Tripathy Koushik, Chawla Rohan, Venkatesh Pradeep, Vohra Rajpal, Sharma Yog Raj
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2016 Jun;64(6):422-6. doi: 10.4103/0301-4738.187656.
The purpose of this study was to analyze the clinical profile of medicolegal cases (MLCs) presenting to the eye casualty in a tertiary care hospital.
Retrospective review of records. The cases were grouped according to the Ocular Trauma Classification Group classification system.
Out of 188 MLCs, 164 (87.2%) were male. Mean age (±standard deviation) was 31.6 (±12.7) years. Age ranged from 7 to 75 years. Twenty-six (13.8%) patients had bilateral involvement. The fist was the most common mode of injury, which was seen in 109 (58%) cases. A total of 27 (14.3%) patients had associated extraocular injury. No evidence of ocular or orbital trauma (malingering) could be found in 13 (7%) patients. Mechanical trauma was present in 169 (90%) patients with injury to globe in 129 (69%) patients and injury to lid or orbit without damage to the globe in 40 (21%) patients. Chemical injury was observed in 6 (3%) patients. Closed globe injury (CGI) was seen in 116 eyes and open globe injury (OGI) was noted in 29 eyes. The most common type of injury, zone, pupil, and grade of injury in CGI were Type A or contusion (79%), Zone I (72%), Pupil B (absence of relative afferent pupillary defect) in 95%, and Grade A [visual acuity (VA) ≥20/40] in 68% of the eyes, respectively. The most common type of injury, zone, pupil, and grade of injury in OGI were Type B or penetrating (48%), Zone II (38%), Pupil B (59%), and Grade D (VA 4/200-light perception) (42%), respectively.
The most common form and mode of ocular injury in MLC were closed globe injury and fist, respectively. The most common type of injury in CGI and OGI was contusion and penetrating injury, respectively.
本研究旨在分析一家三级医院眼科急诊中医疗法律案件（MLC）的临床特征。
对病例记录进行回顾性分析。病例根据眼外伤分类组分类系统进行分组。
在188例医疗法律案件中，164例（87.2%）为男性。平均年龄（±标准差）为31.6（±12.7）岁。年龄范围为7至75岁。26例（13.8%）患者为双眼受累。拳击是最常见的致伤方式，见于109例（58%）病例。共有27例（14.3%）患者伴有眼外损伤。13例（7%）患者未发现眼或眼眶外伤（诈病）证据。169例（90%）患者存在机械性外伤，其中129例（69%）患者眼球受伤，40例（21%）患者眼睑或眼眶受伤但眼球未受损。6例（3%）患者观察到化学伤。116只眼出现闭合性眼球损伤（CGI），29只眼出现开放性眼球损伤（OGI）。CGI中最常见的损伤类型、区域、瞳孔及损伤分级分别为A型或挫伤（79%）、I区（72%）、B型瞳孔（无相对性传入瞳孔障碍）占95%、A级[视力（VA）≥20/40]占68%的眼。OGI中最常见的损伤类型、区域、瞳孔及损伤分级分别为B型或穿透伤（48%）、II区（38%）、B型瞳孔（59%）、D级（VA 4/200 - 光感）（42%）。
医疗法律案件中最常见的眼外伤形式和方式分别为闭合性眼球损伤和拳击。CGI和OGI中最常见的损伤类型分别为挫伤和穿透伤。
