Search

Purpose: To determine the pattern of medicolegal ocular trauma and its visual outcome in cases of assault presenting in the outpatient department of ophthalmology. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Abbasi Shaheed Hospital, Karachi Medical and dental college (KMDC), from January, 2020 to June, 2022. Methods: This study included 199 patients of assault, registered as medicolegal cases and referred for examination by a police surgeon. Findings were recorded on a pre designed proforma and categorised according to Bermingham Eye Trauma Terminology (BETT). The results were presented in frequencies. Results: The study analysed ocular injuries in a group of participants, predominantly male (81.9%), with a mean age of 34 years. The majority of injuries were closed-globe (70.4%), primarily occurring in Zone 1. Pre-treatment visual acuity was generally high, with 85.4% of patients having 20/20-20/40 vision, which improved slightly to 87.4% post-treatment. Open-globe injuries were rare (1.0%) and also confined to Zone 1. The most common trauma setting was the home, and the most frequent cause of injury was assault using a fist. Conclusion: Majority of the patients were young males who suffered trauma at home and fist was the most common causative agent. The study highlights the prevalence of closed-globe injuries, the effectiveness of treatment in preserving visual acuity, and the domestic nature of most ocular traumas. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to determine the opinions of ophthalmologists about the use of telemedicine applications in the field of ophthalmology. Methods: A standardized questionnaire consisting of 20 questions about demographic information and the use of telemedicine applications in ophthalmology was sent electronically to 110 ophthalmologists. The physicians were asked to answer the questionnaire, and the data were analyzed. Results: Of the 110 physicians who received the questionnaire, 87 answered all the questions in the questionnaire, and the results were evaluated based on the answers of 87 physicians. Only 9 (11%) of the physicians stated that they had sufficient knowledge about telemedicine, and it was observed that all of these physicians were between the ages of 24-34. Fifty-eight (67%) of the physicians stated that telemedicine applications could be used, and 60 (69%) stated that the patients would also benefit from these applications. It has been observed that the rate of physicians who think that the patient-physician relationship will be affected by these practices is only 29 (33%). Sixty-two (74%) of the physicians stated that the telemedicine services to be provided through voice communication and video transmission in the field of ophthalmology would be insufficient, and they stated that video conversation would be appropriate. Conclusion: The necessity of keeping up with the speed of technology development in health services will include telemedicine applications more in our lives. As a result of our study, we can predict that ophthalmologists will support this field if deficiencies are eliminated, and medicolegal regulations are made. [ABSTRACT FROM AUTHOR]

Eye examination plays an important role when living individuals are forensically investigated. The iris colour, retinal scans and other biometric features may be used for identification purposes while visual impairments may have legal implications in employment, driving and accidents. Ocular manifestations provide clues regarding substance abuse, poisoning and toxicity, and evidence of trauma, abuse or disease can be revealed along with psychological traits and lifestyle. Thus, the eye is a valuable tool in forensic investigations of living subjects, providing identifying characteristics along with health information. This review focuses on the medico-legal aspects of the eye's contribution when the living are subjected to forensic examination.

Purpose: The purpose of this study was to analyze the clinical profile of medicolegal cases (MLCs) presenting to the eye casualty in a tertiary care hospital.Materials and Methods: Retrospective review of records. The cases were grouped according to the Ocular Trauma Classification Group classification system.Results: Out of 188 MLCs, 164 (87.2%) were male. Mean age (±standard deviation) was 31.6 (±12.7) years. Age ranged from 7 to 75 years. Twenty-six (13.8%) patients had bilateral involvement. The fist was the most common mode of injury, which was seen in 109 (58%) cases. A total of 27 (14.3%) patients had associated extraocular injury. No evidence of ocular or orbital trauma (malingering) could be found in 13 (7%) patients. Mechanical trauma was present in 169 (90%) patients with injury to globe in 129 (69%) patients and injury to lid or orbit without damage to the globe in 40 (21%) patients. Chemical injury was observed in 6 (3%) patients. Closed globe injury (CGI) was seen in 116 eyes and open globe injury (OGI) was noted in 29 eyes. The most common type of injury, zone, pupil, and grade of injury in CGI were Type A or contusion (79%), Zone I (72%), Pupil B (absence of relative afferent pupillary defect) in 95%, and Grade A [visual acuity (VA) ≥20/40] in 68% of the eyes, respectively. The most common type of injury, zone, pupil, and grade of injury in OGI were Type B or penetrating (48%), Zone II (38%), Pupil B (59%), and Grade D (VA 4/200-light perception) (42%), respectively.Conclusions: The most common form and mode of ocular injury in MLC were closed globe injury and fist, respectively. The most common type of injury in CGI and OGI was contusion and penetrating injury, respectively. [ABSTRACT FROM AUTHOR]

Contact lenses have had rare relevance in trials and/or investigations. After 5 years of burial, orbital remnants were retrieved from an exhumed body and subsequently identified as a key piece of material evidence in a murder trial. The exhumed case materials were evaluated under laboratory conditions and were determined to be contact lens remnants. Contact lens fracture and burial simulation studies were performed to provide additional corroboration of the physical findings of the exhumed contact lens remnants. This material evidence was instrumental in providing factual proof refuting the defendant's testimony in the murder trial. A brief history of contact lens composition and use is provided for understanding the methods and observational results. This forensic case study represents the first published documentation of a contact lens from an exhumed body being used in a murder investigation and establishes an operational procedure for future forensic contact lens examinations. [ABSTRACT FROM AUTHOR]

A person is considered to be a forensic case if an other person is responsible of health loss. Health workers are obligated to report suspected guilt at work. Forensic reports have to depend on signs and symptoms, consultation reports, examination results and medical specialist knowledge and have to be objective. Forensic ophthalmologic cases might be classified as; cases that can be created by simple operations, cases that can not be treated by simple operations, life threatening ophthalmologic cases, cases with ophthalmologic sense and organ failure. "The rules about defectiveness degree, classification and writing health councill reports for disabled people" had been inured At 14.01.2012. In this review forensic reporting principles for ocular trauma according to actual laws and rules are discussed. [ABSTRACT FROM AUTHOR]

We present the case of a 59-year-old male patient with progressive vision impairment and consecutive visual field narrowing ('tunnel view') for 7 years and a known retinitis pigmentosa for 5 years. The remaining Goldmann perimetric visual field at time reported was less than 5°. A request for blindness-related social benefits was rejected because an ophthalmologic expert assessment suggested malingering. This prompted us to assess an objective determination of the visual field using multifocal VEPs. Objective visual field recordings were performed with a four-channel multifocal VEP-perimeter using 58 stimulus fields (pattern reversal dartboard stimulus configuration). The correlated signal data were processed using an off-line method. At each field, the recording from the channel with the maximal signal-to-noise ratio (SNR) was retained, thus resulting in an SNR optimized virtual recording. Analysis of VEP signals was performed for each single field and concentric rings and compared to an average response measured in five healthy subjects. Substantial VEP responses could be identified in three fields within the innermost ring (eccentricity, 1.7°) for both eyes, although SNR was generally low. More eccentric stimuli did not elicit reliable VEP responses. The mfVEP recording was correlated with perimetric visual field data. The current SNR optimization by using the channel with the largest SNR provides a good method to extract useful data from recordings and may be appropriate for the use in forensic ophthalmology. [ABSTRACT FROM AUTHOR]