Eye Damage Might Not Signal Child Abuse

Contrary to conventional wisdom, retinal hemorrhage has many causes, study finds

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MONDAY, Feb. 27, 2006 (HealthDay News) -- Doctors have long looked upon hemorrhage in a child's retina as potential evidence of child abuse. But a new study suggests this strategy may be flawed.

"Contrary to what many doctors have been taught, we found that number and location of hemorrhages of the eye's retina aren't always proof of child abuse," forensic pathologist Dr. Patrick Lantz, of Wake Forest University Baptist Medical Center in Winston-Salem, N.C., said in a prepared statement.

His team was schedule to present their findings over the weekend at the annual meeting of the American Academy of Forensic Sciences meeting in Seattle.

"Retinal hemorrhages occur more often than most doctors think and are associated with a wide variety of conditions," Lantz noted.

The retina is the light-sensitive nerve tissue at the back of the eye. Hemorrhages occur when tiny blood vessels on the surface of the retina rupture.

Lantz found that about 16 percent of the 700 people of all ages he examined during autopsy had hemorrhages of the retina. These hemorrhages were found in people who died from ruptured aneurysms, falls, car crashes, gunshot wounds, meningitis and drug overdose.

He detected retinal hemorrhages in 30 children under age 14, but only six of those cases were associated with child abuse.

"Our research shows that you see the hemorrhages in a lot of different situations. Retinal hemorrhages occur in child abuse, but they don't always mean a child was abused," Lantz said.

"Unfortunately, many pathologists, pediatricians and ophthalmologists have been taught that retinal hemorrhages are diagnostic of child abuse unless the child was involved in a high-speed car crash or fell more than two stories," he added.

More information

The U.S. National Library of Medicine has information about shaken baby syndrome.

SOURCE: Wake Forest University Baptist Medical Center, news release, Feb. 25, 2006

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