Workplace Eye Injury Expert Witness

The injuries that reach litigation

• Corneal and conjunctival foreign bodies from grinding, drilling, hammering or metalwork. Most heal without sequelae; the litigated ones involve a retained fragment, an infected ulcer, a scar in the visual axis, or a missed intraocular foreign body behind a small entry wound.
• Chemical exposure from cleaning agents, cement, plaster, industrial solvents or batteries. Alkali injuries penetrate deeper than acids, and the adequacy and timing of irrigation at the scene and in the emergency department are often the central questions. See Chemical Eye Injury.
• Ultraviolet keratitis (welding flash or arc eye), painful but usually self-limited; a claim of lasting loss after a flash burn calls for careful correlation with the examination findings.
• Blunt trauma from tools, straps, falling objects or falls, producing hyphema, angle recession, traumatic cataract, commotio retinae or orbital fracture. See Blunt Eye Trauma.
• Penetrating and perforating injury from nails, wire, glass and high-speed fragments. See Penetrating Eye Injury.
• Delayed consequences that surface months or years later: angle-recession glaucoma, traumatic cataract, epiretinal membrane, or a retinal detachment from a tear created at the time of injury. These late sequelae are where causation is most often contested.

What the records usually show, and what they miss

The first record is typically an urgent care or emergency department note, followed by an occupational medicine visit and, if the injury is significant, an ophthalmology referral. The documents that decide the case are often the ones nobody requested: the pre-injury optometry record that fixes baseline vision, the safety incident report describing the mechanism, and the ophthalmology chart with its imaging in native digital format. The absence of a dilated fundus examination in the first weeks after a blunt injury is a recurring finding, and it matters because a peripheral retinal tear or early angle recession is invisible without one.

Causation and apportionment

Workplace claims often involve an eye with a history. Diabetic retinopathy, glaucoma, high myopia, prior surgery or an earlier injury can each account for part of the present impairment. In California workers’ compensation, Labor Code sections 4663 and 4664 require the evaluator to state what percentage of the permanent disability was caused by the industrial injury and what percentage by other factors, with the reasoning shown. The method is explained at Apportionment in Ophthalmic Injury Claims and illustrated in a worked example.

Impairment rating

Permanent visual impairment is rated from best-corrected visual acuity, visual field extent and, where present, diplopia and other functional deficits, using the AMA Guides framework and, in California, the Schedule for Rating Permanent Disabilities. The rating is only as good as the underlying testing: an unreliable visual field or an uncorrected refraction produces a number that will not survive review. See Whole Person Impairment for Vision Loss and Visual Disability Evaluation.

Roles Dr. Shomer serves in workplace matters

• California Qualified Medical Evaluator or Agreed Medical Evaluator in disputed workers’ compensation claims. See Eye Injury QME Evaluations.
• Independent medical examiner for carriers and third-party administrators in California and Nevada.
• Retained expert for plaintiff or defense counsel in third-party actions arising from workplace injuries, including product and premises claims, where the workers’ compensation exclusivity rule does not bar suit.

What attorneys should gather

The incident report and any photographs of the scene or the object; the emergency and occupational medicine records; every ophthalmology and optometry record before and after the injury; imaging in native format; and the safety program documentation covering eye protection for the task. The general checklist is at Attorney Checklist for Eye Injury Cases.

Frequently Asked Questions

Authorities Cited

Primary sources referenced on this page. Links open the official text on the publishing agency’s site.

• California Labor Code section 4663 (apportionment of permanent disability to causation)
• California Labor Code section 4664 (employer liability limited to the percentage of permanent disability directly caused by the injury; prior awards)
• California Labor Code section 139.2 (appointment and reappointment of Qualified Medical Evaluators)
• Division of Workers’ Compensation, Qualified Medical Evaluator process
• American Medical Association, Guides to the Evaluation of Permanent Impairment (program page)
• California Schedule for Rating Permanent Disabilities (2005), Division of Workers’ Compensation