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Ocular Injuries in Pediatric Patients Admitted With Abusive Head Trauma

Rebecca Weiss1, Catherine H He2, Sabine Khan1

  • 1Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Bronx, New York; Albert Einstein College of Medicine, Bronx, New York.

Pediatric Neurology
|December 18, 2021
PubMed

Insights

Ocular injuries are common in pediatric abusive head trauma (AHT), especially in infants. While younger children have higher odds of retinal hemorrhages and subdural hematomas, older children face greater mortality risks.

Area of Science:

  • Ophthalmology
  • Pediatric Medicine
  • Forensic Pathology

Background:

  • Pediatric abusive head trauma (AHT) involves head injuries in children five years or younger due to intentional force or shaking.
  • Ocular injuries are a significant concern in AHT cases.
  • Evaluating the epidemiology of ocular injuries in AHT is crucial for understanding and preventing child abuse.

Purpose of the Study:

  • To determine the frequency and patterns of ocular injuries in pediatric abusive head trauma (AHT).
  • To analyze the association between ocular injuries and demographic factors, non-ocular injuries, and outcomes in AHT.
  • To identify age-related variations in ocular injury types and mortality in AHT.

Main Methods:

  • Retrospective analysis of the National Trauma Data Bank (2008-2014).
  • Inclusion of children aged five years or younger diagnosed with AHT and ocular injuries using ICD-9-CM codes.
  • Tabulation and analysis of demographic data, injury types, severity, and mortality rates.

Main Results:

  • Over 10,545 children with AHT, 24.2% had ocular injuries.
  • Common ocular injuries included contusions (73.7%) and retinal edema (59.3%).
  • Infants (<1 year) had higher odds of retinal hemorrhages and subdural hematomas (SDH); 2-3 year olds had higher odds of contusions and mortality.

Conclusions:

  • Ocular injury patterns in AHT vary significantly with age.
  • The youngest children (<1 year) are most frequently affected by ocular injuries.
  • While infants show higher injury rates, older children (2-3 years) experience greater mortality.
Abstract

Keywords:
Ocular injuriesPediatric abusive head traumaRetinal edemaRetinal hemorrhagesShaken baby syndromeSubdural hemorrhages

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