinical investigations of investigatory lenses or solutions, and for extended wear patients. Sample forms are utilized for purposes of illustration.

Contact Lenses↗

A review of professional liability cases affecting the practice of optometry.

In establishing the liability of optometrists for negligence the courts have applied the same standard of care that is imposed upon other health care professionals, holding that optometrists must employ the minimum degree of skill, care and learning that is ordinarily exhibited by members of the profession who are in good standing. The leading cases establishing this standard have involved glaucoma, retinal detachment, and intraocular tumors. Optometrists have also been held liable under product liability law for injuries caused by ophthalmic lenses, which illustrates the trend toward strict liability. Other cases have involved the doctrine of informed consent.

Consumer Product Safety↗

Epinephrine maculopathy.

Epinephrine maculopathy is a reversible macular change that occurs in aphakic eyes being treated with topical epinephrine compounds. The first symptom is transient blurred vision, which can be followed by decreased visual acuity, flame-shaped hemorrhages, and cystoid macular edema. Onset of symptoms can range from a few days after the commencement of epinephrine therapy to several months thereafter. Epinephrine maculopathy should be differentiated from Irvine-Gass syndrome. Treatment consists of changing the patient's therapeutic regimen for glaucoma to other pharmaceutical agents. When this is done recovery of pre-maculopathy visual acuity and reversal of cystic macular changes usually occur.

Aphakia, Postcataract↗