Modern OptometryLegal Liability Issues in Keratoconus

An optometrist — and lawyer — provides some helpful tips and advice.

Primary care optometrists and ophthalmologists are vulnerable to legal risks when treating patients with keratoconus (KC). By failing to properly detect, refer, or appropriately recommend specialists for this eye condition, they expose themselves to potential malpractice claims. This article discusses three types of legal risks that eye care providers should be aware of in order to avoid liability.

HCN Medical Memo
For physicians, understanding the legal landscape surrounding the treatment of keratoconus is crucial for practice management. Failure to adapt to updated guidelines and procedures may not only affect patient care but also expose you to considerable legal risks. Keeping abreast of scientific advancements and incorporating them into your standard procedures is more than good practice—it’s a legal imperative.

Key Points

• Failure to Detect: Standard equipment like slit lamps and keratometers can detect KC. Missed early detection puts the provider at legal risk.
  • Physician Perspective: The case of a patient in his 30s highlights the importance of early detection to avoid legal complications.
• Failure to Refer: Standards of care now demand earlier referrals for treatments like corneal cross-linking (CXL), shifting away from just monitoring.
  • Physician Perspective: Ignoring guidelines from the American Academy of Ophthalmology on KC treatment jeopardizes the provider’s legal standing.
• Improper Referral: Referring to specialists who don’t follow FDA-approved treatments may expose the referring provider to legal risks.
  • Physician Perspective: An example involving a 19-year-old patient illustrates the repercussions of improper referral.

“As a lawyer specializing in health care law, I can attest that many more malpractice suits are settled quietly out of court. The doctors involved avoid a trial, but the experience is stressful, expensive, time-consuming, and psychologically draining.”
– Katie Gilbert-Spear, OD, JD, MPH

Additional Points

• Standard of Care: Constantly evolving, and varies by region; physicians should adhere to the latest formal guidelines.
• Patient Non-Compliance: Document cases where patients refuse treatment or fail to schedule appointments to protect against claims.
• In-House Policies: Standard procedures for follow-up with diagnosed patients can act as legal safeguards.

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