Ocular Injury Secondary to Nonaccidental Trauma
The presenting sign of child abuse involves the eye in approximately 5% of cases. Blunt trauma inflicted with fingers, fists, or implements such as belts or straps is the usual mechanism of nonaccidental injury to the ocular adnexa or anterior segment. Periorbital ecchymosis, subconjunctival hemorrhage, and hyphema should raise suspicion of recent abuse if the explanation provided is implausible (see the section “Hyphema” earlier in this chapter). Cataract and lens dislocation may be a sign of repeated injury or trauma inflicted earlier. Child abuse should also be suspected with rhegmatogenous retinal detachment in a child without a history of injury or an apparent predisposing factor, such as high myopia.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.