对比度视力在夸大视力障碍鉴定中的应用

Application of Contrast Vision in Identifying the Malingering Decreased Vision

目的研究对比度视力在夸大视力障碍程度鉴定中的应用价值。方法选择中青年健康志愿者31人,随机分为两组,第一组16人32眼,第二组15人30眼。视标对比度分别采用100%、25%、10%、5%。测定第一组的对比度视力。第二组分别用以下4种方法检查对比度视力:(1)受检者配合;(2)受检者配合且检查者干预;(3)受检者伪装视力降低;(4)受检者伪装视力降低且检查者干预。然后进行统计学分析。结果对比度视力与对比度大小存在密切的关系,随着对比度降低,所测得的视力水平亦逐步降低。受检者用前两种方法检查,其对比度视力曲线呈现良好的重复性;而用后两种方法所形成的两条曲线重复性均差。结论利用检查者的干预技术并观察不同次检查结果的重复性可鉴别伪装视力降低,获取的对比度视力曲线可作为直观的证据提交给法庭以提高鉴定结论的证明力。

Objective To study the application value of contrast vision in identifying the malingering decreased vision in the practice of clinical forensic medicine.Methods Thirty-one young and middle aged volunteers were selected and divided randomly into group 1（16 persons with 32 eyes） and group 2（15 persons with 30 eyes）.The optotype contrast was 100%,25%,10% and 5%,respectively.The contrast vision of group 1 was tested.The contrast vision of group 2 was tested as follows：（1） the volunteers cooperated without inspector＇s interference;（2） the volunteers cooperated under inspector＇s interference;（3） the volunteers disguised decreased vision without inspector＇s interference;（4） the volunteers disguised decreased vision under inspector＇s interference.The data was then analyzed by statistics.Results There was a close correlation between contrast vision and contrast.As the contrast decreased,the vision acuity also decreased.The contrast vision curve of former two methods showed a good reproducibility while the contrast vision curve of latter two methods had a bad reproducibility.Conclusion The repetition of contrast curve with or without inspector＇s interference can be used to discriminate malingering vision.The acquired contrast curves can be provided to the court as direct evidence and can help enhance the verification conclusion.