by Mr Lorcan Butler
Mr Lorcan Butler – Dispensing Optician and Optometrist
With over twenty years’ experience across Ireland, the UK and New Zealand, Mr Lorcan Butler brings extensive clinical expertise and a strong commitment to patient safety to his role as a clinical expert witness. A qualified Dispensing Optician and Optometrist, his practice spans the full spectrum of eye care, including cataracts, glaucoma, diabetic and neuro-ophthalmic disease, and complex visual field disorders.
A Clinician with a Passion for Education and Standards
Mr Butler’s early career was rooted in primary care optometry, where he built his reputation for patient-centred care and clinical precision. Over time, his interest expanded beyond the consulting room to education, policy and professional governance. As a former council representative for the College of Optometrists, he became deeply involved in promoting excellence across the profession, combining hands-on clinical work with broader initiatives in practitioner training and patient safety.
From Clinical Practice to Expert Witness Work
Mr Butler’s move into medico-legal work stemmed from a desire to protect patients from substandard or commercially driven practice. He notes that the growing commercialisation of high-street optometry can sometimes compromise care standards, particularly among locum practitioners who now comprise around a third of the UK workforce.
“Everyone deserves the same high standard of eye care, regardless of where they attend for their examination.”
The Optometrist’s Role in Early Detection
Mr Butler is also widely recognised for his work in brain tumour awareness and education, including his involvement with The Brain Tumour Charity. He emphasises that while only around 30% of brain tumour patients initially present with visual symptoms, the optometrist’s role can be pivotal in early detection.
“We have a duty of care to every patient, and when something doesn’t look right, we can refer urgently. Optometrists are often the first to identify subtle visual or neurological signs that point to a deeper problem.”
However, he highlights that many patients first visit their GP or pharmacist, often several times, before seeing an optometrist. By the time 60% of brain tumour cases reach A&E, prognosis is typically poor.
“Earlier referral and better awareness, both among the public and GPs, could transform outcomes.”
Clinical Themes in Negligence Cases
In his expert witness work, Mr Butler frequently encounters recurring patterns in delayed or missed diagnoses, including failure to conduct appropriate tests, inadequate safety-netting, and poor communication. His comprehensive clinical background allows him to advise legal teams on whether accepted standards of practice were met, particularly in cases involving optic nerve disorders, neurological symptoms, or systemic disease manifesting in the eye.
“With experience across both paediatric and adult populations, I have a clear understanding of which tests should be undertaken, when referral is warranted, and how each presentation should be managed. This insight is crucial when evaluating the validity and strength of a case.”
The Honey Rose Case
The Honey Rose case (2013) in which a locum optometrist failed to detect hydrocephalus in a young patient who later died illustrates just how critical early detection and appropriate referrals are. The case led to the first manslaughter conviction of an optometrist in the UK and a surge in defensive referrals to secondary care.
World Sight Day
Reflecting on World Sight Day (9th October), Mr Butler highlights the broader public health importance of regular eye examinations.
“Optometrists do far more than prescribe glasses. We can detect early signs of high blood pressure, diabetes, stroke and even brain tumours. Yet many patients see their GP and pharmacist before ever considering an optometrist. That delay can have life-changing consequences.”
He welcomes recent safety initiatives such as ‘Jess’s Rule’ (introduced in 2025), which encourages GPs to review and refer after three unresolved consultations, promoting accountability and earlier intervention across healthcare disciplines.
A Commitment to Excellence
What continues to motivate Mr Butler is a clear sense of professional integrity.
“As optometrists, we are specialists in the eyes. Maintaining trust, respect and excellence in our work benefits not only patients, but the wider healthcare system. My medico-legal work is an extension of that commitment, protecting patients, recognising excellence, and ensuring that standards remain at the highest possible level.”
Areas of Expertise:
- Cataracts
- Congenital Cataract and Glaucoma
- Diabetic Eye
- Dry Eye Disease
- Glaucoma
- Visual Field Defects
To instruct Mr Lorcan Butler, please contact his case coordinator today.