To Describe Clinical Profile and Meticulous Documentation in Ocular Medico-Legal Cases at Tertiary Hospital in Ahmedabad

Abstract

Background: Ophthalmologists play an important role in the management and fixing of legal responsibility in ocular medico legal cases (MLCs). All penetrating or non-penetrating intentional ocular trauma causing loss of an organ or part of organ and which have as consequence the facial disfigurement or post trauma complication have forensic implications. Objective: To describe the clinical profile and meticulous documentation in ocular medico-legal cases attending the ophthalmic unit at a tertiary care hospital in Ahmedabad. Methods: Medical records of ocular MLC from May 2018 to November 2020 were considered. A total of 112 cases of ocular injury constituted the sample size. The injuries were categorized as adnexal and globe injuries. The clinical profile was recorded in the clinical record forms and analyzed accordingly. Results: A total of 112 patients with ocular trauma were recruited with follow up to 6 months following recruitment. The most affected age group was 26-40 years (25.89%). The most common mode of injury was assault with fist in 22 (18.74) of cases. Most patients had open globe injury (28, 25%), while 20 (16.5%) had closed globe injury, 38 (33.93%) had the adnexal injury, 7 (6.25%) had open plus adnexal, 7 (6.25%) had closed plus adnexal and 12 (10.71%) had chemical injury. Adnexal injuries were the most common (38,33.93%). Lid / periorbital contusion and sub-conjunctival hemorrhage were the most common presentations among adnexal and globe injuries respectively. Malingering was present in 3(3 %) cases. Furthermore, among the adult population, majority 28 (25%) had ocular injury at workplace, while most pediatrics injuries 23(20.54%) occurred at home during play. Incidence of monocular blindness was 2(9%) at 6 months follow up. Factor that was associated with monocular blindness was open globe injuries. Conclusion: Fist injury was the most common cause of trauma to the eye. A substantial number of patients who had adnexal injuries or sub-conjunctival hemorrhage had good vision, contrary to open globe injuries which resulted in very poor vision.

Keywords

• forensic medicine
• medico-legal case
• ophthalmic mlc