《人体损伤程度鉴定标准》“视力视器损伤”条款解读与分析

《人体损伤程鉴定标准》＂视力视器损伤＂部分,在充分吸纳国内、国外新的损伤理念（如WHO关于盲目的分类、《国际功能、残疾和健康分类（ICF）》,美国医学会《永久残损评定指南（GEPI）》）的基础上,进一步追求标准的科学性、规范性。该标准去除了旧标准中不适当的条款,增加了标准的可操作性,并使得标准更符合国际潮流。与旧标准相比,条款总体变化的情况如下：条目大量增加,条目由旧标准的19条目增加至39条目;条款内容细化;新增了视野缺损条款5个条目。上述变化,需要法医临床学工作者加以关注并正确解读。同时,在司法鉴定实践中,伪盲鉴别、视野检查及其客观评定方面的操作难度将大幅增加,相应的科学研究需同步跟进。本文对本标准运行中存在的技术难点给予了解读;同时详解了＂视野有效值＂的计算方法,即：实测视野有效值（%）=（8条子午线实测视野值之和/500）×100%。

The Standard of Human Body Injury Assessment-Interpretation and Analysis of the Vision and Visual Organ Impairment Section

On the basis of adopting new concepts of visual injury at home and abroad, e.g. ＂Blind classification＂ and ＂International Classification of Functioning, Disability and Health, ICF＂ promulgated by World Health Organization, American Medical Association＇s ＂Guides to the Evaluation of Permanent Impairment, GEPI＂, the section of vision and visual organ impairment in the Standard of Human Body Injury Assessment is compiled to be more scientific and normative. Some inappropriate clauses are removed, and the new standard is more operable and consistent with the international trends. Compared with the old standard, the new standard has a lot of changes. In general： The clauses increase from nineteen to thirty-nine, The contents of the clauses are more specific, Five clauses on defect of visual field are added. The experts of clinical forensic medicine need to pay more attention to these changes and understand them properly. At the same time, in the judicial practice, it will become more difficult to identify the pseudo blindness, perform the perimetry test and assess the objective visual field. Therefore, related scientific studies are required to step up. This paper interpretes the technical difficulties in the new standard, and describes in detail the method for calculating the ＂effective value of visual field＂, i.e. the measured effective value of visual field （%） = SUM of 8 visual field values measured in meridians/500） × 100%.