Clinical guidance key to hearing evidence

Oxfordshire-based practitioner Michael Barfield faced a charge of serious professional misconduct for failure to adequately test the eyes of an elderly patient. He was accused of not performing a visual field test, examining the optic fundi including the optic nerve heads or referring him to a medical practitioner on three separate occasions between 1998 and 2001. He admitted not having performed visual field tests, but denied serious professional misconduct.
Much of the hearing hinged on GOC evidence that visual field tests should always be performed on patients aged over 40 in accordance with guidelines from the AOP and the College of Optometrists and the expert advice of Dr Simon Barnard.
Barfield said he did not reject the professional bodies' guidance, but had exercised his clinical judgment on all three occasions. He said he now performs visual field tests on all over-40s because 'I don't want to come here again'.
His defence, the AOP's legal team, submitted a number of surveys showing half of the practitioners questioned did not regularly perform the tests, claiming Barfield's stance was in line with general everyday practice.
Bradley Albuery, representing the GOC, opened his case stating that Barfield was respected by the local community, had no previous charges against him and was a 'man of good character'. He said the case did not concern Barfield's general practice, but only referred to the three appointments of a man in his 80s, who was unable to attend the hearing because of ill health.
Barfield first examined the patient in 1998 when he visited him because he was dissatisfied with his former practitioner. He returned in 2000 complaining of a 'rapid deterioration of his eyesight'. There was evidence of a cataract, but not serious enough to be referred. His IOP had risen from 16 and 18 to 21 and 23, something that 'should have prompted a reasonably competent optometrist to perform more tests,' said Albuery. Barfield said he noted that the patient should return in six months for further IOP tests and he sent a reminder letter.
He returned for the last time in 2001, saying his sight was 'even worse'. Barfield told him there was no change in his IOP or visual acuity, and there was no reason to be referred.
The patient saw John Salmon, consultant ophthalmologist at Oxford Eye Hospital, in 2002, and was diagnosed with chronic glaucoma and cataract in his left eye.
Barfield was found not guilty of serious professional misconduct.
The issue of whether or not optometrists should carry out visual field tests on every patient over the age of 40 was raised this week at a hearing of the disciplinary committee of the GOC.
Oxfordshire-based practitioner Michael Barfield faced a charge of serious professional misconduct for failure to adequately test the eyes of an elderly patient. He was accused of not performing a visual field test, examining the optic fundi including the optic nerve heads or referring him to a medical practitioner on three separate occasions between 1998 and 2001. He admitted not having performed visual field tests, but denied serious professional misconduct.
Much of the hearing hinged on GOC evidence that visual field tests should always be performed on patients aged over 40 in accordance with guidelines from the AOP and the College of Optometrists and the expert advice of Dr Simon Barnard.
Barfield said he did not reject the professional bodies' guidance, but had exercised his clinical judgment on all three occasions. He said he now performs visual field tests on all over-40s because 'I don't want to come here again'.
His defence, the AOP's legal team, submitted a number of surveys showing half of the practitioners questioned did not regularly perform the tests, claiming Barfield's stance was in line with general everyday practice.
Bradley Albuery, representing the GOC, opened his case stating that Barfield was respected by the local community, had no previous charges against him and was a 'man of good character'. He said the case did not concern Barfield's general practice, but only referred to the three appointments of a man in his 80s, who was unable to attend the hearing because of ill health.
Barfield first examined the patient in 1998 when he visited him because he was dissatisfied with his former practitioner. He returned in 2000 complaining of a 'rapid deterioration of his eyesight'. There was evidence of a cataract, but not serious enough to be referred. His IOP had risen from 16 and 18 to 21 and 23, something that 'should have prompted a reasonably competent optometrist to perform more tests,' said Albuery. Barfield said he noted that the patient should return in six months for further IOP tests and he sent a reminder letter.
He returned for the last time in 2001, saying his sight was 'even worse'. Barfield told him there was no change in his IOP or visual acuity, and there was no reason to be referred.
The patient saw John Salmon, consultant ophthalmologist at Oxford Eye Hospital, in 2002, and was diagnosed with chronic glaucoma and cataract in his left eye.
Barfield was found not guilty of serious professional misconduct.