Medical Malpractice > Optometry Malpractice

ABOUT OPTOMETRY Malpractice

Optometry injuries or conditions causing vision loss can be scary for patients suddenly and unexpectedly experiencing a deficiency in one of their five senses. Optometrists must undergo a rigorous optometric doctoral program to practice in the field, but mistakes can and do happen. While negligence and optometry malpractice examples are less frequent than in other areas of healthcare, patients experiencing adverse effects from eye injuries or conditions, combined with an act of negligence or malpractice, can be left with a permanent decline in vision and many questions about their options in pursuing an optometry malpractice case.

According to the National Practitioner Data Bank (NPDB), there have been between approximately 100 and 250 combined instances of medical malpractice and adverse action reports filed against optometrists each year since 2000. Proving optometric negligence and medical malpractice in Indiana can be a difficult threshold to meet, and patients should consult with experienced Indiana eye injury lawyers as soon as possible to explore their circumstances and full legal options.

When Vision Loss is Medical Malpractice

If you’re searching for information about optometry malpractice, you may already suspect that something went wrong during your eye care. Perhaps your vision declined after a routine exam. Maybe your symptoms were dismissed or misunderstood, and a serious condition went undiagnosed. Or maybe a diagnosis came, but it came too late to prevent permanent or significant harm. These experiences are more common than many people realize, and they deserve thoughtful attention.

Optometrists are trained to identify and manage a wide range of non-surgical eye conditions. As primary eye care providers, they are often the first to evaluate symptoms such as blurry vision, eye pressure, flashes of light, or sudden changes in clarity. Because of this role, patients expect them to recognize red flags and know when to refer a patient to a specialist for advanced care.

When those signs are missed or ignored, or when referrals and treatment are delayed, patients may suffer injuries that proper care could have prevented. That’s the core of what defines malpractice: whether the provider failed to meet the accepted standard of care, what another trained optometrist would have done under the same circumstances.

Unlike surgical errors or acute medical crises, many optometry-related injuries develop gradually. You may have sensed that something was off as your symptoms worsened, yet received reassurance that everything was normal. You may have been given a new prescription or told to wait and see. And by the time a serious diagnosis, such as glaucoma, retinal detachment, or an ocular tumor, was finally made, options to fully protect your vision may have already narrowed.

That slow progression makes these cases especially difficult. The damage often unfolds quietly, and by the time the seriousness becomes clear, so much has already changed. If you’re questioning the care you received, you’re not alone. Many people are unsure whether their provider made a preventable error. Even if you aren’t certain, it’s worth taking the time to understand what happened—and whether better care could have made a difference.

A legal review can help bring that clarity. These cases typically involve careful evaluation of your records, expert consultation, and a detailed understanding of how optometrists are expected to respond to specific symptoms. An experienced legal team can help you make sense of complex medical information and determine whether you have a case.

For many of our clients, seeking answers is about more than compensation. It’s about understanding what happened. Making sure what happened to them is acknowledged—and not repeated.

If you’ve experienced lasting vision loss after optometric care, and you believe something about your treatment didn’t align with what you needed or expected, learning more about your options is a meaningful next step.

The Most Common Causes of Optometry Malpractice

Misdiagnosis

In a 2017 University of Michigan study, researchers found 22% of all paid medical malpractice claims are related to mistakes made during initial diagnoses.

By comparison, a failure to properly diagnose eye injuries or conditions accounts for approximately 45% of optometry malpractice claims, according to the NPDB. Glaucoma, retinal detachment, and tumors are among the conditions most frequently overlooked during diagnoses.

Many forms of glaucoma don’t display apparent symptoms or warning signs, and effects can develop so gradually that patients may not recognize a noticeable change in their vision until the condition is in its later advanced stages, leading to blindness. Clinical signs and symptoms can be missed if a patient’s analyses are performed improperly, such as failing to fully dilate a patient’s pupils during an examination. 

An improper initial diagnosis can lead to physicians performing or ordering irrelevant tests and treatments that could fail to control progression, worsen certain conditions, and cause serious harm to patients.

Delayed Diagnosis

If an optometrist fails to diagnose a patient’s condition early enough, the undetected and underlying disease or illness can progress and further worsen a patient’s vision.

Patients could also be subject to a negligent delay of critical care if an optometrist fails to refer them to a necessary specialist for further testing or treatment. 

Surgical Errors

Eye surgeries require meticulous technique and a deep understanding of ocular anatomy. Even a slight deviation from standard procedure—just a few millimeters or a brief lapse in attention—can result in permanent vision loss. According to the American Academy of Ophthalmology, nearly two-thirds of surgical errors in ophthalmology are preventable. Many involve wrong lens implants, anesthesia mistakes, inaccurate measurements, or even operating on the wrong eye.

These mistakes are not minor. They can alter a patient’s life forever. When a provider implants the wrong lens, overlooks a necessary test, or misidentifies the surgical site, the consequences go far beyond inconvenience or temporary discomfort. These errors often signal a failure to meet the expected standard of care and may warrant further legal review.

In complex procedures such as cataract removal, corneal transplants, retinal repairs, or vitrectomies, the stakes are particularly high. Surgeons must work within tight spaces using extremely fine instruments. A single slip or tool misplacement can damage the cornea, retina, or optic nerve. Unlike many other parts of the body, these structures do not heal easily. The damage may be permanent, reducing vision or eliminating it altogether.

Infection also remains a leading concern after eye surgery. Some surgical centers rely on small autoclaves or rapid manual cleaning that may not fully sterilize delicate instruments. Even minor shortcuts in sanitization—such as insufficient rinsing or skipped steps—can allow bacteria to enter the eye. When infections like endophthalmitis set in, vision can deteriorate rapidly, sometimes within hours. If the surgical team fails to recognize and treat the problem right away, the damage can be irreversible.

Post-operative care plays an equally important role in patient outcomes. Providers must monitor recovery closely, follow up on reported symptoms, and respond quickly to any signs of trouble. Unfortunately, some providers fail to act when patients describe pain, blurriness, or unusual light sensitivity. When a surgeon dismisses these concerns or delays follow-up care, the opportunity to prevent permanent injury may be lost.

Patients should not assume that post-surgery discomfort or vision changes are normal, especially when they worsen or persist. Trust your instincts. If your care team avoids your questions, fails to explain what’s happening, or tells you to “wait and see” without clear justification, those responses may be worth a second look.

These preventable breakdowns in care often form the basis of a legal claim for vision damage. Medical records, imaging results, and your documentation of symptoms can help clarify whether the care you received aligned with professional standards.

If you are recovering from eye surgery and something doesn’t feel right, you are not alone. Many patients have faced similar challenges. Knowing what errors to look for and understanding how complications may qualify as medical negligence can help you determine whether to pursue legal action.

Proving Negligence and Optometry Malpractice

Medical negligence and malpractice lawsuits are complex and challenging to prove. An initial misdiagnosis, or cases in which patients experience negative results despite proper treatment but are dissatisfied with a provider’s effectiveness, do not automatically constitute negligence or malpractice.

A successful medical malpractice lawsuit must meet the legal definition of negligence by satisfying four key elements:
 

1. Showing there was a duty of care between the patient and healthcare provider established by the existence of a doctor-patient relationship. Any devolving or “disengaging” of a doctor-patient relationship or referral of an outgoing patient should always be documented in writing.

2. Proving a breach of duty or that accepted standards of care were not met. There must be evidence that services or treatment provided fell below the standards of care that a reasonable optometrist would and should have administered in the situation. The standards of eye care are generally well-established by the American Optometric Association. However, the measuring stick for “reasonable” care, skills, and decisions made by a patient’s provider continues to evolve, as do the tools and treatment protocols for specific injuries and conditions.

3. The patient and their legal team must prove that harm or injury occurred. In the field of optometry, the most likely evidence of harmful damage includes permanently blurred or lost vision.

4. A patient’s medical malpractice attorneys must prove that the optometrist’s actions—or negligent inaction—were the direct causation of their client’s injury or harm. The causes and effects involved are crucial elements of every medical malpractice claim. A successful negligence and malpractice claim must prove that a provider’s misdiagnoses or improper treatment caused the preventable loss or unnecessary damage. Unpreventable damage or harm caused by an untreatable condition, even if initially misdiagnosed by an optometrist, does not constitute malpractice by the provider.

Optometry vs. Ophthalmology Malpractice: What’s the Difference?

When vision problems arise after eye care, patients often ask whether they may have an optometry malpractice or an ophthalmology malpractice claim. The terms are sometimes used interchangeably, but they involve different providers, different standards of care, and different paths to accountability. Understanding the distinction helps clarify whether you have a case, what evidence matters most, and how an attorney can pursue justice on your behalf.

Optometrists are licensed eye care professionals who provide front-line services such as:

• Routine eye exams and vision screenings
• Diagnosing conditions like cataracts, glaucoma, and dry eye
• Prescribing glasses, contact lenses, and certain medications
• Offering pre- and post-surgical care in coordination with ophthalmologists

Because optometrists are not medical doctors, they do not perform surgery. Still, they play a critical role in diagnosing problems early and guiding patients to appropriate treatment.

Optometry malpractice occurs when an optometrist fails to meet accepted standards of care. Examples include:

• Missing or misdiagnosing cataracts, glaucoma, or retinal disease
• Prescribing the wrong corrective lenses, worsening vision
• Overlooking systemic conditions such as diabetes or hypertension that affect eye health
• Failing to refer a patient promptly to an ophthalmologist when surgery is needed
• Ignoring or downplaying dangerous post-surgical symptoms in a co-management role

When these lapses cause preventable harm, patients may have grounds for an optometry malpractice claim.

What Is Ophthalmology Malpractice?

Ophthalmologists are medical doctors (MDs or DOs) who treat complex eye diseases and perform surgery, including:

• Cataract surgery
• LASIK and other refractive procedures
• Retinal and corneal surgery
• Management of advanced glaucoma and macular degeneration

Ophthalmology malpractice occurs when a surgeon’s actions fall below accepted medical standards. Examples include:

• Wrong-site or wrong-lens cataract surgery
• Surgical errors that damage delicate eye structures
• Poor sterilization leading to infections such as endophthalmitis
• Delayed or improper response to complications like retinal detachment or dangerous pressure spikes
• Inadequate documentation or failure to secure informed consent

Because ophthalmologists operate within such narrow surgical margins, even small mistakes can lead to permanent vision changes or blindness.

How They Intersect in Real Cases

In many situations, patients are treated by both optometrists and ophthalmologists. For example:

• An optometrist diagnoses cataracts and refers the patient for surgery.
• An ophthalmologist performs the procedure.
• The patient returns to the optometrist for follow-up monitoring.

If something goes wrong, liability may rest with either provider, or both. An optometrist might miss post-surgical warning signs, while an ophthalmologist might implant the wrong lens. Sorting out responsibility requires careful review of records, imaging, prescriptions, and clinical notes.

Does the Distinction Matter for Your Claim?

To a patient, the line between optometry and ophthalmology malpractice may not seem important — what matters most is that your vision was harmed. Legally, however, identifying the correct provider is essential because it determines:

• Which medical experts should review your case
• The standards of care that apply
• How responsibility is assigned between providers
• What evidence will be most persuasive in a claim or settlement

An experienced malpractice attorney will untangle these details for you, ensuring the right claims are pursued against the right parties.

LASIK Co-Managed Care: Where Gaps Arise and How Negligence Can Occur

LASIK surgery reshapes the cornea to reduce or eliminate patients’ need for glasses or contacts. Many practices use a co-management model for LASIK procedures, in which an optometrist screens and handles most follow-up care and an ophthalmologist performs the surgery. Co-management can work well when teams coordinate tightly, but problems and opportunities for negligence can arise when roles blur or communication breaks down.

Before Surgery: Screening, Risk Flagging, and Referral

Optometrist Responsibilities

The optometrist establishes candidacy, optimizes the ocular surface, and flags potential risks. Negligence can occur when an optometrist:

• Skips topography/tomography, pachymetry, or tear assessment.
• Misses ectasia risk factors, such as thin corneas, suspicious maps, high myopia, or keratoconus history.
• Sends a patient forward without stabilizing significant dryness or inflammation.
• Sets unrealistic expectations that the surgeon’s plan cannot meet.

Ophthalmologist Responsibilities

The surgeon confirms candidacy and measurements, reviews records, and tailors the procedure plan. Negligence can occur when a surgeon:

• Accepts outside numbers without repeat confirmation.
• Proceeds despite documented red flags.
• Chooses an incorrect ablation profile or skips device calibration.

Both providers should sign off on candidacy, document a shared plan, and agree on who owns last-minute decisions and patient communication.

Day of Surgery: Plan Execution and Real-Time Updates

The ophthalmologist must verify the patient’s condition, recheck refraction and keratometry, confirm laser settings, and note any intraoperative issues. Negligence can occur if the surgeon withholds operative details that change follow-up needs, such as flap complications or suction loss.

The optometrist assumes risk if they resume routine care without reviewing the operative notes and updated instructions.

After Surgery: Follow-Up, Escalation, and Shared Accountability

Optometrist Responsibilities

The optometrist leads early follow-up, monitors for epithelial ingrowth or interface inflammation, tracks refraction and corneal shape, and manages dryness. Negligence can occur when the optometrist:

• Dismisses escalating pain, photophobia, worsening glare, or persistent blur.
• Delays referral back to the surgeon or a cornea subspecialist.
• Alters steroids or antibiotics without coordination.

Ophthalmologist Responsibilities

The surgeon remains available for any complications that require surgical judgment. Negligence can occur when the surgeon:

• Limits access for urgent co-managed concerns.
• Declines to see a patient despite red-flag symptoms.
• Defers enhancement or medication decisions without clear parameters.

Optometrist and ophthalmologist teams should share the operative notes and laser logs the same day, and set explicit thresholds for a patient’s urgent return related to pain, discharge, decreasing vision, or a surge in nighttime glare.

LASIK co-management can increase a patient’s exposure to negligence when records conflict or no one provider owns a decision. Each clinician should document candidacy rationale, the surgical plan, post-op instructions, and every escalation. Clear written roles—who measures, who decides, who follows, and who calls—support safe, effective, and negligence-free LASIK care.

Pursue Justice with the Optometry Malpractice Attorneys at Montross Miller

Time is of the essence in any medical malpractice case, although it’s especially critical when proper care and treatment could mean saving a patient’s long-term eyesight.

An experienced negligence and malpractice attorney from Montross Miller can help answer questions, obtain medical records, negotiate a settlement, or file a claim within Indiana’s two-year statute of limitations. 

Contact the Montross Miller team today if you believe you or a loved one have experienced optometry malpractice. Our experienced malpractice attorneys and medical professionals can review your specific circumstances, answer any questions, and provide the guidance you need.