道路交通事故眼损伤伤残评定的标准化和规范化

发布时间：2018-06-28 00:43

本文选题：道路交通事故 + 眼损伤　；参考：《中国司法鉴定》2010年04期

【摘要】：GB18667-2002《道路交通事故受伤人员伤残评定》标准(以下简称"标准")中有关眼损伤的条款较为原则和笼统。随着"标准"的广泛应用,加之法医学和临床眼科学技术的不断进步,对眼损伤后遗症的检验技术和认识水平已有较大的提高。建议采用视力表投影仪代替国际视力表进行行为视力检查,存在屈光不正的应了解屈光度后再检查其矫正视力;疑有伪盲或伪装视力降低时,可行伪盲试验或伪装视力降低的检验,视觉电生理技术是测试伪盲或伪装视力降低的有效方法。运用电脑视野计可进行视野检查,动态视野检查结果可通过视野有效值换算为残存视野半径(或直径);视野检查存在一定的干扰因素,分析时应密切结合原发损伤及其他检查结果。对于遗留复视等双眼视障碍的,可采用同视机等检查方法,检验结果应考察功能障碍与眼肌等原发性损伤的符合性。泪器损伤后遗留溢泪症状的,应采用相应的检查方法证实泪道狭窄或梗阻。眼睑下垂及眼睑畸形分为轻度及重度;眼睑畸形包括闭合不全、眼睑缺损及眼睑外翻等情形。影响视力的外伤性白内障符合"标准"相关条款的规定。根据现行"标准"对道路交通事故所致眼损伤进行伤残评定,应进行视觉功能检测、眼球结构检查、伪盲试验及视觉电生理检测,最后综合病史材料及既往情况综合分析,得出评定结果。统一对现行"标准"的理解,规范检测手段和结果评价原则,有助于道路交通事故眼损伤伤残评定的标准化和规范化。
[Abstract]:The articles about eye injury in the Standard (hereinafter referred to as "Standard") in GB18667-2002 are more general and general. With the extensive application of "standard" and the continuous progress of forensic science and clinical ophthalmic science and technology, the test technique and understanding level of the sequelae of eye injury have been greatly improved. It is suggested that the vision chart projector should be used instead of the international visual acuity chart for behavioral visual acuity examination. If there is ametropia, the corrected visual acuity should be checked after the diopter is known; if there is a false blindness or the camouflage visual acuity is reduced, Visual electrophysiology is an effective method to test false blindness or camouflage vision loss. The result of dynamic visual field examination can be converted to the radius (or diameter) of residual visual field by the virtual value of visual field, and there are some interference factors in visual field examination. Analysis should be closely combined with primary injury and other examination results. The conformance between functional disorders and primary injuries such as ocular muscles should be investigated by using the same machine to examine the residual binocular visual disorders such as diplopia. Lacrimal duct stenosis or obstruction should be confirmed by appropriate examination method if lacrimal organ injury left behind lacrimal symptoms. Blepharoptosis and eyelid malformation can be classified as mild and severe, including malocclusion, eyelid defect and ectropion. Traumatic cataracts that affect vision comply with the relevant provisions of the Standards. According to the present "standard", the evaluation of eye injury caused by road traffic accident should be carried out with visual function test, eyeball structure examination, pseudo-blind test and visual electrophysiology test. Finally, comprehensive analysis of medical history materials and previous situation should be made. Get the result of the evaluation. Unifying the understanding of the current "standard", standardizing the means of inspection and the principle of evaluating the result, will help to standardize and standardize the evaluation of eye injury and disability in road traffic accidents.
【作者单位】：司法部司法鉴定科学技术研究所上海市法医学重点实验室;复旦大学上海医学院法医学系;
【基金】：上海市科委《视觉功能障碍法医学鉴定指南》资助课题(08DZ0503900)
【分类号】：D919

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