Gürol BERBER, Orhan ATEŞ, Muhammed Nabi KANTARCI, Feride Aylin KANTARCI, Eyüp KANDEMİR

Blefaroptozis etyolojisinin adli tıp açısından değerlendirilmesi

Ptozisin çok çeşitli nedenleri vardır. Adli rapor düzenlenme den önce ptozis nedenini tespit etmek önemlidir. Özellikle işkence mağdurları gibi bazı travmatik olgular akut dönemde çeşitli nedenlerden dolayı sağlık kuruluşlarına başvurmamaktadırlar. Bazen de sağlık çalışanlarının ihmaline bağlı olarak akut dönemde başvuru yapılan sağlık kuruluşunda olaya dair rapor tutulmamaktadır. Travmadan sonra geç başvuru yapan olgularda cilt bulguları azaldığından veya tamamen kaybolduğundan dolayı ptozisin nedenini ortaya koyma açısından Göz Hastalıkları ve Adli Tıp Uzmanları olabildiğince güç durumda kalabilmektedirler. Kronik ptozis olgusu ile karşılaşan bir doktor her şeyden önce olaya ciddiyetle yaklaşmalıdır. Etyolojik nedenlerin oldukça geniş bir yelpaze içinde bulunması ayırıcı tanıyı yapmayı güçleştirmektedir. Tanı koyma aşamasında yaşanan sorunların ana nedeni ise, anamnezin iyi alınmayışı veya ciltteki lezyonun iyileşmesi bazen skar dokusunun dahi tespit edilemeyişidir. Tanı yöntemleri işi aceleye getirmeden büyük bir sabır ve ciddiyetle uygulanmalı ve ptozisin, kişinin aşadığı olayla nedensellik bağı kurulmalıdır.

The evaluation of blepharoptosis etiology from the point of forensic medicine

There are several reasons for ptosis. It is important to determine the cause of ptosis before writing the forensic report. In some traumatic cases, victims, especially victims of torture, do not apply to health care providers for some reasons. Sometimes, healthcare provider institution, to which victims apply during the acute phase, does not keep an incident report due to the negligence of health professionals. The skin findings in patients who apply late after the trauma go down or completely disappear. Because of that, optometrists and forensic science experts have difficulty to determine the cause of ptosis. A doctor faced with a chronic case of ptosis must treat the event seriously. The presence of a wide range of etiological factors makes it difficult to make the differential diagnosis. The main reason for the problems in the diagnostic phase is anamnesis not taken properly or healing of skin lesions; sometimes even the scar tissue can not be found. Diagnostic methods should be performed patiently and carefully without rushing and causality should be established between the event and the victim.

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