ドメスティック・バイオレンスによる外傷性眼障害者の1例

A case of severe eye injury by domestic violence

要約　目的：家庭内暴力により白内障と網膜剝離が生じ，眼科的ならびに社会的に救済できた症例の報告。症例：33歳女性が両眼の視力低下で受診した。10年以上前から父と義母から家庭内で暴力を受けていたという。8年前に右下肢骨折，6年前に左下肢骨折，4年前に肝臓の圧迫破裂，2週間前に熱湯による顔面と上半身の熱傷があった。矯正視力は右光覚弁，左手動弁であり，両眼に外傷性白内障と網膜剝離があった。経過：左眼に対し白内障手術，眼内レンズ挿入術，シリコーンオイル併用の硝子体手術を行った。7週後のシリコーンオイル抜去後に網膜剝離が再発した。網膜冷凍凝固術で網膜は復位し，0.3の最終視力を得た。退院後は実家に帰らせず福祉施設に入居させた。結論：本症例の救済には，医学的治療に加え，患者の親戚，医療スタッフ，病院間の連携，警察の協力など法律を含めた総合的な対策が奏効した。

Abstract.　Purpose：To report a successfully salvaged case of cataract and retinal detachment by domestic violence. Case and Findings：A 33-year-old female presented with impaired vision in both eyes. She had reported been victim of domestic violence by her father and mother-in-law for over 10 years. Her corrected visual acuity was light perception right and hand motion left. Both eyes showed traumatic cataract and retinal detachment. Clinical Course：The left eye was treated by cataract surgery, implantation of intraocular lens, and vitrectomy with silicone tamponade. Retinal detachment recurred after removal of silicone oil 7 weeks later. The retina became reattached following cryosurgery resulting in final visual acuity of 0.3. After discharge from the hospital, she started living in a welfare institution unknown to her parents. Conclusion：This victim of domestic violence could be salvaged not only by medical treatments but also by relatives, medical staff, interhospital co-operation, and advice from the police.