Ophthalmology IME Services
An ophthalmology IME is an independent medical examination of an eye or vision claim by an ophthalmologist who has no treatment relationship with the examinee, producing an objective evaluation for use in personal injury litigation, disability determinations, and liability matters. Marc H. Shomer, MD, PhD, QME performs ophthalmic IMEs in person nationwide by arrangement and provides remote record review where an in-person examination is not required.
Where Ophthalmic IMEs Arise
Unlike the QME process, which is specific to California workers' compensation, the IME is a general instrument used across civil contexts:
- Personal injury. Motor vehicle collisions, falls, assaults, and product incidents producing claimed eye injury or vision loss. The IME tests whether the claimed deficits are present, measurable, and attributable to the incident.
- Disability claims. Private disability insurers and government agencies request independent assessments of whether documented visual impairment supports claimed functional limitations — whether an insured can drive, read, or perform occupational tasks.
- Liability and other civil matters. Premises liability, alleged toxic exposures affecting vision, and disputes over the extent of injury in settlement negotiations.
Where the dispute concerns the quality of prior eye care rather than the extent of injury, the appropriate engagement is usually expert witness consultation on standard of care and causation rather than an IME of the claimant.
What an Ophthalmic IME Includes
A properly conducted IME has three components: record review, examination, and a written report.
Record review first. The examination is interpreted against the medical history, so the review comes first: acute-care records from the incident, all subsequent eye care, prior eye examinations establishing baseline vision, and relevant systemic history (diabetes, hypertension, prior surgery). Reviewing actual test printouts — visual fields, OCT scans — rather than summaries avoids inheriting earlier interpretive errors.
The examination. A comprehensive ophthalmic evaluation: best-corrected visual acuity (BCVA), refraction, pupillary testing, ocular motility, intraocular pressure, slit-lamp examination, and dilated retinal examination. Objective testing is added as the issues require — automated perimetry to quantify visual field loss, OCT (optical coherence tomography, an objective cross-sectional retinal scan) to document structural injury, and consistency testing where reported vision loss is out of proportion to the findings. Because several key tests do not depend on the examinee's answers, an ophthalmic IME can be unusually objective compared with examinations that rest mainly on reported symptoms.
The report. The written product addresses diagnosis, causation, the presence and degree of measurable impairment, prognosis, and — where requested — functional capacity and future care. Opinions are stated to a reasonable degree of medical probability, with the reasoning shown and genuine uncertainty acknowledged.
Key point: Ophthalmology is well suited to independent examination because so much of the evidence is objective. OCT imaging, pupillary responses, and structure-function correlation allow claims of vision loss to be tested rather than simply credited or doubted.
Causation: The Central Question
The recurring IME question is not whether the examinee has an eye condition but whether the incident caused it. Cataracts, macular degeneration, glaucoma, and diabetic retinopathy are common in the general population and progress on their own; an incident can be temporally associated with a diagnosis without having caused it. The analysis turns on mechanism plausibility, injury pattern, timing, and baseline records. The report should distinguish association from causation explicitly, and address reasonable alternatives — pre-existing disease, natural progression, unrelated pathology — rather than ignoring them.
What an IME Cannot Determine
An IME is a snapshot. It cannot recreate the eye's condition on the day of a years-old incident — contemporaneous records must supply that. Purely subjective symptoms such as glare sensitivity or visual fatigue can be assessed for consistency with objective findings but not directly measured. And the examiner offers medical opinions only; questions of legal liability remain with counsel and the trier of fact.
Arranging an Examination
Dr. Shomer performs in-person IMEs nationwide by arrangement, subject to scheduling; Nevada logistics are described on the Nevada IME page. For matters elsewhere, he provides nationwide remote record review, with travel by arrangement where an in-person examination is essential. Requesting parties should provide complete records, actual imaging and field printouts, and a focused list of the questions the report should answer.
Frequently Asked Questions
What is included in an ophthalmology IME?
A complete record review, a comprehensive eye examination (visual acuity, refraction, pupils, pressure, slit-lamp and dilated examination), objective testing such as automated visual fields and OCT as indicated, and a written report addressing diagnosis, causation, impairment, and prognosis to a reasonable degree of medical probability.
Who requests ophthalmic IMEs?
Defense and plaintiff counsel in personal injury litigation, disability insurers, third-party administrators, employers, and government agencies. The requesting party frames the questions; the examiner's opinions are independent of who made the request.
Can an IME detect exaggerated or non-organic vision loss?
Often, yes. OCT imaging, pupillary responses, electrophysiology where needed, and internal consistency checks are independent of the examinee's answers, so claimed vision loss can be compared against objective structure and function. The report describes what the objective evidence supports rather than labeling the examinee.
Where does Dr. Shomer perform IMEs?
Nationwide. His office in Upland, California is fully equipped for examination, and he travels elsewhere by arrangement, subject to availability. Where an examination would not change the analysis, remote record review alone is often the more efficient course.
Educational information only. This page provides general information for attorneys and other medical-legal professionals. It is not medical or legal advice, does not address any particular case, and does not create a physician-patient, attorney-client, or expert-client relationship. Opinions in any matter are formed only after review of the specific records, examination findings, and applicable literature. Past engagements do not guarantee any result.
Board-certified ophthalmologist; Adjunct Associate Professor of Ophthalmology, Keck School of Medicine of USC; active California Qualified Medical Evaluator. Full biography · Curriculum vitae
Published August 2, 2026 · Last substantive review August 2, 2026 · Medical reviewer: Marc H. Shomer, MD, PhD, QME
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