Blindness and visual impairment cause life-changing disability and commonly feature in medical negligence claims. Whilst this devastating form of disability is sometimes the result of direct injury or damage to the eye, blindness and impaired eyesight can also arise from injury to the brain. When errors in maternity, neonatal, medical/surgical or ophthalmic care result in blindness or sight loss, the injured person may be entitled to make a compensation claim. We understand that compensation can’t reverse the injury or remove the injured person’s disability, but it can provide our clients with much-needed care and support, rehabilitation, specialist technology and other physical, psychological and financial assistance. With this help, our clients can and do improve their independence, mobility, communication and quality of life. What is cortical visual impairment (CVI) or cortical blindness? Cortical visual impairment, sometimes known as cortical blindness, is a condition which happens within the brain. The eyes can see but the brain cannot interpret what the eyes see. Children who suffer from CVI usually also have other serious neurological problems, such as cerebral palsy, caused by the same injury to their brain. Common causes of CVI include: perinatal hypoxia - oxygen deprivation around the time of birth, leading to hypoxic ischaemic encephalopathy or HIE; cerebral vascular accident – a stroke, in which the blood supply to the brain is disrupted by a blood clot or ruptured artery; meningitis – infection and inflammation of the protective lining (meninges) of the brain; acquired hypoxia – oxygen deprivation from other causes, such as cardiac arrest. Boyes Turner’s medical negligence solicitors have secured life-changing compensation settlements for many clients who have suffered cortical blindness along with other devastating neurological disability, such as HIE and cerebral palsy, as a result of mistakes in maternity or neonatal care. Severe birth injury disability and cortical blindness often occur together, because delays in delivery and/or resuscitation of a severely asphyxiated baby can cause damage to the brainstem or the visual cortex which processes visual information. Can kernicterus from untreated jaundice cause visual impairment? Kernicterus (also known as bilirubin encephalopathy) is a type of neonatal brain injury that can cause visual impairment along with severe neurological disability. Kernicterus brain injury occurs when a baby has too much bilirubin in their blood (hyperbilirubinaemia). Bilirubin is a natural, yellow pigment that is released into the bloodstream during the body’s normal process of breaking down old red blood cells. Bilirubin is processed in the liver and then stored in the bile duct and gallbladder, so that it can help the body digest fats in the small intestine (as bile). It is then passed out of the body with the rest of the body’s waste. If the newborn baby’s liver is unable to process all the bilirubin, the excess, unprocessed and highly toxic bilirubin can damage the baby’s brain and spinal cord, resulting in severe disability from cerebral palsy, learning disability, hearing loss and visual impairment. The first warning sign of bilirubin toxicity is jaundice. The excess, unprocessed bilirubin causes the yellow discolouration of skin and eyes that is known as jaundice and is commonly seen in newborn (particularly breastfed) babies. Neonatal jaundice is often transient and harmless but must be carefully monitored to ensure that, if needed, the baby has phototherapy or exchange transfusion treatment before their bilirubin reaches dangerous levels. Kernicterus brain injury is totally preventable and should not happen with correct monitoring and treatment. Visual impairment and other severe disability from kernicterus in babies usually only occurs where there has been substandard neonatal care. Can hypoglycaemia cause blindness or visual impairment to a newborn baby? Neonatal hypoglycaemia can cause neurodevelopmental disability, including cortical blindness or visual impairment. Neonatal hypoglycaemia (low blood sugar or glucose) is a metabolic condition that is common in newborn babies, particularly where the baby has a low birthweight, growth restriction (IUGR) or feeding difficulties, or their mother has diabetes. In the first few days of life, babies who have not yet settled into a regular feeding pattern often need help to maintain safe blood sugar levels. Early signs of hypoglycaemia can often be corrected by feeding the baby or, if necessary, by raising their blood glucose levels via an intravenous (IV) drip. Hypoglycaemia becomes dangerous when the newborn’s blood sugar is allowed to drop below a safe level. Without correct monitoring and treatment, a baby with hypoglycaemia can suffer permanent brain injury resulting in physical, learning, behavioural and visual disability. Unlike cerebral palsy, HIE birth injury and other types of neonatal brain injury, the child’s neurodevelopmental disability from hypoglycaemia may not be obvious to their parents in the child’s infancy and early years. The effects of injury from untreated neonatal hypoglycaemia might be mistaken for other things, such as behavioural problems or developmental learning challenges, until the true extent of the child’s disability is revealed by problems at school. What is retinopathy of prematurity (ROP)? Retinopathy of prematurity (ROP) is a condition which affects the eyesight of very premature babies who are born before their retina have fully developed. After premature birth, the baby’s retinal blood vessels develop abnormally leading to detachment of the retina and, ultimately, blindness. Premature babies who have very low birthweight or who have needed oxygen therapy to help them breathe owing to under-development of their lungs, are thought to be at increased risk of ROP. Premature babies are known to be at risk of ROP and must be carefully monitored so that treatment can take place at the correct time. Failure to monitor or to provide timely treatment for ROP can lead to permanent blindness. Infection, inflammation and raised intracranial pressure as a cause of blindness or visual impairment Blindness or visual impairment can also be caused by negligent medical management of other types of conditions which affect the brain and the optic nerve. These include infection, traumatic injury, strokes and tumours. Infections, such as meningitis or encephalitis, which cause inflammation within or around the brain can cause damage to the optic nerve, leading to visual impairment. Optic nerve damage can result in partial or complete sight loss in one or both eyes. Cortical blindness can also be caused by serious infection. Meningitis and viral encephalitis are medical emergencies which need urgent hospital admission and prompt treatment. Delays in diagnosis and treatment can lead to death or severe disability. Brain tumours can permanently impair the affected person’s sight if allowed to put pressure on the optic nerve. Strokes, brain haemorrhages and damage to the brain from cardiac arrest can also result in permanent loss of vision. Compensation for blindness and visual impairment from medical negligence Boyes Turner’s medical negligence solicitors are highly skilled and experienced in securing compensation for patients who have suffered cortical blindness and visual impairment as a result of negligent healthcare. Blindness, partial sight loss or visual impairment are often devastating and cause life-changing disability. Learning to adapt to living with blindness takes time, resources, care and support, and rehabilitation. Where the injury was caused or significantly worsened by medical negligence, we can help visually-impaired clients rebuild their lives and provide financial security by recovering substantial, individually tailored compensation. Depending on the severity of our client’s injury, their disability and personal circumstances, we can help recover compensation for: pain, suffering and disability arising from the injury; care and domestic assistance; case management; rehabilitation and therapies; specialist equipment; adapted accommodation; support with special educational needs (SEN); vocational retraining and support; transport and travel; financial losses, such as loss of earnings; medical costs. Recent compensation settlements in claims involving blindness and visual impairment from neurological injury include: £480,000 settlement for a child whose inevitable sight loss from a rare, benign brain tumour was made worse by a six-month delay in diagnosis by an optician; £18.1 million settlement for a child whose birth injury left him with maximum severity disability from whole body cerebral palsy, severe visual impairment, learning difficulties and epilepsy; $23 million settlement for a boy who suffered kernicterus brain injury, with disability including visual impairment, after community midwives failed to recognise and act on his signs of jaundice; £12 million settlement for a child who suffered a profound brain injury leaving her with maximum severity disability from four-limb dyskinetic cerebral palsy, including cortical visual impairment, as a result of maternity mistakes during a water birth labour; £2,225,000 settlement in a twin-to-twin-transfusion syndrome (TTTS) birth injury claim for a child with severe disability from spastic quadriplegic cerebral palsy, cortical visual impairment and severe learning difficulties; £150,000 settlement in a GP negligence claim for our client’s loss of central vision in one eye arising from the GP’s failure to refer her urgently to a stroke/TIA clinic for treatment of ‘amaurosis fugax’ (episodes of temporary loss of vision from lack of blood flow to the retina); Settlement providing a £3.25 million lump sum plus PPO payments of up to £320,000pa in a VBAC HIE birth injury claim for a girl who suffered maximum severity disability from quadriplegic cerebral palsy, including profound learning difficulties and impaired vision and language. If you or a family member have suffered severe injury as a result of medical negligence or have been contacted by HSSIB/MNSI or NHS Resolution you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.
