Subscribe to RSS
DOI: 10.1055/a-1178-5031
Contextual Assessment of Retinal Injuries – Tasks of the Ophthalmological Expert
Article in several languages: English | deutsch![](https://www.thieme-connect.de/media/klimo/202009/lookinside/thumbnails/10-1055-a-1178-5031_kl2195_en-1.jpg)
Abstract
The ophthalmologic assessment of causal relationships is subject to formal guidelines, depending on the legal field (social law in the statutory accident insurance, civil law in the private accident insurance). After determining all objective and subjective findings of the individual case with complete recording of the medical facts, the ophthalmologist has the task of making a summarizing assessment of the existing cause-and-effect relationship. With regard to the distinction between retinal damage caused by an accident or retinal disease not caused by an accident, it is necessary to weigh up the natural causality according to the state of medical experience on the basis of the criteria strength of association, consistency, specificity, temporal sequence, dose dependence, agreement with previous findings, experimental reliability and analogous consideration. All records of medical findings from the patientʼs medical history and the individual description of the accident must be included in the expert opinion. In the case of several competing causes (often accident and pre-existing damage), the social law in the statutory accident insurance must present the causal contributions with roughly estimated probabilities. In civil law, valid for the private accident insurance, the existence of partial causality (approx. 25, 50, 75%) must be evaluated.
Key words
retinal detachment - causal relationship - accident insurance - expert opinion - ocular disease - ophthalmologistPublication History
Received: 28 April 2020
Accepted: 13 August 2020
Article published online:
23 September 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Stuttgart · New York
-
References/Literatur
- 1 Brodowska K, Stryjewski TP, Papavasileiou E. et al. Validation of the retinal detachment after open globe injury (RD-OGI) score as an effective tool for predicting retinal detachment. Ophthalmology 2017; 124: 674-678
- 2 Rohrbach JM, Steuhl K, Knorr M, Kirchhof B. Hrsg. Ophthalmologische Traumatologie. Stuttgart: Schattauer; 2002
- 3 Hoogewoud F, Chronopoulos A, Varga Z. et al. Traumatic retinal detachment–the difficulty and importance of correct diagnosis. Surv Ophthalmol 2016; 61: 156-163
- 4 Gramberg-Danielsen B. Hrsg. Medizinische Grundlagen der augenärztlichen Begutachtung. 2. Aufl.. Stuttgart: Enke; 1996
- 5 AWMF. AWMF Leitlinie 094/001 Allgemeine Grundlagen der medizinischen Begutachtung: (April 2020). Available at (Accessed 31.01.2019): http://www.awmf.org/leitlinien/detail/ll/094-001.html
- 6 Spellbrink W. Die Aufgabenverteilung zwischen (medizinischem) Sachverständigen und Richter bei der Kausalitätsprüfung im Recht der gesetzlichen Unfallversicherung. Med Sach 2017; 113: 51-56
- 7 Fabra M. Einfache („objektive“) Kausalität am Beispiel der Bradford-Hill-Kriterien angewendet auf Traumafolgestörungen. Med Sach 2014; 110: 6-12
- 8 Kapoor M, Chawla R, Tripathy K. et al. Traumatic Retinal Detachment. DOS Times 2015; 20: 29-32
- 9 Kuhn F, Morris R, Witherspoon CD. et al. Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiol 2006; 13: 209-216
- 10 Stryjewski TP, Andreoli CM, Eliott D. Retinal detachment after open globe injury. Ophthalmology 2014; 121: 327-333
- 11 Domarus D, Deuble-Bente K, Naumann GOH. Trauma, Operationen und Wundheilung des Auges. In: Naumann GOH. Hrsg. Pathologie des Auges. Berlin, Heidelberg: Springer; 1997: 301-368
- 12 Schutz JS, Mavrakanas NA. The value of the ophthalmological independent medical examination: analysis of 344 cases. Br J Ophthalmol 2009; 93: 1371-1375
- 13 Hollander DA, Irvine AR, Poothullil AM. et al. Distinguishing features of nontraumatic and traumatic retinal dialyses. Retina 2004; 24: 669-675
- 14 Rohrschneider K, Tost F. Das augenärztliche Gutachten in unterschiedlichen Rechtsgebieten. Augenheilkunde up2date 2020; 10: 183-201
- 15 Tost F. Wesentliche Aspekte der augenärztlichen Begutachtung für die private Unfallversicherung. Ophthalmologe 2014; 111: 579-596
- 16 Byer NE. Kann die rhegmatogene Netzhautablösung verhindert werden? Überlegungen zur Geschichte der „prophylaktischen“ Behandlung der Netzhautablösung. Ophthalmologe 2000; 97: 696-702
- 17 Heimann H. Netzhautablösung, periphere Netzhautdegenerationen und Retinoschisis. In: Kellner U, Wachtlin J. Hrsg. Retina. Stuttgart: Thieme; 2008: 161-177
- 18 Tost F, Kolling G, Lachenmayr B. Private Unfallversicherung. In: Lachenmayr B. Hrsg. Begutachtung in der Augenheilkunde. 3. Aufl.. Berlin, Heidelberg: Springer; 2019: 185-238