10例青光眼法医临床学鉴定分析

目的探讨青光眼的形成机制、鉴别诊断、鉴定方法等相关问题。方法对10例青光眼的临床法医学鉴定例资料进行回顾性研究。结果10例青光眼中,5例为外伤性青光眼,1例可能为混合型,4例属病理性青光眼;鉴定时间在伤后3-12个月,其中轻微伤2例,轻伤6例,重伤2例。结论外伤性继发性青光眼的认定首先需有明确的眼部外伤史,其次是有能导致青光眼的损伤,而后监测眼压确诊青光眼;与病理性青光眼主要鉴别点为前房深浅、前房角、杯/盘比(C/D)、眼底血管改变等;损伤程度应在明确诊断及进行相关治疗后,主要依据视力及视野损害情况确定。

Clinical forensic medicine expertise and analysis on 10 cases of glaucoma

Objective To explore relative problems of the mechanism,differential diagnose and expertise method of glaucoma.Methods A retrospective study was carried on the expertise data of clinical in 10 cases of glaucoma.Results Of 10 cases of glaucoma,there were five traumatic cases,four pathologic cases and one case of both traumatic and pathological factors.Time of expertise of forensic medicine was 3-12 months after injury.There were two cases of slight injury;six,middle and two severe.Conclusion The diagnosis points of affirming traumatic secondary glaucoma,including definite history of ocular injury,the traumatic changes causing glaucoma and results of monitoring intraocular pressure.The key points of distinguish between traumatic and pathological glaucoma are the depth of anterior chamber,angle of anterior chamber,ratio of C/D and change of fundus retinal vessel,and soon.The degree of injury should be come out on the basis of traumatic changes of visual acuity and visual field after definite diagnosis and necessary therapy.