Clinical profile of Medico-Legal cases in Ophthalmology: a descriptive study

Introduction: Ophthalmologists play an important role in the management and fixing of legal responsibility in ocular medicolegal cases (MLCs).

 

Objective: To describe the clinical profile of ocular medico-legal cases attending the ophthalmic unit at a tertiary care hospital in north India

 

Methods: Medical records of of ocular MLC from November 2015 to May 2018 were considered. The injuries were categorised as adnexal and globe injuries. The clinical profile was recorded in the clinical record forms and analyzed accordingly.

 

Results: Hundred and fifty six patients were enrolled in the study of which 88 % (137) were male. The mean age was 31.4 years. The most common mode of injury was assault with fist in 55% (86) of cases. Adnexal injuries were the most common n= 72 (46 %). Lid /periorbital contusion and subconjunctival hemorrhage were the most common presentations among adnexal and globe injuries respectively. Open globe injury occurred in 5% (8), of which all had poor prognosis. Malingering was present in 3 % (4). All presented with profound and sudden loss of vision with bleeding from the eye and 12 % (18) of patients had related preexisting ocular morbidity with the present injury.

 

Conclusion: Fist injury was the most common cause of trauma to the eye. A substantial number of patients who had adnexal injuries or subconjunctival hemorrhage had good vision, contrary to open globe injuries which resulted in very poor vision.

 

Recommendation: Medicolegal cases require meticulous eye examination along with clear and concise documentation. It is important to always correlate reduced vision with signs of recent injury and be aware of malingering.