Title: “Shaken Baby Syndrome”
Description: Shaken Baby Syndrome is a form of physical child abuse, a non-accidental traumatic brain injury. The ocular manifestations of child abuse are numerous. There may be signs of periorbital trauma (e.g., ecchymosis, lid edema, orbital fractures), Anterior segment trauma (e.g., hyphema, iris prolapse, corneal laceration, cataract), or posterior segment trauma (e.g., vitreous hemorrhage, retinal detachment, optic nerve avulsion).
There may be associated brain injury and intracranial bleeding.
The incidence of retinal hemorrhages is approximately 85%. Classically, children have retinal hemorrhages, which are multilayered – preretinal, intraretinal, and subretinal. They are usually too numerous to count and extend out to the retinal periphery (i.e., not just confined to the posterior pole). This image shows numerous retinal hemorrhages in the LE of a child with ‘shaken baby syndrome’. Macular retinoschisis may also be associated. The greatest diagnostic clue is a detailed history that is incompatible with the extent and severity of the injuries found on dilated fundus exam.
