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A teenage boy has secured an €80,000 settlement of his High Court action taken after a HSE eye clinic failed to take steps when the boy was aged five to address a lazy eye problem. 
Mr Justice Garrett Simons said on Monday he was satisfied to approve the “very good” settlement offer from the HSE to Micheál Keane, now aged 14, of Abbeyknockoy, Co Galway. 
 
It was unfortunate there was a failure to sanction the “simple step” of wearing an eye patch over the boy’s good eye, requiring the other eye to work harder, the judge said. 
 
However, this injury was “a great deal less” than an eye injury valued at €120,000 under the Book of Quantum, which provides guidance in relation to awards for some personal injuries. 
 
The judge said he understood Micheál is a very bright child who might well have taken on careers such as a pilot or surgeon if he had better vision. 
 
It was most unlikely the child would have got more had the case gone to trial, there was a “significant risk” he could have done worse and the court had “no hesitation” approving this settlement offer, Mr Justice Simons said. 
 
Earlier, counsel for the boy said liability was conceded but the real issue in the case was causation of the injury. Experts for both sides agreed, when the child was examined aged five, his good eye should have been patched and the lazy eye worked harder and there was a lost opportunity to improve his vision at that stage. 
 
His current vision is 6/36 up to 6/18 with lens so there cannot be certainty he would have achieved 3D vision, counsel said. In the circumstances, the €80,000 offer was a good offer. 
 
In the action, Micheál, suing through his mother, Norrie Keane, alleged failure to properly examine him, to take account of his age and family history, to diagnose his condition and to undertake appropriate treatment. 
 
The child was aged five when he attended a school health screening concerning vision and hearing under a HSE screening service at Brierfield national school in Tuam. On examination, he had full vision in left eye and about 50 per cent vision in his right. 
 
He was referred to the HSE’s eye clinic in April 2012 with a referral note saying “lazy eyes”. On examination, his vision was recorded as full in left eye and it was noted he struggled with his right eye. Vision was recorded at 6/6-1 in his right eye and it was determined no glasses were necessary. 
 
A report obtained from an opthalmic surgeon for the proceedings said a diagnosis of amblyopia — lazy eye — was correctly made and it would have been correct at that stage to use some eye patching, patching the good eye for some hours daily to make him try and use the weak eye. 
 
The younger such treatment is done the better because, the longer it is left, the weaker the weak eye becomes, the surgeon reported. A patch should have been introduced at this initial visit when aged five, with monitoring and treatment adjusted depending on progress and the absence of follow up was “not acceptable”, he said. 
 
When Micheál was examined aged almost 10, it was noted he does not have, and will not develop, 3D vision, meaning his judgment of depth or height will always be defective, it was stated. 
 
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