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June 1996

The Association of Vision-Threatening Ocular Injury With Infant Walker Use-Reply

Author Affiliations

Department of Ophthalmology University of Medicine and Dentistry of New Jersey Newark, NJ

Arch Pediatr Adolesc Med. 1996;150(6):652. doi:10.1001/archpedi.1996.02170310086023

Ophthalmologists are frequently asked to evaluate the fundiof traumatized children to rule out the diagnoses oj retinal and/or choroidal hemorrhages. These jindings, when seen in conjunction with evidence oj other injuries, particularly fractures ojlong bones or ribs, are suggestive oj a child who has been repeatedly abused. Injant walker injuries are, unfortunately, jairly common events, and the majority oj serious injuries involve jractures oj the head and neck.1 Preretinal and/or vitreous hemorrhage in association with an intracranial hemorrhage (Terson syndrome) can be caused by a single accident such as an infant walker fall. By our clinical findings alone, we can neither confirm nor rule out child abuse in these situations. The findings of retinal and/or choroidal hemorrhages at different stages of healing are more indicative of a child who has been repeatedly abused.

The welfare of children is of the upmost importance to the medical community, and, for this reason,