Eye exam has flaws in proving child abuse

By HSC Staff Writer • Published: June 7th, 2006
Category: Health in a Heartbeat

When a child is suspected to be a victim of abuse, doctors commonly conduct an eye exam to look for retinal hemorrhages and other eye changes considered proof the youngster was mistreated. The retina is the light-sensitive nerve tissue at the back of the eye.

A new study, though, suggests the number and location of hemorrhages of the eye’s retina aren’t always proof of child abuse. Scientists say the hemorrhages can be associated with a wide variety of conditions, including suffocation, meningitis, ruptured aneurysms, strokes, brain cancer and high blood pressure. The bleeding occurs when tiny blood vessels on the retina’s surface rupture.

The findings were reported recently at the annual meeting of the American Academy of Forensic Sciences. The researchers found that about sixteen percent of seven-hundred infants, children and adults examined during autopsy had hemorrhages of the retina. Retinal hemorrhages were found in thirty children under age fourteen, but only six cases were associated with child abuse.

The medical literature describes retinal hemorrhages in infants as rare except in cases of abuse, but the new study indicates just the opposite. The researchers found more eye changes in non-abuse cases than in abuse cases, yet most doctors normally don’t look in the eyes of children unless they suspect child abuse.

The researchers say the findings are, well, nothing short of eye-opening. The retinal exam could, they say, help diagnose ailments like hypertension, glaucoma, Marfan syndrome and even diabetes in some patients.