外伤后视力下降的法医学鉴定

Forensic investigation of the post-traumatic vision loss

目的探讨外伤后视力下降与外伤之间的关系以及法医学鉴定要点。方法对2009年6月至2013年6月受理的300例外伤后出现视力下降的案例进行回顾性分析。所有伤者均进行体表检查、视力检查、眶骨CT扫描,以排除伤前视力下降、伪盲等,分析视力下降的原因。结果视力下降与外伤有关267例(89.0%),其中短期内恢复185例(61.7%);视力下降与外伤之间的关系无法认定或与外伤无关33例(11.0%)。鉴定情况:重伤21例(7.0%),轻伤201例(67.0%),轻微伤71例(23.7%),未见外伤7例(2.3%)。结论外伤后视力下降大部分为功能性下降,经过短期恢复,视力可正常或接近正常;视力明显下降并且不能恢复的均存在器质性损伤;伤病共存案例中外伤所起作用是鉴定的关键;部分案例因无器质性损伤,与外伤关系无法认定。

Objectives To explore the relationship between post-traumatic vision loss and the trauma and forensic investigation point.Methods Three hundred cases of vision loss collected from June 2009 to June 2013 were retrospectively analyzed. All the injured were carried out for exterior examination, visual acuity and orbital bone CT scan to rule out pre-injury vision loss, pseudo-blindness and other causes of vision loss. Results Decreased vision of 267 cases(89.0%) was related to trauma, with 185(61.7%) of them having shortterm vision recovery. Vision loss of 33 cases(11.0%) was not identified to have relationship with trauma or related to trauma. Forensic investigation results included serious injury of 21 cases(7.0%), moderate injury of 201 cases(67.0%), minor injury of 71 cases(23.7%), and non-trauma of 7 cases(2.3%).Conclusion The majority of post-traumatic vision loss was functional. Vision can return to normal or near normal level. The patients who had decreased vision and could not return to normal level might have organic damage. Trauma played an important role in investigating injuries coexistence scenario cases. Some cases were not identified to have relationship with trauma because of no organic damage.