Multiple giant retinal tears due to inflicted injury in a neonate
Sadik Taju Sherief1, Arjan S Dhoot2, Sarah Schwartz2,3
1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada.
Insights
This case study details the successful surgical treatment of multiple giant retinal tears (GRTs) in a 4-week-old infant, linked to physical abuse. Long-term follow-up showed no vision-threatening complications.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Forensic Medicine
Background:
- This report focuses on a rare case of multiple giant retinal tears (GRTs) in an infant.
- The patient, a 4-week-old male, presented with unexplained injuries, including bilateral GRTs.
Observation:
- The infant exhibited a shallow retinal detachment with two GRTs in the left eye, without retinal hemorrhages.
- Extensive investigations ruled out underlying medical conditions, and the injuries were attributed to physical abuse.
Findings:
- Successful surgical management of the GRTs was achieved using lens-sparing pars plana vitrectomy.
- A 5-year follow-up revealed no progression of cataract or development of glaucoma.
Implications:
- Pediatricians and ophthalmologists should consider non-accidental trauma in infants presenting with GRTs, even without retinal hemorrhages.
- Early identification and intervention are crucial for safeguarding children and managing ocular trauma in abusive head injury cases.
Purpose:
This case represents the longest follow-up period and youngest patient treated for multiple GRTs in the same eye associated with physical abuse.
Observations:
A 4-week-old otherwise healthy male presented with a constellation of unexplained injuries. Examination of the left eye revealed a mild lens opacity and a shallow retinal detachment with two giant retinal tears (GRTs) and no retinal hemorrhages. Examination of the right eye was unremarkable. Extensive investigations were negative for any underlying medical conditions. The constellation of injuries was felt to be due to physical abuse. The giant retinal tears were treated successfully with lens sparing pars plana vitrectomy. After long-term follow-up of 5 years, there was no cataract progression or development of glaucoma.
Conclusions And Importance:
Clinicians should suspect child abuse in any pediatric patient with GRTs, with or without retinal hemorrhages, to ensure they are connected with the appropriate children's safeguarding society as soon as possible.
