眼外伤后视网膜脱离15例的法医学鉴定分析

目的:探讨视网膜脱离的形成机制、鉴别诊断、鉴定方法等相关问题。方法:对15例视网膜脱离的临床法医学鉴定资料进行回顾性研究。结果:15例视网膜脱离案例中,10例为外伤性视网膜脱离,其他5例存在不同程度的眼球组织结构病变,为非外伤性视网膜脱离;鉴定时间在3～14mo,其中轻微伤2例,轻伤5例,重伤8例。结论:外伤性视网膜脱离要有明确的眼部外伤史,且损伤程度重,玻璃体、视网膜未见明显变性改变;而非外伤性视网膜脱离的主要特点为外伤程度轻,多以外眼损伤为主,存在玻璃体、视网膜变性;损伤程度应在诊断明确及进行相关治疗后,主要依据中心视力或视野损害情况确定。

Clinical forensic medicine expertise and analysis on 15 cases of retinal detachment

AIM:To explore relative problems of the mechanism,differential diagnose and expertise method of retinal detachment.·METHODS: A retrospective study was carried on the clinical expertise data in 15 cases with retinal detachment. ·RESULTS: Of 15 cases with retinal detachment,there were 10 traumatic cases,and other 5 cases existed pathological changes of globe tissue structure of different degrees,they were non-traumatic cases. Time of expertise of forensic medicine was 3-14 months after injury. There were 2 cases of slight injury,5 middle and 8 severe.·CONCLUSION: The diagnosis points affirming traumatic retinal detachment,including definite history of ocular injury ,and the degree of injury was severe,the degeneration of vitreous body and retina had not yet been found via the examination of ocular fundus. While the non-traumatic retinal detachment,main features were as follows: the degree of trauma is slight,injury of outer eye is dominant,there exist degeneration of vitreous body and retina. The degree of injury should be come out on the basis of central vision or visual field damage after definite diagnosis and necessary therapy.