What Is The Definition Of Penetrate

[Santi Dubrova]

Digitalpenetration is just one form of sexual penetration. Digital penetration as it sounds refers to the use of the digits, that is, the fingers, the thumbs or the toes to sexually penetrate the vagina or anus of a person. The specific definition of digital penetration can be extracted from the broader definition of sexual penetration defined at section 35A of the Crimes Act 1958 and can be explained as follows:

It is often thought by people in the general community that digital penetration or digital rape is not as serious as other forms of sexual penetration. It is true to say that up until 1991 digital penetration could not attract the charge of rape and only form the basis for the lesser charge of indecent assault, but that has all changed now with the introduction of section 35 of the Crimes Act 1958.

Further to the legislative changes, the Court of Appeal in R v Lomax [1998] 1 VR 551 has ruled that there is no hierarchy of penetration in Victoria making one form of penetration more or less serious than another. What this means is that whether someone penetrates another with their penis or digit does not mean the penetration is more or less serious. When assessing the gravity of a penetrative act all the facts of the case must be considered. When assessing the gravity of a penetrative act involving a digit, one might consider that a digital penetration does not carry the same risk of injury, infection or risk pregnancy when compared to a penetrative act involving a penis. But these are merely examples of what might be considered when looking at the surrounding circumstances. To make a proper assessment, you need to consult a lawyer.

It is also relevant to consider that in the more recent case of DPP v Shrestha [2017] VSCA 364, the Court of Appeal expressed the need to uplift sentences involving digital penetration. Common charges that relate to digital penetration are rape and sexual penetration of a minor.

If you have been charged or are about to be interviewed, you should call our office for advice. Dribbin & Brown have handled hundreds of cases involving digital penetration. Consideration of the finer nuances of the evidence, what is said on a record of interview and meticulous preparation are all crucial to achieving the right outcome. If you are facing charges or being asked to attend an interview you should engage our office to assist you.

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Ocular penetrating and perforating injuries (commonly referred to as open globe injuries) can result in severe vision loss or loss of the eye. Penetrating injuries by definition are caused by a sharp object that penetrates into the eye (i.e. laceration) but not through and through--there is no exit wound. Perforating injuries go 'through and through' the eye and therefore have both an entrance and an exit wound. Typically, to constitute one of these injuries, a full-thickness wound through the cornea and/or sclera must be present. Open globe rupture, in contrast, refers to blunt injury of the eye causing sudden increase in intraocular pressure resulting in eye wall dehiscence and ultimately globe collapse. These terms are used to standardize the nomenclature associated with severe ocular trauma[1]. This typically occurs at the limbus and near the equator behind the recti muscles insertions, where the sclera is thinnest[2]. This can also occur at sites of prior intraocular surgery due to potential iatrogenic lack of tissue integrity at these sites. The injury is further classified based on three zones: I, II, and III (see Zone of Injury)[3]. Zone I involves the cornea up to the limbus, Zone II involves the sclera from the limbus back to 5mm beyond the limbus, which anatomically is 5mm anterior to the ora serrata that does not extend into the retina, and Zone III refers to any injury greater than 5mm beyond the limbus, which results in anatomic injuries posterior to the ora serrata that involve the retina[2].

Penetrating or perforating ocular injuries can be due to injury from any sharp or high velocity object. Most individuals sustaining eye injuries are male with an estimated relative risk of 5.5 times greater than women[4]. Average age of the patient is typically in their 30s. The home and workplace are the most frequent locations for injuries, and the most common situations were domestic assaults, battery assaults, and workplace accidents. The most common blunt objects reported by May et al from the United States Eye injury Registry were rocks, fists, baseballs, lumber and fishing weights[4]. Paintball and BB guns are also common in the teenage demographic. In the elderly, globe rupture is actually more common typically from falls and structural weakening of the eye with age[5]. The most common sharp objects were sticks, knives, scissors, screwdrivers and nails. When one of these objects becomes lodged in the eye, it is referred to as an intraocular foreign body (IOFB), which occurs in up to 40% of ocular penetrating or perforating injuries (see Intraocular Foreign Bodies (IOFB)).

As noted from the epidemiological studies above, male gender is a large risk factor for ocular trauma[4]. Failure to wear adequate eye protection while performing high risk activities such as baseball, basketball and use of power tools in the home environment have also been noted to be risk factors for eye injuries.[4][6][7] Substance abuse, including alcohol and marijuana, is also known to increase the risk of eye trauma.[7]

Appropriate and adequate eye protection when performing visually threatening activities is the most effective method to prevent ocular trauma. Avoiding high-risk activites is also an effective method of prevention. The American Academy of Ophthalmology Eye Injury Snapshot is a yearly survey designed to collect data and educate the public about the causes and prevention of eye injuries. Through educational programs such as this, potential eye injuries may be prevented.[6]

It is important to obtain a thorough history from the patient to help identify the timing of the injury and mechanism. Any injuries other than the eye should be ascertained. Questions such as what the patient was doing during the injury and what potential objects could have caused the injury are important prior to physical evaluation. It is important to note whether safety glasses or prescription eyeglasses were being worn at the time of the injury. Also, make sure to ask the patient if he/ she has a history of limited vision in either eye (amblyopia or other prior cause of visual loss).

A pertinent medical history including current medications, allergies, tetanus status, and timing of last meal can help with diagnosis and management. Prior ocular history and ocular surgical history is also important to obtain.

Patients with penetrating or perforating injuries usually complain of pain, vision loss, or double vision. In more subtle injuries, there may be minor symptoms such as foreign body sensation or blurred vision. Severe redness, light sensitivity, and foreign body sensation are also symptoms of open globe injuries.

Subconjunctival hemorrhage, shallow or flat anterior chamber, hyper-deep anterior chamber, peaked pupil, corneal or scleral discontinuity, hyphema, iris deformities, uveal prolapse, lens disruption, or posterior segment findings such as vitreous hemorrhage, retinal tears, or retinal hemorrhage are concerning when seen in a patient with suspected trauma.

Ophthalmic examination after severe trauma can be difficult. Obtaining a visual acuity and pupillary examination may be the most important elements to ascertain, though tonometric measurement of intraocular pressure should be avoided given it places pressure on the globe and may result in extrusion of intraocular contents.[8] Obvious trauma requires careful handling of the eye with care taken to prevent any pressure on the globe if an open globe is suspected; exam maneuvers commonly conducted that exert such pressure are contraindicated, such as forced ductions, gonisocopy, scleral depression, and B-scan. Moreover, eyedrops should be avoided in cases of obvious penetrating or perforating injury. The adnexa should be carefully examined with delicate palpation of the orbital rim.

Once an extraocular muscle and external examination is complete, a thorough conjunctival and anterior segment examination must be completed if penetrating or perforating injury is suspected. A posterior exam should be done to look for intraocular damage as long as there is a view through the pupil.

Full thickness corneal lacerations often result in leakage of aqueous humor from the anterior chamber. Applying fluorescein dye to the suspected corneal wound is called a 'seidel test' and can be used to assess for full thickness lacerations in cases where it may not be obvious. In these cases, the fluorescein dye under cobalt blue light will be 'washed away' by the aqueous humor leaking from the full thickness wound and confirms the presence of a full thickness wound. If the fluorescein dye is washed away, the wound is considered 'seidel positive', while lack of fluid coming from the wound means it is 'seidel negative'. An example video of a 'seidel positive' exam can be found here. Similar testing can sometimes be performed on the sclera and conjunctiva, though vitreous may plug scleral wounds and cause a lack of seidel positivity.

Computed tomography (CT) scans of the orbits are indicated to assess for intraocular foreign body, especially in cases of poor views to the vitreous and retina. It is important to obtain thin 1 mm CT cuts in the axial, coronal, and sagittal planes to rule out IOFB, which can be present in up to 40% of penetrating ocular injuries[9]. When direct visualization is not possible, gentle ultrasound can be considered to evaluate the globe, though extreme caution should be used as the pressure from the ultrasound device and cause extrusion of intraocular contents. Ultrasonography can be helpful when the media preclude a posterior exam, and has been shown to have a 100% positive predictive value for diagnosing retinal detachment and IOFB[10]. If there is a suspicion for an IOFB, magnetic resonance imaging (MRI) is contraindicated. MRI is also contraindicated in any case where a metal object is thought to be involved.

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