An optometrist who worked at two branches of Specsavers earlier this year has been accused of professional misconduct and poor professional performance over his treatment of over 30 patients, including the failure to identify serious eye conditions in several cases.
Nagesh Puranik appeared before a fitness-to-practise inquiry of CORU – the regulatory body of health and social care professionals – in relation to his work at the Mallow and Midleton branches of Specsavers in Cork in the first two months of 2022.
Mr Puranik, who attended the hearing via videolink, is facing a total of 36 allegations relating to his care of patients during eye tests he conducted between January 21 and February 8.
He joined Specsavers at the start of this year having spent most of his professional career over the past 15 years working in his native India.
He resigned on February 16 after less than a month in the job.
Counsel for CORU, Eoghan O’Sullivan BL, claimed all the allegations, if proven, amounted to poor professional performance in that Mr Puranik had failed to meet the standard of competence expected of a registered optometrist.
Mr O’Sullivan said the allegations against Mr Puranik also represented a breach of the code of professional conduct and ethics for optometrists.
In relation to some allegations, Mr O’Sullivan said it would be argued that they amount to professional misconduct.
Mr O’Sullivan said the majority of allegations related to claims that the optometrist had failed to perform appropriate eye examinations of patients and to identify correct prescriptions.
He said there were many cases where Mr Puranik failed to identify when photos or images of an eye were of inadequate quality to make a proper diagnosis.
Mr O’Sullivan said there were also allegations that he had failed to take appropriate action based on the clinical presentation by patients and failed to identify particular issues which should have been evident during eye tests.
In one case, he said the optometrist failed to identify macular holes in both eyes of an elderly patient in the Mallow outlet which he said should have warranted immediate referral to hospital.
The inquiry heard there were several cases where he had not noticed significant differences in the intraocular pressure of a patient’s eyes.
It is alleged he failed to identify keratoconus – a condition affecting the cornea which can lead to permanent loss of vision if untreated – in one patient.
In another case, Mr Puranik is accused of failing to identify the presence of cylinders in a patient’s eye which can cause blurred vision.
Mr O’Sullivan said he also failed to keep adequate clinical records of eye tests on patients.
The inquiry heard that CORU’s preliminary proceedings committee decided in May that Mr Puranik’s work required further investigation following a formal complaint.
Mr O’Sullivan said it would be claimed that the optometrist failed to inform Specsavers that he required some training before starting work with the company.
During induction at the Mallow branch, it was claimed the only issue of concern raised by Mr Puranik was that he was uneasy about treating children under 12 which Mr O'Sullivan said was not a problem for the branch’s directors, Ian and Ciara McCallum.
However, Mr O’Sullivan said concerns arose about his work within a few days because of the speed at which he was conducting eye tests.
The barrister said normal tests would last around 20 minutes but Mr Puranik was only taking five to 10 minutes on average to conduct examinations.
He said the McCallums were also concerned that very few of his patients required new prescriptions which was described as “extremely unusual”.
The inquiry heard the allegations related to 19 of 121 patients seen by Mr Puranik in Mallow and 12 of 28 patients seen by him in Midleton.
The FTP committee was informed that all affected patients seen by the optometrist had been recalled for a re-examination.
Mr Puranik, who qualified as an optometrist in India in 2007, complained that he only became aware of the detailed allegations against him last month.
He claimed he had not had the opportunity to examine all records he had been provided with in relation to patient files from the two Specsavers outlets, including some documents that he received only last week.
In correspondence with CORU, Mr Puranik rejected any suggestion that he posed a risk to the public and questioned how he could have had a long career without complaint if he was not competent.
The inquiry heard that Mr Puranik had returned to India after leaving his job in Specsavers but hoped to work in Ireland again.
The hearing is expected to last five days.