Articles for attorneys, claims professionals and medical-legal audiences on how ophthalmic evidence is evaluated: what the testing shows, how causation is reasoned, and what distinguishes a rigorous medical-legal evaluation from an advocacy opinion.
All articles are authored and reviewed by Marc H. Shomer, MD, PhD, QME, board-certified ophthalmologist and active California Qualified Medical Evaluator.
August 2, 2026 · Marc H. Shomer, MD, PhD, QME
Two board-certified ophthalmologists can read the same chart and reach different conclusions without either one being dishonest or incompetent. Most of the time, the divergence traces to something identifiable: they assumed different facts, they weighted the same findings differently, they were…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
An eye is permanent and stationary, the California workers' compensation term for what other systems call maximal medical improvement, when its condition has stabilized and is not reasonably expected to change materially over the next year, with or without further treatment. The determination…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
Non-organic visual loss, also called functional visual loss, describes reported vision worse than the visual system's measurable capacity. It is a descriptive finding about test results, not a statement about character or intent, and the distinction matters clinically and legally.…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
In retinal detachment litigation, one anatomic fact organizes almost everything else: whether the macula was still attached when the patient was seen. A macula-on detachment threatens central vision that is still intact and is treated as a surgical urgency; a macula-off detachment has already…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
Apportionment in California workers' compensation is a reasoning exercise, not an arithmetic one. Labor Code sections 4663 and 4664 require an evaluator to determine what caused the permanent disability and to assign portions of it to industrial and non-industrial factors, and a percentage…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
The letters QME after a physician's name denote a specific, state-issued distinction: appointment by the Administrative Director of the California Division of Workers' Compensation as a Qualified Medical Evaluator, earned by examination and maintained through continuing education and periodic…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
The four labels attach to different things: QME is a state-issued designation, AME is a role created by the parties' agreement, IME is a category of examination, and expert witness is a litigation function. One physician can hold or serve in all four, but each carries its own selection process,…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
No other sensory organ can be measured as objectively as the eye. Its structures can be photographed and scanned at micron resolution, its function mapped point by point, and its electrical responses recorded without any voluntary participation by the examinee. For litigation, this has a…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
Causation analysis in a vision loss claim is a structured comparison: what the eye could do before, what happened to it, what it can do now, and whether the alleged event, as opposed to the other candidates, best explains the difference. "My vision is worse since the accident" states an…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
The recurring problems in eye injury litigation are rarely exotic: they are a handful of structural mistakes that repeat across firms, case types, and both sides of the v. Each is understandable: ophthalmic records are dense, the specialty is technical, and busy dockets reward triage. But each…
Read the full article →August 2, 2026 · Marc H. Shomer, MD, PhD, QME
A rigorous ophthalmic medical-legal report has a recognizable anatomy: an inventory of everything reviewed, a documented history, detailed examination findings, diagnoses, direct answers to the referral questions, transparent causation reasoning, apportionment where the venue requires it, and an…
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