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Case of the Year

April 2024

NON-ACCIDENTAL TRAUMA

Kanwaljeet Harjot Madan

Originally posted on @retina.rocks 03/14/2024

This 11YO boy presented with decreased vision in his left eye after his friend’s father thrashed him and was hit in the head 3 days earlier. There was no other sign of bodily injury. Vision was 20/20 in his normal right eye and counting fingers in his left eye.

Our patient’s findings are predominated by numerous mostly sub-ILM hemorrhages. His case is unusual given his age and unilateral findings. Fortunately, with observation, vision recovered to 20/30 three weeks later, with resolution of all findings.

Learning Points:
The shaken baby syndrome is a form of non-accidental traumatic child abuse where the young infant is vigorously shaken, causing whiplash-induced intracranial and intraocular hemorrhaging, often without obvious external trauma.

The ocular findings are usually bilateral, with the hemorrhages often having multiple layers, including subretinal, intraretinal, and preretinal.