Ms L Nasr v Epsom and St Helier University Hospitals NHS Trust: 2306903/2024

EMPLOYMENT TRIBUNALS

Case No 2306903/2024

Between

Ms Lena NasrClaimant

Epsom and St Helier University Hospitals NHS TrustRespondent

Before

Employment Judge Ost

In person for claimant

Mr T Kirk (instructed by Counsel) for respondent

Date 19 February 2026

JUDGMENT

After consideration of the evidence provided and hearing from the parties, the judgment of the Tribunal is as follows: Disability Status

[1]At the relevant times the Claimant was a disabled person as defined by section 6 Equality Act 2010 because of a sight impairment which was medically diagnosed as narrow or closed drainage angles and which led to ophthalmic/retinal migraines.

REASONS

[2]The Respondent is an NHS hospitals trust. The Claimant was employed by the Respondent as an assistant service manager from 15 July 2019 until 10 May 2024.

[3]Early conciliation started on 22 July 2024 (Day A) and ended on 23 August 2024 (Day B).

[4]On 22 September 2024 the Claimant presented a claim form containing complaints of: 4.1. Detriment for making protected disclosures 4.2. Failure to make reasonable adjustments 4.3. Victimisation

[5]The Claimant originally asserted that she was disabled by two impairments described as: 5.1. Mental health disability exacerbated by stress (anxiety, depression) 5.2. Sight impairment

[6]On 22 October 2024 the Respondent submitted a response form in which it resisted all of those complaints and it did not admit that the Claimant was disabled.

[7]A case management preliminary hearing took place on 11 September 2025 before Employment Judge Lumby. The case management orders from that preliminary hearing were issued in writing to the parties by Tribunal on 14 November 2025. At paragraphs 1 to 5, Employment Judge Lumby ordered a further preliminary hearing take place to determine whether the Claimant had at the relevant times a disability for the purposes of section 6 of the Equality Act 2010. The hearing allocation was for 3 hours and it was listed as a public hearing.

[8]Employment Judge Lumby ordered that the Claimant must on or before 17 October 2025: 8.1. confirm precisely the impairments which she wished to rely upon (paragraph 19); 8.2. provide details about her impairments and the effects (paragraph 20); and 8.3. provide copies of relevant parts of her GP and other medical records that are relevant to whether she had a disability at the time of the events the claim is about, and, any other evidence relevant to that issue (paragraph 21).

[9]After various delays and after the imposition of an unless order, on 4 December 2025 the Claimant provided further and better particulars of her claim in which she stated that she was no longer relying upon the mental health impairment but she did continue to rely upon “the Sight impairment”. She also provided a Disability Impact Statement providing information about the impairment she relied upon. The Claimant specified that she was only relying upon the sight impairment.

The hearing

[10]The hearing was a remote public hearing, conducted using the cloud video platform (CVP) under Rule 46. The tribunal considered it was just and equitable to conduct the hearing in this way. In accordance with Rule 46, members of the public could attend and observe the hearing. However, no members of the public did attend.

[11]The parties were able to hear what the Tribunal heard and see the witnesses as seen by the Tribunal. From a technical perspective, there were no difficulties observed by or reported to the Tribunal.

[12]The Tribunal checked with the parties whether either party could foresee any barriers to their full participation in the hearing and, if so, what adjustments might assist. Ms Nasr commented that she had recently had a further eye procedure which caused her some pain but said that no specified adjustments were needed for the 3 hour hearing. The Tribunal suggested that Ms Nasr should notify the Tribunal if she was uncomfortable at any point and needed a short break. Mr Kirk confirmed the Respondent had no objection to short breaks being taken as and when needed. Ms Nasr did take such a break during the hearing.

[13]The Tribunal checked whether there were any issues which needed addressing before the issue of disability status was considered. Ms Nasr said that she had not been through and then provided all of the OH reports relating to her health. The Tribunal checked whether Ms Nasr was applying or wanted to apply for a postponement. Ms Nasr confirmed she was not applying for a postponement, and she wished to proceed today without utilising those OH reports because she believed that she had sufficient evidence to substantiate her disability status.

[14]Mr Kirk indicated that the Respondent also wished to proceed on the basis of the evidence provided. Mr Kirk provided the context that the Respondent considered Ms Nasr’s disclosure to be “patchy” and she had been subject to an unless order dated 26 November 2025 to the effect that the Claimant must provide various elements of information by 4 December 2025. Mr Kirk said that the Claimant had only partially complied with that unless order and she had disclosed records late. Mr Kirk asserted that a postponement at this point may put the final hearing listed for 22-25 June 2026 in jeopardy.

[15]The Tribunal determined that it was in accordance with the overriding objective in rule 3 of the Employment Tribunal Procedure Rules 2024 to continue on the basis of the evidence provided because: 15.1. both parties were on an equal footing have both had more than 4 months to prepare for this preliminary hearing, and, they both wished to proceed on the basis of the evidence provided; 15.2. it was proportionate to proceed on the basis of the preparation actually carried out by the Claimant in accordance with the case management orders, an unless order, and after multiple extensions provided voluntarily by the Respondent and then also by the Tribunal; and, 15.3. a postponement would likely cause substantial additional delay to the proper consideration of the case.

[16]The Claimant then stated that she wanted to mention that her ‘sight impairment’ described within her Disability Impact Statement had been linked to glaucoma. Mr Kirk expressed concern on behalf the Respondent. He said that the Respondent’s position was that the Claimant had not been clear about her disability in her Particulars of Claim which was part of the reason why the Respondent had sought further and better particulars. Mr Kirk referred to paragraphs 19 and 20 of Employment Judge Lumby’s case management orders and said that the Claimant had only belatedly responded and provided the evidence she wished to rely upon. Mr Kirk said that the Respondent would be prejudiced if the Claimant was able to change her description of the impairment from the description provided in her further and better particulars response to those orders to now include Glaucoma.

[17]The Tribunal checked the papers and reminded the parties that within the Claimant’s further and better particulars she had described the asserted impairment she was relying upon as “the sight impairment”. At the same time, she had provided a Disability Impact Statement (page 168-169 of the bundle) within which the Claimant had stated that “she had a disability with respect to the sight impairment” and that “this has been diagnosed as “ophthalmic/retinal migraines”. The Tribunal explained that it was not allowing the Claimant to change her evidential description away from the Disability Impact Statement but it would not be constraining the asserted impairment to a particular medical diagnosis so as to exclude any consideration of evidence provided in support of the specified sight impairment described in the Disability Impact Statement. The Tribunal explained it would carry out the assessment of the disability status test in accordance with section 6 which focuses upon the practical impact of the impairment which the Claimant had described within her Disability Impact Statement and as supported by the evidence provided (not by her description of the precise medical diagnosis, classification, or causation of the impairment). Mr Kirk agreed that there was a wellestablished principle that assessment of an impairment did not depend upon medical diagnosis and he could not go behind that principle. It was accepted that the Claimant’s disability would be assessed by reference to her description within her Disability Impact Statement of the impact of her asserted sight impairment.

[18]After discussion, the parties clarified that the relevant period of the allegations made within the particulars of claim which relied on disability status based on the sight impairment began on 13 February 2023 and ended on the Claimant’s last day of employment 10 May 2024. (Whilst the Claimant was bringing a victimisation allegation after her last day of employment, that complaint did not rely upon disability status.)

[19]The parties had cooperated in the production of an electronic bundle of 170 pages. The Tribunal considered the documentary evidence provided in the bundle.

[20]The Tribunal heard evidence from the Claimant only. No other witnesses were called by either party. The Claimant used her Disability Impact Statement as her witness statement. The Tribunal took time to read the statement in advance. The witness was cross examined by Mr Kirk on behalf of the Respondent and the Tribunal also asked questions.

[21]At the conclusion of the evidence each party was given the opportunity to make oral submissions.

[22]In summary, Mr Kirk made the following submissions: The relevant period to assess was from February 2023 to the end of May 2024. A clinical diagnosis is not necessary but the Claimant still has to satisfy the burden of proof. In the Respondent’s view there was very little in the medical records: there is a series of appointments at eye clinics from Autumn 2022 to March 2023. He accepted that some symptoms could be inferred from those records but said there was very little reference in those records to migraine, headache blackout. He said there was no evidence of medical consultations between the end of March 2023 and December 2023 and the records for December 2023 does not record any ongoing symptoms so the adverse effects were not long term. He invited the Tribunal to draw the inference that the eye procedure not only improved the impairment but fixed it. Mr Kirk said it was very difficult for the Respondent to go behind the Claimant’s description of the nature and impact of her impairment in the Disability Impact Statement but gives the view that there was a lack of corroborating symptoms recorded in medical notes. He invited the Tribunal to find that Dr Mirza’s description of blackouts and migraines as set out in the letter of 14 January 2026 is more likely to be a record of what the Claimant has said to Dr Mirza. Implicitly the Tribunal was being invited to reduce the weight given to this aspect of Dr Mirza’s written opinion. The Respondent says that the Claimant was not disabled at the relevant times.

[23]C’s submissions were in summary that she clearly had a long-term condition which lasted over 12 months and that is a disability. She said her eye issues only arose after she had problems and experienced stress in her relationship with the Respondent. She said that she continues to have issues to date. Her condition still exists, it is still a problem and it is still impacting her now. She said that her eye pressure increased and she had to have procedures. She has to put special measures in place to manage her situation. She said that she was and is disabled.

[24]The Tribunal considered all the evidence and submissions (whether explicitly noted in this judgment or not).

Findings of Fact

[25]Having assessed all of that evidence in the round, the Tribunal made the findings of fact set out in the paragraphs below. Where the Tribunal had to resolve a conflict of evidence, it did so on the balance of probabilities and it has indicted how it resolved that conflict at the relevant point. (References to page numbers are references to the agreed bundle of documents used at the hearing.)

[26]The Claimant had a physical impairment related to her eyes which led to her experiencing symptoms of debilitating headaches, blurred vision, and severe pain. These symptoms were intermittent (i.e. fluctuating) but regularly recurring. The Tribunal accepted the Claimant’s evidence to this effect in paragraph 6 of her Disability Impact Statement (pages 168-169) and her oral evidence. This was supported by the letter from Dr Mirza dated 14 January 2026 (page 139).

[27]The effect of these symptoms upon the Claimant was as follows: 27.1. She had a reduced ability to cope with stress (e.g. “significantly less able to cope with … working for sustained periods” and dealing with the “pressure of deadlines”, “attending a lengthy online meeting”); 27.2. She had a reduced ability to sustain long periods staring at a computer screens (e.g. “using a computer for work for an extended period of time … the Claimant cannot do without significant disadvantage ” and she “cannot watch TV for extended periods”); 27.3. She had a reduced ability to function normally when she is experiencing the symptoms listed above (e.g. “When the claimant has symptoms, the symptoms are debilitating and affect her ability to function normally in any way”. More specifically when she is experiencing these symptoms she “cannot conduct conversations”, or do normal activities such as domestic chores cooking. She can only lie down”. Also, when her “vision is blurred this prevents many normal activities like moving about, or driving”. Similarly, “When in pain, she cannot concentrate on any tasks be it for work or personal life and must take medication and wait for the pain to subside before getting on with normal activities”.)

[28]The Tribunal accepted the Claimant’s evidence in paragraph 6 of her Disability Impact Statement that the symptoms had this effect. There was no evidence before the Tribunal to indicate that the Claimant was being untruthful or exaggerating her symptoms or experience.

[29]The adverse effects described in paragraphs27.1 and

27.2 above are continuous adverse effects caused by the Claimants desire to avoid the symptoms and to avoid the increased risk to her sight. The adverse effect in paragraph 28.3 above is not continuous but is an intermittent/fluctuating in episodes.

[30]When the Claimant experienced fluctuating but regular episodes of debilitating headaches and/or severe pain, she took pain relief medication and had to wait until the symptoms passed before getting on with normal activities. The Tribunal accepted the Claimant’s evidence to this effect in paragraph 6 of her Disability Impact Statement.

[31]The Claimant first started to experience the symptoms of the nature and extent described above on 5 August 2022. In response, she sought medical assessment of these symptoms on 5 and 8 August 2022.

[32]Whilst the Claimant gave evidence that she had the sight impairment since at least 29 March 2021, she did not provide any documentary supporting evidence to indicate that she was experiencing symptoms of the nature and extent described above relevant to any identifiable period prior to 5 August 2022. There are no GP notes or other medical documentary evidence referring to the symptoms of headaches, blurred vision, and pain prior to 5 August 2022. In addition, the documentary evidence which was provided by the Claimant related to the assessments on Friday 5 August 2022 and Monday 8 August 2022 appears to refer the symptoms she experienced at that point in time as “new” symptoms which had emerged over that weekend. The Tribunal considers that if the Claimant had a longer history of these symptoms that information would have been highly relevant to the medical assessment and would have been noted in the contemporaneous records and letters.

[33]On 5 August 2022 the Claimant attended an appointment with the Community Health & Eyecare Ltd. The Claimant was seen by an optician who diagnosed narrow angle closure in both eyes. This led to a referral for a private ophthalmic appointment. A record of an ‘Appointment Outcome’ for the Claimant was issued on that date (page 111). Whilst the quality of the copy document is not good, it is discernible that the outcome document refers to “eye pain”, it states “New Condition Diagnosed: Glaucoma”, records the issue as “urgent”. It then requests “Dear Dr kindly see this patient with shallow AC and closed angles [?] for laser PI soon”. The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical assessment.

[34]On 8 August 2022 the Claimant was sufficiently concerned by her symptoms that day to take herself by public transport to an emergency eye clinic. Whilst travelling she took part in a telephone triage discussion with St Thomas’ Hospital Rapid Access Eye Clinic. The Rapid Access Eye Clinic subsequently wrote a letter on the same day documenting that telephone triage process (pages 114-115). The letter stated: the Claimant was “awaiting an urgent referral to Glaucoma clinic”; the Claimant “was complaining of both eyes being blurry and feels dizzy on going since this morning.” (Underlining our Tribunal’s emphasis) The letter also said “She is on the bus and already on her way to come to eye Casualty”. The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical assessment. The Claimant’s response to these symptoms indicates that she did not wait to address them: she took immediate steps to obtain urgent medical assessment. The Claimant’s urgent response on that day would not be consistent with her having experienced similar symptoms/impacts at an earlier period of time without taking any action resulting in medical documentation.

[35]The Claimant did attend the emergency eye clinic at St Thomas’ Hospital on 8 August 2022. The Claimant was given a ‘primary angle closure’ handout. St Thomas’ Hospital sent a second letter, this time from the eye emergency clinic, on the same date (pages 116-117). Under the heading ‘History’ the letter states “Over weekend patient notes new blurred vision, dizziness, coloured lights in both eyes. Worse when needing to focus on computer screen. Last few weeks, feels like reading distance harder to see.” (Again, underlining the Tribunal’s emphasis). The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical assessment. The Tribunal noted that this letter also records that the Claimant was describing the majority of the symptoms as being new “over the weekend”. The symptoms relating to reading distance is distinguished from the other symptoms by reporting that the Claimant felt that this symptom had occurred over the “last few weeks”.

[36]The Claimant’s follow up assessment and treatment was largely undertaken at glaucoma clinics.

[37]On 1 November 2022 the Claimant attended her first appointment at St Thomas’ Hospital’s glaucoma clinic and was seen by Professor Sheng Lim. At this assessment the Claimant was given a new diagnosis of Primary angle closure within her eyes. She was given a relevant information leaflet of her condition. St Thomas’ Hospital wrote to the Claimant on the same day to confirm the assessment (pages 118-119). Under the heading ‘History’ the writer refers to “Migraine”. It also states under the heading ‘Management’ that “Advised to seek help if any symptoms related to possible angle closure (eye pain, blurred vision eye redness, localised headache, haloes in vision)”. In addition, bilateral laser peripheral iridotomy procedures were recommended as a medical intervention. The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical assessment.

[38]The Claimant was prescribed Timolol eyedrops (used to reduce ocular pressure) as result of the assessments on 8 August 2022 and 1 November 2022.

[39]The recommended iridotomy procedure on the Claimant’s left eye took place at some point between 1 November 2022 and 16 January 2023.

[40]On 30 November 2022, the Claimant was due to attend an appointment at Moorfield’s Eye Hospital at St Georges Hospital but she did not attend. On 13 December 2022 the Consultant Ophthalmic Surgeon, Mr Kuang Hu, wrote to the Claimant’s GP surgery (pages 120-121) to warn that the Claimant has been “referred with high eye pressure and narrow eye drainage angles, a condition that may lead to visual loss if left untreated” and to ask the GP to rerefer the Claimant. The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical correspondence.

[41]On 16 January 2023 the Claimant attended a follow up appointment at St Thomas’ Hospital. On the same date the the Consultant Ophthalmic Surgeon, Mr Ian Rodrigues, wrote to the Claimant to confirm the outcome of the assessment (pages 124-125). He wrote that “left drainage space more open following laser iridotomy.” The outcome of the appointment was followed up in 9 months’ time. The Tribunal accepted the contemporaneous document as an accurate record of the key elements of that medical assessment.

[42]However, on 30 January 2023 the Claimant was seen by Consultant Ophthalmologist, Miss A McElvanney in the eye clinic at St Helier Hospital. Miss A McElvanney wrote to the Claimant’s GP surgery (pages 126-127) to provide a report on the assessment and noted that the IOP (intra ocular pressure) in the Claimant’s right eye was 29 mmHg and she stated that the GP “needs to contact St Thomas’s for FU (follow up) regarding symptoms and IOP”. The Tribunal accepted the contemporaneous document as an accurate record of the key elements of that medical assessment.

[43]The Claimant was using Tiopex eyedrops (also used to reduce ocular pressure) in January 2023. She used Timolol eyedrops in February 2023.

[44]On 27 February 2023 the Claimant had the follow up at St Thomas’ Hospital. On the same date the the Consultant Ophthalmic Surgeon, Mr Rodrigues, wrote to the Claimant to confirm the outcome of the assessment (pages 128- 129). The Tribunal accepted the contemporaneous document as an accurate record of the key elements of that medical assessment.

[45]The iridotomy procedure on the Claimant’s right eye took place in or around 27 March 2023. St Thomas’ Hospital wrote to the Claimant on the same day to confirm the outcome of the procedure (pages 130-131). The Tribunal accepted the contemporaneous document as an accurate record of the key elements of that medical assessment.

[46]On 21 December 2023 the Claimant was again assessed for suspected primary angle closure. No appointments were noted. The Tribunal accepted this contemporaneous document as an accurate record of the key elements of that medical assessment.

[47]The iridotomy procedures reduced the sight impairment but they did not “cure” the impairment. The adverse effects continued intermittently up to (and beyond) the end of her employment with the Respondent on 10 May 2024.

[48]The Tribunal accepted the Claimant’s oral evidence that she continued to experience them up to and after her employment by the Respondent (which was supported in broad terms by Dr Mirza’s description of the symptoms being present “during her former employment”). The Tribunal noted that there was no positive documentary evidence to support an assertion that the Claimant’s impairment was ‘cured’ or that the adverse effects were permanently removed. Rather the Respondent invited the Tribunal to make that finding as an inference based upon the gaps in medical records provided.

[49]After 27 March 2023 there is a substantial gap in medical documentation until 21 December 2023 when an ‘After Visit Summary’ from Guys and St Thomas’ NHS Foundation Trust records that the issue of the Claimant’s primary drainage angle issue was addressed at that visit but no medication was prescribed and there were no upcoming appointments.

[50]In cross examination the Claimant gave evidence that she did not attend appointments with her GP or raise issues specifically regarding the symptoms of her sight impairment during this gap because she was overwhelmed with stress and depressed. She said that she was “just existing during this period”; she did not look after herself and did not deal with her sight impairment. This explanation was supported to a limited degree by the contemporaneous medical evidence which shows that she was being issued with fit notes stating that she was unfit to work for significant periods due to ‘stress’. The Claimant said that she did have appointments with her GP where she mentioned her ongoing symptoms. It was put to the Claimant by Mr Kirk that the sight impairment symptoms were not recorded in any of the fit notes from her GP. The Claimant said that within the appointments to obtain fit notes she did mention the ongoing symptoms but it is always down to the medical professional as to what they would highlight and record as a reason for not being fit for work on a fit note.

[51]The Tribunal considers that fit notes reflect the key outcome of the appointment i.e. the assessment of fitness for work and the reason for that. Patients have a short appointment, commonly only 10 minutes or less, and GPs are under a great deal of time pressure. Fit notes commonly give highly summarised descriptions (often in one word or one phrase) of the reason for non-fitness for work. They are not a complete record of everything discussed or even a summary of all of the medical issues currently experienced by the patient. The Tribunal drew no adverse inference from the brevity of the description in the fit note and the fact that it did not refer the asserted symptoms.

[52]The Claimant’s oral evidence of ongoing symptoms during this period when she was suffering stress is consistent with Dr Mirza’s description within the letter of 14 January 2026 as to when those recurrent ophthalmic/retinal migraines took place: “These episodes were experienced in the context of prolonged and sustained psychological stress during her former employment”.

[53]The Claimant was not (correctly) diagnosed with glaucoma prior to 10 May 2024.

[54]The evidence in the medical documentation before the Tribunal was unhelpfully inconsistent on this issue of whether the Claimant had been diagnosed with glaucoma and this perhaps reflects the difficulty of medical diagnosis. There was reference to an initial diagnosis of glaucoma within the referral document dated 5 August 2022 but this then appeared to have been corrected on 8 August 2022 and 1 November 2022 to a diagnosis of narrow eye drainage angles. Subsequent medical records before the Tribunal did sometimes make reference to glaucoma in different contexts but the predominant description within the medical records is that at that time the Claimant had narrow eye drainage angles which intermittently appeared to be closed.

[55]After the initial (seemingly incorrect) reference to a diagnosis of glaucoma on 5 August 2022, several medical reports explicitly state that there was no evidence of glaucoma. For example, the letters of 16 January 2023 (at pages 122-123) and 27 February 2023 (at pages 128-129) both state “no evidence of glaucoma”. The Tribunal accepted these contemporaneous documents as an accurate record of the key elements of those medical assessments.) Any subsequent diagnosis that the Claimant did in fact have glaucoma was made after the end of her employment on 10 May 2024 and after the relevant time. This is supported by the Claimant’s statement in the hearing that she had more recently been diagnosed as glaucoma. This is also consistent with Dr Mirza’s description within the letter of 14 January 2026 that “In Miss Nasr’s case, the prolonged workplace stress, the onset of migraines, and the later confirmation of raised eye pressure and glaucoma is clinically significant” (underlining the Tribunal’s emphasis).

[56]The Claimant said that she had now been diagnosed with glaucoma and that this is a progressive condition. However, the Claimant did not provide any evidence as to(a) when a diagnosis of glaucoma was made,

(b) when the glaucoma had some effect on the Claimant’s ability to carry out normal dayto-day activities (as opposed to the effects caused by the narrow or closed drainage angles), and,

(c) whether it is likely to have a substantial adverse effect on the Claimant in the future (as opposed to the effects caused by the narrow or closed drainage angles). The Tribunal found that the Claimant had not been diagnosed with correctly glaucoma in the relevant period.

The Relevant Law

[57]Section 6(1) of the Equality Act 2010 (“EqA”) states that: “A person (P) has a disability if— P has a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on P’s ability to carry out normal day-to-day activities [… ]”

[58]In determining whether a person is disabled for the purposes of the EqA, the Tribunal is required to take into account the Guidance that was issued by the Secretary of State under section 6(5) EqA. The Guidance is entitled ‘Equality Act 2010 – Guidance on matters to be taken into account in determining questions relating to the definition of disability’ (“the Guidance”).

[59]Under s15(4) of the Equality Act 2006, a Court or Tribunal must also take into account the Equality and Human Rights Code of Practice on Employment (2011) (“the Code”) in any case where it appears to be relevant.

[60]The Claimant bears the burden of showing that she meets this definition, on the balance of probabilities as per Morgan v Staffordshire University

[2002] IRLR 190

[61]In Goodwin v Patent Office [1999] I.C.R. 302, guidance was provided on the proper approach for the Tribunal to adopt (when applying the predecessor provisions of the Disability Discrimination Act 1995). It identified four questions to be answered by the Tribunal. This four-stage approach was reaffirmed by the Court of Appeal in Sullivan v Bury Street Capital Limited

[2021] EWCA Civ 1694

, where the questions were listed as follows: i. Was there an impairment? ii. What were its adverse effects on normal day-to-day activities? iii. Were they more than minor or trivial? iv. Was there a real possibility that they would continue for more than 12 months?

[62]These are questions for the Tribunal. Although it may be assisted by medical evidence, it is not bound by any opinion expressed.

[63]The relevant point in time to be looked at by the Tribunal when evaluating whether the Claimant is disabled under section 6 is not the date of the hearing, but the time of the alleged discriminatory act as per Cruickshank v Vaw Motorcast Ltd [2002] I.C.R. 729 and All Answers Limited v Mr W(1) and Ms R (2),

2021 EWCA Civ 606

[64]In Goodwin (above) Morison J warned of the risk of “disaggregating” the 4 questions – i.e. whilst they can be addressed separately, it is important not to forget the purpose of the legislation, and to look at the overall picture. This warning was emphasised by HHJ Tayler in Mr A Elliot v Dorset County Council,

UKEAT/0197/20/LA

. Impairment

[65]It will not always be essential for a tribunal to identify a specific ‘impairment’ if the existence of one can be established from the evidence of an adverse effect on the claimant’s abilities (see J v DLA Piper UK LLP

2010 ICR 1052

, EAT; and, College of Ripon and York St John v Hobbs

2002 IRLR 185

, EAT). This accords with the approach taken by the European Court of Justice (ECJ) when considering the scope and meaning of ‘disability’ in the EU Equal Treatment Framework Directive (No.2000/78). In Fag og Arbejde (FOA) (acting on behalf of Kaltoft) v Kommunernes Landsforening (acting on behalf of the Municipality of Billund)

2015 ICR 322

, ECJ, the ECJ emphasised that it was the effects of an impairment or condition, and not its origin, that mattered. Accordingly, it is not always necessary to identify an underlying disease or trauma where a claimant’s symptoms clearly indicate that the claimant is suffering a physical impairment. “substantial”?

[66]Section 212 EqA defines “substantial” as being more than minor or trivial.

[67]Paragraph 5 of Schedule 1 to the EqA provides: “An impairment is to be treated as having a substantial adverse effect on the ability of the person concerned to carry out normal day-to-day activities if: - measures are being taken to correct it, and - but for that, it would be likely to have that effect. ‘Measures’ includes, in particular, medical treatment and the use of a prosthesis or other aid.”

[68]This provision applies even if the treatment results in the effects being completely under control or not at all apparent. There are, however, situations where medical treatment may create a permanent improvement or “cure”. In such situations it may be necessary to consider whether the effects of the impairment are or were sufficiently “long term”. Alternatively, where treatment is continuing it may be having the effect of “masking” or ameliorating a disability so that it does not have a substantial adverse effect. If the treatment simply delays or prevents a recurrence, and a recurrence would be likely if the treatment stopped, then the treatment is to be ignored and the effect is to be regarded as likely to recur (at para C11 of the Guidance). If the final outcome of such treatment cannot be determined, or if the evidence establishes that removal of the medical treatment would result in either a relapse or a worsened condition, it would be reasonable to disregard the medical treatment (at para B13 of the Guidance).

[69]If an impairment ceases to have a substantial adverse effect on a person’s ability to carry out normal day-to-day activities but that effect is likely to recur, it is to be treated as continuing to have that effect - Paragraph 2(2) of Schedule 1 EqA.

[70]The Guidance states that the requirement that an adverse effect on normal day to-day activities should be a substantial one reflects the general understanding of disability as a limitation going beyond the normal differences in ability which may exist among people (at para B1 of the Guidance).

[71]Appendix 1, paragraph 9 of the Code also provides guidance on the meaning of “substantial”. It says, “Account should also be taken of where a person avoids doing things which, for example, causes pain, fatigue or substantial social embarrassment; or because of a loss of energy and motivation.”

[72]Whether an impairment has a substantial effect is for the Tribunal to decide, taking account of the relevant guidance. The Guidance sets out a number of factors to consider including: the time taken by the person to carry out an activity (at para B2); the way a person carries out an activity (at para B3); the cumulative effects of an impairment (at para B4); the cumulative effects of a number of impairments (at para B5 & 6); the effect of behaviour (at para B7); the effect of environment (at para B11) and the effect of treatment (at para B12).

[73]In Aderemi v London and South Eastern Railway Ltd

[2013] ICR 591

, Langstaff P stated: “It is clear first from the definition in section 6(1)(b) of the Equality Act 2010, that what a Tribunal has to consider is an adverse effect, and that it is an adverse effect not upon carrying out normal day-today activities but upon his ability to do so. Because the effect is adverse, the focus of a Tribunal must necessarily be upon that which the Claimant maintains he cannot do as a result of his physical or mental impairment. Once he has established that there is an effect, that it is adverse, that it is an effect on his ability, that is to carry our normal day-to-day activities, a Tribunal has then to assess whether that is or is not substantial. Here, however, it has to bear in mind the definition of substantial which is contained in section 212(1) of the Act. It means more than trivial. In other words, the Act itself does not create a spectrum running smoothly from those matters which are clearly trivial but provides for a bifurcation: unless a matter can be classified as within the heading of “trivial” or “insubstantial”, it must be treated as substantial. There is therefore little room for any form of sliding scale between one and the other”. “normal day-to-day activities”?

[74]Normal day-to-day activities are things people do on a regular basis such as shopping, reading, writing, conversing, getting washed and dressed, preparing food, eating, carrying out household tasks, walking and travelling, socialising, and working. Normal day-to-day activities must be interpreted as including activities relevant to professional life as per Paterson v Commissioner of Police of the Metropolis

[2007] IRLR 763

[75]Day-to-day activities” encompass activities which are relevant to participation in professional life as well as participation in personal life. The Tribunal should focus on what a Claimant cannot do, not what they can do. “Day-to-day activities” encompass activities which are relevant to participation in professional life as well as participation in personal life, and that the Tribunal should focus on what the claimant cannot do, not what they can do. In Harry Stedman v Haven Leisure Ltd

[2025] EAT 82

HHJ Stout said that the Tribunal should not carry out a comparison exercise by weighing what the claimant cannot do against what they can do. She also held that it can be sufficient if the claimant has a mental or physical impairment that has a substantial adverse effect to just one day-to-day activity.

[76]The Guidance provides the examples of what is meant by “normal day-to-day activities”. In general, day-to-day activities are things people do on a regular or daily basis, and examples include shopping, reading and writing, having a conversation or using the telephone, watching television, getting washed and dressed, preparing and eating food, carrying out household tasks, walking and travelling by various forms of transport, and taking part in social activities (at para D3). Normal day-to-day activities can also include general workrelated activities such as interacting with colleagues (at para D3 of the Guidance).

[77]The term ‘normal day-to-day activities’ is not intended to include activities which are normal only for a particular person, or a small group of people. In deciding whether an activity is a normal day-to-day activity, account should be taken of how far it is carried out by people on a daily or frequent basis. In this context, ‘normal’ should be given its ordinary, everyday meaning (at para D4 of the Guidance). It is not necessary, however, that “most people” carry out the activity. However, if the condition also affects day-to-day activities to a substantial degree, those will still be relevant. “long term”

[78]Paragraph 2 of Schedule 1 states: “2(1) The effect of an impairment is long-term if –(a) it has lasted for at least 12 months,

(b) it is likely to last for at least 12 months, or

(c) it is likely to last for the rest of the life of the person affected. (2) If an impairment ceases to have a substantial adverse effect on a person's ability to carry out normal day-to-day activities, it is to be treated as continuing to have that effect if that effect is likely to recur. (3) For the purposes of sub-paragraph (2), the likelihood of an effect recurring is to be disregarded in such circumstances as may be prescribed. (4) Regulations may prescribe circumstances in which, despite subparagraph (1), an effect is to be treated as being, or as not being, long term.”

[79]Likely should be interpreted as meaning “it could well happen” rather than it is more probable than not it will happen (see SCA Packaging Limited v Boyle

(2009) ICR 1056

[80]When considering whether an impairment is “long term”, that consideration must be undertaken as at the time of the discriminatory act, and not at the date of the hearing. This was repeated by the EAT in Alao v Oxleas NHS Foundation Trust

[2022] EAT 135

, where Eady P held that when assessing the question of disability the Tribunal was “bound to have regard” to the position as at the date of the alleged acts of discrimination in issue.

[81]It will be an error of law if a Tribunal does not have regard to all three scenarios envisaged in paragraph 2 of schedule 1. In McKechnie Plastic Components v Grant

UKEAT/0284/08

it was said: “… the Appellant does have a valid ground on one aspect of the judgment; namely the approach the Tribunal adopted in relation to the question of whether the mental impairment was long term. It is not clear why the Tribunal decided at paragraph 6 that the mental impairment had started in January 2007 nor is it clear whether the Tribunal had in mind the full statutory test which has three categories concerning the impairment; namely that it has lasted for 12 months; the period for which it lasts is likely to be at least 12 months or it is likely to last for the rest of the person's life. Paragraph 9 of the decision refers only to the 12 month test. However, the Tribunal do not appear to have considered whether the 12 month test was satisfied at the time of the alleged discriminatory acts as opposed to the date of the hearing. Moreover the Tribunal has made no findings of fact to justify whether the conditions of either of the other categories have been met”.

[82]More recently, in Tesco Stores Ltd v Tennant,

UKEAT/0167/19

, the EAT held that, where the claimant’s condition was found to have the necessary substantial adverse effect, but the claimant provided no evidence that the condition was “likely” to last for at least 12 months, the Tribunal erred in finding the respondent liable for acts of discrimination before the effects had in fact lasted for 12 months.

[83]The Guidance states that conditions with effects that recur only sporadically or for short periods can still qualify as long term impairments for the purposes of the EqA. If the effects on normal day-to-day activities are substantial and are likely to recur beyond 12 months after the first occurrence, they are to be treated as long term. The Guidance sets out examples of impairments with effects which can recur beyond 12 months, or where the effects can be sporadic (at paras C5 & 6 of the Guidance).

[84]The Guidance states that it is not necessary for the effect to be the same throughout the period which is being considered in relation to determining whether the ‘long-term’ element of the definition is met (at para C7 of the Guidance).

[85]The Guidance sets out what should be considered in relation to the likelihood of recurrence. Essentially, all circumstances should be taken into account including the way in which a person can control or cope with the effects of an impairment, which may not always be successful (at para C10 of the Guidance). Analysis and Conclusions

[86]The issues to be determined at the Preliminary Hearing when deciding whether the Claimant had a disability as defined in section 6 of the Equality Act 2010 at the time of the events were as follows: The Tribunal will decide:a. A. Did they have a physical impairment: being ‘the sight impairment’ as described within the Claimant’s Disability Impact Statement?

b. B. Did it have a substantial adverse effect on their ability to carry out day-to-day activities?

c. C. If not, did the claimant have medical treatment, including medication, or take other measures to treat or correct the impairment?

d. D. Would the impairment have had a substantial adverse effect on their ability to carry out day-to-day activities without the treatment or other measures?

e. E. Were the effects of the impairment long-term? The Tribunal will decide:

(a) did they last at least 12 months, or were they likely to last at least 12 months?

(b) if not, were they likely to recur? (This list of issues addresses the 4 questions set out in Goodwin (above) and Sullivan (above).) A. Did they have a physical impairment: being ‘the sight impairment’ as described within the Claimant’s Disability Impact Statement)?

[87]The Respondent said in submissions that it was difficult not to accept there was an impairment at the end of 2022 and early 2023.

[88]The Code (at para 2.12) and the Guidance (at para A5) both confirm that sensory impairments, such as those affecting sight, are included within the concept of a physical impairment.

[89]The Tribunal found that the Claimant started to experience the symptoms of blurred vision and pain and their impacts upon her day-to-day activities on 5 August 2022, and then debilitating headaches from 1 November 2022. Regardless of any ambiguity over the medical diagnosis of the Claimant’s medical condition at any point in time, as per DLA Piper (above), Hobbs (above) and Fag og Arbejde (above), the Claimant’s symptoms clearly indicate that she was suffering a physical impairment on 5 August 2022.

[90]Whilst the Tribunal was not required to identify the medical cause to establish an impairment, it is evidentially significant to note that the documentary evidence provided by the Claimant does appear to identify the medical cause for the impairment symptoms reported by the Claimant between November 2022 and December 2023. After an initial diagnosis of glaucoma, the medical cause was identified as narrow or closed eye drainage angles leading to increased internal eye pressure.

[91]The Tribunal concluded that the Claimant had a physical sight-related impairment. B. Did it have a substantial adverse effect on their ability to carry out day-to-day activities?

[92]As per Stedman (above) the Tribunal focused on what the Claimant could not do as result of the impairment in comparison to that which she would otherwise be able to do without the impairment (at para B9 of the Guidance).

[93]The effect of the symptoms of the debilitating headaches, blurred vision, and severe pain upon the Claimant’s was as follows: 93.1. She had a reduced ability to cope with stress (e.g. “significantly less able to cope with … working for sustained periods” and dealing with the “pressure of deadlines”, “attending a lengthy online meeting”); 93.2. She had a reduced ability to sustain long periods staring at a computer screens (e.g. “using a computer for work for an extended period of time … the Claimant cannot do without significant disadvantage” and she “cannot watch TV for extended periods”); 93.3. She had a reduced ability to function normally when she is experiencing the symptoms listed above (e.g. “When the claimant has symptoms, the symptoms are debilitating and affect her ability to function normally in any way”. More specifically when she is experiencing these symptoms she “cannot conduct conversations”, or do normal activities such as domestic chores cooking. She can only lie down”. Also, when her “vision is blurred this prevents many normal activities like moving about, or driving”. Similarly, “When in pain, she cannot concentrate on any tasks be it for work or personal life and must take medication and wait for the pain to subside before getting on with normal activities”.)

[94]There is supporting documentary evidence for some of these impacts on the Claimant at the relevant time. The letter from St Thomas’ Hospital dated 8 August 2022 under the heading ‘History’ records that the Claimant’s symptoms at that time become “worse when needing to focus on computer screen” (page 116). Similarly, the letter from St Thomas’ Hospital dated 27 February 2023 under the heading ‘History’ records that some of the Claimant’s symptoms become “worse when driving” (page 128).

[95]The Respondent invited the Tribunal to find that Dr Mira’s description of blackouts and migraines in the letter of 14 January 2026 is more likely to be a record of what the Claimant has said to Dr Mirza rather than because they took place. The Tribunal notes that Dr Mirza refers to various elements of medical records as the basis for the opinion given. The Tribunal finds no basis on which to assume that Dr Mirza has acted in anything other than a responsible and professional manner when compiling and providing the letter of 14 January 2026. The Tribunal does not find that Dr Mirza has simply reported as his own opinion what the Claimant has said to him. The Tribunal noted that there is some corroborating evidence that the Claimant experienced migraines. The letter from St Thomas’ Hospital dated 1 November 2022 under the heading ‘History’ explicitly refers to “Migraine” (page 118). Notably Dr Mirza refers to this as the documentary record of the Claimant experiencing migraines in the third paragraph the letter (p139). (The Claimant did not give evidence or assert that she experienced ‘black outs’ or ‘dizziness’ in her particulars of claim or her Disability Impact Statement and this was not found as a fact by the Tribunal.).

[96]The Tribunal noted that work related activities can constitute normal day-today activities (Schedule 1, paragraph 5A EqA, para D3 of the Guidance, and, Appendix 1, paragraph 15 of the Code).

[97]In the Tribunal’s view, the activities described in paragraph 93.1 refer to normal day-to-day activities. Working for a sustained period is a normal dayto-day activity. In today’s post-Covid environment, attending lengthy online meetings for work or for social reasons is now relatively normal for a significant proportion of people so as to amount to a day-to-day activity. Dealing with the pressure of deadlines is a component part of numerous different normal day-to-day activities both in work and also in relation to personal matters.

[98]The different activities in paragraph 93.2 and 93.3 above are all types of activities which are explicitly listed as examples of normal day-to-day activities within the Guidance (at para D3 of the Guidance).

[99]The Tribunal found that there were medical interventions in the form of two laser peripheral iridotomy procedures and also in the form of eyedrops used to reduce ocular pressure on multiple occasions. The Tribunal considers that a professional medical recommendation for medical intervention in the form of two operations and the provision of pressure reducing medication is indirect evidence to suggest that the medical issues and the impact upon the Claimant were substantial enough as to warrant those types of intervention.

[100]In respect of the adverse effect described in paragraphs93.1 and

93.2 above, the Claimant’s need/desire to avoid triggering the symptoms of her impairment is a continuous and substantial adverse effect on those normal day-to-day activities which the Claimant would otherwise be able to carry out without restriction if the impairment and its symptoms were not present (see para D22 of the Guidance). In respect of the adverse effect related to the extended use of screens described in paragraph 93.2 above the Tribunal noted that the use of screens (including computers and television) for professional, domestic and social purposes is now a common feature of modern life for many people. As such the Tribunal considered this to be a normal day-to-day activity. Appendix 1, paragraph 10 of the Code states that “the impairment might make the activity more than usually fatiguing so that the person might not be able to repeat the task over a sustained period of time”. The Tribunal was satisfied that an inability to use screens for a sustained period of time in today’s society is a continuous and substantial adverse effect on various normal day-to-day activities.

[101]In respect of the adverse effects of the direct symptoms described in paragraph 93.3 above, these appear to be intermittent symptoms. The debilitating headaches, blurred vision, and severe pain are not permanently present. When they occur, they have an effect upon the Claimant’s ability to concentrate and/or see clearly. Notably, the word which the Claimant used in her Disability Impact Statement to describe her headaches was ‘debilitating’. As a medical professional who would be well used to the clinical spectrum of pain, Dr Mirza described the Claimant’s ocular pain as ‘severe’. The Tribunal was satisfied that the occurrence of debilitating headaches and severe pain makes conducting normal day-to-day activities such as driving, socialising, carrying on a conversation and doing household chores such as cooking very difficult. For some of those activities those symptoms would, very possibly, make those activities extremely unsafe for the Claimant and others.

[102]The Tribunal also noted that within the letter dated 14 January 2026, Dr Mirza referred to the Claimant’s symptoms and said “… all of which had a substantial impact on her daily functioning”. The Tribunal did not consider itself bound by Dr Mirza’s opinion of the impact upon the Claimant’s daily functioning, but rather it took it into account as a piece of evidence from a medical professional who had contact with Claimant and had access to her medical records.

[103]As stated above, the medical professionals treating the Claimant during the relevant period identified the medical cause for the impairment symptoms reported by the Claimant between November 2022 and December 2023 as narrow or closed eye drainage angles leading to increased internal eye pressure. In Stedman (above), HHJ Stout made obiter comments that a medical diagnosis was relevant not only to the question of whether there was an impairment but also to the determination of whether that impairment had a substantial adverse effect. A diagnosis (in broad terms) reflects a clinical judgement that someone is significantly different from the norm as regards the area of functioning covered by the diagnosis.

[104]The fact that the medical professionals recommended medical intervention in the form of two operations and multiple courses of pressure reducing medication is not inconsistent with a conclusion that the adverse effects of the impairment were substantial.

[105]The Tribunal determined that the adverse effects experienced by the Claimant described at paragraphs 93.1 to 93.3 did have a substantial adverse effect on the Claimant’s ability to carry out normal day-to-day activities. C. If not, did the claimant have medical treatment, including medication, or take other measures to treat or correct the impairment?

[106]For the sake of completeness, the Tribunal will address this question as well.

[107]The Tribunal accepted the Claimant’s evidence that, at the times when she experienced the symptoms, she would have to take medication and wait for the pain to pass rather than coping with the effect.

[108]The Tribunal found that the Claimant had two laser bilateral peripheral iridotomy procedures; one in each eye during the relevant period.

[109]The Tribunal found that the medical professionals treating the Claimant’s sight impairment prescribed multiple courses of pressure reducing eye drops. D. Would the impairment have had a substantial adverse effect on their ability to carry out day-to-day activities without the treatment or other measures?

[110]The Tribunal deduced that if the Claimant did not take pain relief medication and take additional behavioural measures by lying down, then each episode of the symptoms would have been materially more painful, would have lasted for longer, and would have required a longer recovery period so that the adverse effects of the impairment would be more substantial.

[111]On 13 December 2022 the Consultant Ophthalmic Surgeon, Mr Kuang Hu, wrote to the Claimant’s GP surgery (at page 120-121) to warn that the Claimant has been “referred with high eye pressure and narrow eye drainage angles, a condition that may lead to visual loss if left untreated”. This provides a clear description from a medical specialist of the possible development of the Claimant’s impairment if left untreated.

[112]The Tribunal concludes that the deduced effect of the impairment if the Claimant had not had the iridotomy procedures is that her symptoms of headache, blurred vision and pain would likely have continued on the existing basis and they could well have increased in intensity, frequency and duration. Also, in due course it is apparent from Mr Hu’s advice that the Claimant’s sight itself may have deteriorated to the point of visual loss. If so, this would have had a much greater adverse effect on a much wider range of normal day-to-day activities. E. Were the effects of the impairment long-term? The Tribunal will decide:(a) did they last at least 12 months, or were they likely to last at least 12 months?

(b) if not, were they likely to recur?

[113]The Tribunal focused solely on establishing whether the impairment in question constituted a ‘disability’ within the meaning of section 6 at the time of the alleged discriminatory acts. This was assessed by reference to the facts and circumstances existing at that date and did not have regard to events occurring subsequently as per the All Answers case (above).

[114]The adverse impacts had not lasted for 12 months until 4 August 2023.

[115]The Tribunal noted Dr Mirza’s medical opinion regarding the nature of the Claimant’s condition when writing in the letter of 14 January 2026 that “Miss Nasr’s condition should be regarded as a long-term illness with ongoing implications for her health and well being.” Whilst Dr Mirza did not state what was meant by the phrase ‘long-term’, the additional description of it being ‘ongoing’ provides context to indicate that the condition lasts several years (i.e. more than 12 months). This is also consistent with the evidence of medical appointments for related treatments and assessments being required between 5 August 2022 and at least 23 December 2023.

[116]The Tribunal considered the indirect ‘symptom avoidance’ adverse effects described in paragraph93.1 and

93.2 above, were continuous. The symptom avoidance effects were driven by the Claimant’s experience of those symptoms and her awareness of the risks posed by the impairment itself. These symptom avoidance effects of the impairment were likely to last at least 12 months from her first experience of the symptoms on 5 August 2022, the first medical assessments on 5 and 8 August 2022 which diagnosed the general type of condition causing the symptoms, and when she was informed of the risks posed by high ocular pressure.

[117]The substantial adverse effects in respect of the symptoms of the impairment as described in paragraph 93.3 were intermittent.

[118]The Guidance stipulates that an event is likely to happen if it ‘could well happen’ (at para C3 of the Guidance) which reflects the guidance in Boyle (above). The Tribunal took into account the elements of the Code (Appendix 1, paragraph 13) and the Guidance (at para C5 to C11) which related to determining whether the effects of the Claimant’s impairment which had fluctuating or recurring effects are long-term.

[119]The Claimant gave oral evidence at paragraphs 7 and 8 of her Disability Impact Statement that the impairments have not ceased and the effects of her impairments were the effects at the relevant time. Also, in answer to the Tribunal’s questions during oral evidence, the Claimant stated that the sight impairment symptoms she experienced occurred regularly and consistently up to and after she left the Respondent’s employment.

[120]The Tribunal also took into account the fact that from the outset and at several points thereafter when the medical professionals dealing with the sight impairment wrote to the Claimant, they identified in advance symptoms for which she should be alert. Typically, this list included “eye pain, blurred vision, eye redness, localised headache, haloes in vision”. This list therefore included three of the symptoms which the Claimant experienced. The preknowledge and advance notification of these symptoms by the medical professionals with specialist knowledge and experience of the Claimant’s condition, led the Tribunal to conclude that the three symptoms of eye pain, blurred vision and localised headache experienced by the Claimant could well occur/reoccur to someone with her condition. The Tribunal noted that some follow up appointments were scheduled for 9 months’ time suggesting 12 months or more was not unrealistic for a diagnosis of the Claimant’s type of condition. However, the fact that a 9 month follow up was diarised did not mean that the Claimant would not have symptoms as demonstrated by the assessments of 16 and 30 January 2023.

[121]In respect of the intermittent adverse effects described in paragraphs 93.3 above, the Tribunal concluded that the episodic nature of the symptoms meant that the Claimant had an impairment which regular ceased to have a substantial adverse effect on her ability to carry out normal day-to-day activities, but which should be treated as continuing to have that effect because that effect is likely to recur, in accordance with paragraph 2(2) of Schedule 1 EqA.

[122]The Tribunal concluded that the substantial adverse effects of the impairment were long term as from 5 August 2022. Was the impairment cured or were its adverse effects permanently reduced so that they were only minor or trivial?

[123]In cross examination and in submissions, Mr Kirk suggested on behalf of the Respondent that the gaps in the medical records referring to the sight Impairment after March 2023 indicated that the iridotomy procedures had cured the impairment and/or removed its adverse effects by that point.

[124]The Tribunal noted that there was a substantial gap in medical records which referred to the sight impairment between 27 March 2023 and 21 December 2023. On 21 December 2023 an ‘After Visit Summary’ from Guys and St Thomas’ NHS Foundation Trust records that the issue of the Claimant’s primary drainage angle issue was addressed at that visit even if no medication was prescribed and there were no upcoming appointments. There was then a further gap which lasted until the end of the relevant period on 10 May 2024.

[125]Whilst these gaps could possibly be explained by the iridotomy curing the narrow/closed primary angles, the Claimant provided an alternative explanation. She said that she was stressed. anxious and depressed in 2023 so that she became withdrawn; interacting with her GP to a lesser degree and focused on her stress and depression. There was contemporaneous medical documentary evidence to support the Claimant’s explanation in the form of fit notes in February, April and September 2023 which refer to anxiety and stress.

[126]As stated above, on 16 January 2023 the Consultant Ophthalmologist, Mr Ian Rodrigues, recorded that the drainage angle in the left eye was now “more open following laser iridotomy”. He also recorded that “Pressure normal in both eyes without Tiopex, so can remain off this for now. No eye pressure lowering treatment required at present”. (In each case the underlining is our emphasis). Mr Rodrigues description leads the Tribunal to conclude that there was an improvement following the iridotomy but that the Consultant considered that improvement was not certain or permanent and the Claimant’s eye pressure may well increase and cause the same symptoms again. Mr Rodrigues also indicated that the Claimant would need follow up in 9 months. As it turned out the evidence showed the Claimant would need follow up in a matter of weeks.

[127]As stated above, the Claimant gave clear and consistent oral evidence that she still suffered with the symptoms after the iridotomy procedures and she continues to experience them up to the present day.

[128]The improvements following the iridotomy procedures do appear to have assisted the Claimant and reduced the symptoms for a while afterwards so that the number of medical interactions regarding the sight impairment symptoms were reduced. However, the Tribunal concluded that the impairment was not cured, and, the adverse effects of the impairment were not permanently reduced to the level of being only minor or trivial. Summary

[129]On the basis of the conclusions above, the Tribunal determined that between 5 August 2022 and 10 May 2024 inclusive the Claimant did have a physical impairment (which she labelled as a ‘sight impairment’,) and that impairment had a substantial and long-term adverse effect on her ability to carry out normal day-to-day activities.

[130]As such, the Tribunal’s judgment is that the Claimant had a disability for the purposes of section 6 EqA during the relevant period of 13 February 2023 to 10 May 2024. Employment Judge Ost 19 February 2026 Notes All judgments (apart from judgments under Rule 51) and any written reasons for the judgments are published, in full, online at https://www.gov.uk/employment-tribunal-decisions shortly after a copy has been sent to the claimants and respondents. If a Tribunal hearing has been recorded, you may request a transcript of the recording. Unless there are exceptional circumstances, you will have to pay for it. If a transcript is produced it will not include any oral judgment or reasons given at the hearing. The transcript will not be checked, approved or verified by a judge. There is more information in the joint Presidential Practice Direction on the Recording and Transcription of Hearings and accompanying Guidance, which can be found here: www.judiciary.uk/guidance-and-resources/employment-rules-and-legislation-practice-directions/