Professor Bruce Evans: Expert witness work

Professor Evans has been involved as an expert witness in several cases over the last 10 years. These have included civil litigation and complaints brought before the General Optical Council Disciplinary Committee. He has taken instructions from solicitors (for both prosecution and defence), the Association of Optometrists, and from PCTs. The table below gives a general description of some of the cases on which he has provided reports. Professor Evans’ fees for expert witness work are £120 per hour.

General allegation	Explanation
Did the optometrist fail to detect and treat or refer strabismus (squint) in a child?	Professor Evans has provided expert advice in several cases of this type. Often, the issue revolves around whether the optometrist took adequate steps to detect the main risk factor for a convergent squint: long-sightedness.
Did the optometrist fail to detect and treat or refer amblyopia (lazy eye) in a child?	The amblyopia usually results from either strabismus or anisometropia, which may not have been detected by the optometrist.
Did the optometrist fail to adequately treat amblyopia (lazy eye)?	Amblyopia is usually treated by patching before the age of 7-8 years. Optometrists can treat the condition or refer, but treatment needs to be appropriate.
Did the optometrist carry out an adequate eye examination of a child?	Children can be difficult to examine. The clinical records are of paramount importance in these cases. The decision about whether to use cycloplegic drops can also be pivotal.
Did the optometrist fail to detect a decompensating binocular vision anomaly in an adult?	The binocular vision anomaly might be a long-standing muscle weakness or heterophoria. Decompensation should be detected because early intervention might be most effective.
Did an optometrist fail to prescribe precision tinted lenses with enough accuracy?	Precision tinted lenses can be helpful for some people with reading difficulties (Meares-Irlen Syndrome), migraine, or photosensitive epilepsy. Appropriate testing and prescribing can be important.
Was an optometrist negligent for failing to detect a retinal detachment?	Professor Evans has been involved in research evaluating the content of optometric eye examinations for patients with symptoms suggestive of a retinal detachment. He is able to comment on the eye examination that should be expected of a reasonably competent optometrist.
Is an optometrist making inappropriate claims from the NHS for children’s spectacles?	Usually, only a small proportion of optical prescriptions include prisms. On more than one occasion, the NHS has investigated an optometrist who prescribes prisms to a high proportion of children’s prescriptions.