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Miss T was three years old when she injured her right eye whilst playing with a stick. Six hours after the injury she was seen by Mr F, consultant ophthalmologist.
He found a superficial laceration of the cornea containing purulent slough in its floor and margin. There was oedema, conjunctival congestion and evidence of pus in the anterior chamber.
Mr F felt that the globe was perforated and contained a foreign body. In the presence of infection, his preferred course was to treat with oral and topical antibiotics, with a view to later surgical exploration. Miss T’s mum, a medical practitioner, attended with Miss T, and Mr F explained his opinion and plan to her.
Mr F reviewed Miss T the next day, about 15 hours after the original injury and arranged to examine Miss T’s eye under general anaesthetic, after she had been starved. At operation he found a perforating conjunctivalscleral tear and removed a 2cm splinter from the eye.
He repaired the tear and applied conjunctival gentamicin. Miss T did well and by the seventh postoperative day all inflammation had resolved and the tear had healed nicely.
To Mr F’s surprise, a claim alleging negligence was brought by Miss T’s family. He was accused of ‘examining the eye roughly with a torch, when he knew this to be inadequate’, of failing to examine the eye in theatre under general anaesthesia, subjecting Miss T to unnecessary ‘torture’ by directing torchlight at the eye, failing to diagnose a perforation and foreign body, giving the wrong treatment and delaying removal of the splinter for 22 hours.
Was Mr F Negligent?