Detecting eye problems in babies

A woman complained that her newborn baby had been discharged from hospital without a health examination. A congenital cataract had not been detected, and this led to a delay in diagnosis and treatment of the cataract. As a result, the baby developed a significant visual impairment.

The Commission referred this matter for assisted resolution. Both the mother and the hospital agreed to participate in the process.

The Resolution Officer discussed the hospital’s response to the complaint with the mother. The hospital explained that not all babies were assessed by a doctor before discharge. Babies not assessed by a doctor are assessed by a midwife. A midwife’s assessment includes an examination of the baby’s eyes, but they do not perform the ‘red eye reflect’ test for detecting a cataract, because they are not trained to use an ophthalmoscope.

After this explanation, the mother criticised the hospital for not telling her at the time of discharge that her baby had not been examined by a doctor, and that the midwife had not carried out a full test for cataracts. She asked whether it was possible to train midwives to carry out this test.

The Resolution Officer organised a meeting between the mother and representatives of the hospital to discuss these issues.

The hospital said that, in future, midwives would provide a more detailed explanation of what tests had and had not been conducted. In addition, the standard discharge letter would be amended to make clear whether the baby had been examined by a doctor before discharge, and that a general practitioner should further examine the baby’s eyes, hips and heart. The hospital also agreed to train midwives in the use of the ‘red eye reflex’ test, and would buy additional ophthalmoscopes for them.

The mother was pleased with this outcome.

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