Citation

Levin AV. Pediatrics 2010; 126(5): 961-970.

Affiliation

Pediatric Ophthalmology and Ocular Genetics, Wills Eye Institute, and Departments of Ophthalmology and Pediatrics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.

Copyright

(Copyright © 2010, American Academy of Pediatrics)

DOI

10.1542/peds.2010-1220

PMID

20921069

Abstract

Retinal hemorrhage is a cardinal manifestation of abusive head trauma. Over the 30 years since the recognition of this association, multiple streams of research, including clinical, postmortem, animal, mechanical, and finite element studies, have created a robust understanding of the clinical features, diagnostic importance, differential diagnosis, and pathophysiology of this finding. The importance of describing the hemorrhages adequately is paramount in ensuring accurate and complete differential diagnosis. Challenges remain in developing models that adequately replicate the forces required to cause retinal hemorrhage in children. Although questions, such as the effect of increased intracranial pressure, hypoxia, and impact, are still raised (particularly in court), clinicians can confidently rely on a large and solid evidence base when assessing the implications of retinal hemorrhage in children with concern of possible child abuse.

Language: en