We examined a 5-month-old girl who came to the emergency department with fever and diarrhea. She was found to have a comminuted right femur fracture and scattered bruises, including one on the labia majora and one over the left parietal skull. Computed tomography of the brain showed a focal hyperdensity in the left frontal cortex possibly representing a contusion; no intracranial hemorrhage was identified. The mother confessed to shaking the infant.
The right fundus showed a posterior vitreous detachment with a prominent Weiss ring; there was a slight amount of red blood coating the back of the posterior vitreous face, as well as a few optic disc margin hemorrhages. The left fundus showed a slightly greater amount of hemorrhage on the optic disc and detached posterior vitreous face without an obvious Weiss ring. There were no other preretinal or intraretinal hemorrhages on depressed fundus examination to the ora serrata for 360° in both eyes.
Brown SM, Bradley JC. Hemorrhagic Posterior Vitreous Detachment Without Intraretinal Hemorrhage in a Shaken Infant. Arch Ophthalmol. 2007;125(9):1301. doi:10.1001/archopht.125.9.1301-a