Medico-Legal Perspectives on Ocular Injuries in India: Challenges and Implications for Clinical Practice and Forensic Evaluation
DOI:
https://doi.org/10.48165/jfmt.2025.42.2.15Keywords:
Ocular trauma, Medico-legal aspects, Forensic ophthalmology, Medical negligence, IndiaAbstract
Introduction:Ocular trauma is a significant public health concern, often leading to vision impairment or blindness. In India, medico-legal considerations play a crucial role in the assessment and management of ocular injuries, necessi tating a comprehensive understanding of forensic evaluation, legal obligations, and clinical responsibilities.Objective: This review explores the medico-legal aspects of ocular trauma in India, analysing the epide miology, forensic assessment, legal implications, and challenges in clinical practice.Methods: A systematic review was conducted using electronic databases such as PubMed, Scopus, Google Scholar, and Indian Kanoon, focusing on studies published in the last 30 years. The review included peer-reviewed arti cles, legal statutes, forensic guidelines, and judicial precedents related to ocular trauma. Results and discussion: The incidence of ocular injuries remains high, particularly among males in occupational and road traffic accidents. Classification systems, such as the Ocular Trauma Score (OTS) and BETT classification, aid in prognosis and documen tation. Legal aspects include requirements for informed consent, medico-legal documentation, expert witness testimony, and liability in cases of medical negligence. The review highlights challenges in maintaining proper records, ethical considerations, and the need for increased medico-legal awareness among ophthalmologists.Conclusion:Medico-legal knowledge is essential for ophthalmologists to ensure legal compliance and ethical practice. Proper documentation, adherence to forensic guidelines, and understanding the implications of medical negligence can help safeguard both patients and practitioners.
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References
Lyon, I. B., Dogra, T. D., & Rudra, A. (2005). Lyon’s Medical Jurisprudence and Toxicology (11th ed., p. 367). Delhi, India: Delhi Law House.
Gupta, P., Shukla, A., & Kujur, R. (2021). Clinical profile of medico-legal cases in ophthalmology. Sri Lanka Journal of Forensic Medicine, Science & Law, 12(1), 1–5. https://doi.org/10.4038/sljfmsl.v12i1.7868
Kaçer, E. Ö., & Kaçer, İ. (2022). Ocular trauma in the paediatric age group: A systematic review. Egyptian Pediatric Association Gazette, 70(1), 28.
Thylefors, B. (1992). Epidemiological patterns of ocular trauma. Australian and New Zealand Journal of Ophthalmology, 20(2), 95–98.
Costea, C. F., Sava, A., Dumitresea, G. F., Albert, M., Cucu, A., Turliuc, S., & Turliuc, D. (2015). Forensic aspects of ocular trauma. Aperito Journal of Ophthalmology, 1(2), 109. https://doi.org/10.14437/AJO1-109
Kumar, S., & Blace, N. (2024). Retrobulbar Hematoma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576417/
Vingopoulos, F., Wang, Y., Grob, S., Li, C. Y. L., Eliott, D., Kim, L. A., et al. (2020). Open-globe injury with intraocular foreign body. Journal of Vitreoretinal Diseases, 5(4), 288–294.
Mohseni, M., Blair, K., Gurnani, B., & Bragg, B. N. Blunt Eye Trauma. In: StatPearls [Internet].
Maurya, R. P., Srivastav, T., Singh, V. P., Mishra, C. P., & Al-Mujaini, A. (2019). The epidemiology of ocular trauma in Northern India: A teaching hospital study. Oman Journal of Ophthalmology, 12(2), 78–83.
Doshi, R., & Noohani, T. (2024). Subconjunctival Hemorrhage. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551666/
Costagliola, C., Romano, V., Forbice, E., Angi, M., Pascotto, A., Boccia, T., et al. (2013). Corneal oedema and its medical treatment. Clinical and Experimental Optometry, 96(6), 529–535.
Chow, V. W. S., Agarwal, T., Vajpayee, R. B., & Jhanji, V. (2013). Update on diagnosis and management of Descemet’s membrane detachment. Current Opinion in Ophthalmology, 24(4), 356–361.
Miller, D. D., Hasan, S. A., Simmons, N. L., & Stewart, M. W. (2019). Recurrent corneal erosion: A comprehensive review. Clinical Ophthalmology, 13, 325–335.
Yucel, O. E., Demir, S., Niyaz, L., Sayin, O., Gul, A., & Ariturk, N. (2016). Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma. Eye (London), 30(12), 1606–1613.
Walton, W., Von Hagen, S., Grigorian, R., & Zarbin, M. (2002). Management of traumatic hyphema. Survey of Ophthalmology, 47(4), 297–334.
Current approach in diagnosis and management of anterior uveitis. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841369/
Balamurugan, R., Gupta, P. C., Sharma, V. K., Khurana, S., & Ram, J. (2020). Alternate iris bypass technique of iridodialysis repair. Indian Journal of Ophthalmology, 68(6), 1143–1147.
Mikropoulos, D. G., Kymionis, G. D., Grentzelos, M. A., Voulgari, N., Katsanos, A., & Konstas, A. G. (2019). Combined Pupilloplasty and Retropupillary Iris-Claw Intraocular Lens Implantation with DSAEK in a Patient with Traumatic Iridoplegia, Aphakia and Corneal Decompensation. Ophthalmology and Therapy, 8(3), 497–500.
Impallomeni, M. (1997). Transient complete ptosis and miosis following trauma to the right eyeball in a rugby injury: Where was the lesion? Journal of the Royal Society of Medicine, 90(11), 630–631.
Coleman, D. J. (1995). Evaluation of ciliary body detachment in hypotony. Retina, 15(4), 312–318.
Gupta, V. B., Rajagopala, M., & Ravishankar, B. (2014). Etiopathogenesis of cataract: An appraisal. Indian Journal of Ophthalmology, 62(2), 103–110.
Singh, R. B., Thakur, S., & Ichhpujani, P. (2018). Traumatic rosette cataract. BMJ Case Reports, 11(1), e227465.
Praveen, M. R., Vasavada, A. R., & Singh, R. (2003). Phacoemulsification in subluxated cataract. Indian Journal of Ophthalmology, 51(2), 147–154.
Yu-Wai-Man, P. (2015). Traumatic optic neuropathy—Clinical features and management issues. Taiwan Journal of Ophthalmology, 5(1), 3–8.
Park, J. Y., Nam, W. H., Kim, S. H., Jang, S. Y., Ohn, Y. H., & Park, T. K. (2011). Evaluation of the central macula in commotio retinae not associated with other types of traumatic retinopathy. Korean Journal of Ophthalmology, 25(4), 262–267.
[PMC article missing details — reference incomplete]
Dogramaci, M., Erdur, S. K., & Senturk, F. (2021). Standardized classification of mechanical ocular injuries: Efficacy and shortfalls. Beyoglu Eye Journal, 6(3), 236–242.
Scott, R. (2015). The Ocular Trauma Score. Community Eye Health, 28(91), 44–45.
Tripathy, K., Chawla, R., Venkatesh, P., Vohra, R., & Sharma, Y. R. (2016). Clinical profile of medicolegal cases presenting to the eye casualty in a tertiary care center in India. Indian Journal of Ophthalmology, 64, 422–426.
Das, S., & Sharma, M. (2017). Analysis of medico-legal cases registered at eye casualty in Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam. Journal of Evolution of Medical and Dental Sciences, 6(93), 6717–6721. https://doi.org/10.1426/jemds/2017/1454
Nandimath, O. V. (2009). Consent and medical treatment: The legal paradigm in India. Indian Journal of Urology, 25, 343–347.
Ministry of Law and Justice, Government of India. (2005). The Right to Information Act, 2005. Available from: https://righttoinformation.gov.in/rti-act.pdf
Ministry of Electronics and Information Technology, Government of India. (2000). The Information Technology Act, 2000. Available from: https://www.meity.gov.in/content/information-technology-act-2000-0
Ministry of Health and Family Welfare, Government of India. (2010). The Clinical Establishments Act, 2010. Available from: https://www.clinicalestablishments.gov.in/WriteReadData/969.pdf
