Of 14 consecutive infant walker–related injuries evaluated at the Emergency Department of Staten Island (NY) University Hospital over a period of 1 year, two children (14%) sustained skull fractures in association with serious ocular injury in the form of Terson's syndrome. Terson's syndrome may be defined as the association of preretinal and/or vitreous hemorrhage with an intracranial hemorrhage.
Patient 1. A 6-month-old boy fell down a six-stair landing at home while in his walker. There was no gate, and the parents did not believe that the child was agile enough to reach the stairs while under their supervision. He sustained a right parietal skull fracture along with epidural and subdural hematomas, necessitating neurosurgical evacuation. There were no visible external signs of trauma. Dilated ophthalmoscopy revealed a large preretinal hemorrhage surrounding the right optic nerve head and obscuring the macula. Follow-up examination revealed a persistent left hemianopsia related to
Koser M, DeRespinis PA. The Association of Vision-Threatening Ocular Injury With Infant Walker Use. Arch Pediatr Adolesc Med. 1995;149(11):1275-1276. doi:10.1001/archpedi.1995.02170240093016