Update on shaken baby syndrome: ophthalmology

Abstract

Ophthalmologists play a key role in the diagnosis of shaken baby syndrome. In addition, they are in a unique position to study ophthalmic aspects of the syndrome, which in turn furthers the overall understanding of this devastating condition.

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

“…Some 1-5% of cases present initially with ocular symptoms which stresses the role of the ophthalmologist both in helping to establish the diagnosis and aid in its further management [34,39,84,91]. Paralleling the discovery of the "battered child" [63], first isolated case reports on ophthalmologic findings in these patients began to appear in the early 1960s.…”

“…A detailed histopathologic study of the orbit of 18 SBS patients revealed optic nerve sheath hemorrhaging at the anterior or posterior portions of the optic nerve, as well as hemorrhages into the orbital fat and extraocular muscles [123]. Consequently, the postmortem analysis of these tissues has been called for [84,123].…”

“…More comprehensive case series were soon to follow [53, 86,87]. Since then, the number of papers has steadily risen over the years, with the emphasis and focus of the literature becoming continuously diverse, stressing the need for this topical review for the forensic pathologist [1,5,45,65,66,70,72,84].…”

Retinal Morphologic Features in Shaken Baby Syndrome Evaluated by Optical Coherence Tomography

“…2,3 As shown by the authors, partial posterior hyaloid separation was associated with a lamellar MH in 1 eye. Vitreomacular traction resulting from incomplete posterior vitreous detachment has been attributed to cause MHs.…”

Rare retinal haemorrhages in translational accidental head trauma in children

“…18 Extensive retinal haemorrhages are not caused by cardiopulmonary resuscitation, vomiting, coughing, or apnoea. 19 The aim of this retrospective study was to determine the frequency and the severity of retinal haemorrhages in paediatric patients with accidental translational head trauma caused by falls.…”