Pediatric ocular surface disease associated with suspected abuse

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Forensic Medicine

Background:

• Ocular surface disease in children can be challenging to diagnose.
• Nonaccidental injury (NAI) is a critical consideration in pediatric eye conditions.
• Identifying NAI-related ocular trauma requires careful evaluation.

Purpose of the Study:

• To present one of the largest case series of children with ocular surface disease suggestive of NAI.
• To detail the clinical presentations, management, and outcomes of these pediatric patients.
• To review existing literature on NAI affecting the ocular surface.

Main Methods:

• Multicenter retrospective case series.
• Inclusion of 4 pediatric patients with anterior segment NAI concerns.
• Analysis of patient history, examination findings, treatments, and outcomes.

Main Results:

• A wide range of anterior segment findings were observed in the case series and literature.
• NAI-related ocular surface disease may present as bilateral and recurrent conditions.
• Improvement during hospitalization was noted to be better than initially anticipated.

Conclusions:

• Ocular surface NAI is a diagnosis of exclusion requiring comprehensive history and examination.
• Suspicion of ocular NAI warrants examination for other signs of bodily injury, particularly in young children.
• Siblings of children diagnosed with NAI may be at increased risk.