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GPs warned of claims over failure to diagnose rare eye condition

20 December 2007

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GPs have been alerted to the danger of failing to diagnose an uncommon condition that can lead to blindness.

In the latest edition of the Medial Defence Union (MDU) Journal, ophthalmologist Mr Paul Riordan-Eva examines where difficulties can arise in diagnosing giant cell arteritis (GCA), which most GPs will only encounter in one or two patients during their careers.

Around 3% of cases notified to the MDU by GPs relate to ophthalmic conditions, and over a recent five-year period the MDU settled 51 claims aris ing from ophthalmology in primary care.

Cases arising from GCA were responsible for the largest value settlements, even though the condition was the second most common cause of claims (the most common being delayed diagnosis of retinal detachment).

Compensation payments for ophthalmic claims ranged from £90,000 to £700,000. The reason for the large awards is mainly because GCA can rapidly result in severe visual impairment in both eyes if not treated promptly.

Mr Riordan-Eva commented: “GCA is uncommonly seen in primary care, but by being aware of some typical features GPs can make an early diagnosis and patients may avoid loss of vision or even blindness.

“Symptoms to look out for include severe headache, scalp tenderness, or jaw pain in patients over 50, especially in the setting of sudden loss of vision.

“If GPs suspect GCA it is crucial to start, or arrange emergency hospital referral for, treatment with high-dose systemic steroids, which usually will prevent further loss of vision.

“In general, it is preferable that some patients receive a short course of treatment unnecessarily than others suffer loss of vision due to delay in treatment.”