Part 6 — Appendices & Evidence (Part 2)

6.3 — Timeline of Clinical History (1993–2026)

This timeline summarises the key clinical events, specialist findings, and continuity‑of‑care markers over a 33‑year period. It demonstrates the stability of the young person’s neurological visual impairment and highlights the point at which the clinical record diverged from the established baseline.

1993–1994 — Initial Diagnosis and Baseline Established

• First specialist assessments following childhood trauma.
• Diagnosis of permanent neurological visual impairment.
• Identification of:
• vertical nystagmus
• severely impaired eye‑movement control
• divergent strabismus
• intractable diplopia
• poor spatial awareness
• Functional‑vision difficulties documented.
• Baseline established: lifelong, non‑fluctuating neurological impairment.

1994–2017 — Consistent Specialist Findings

Across multiple specialist reviews:

• Visual acuity remained stable.
• Vertical nystagmus consistently observed.
• Eye‑movement impairment described as severe.
• Spatial‑awareness deficits repeatedly confirmed.
• Functional‑vision risk documented (especially in busy environments and near traffic).
• No improvement, fluctuation, or resolution recorded.
• All findings aligned with the original neurological diagnosis.

The clinical picture remained unchanged.

2018 — Specialist Neuro‑Ophthalmology Review

The 2018 report confirms:

“there has been no change in your visual impairment since 1994…” “your control of eye movements is very poor and this constitutes a significant and severe visual impairment…”

Key features reaffirmed:

• permanent vertical nystagmus
• severely impaired eye‑movement control
• divergent strabismus
• intractable diplopia
• extremely poor spatial perception
• real‑world danger in visually complex environments
• impairment is permanent and not susceptible to treatment

This report forms the modern baseline.

2019–2025 — Ongoing Functional‑Vision Difficulties

During this period:

• No clinical evidence of improvement or fluctuation.
• Functional‑vision challenges remained consistent.
• Spatial‑awareness difficulties continued.
• No specialist contradicted the established baseline.
• No clinician reported “intermittent” or “variable” neurological features.

The impairment remained stable and permanent.

February 2026 — Routine WGOS 1 Sight Test

The 2026 routine assessment:

• used an optometric (ocular) framework
• omitted essential neurological and functional‑vision tests
• did not reference the 30‑year baseline
• did not reference the 2018 specialist report
• introduced the clinically impossible term “intermittent nystagmus”
• failed to assess spatial awareness
• failed to assess eye‑movement control
• failed to assess functional vision
• misinterpreted neurological features
• produced unsupported conclusions

This is the only assessment in 33 years that contradicts the established neurological record.

2026 — Break in Continuity of Care

The 2026 letter represents:

• a procedural break
• a governance failure
• a safeguarding risk
• a clinically unsafe deviation from the baseline

It is inconsistent with:

• the 1994 baseline
• every specialist review
• the 2018 neuro‑ophthalmology report
• the known behaviour of neurological nystagmus

the permanent nature of the impairment

Summary of Timeline

From 1993 to 2025:

• the impairment remained stable
• the neurological features remained permanent
• the clinical findings remained consistent
• the functional‑vision risks remained unchanged

Only the 2026 routine sight‑test letter deviates from the established clinical record.

This timeline demonstrates that the 2026 findings are not credible, not clinically justified, and not aligned with 33 years of specialist evidence.

Next 6.4 — Matrix of Contradictions

(2018 Specialist Report vs 2026 Routine Sight Test)

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