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Retinal Hemorrhage: No More a Sure Sign of Child Abuse

A new study has now found out that retinal examination of a child, to determine the location and number of hemorrhages may not be a sure sign of abuse. // This was discussed in the American Academy of Forensic Sciences annual meeting held in Seattle recently.

Retina is a light sensitive tissue located behind the eye. Any rupture in the retinal surface can damage the tiny blood vessels and the result is bleeding or retinal hemorrhage.

A wide variety of conditions such as falls, car wrecks, gunshot wounds, drug overdose, meningitis and ruptured aneurysms may result in retinal hemorrhage, making it an unreliable indicator of child abuse. The study was conducted on nearly than 700 cases that had presented for autopsy examination.

Other conditions where retinal damage may be manifested include suffocation, SIDS (sudden infant death syndrome), head injury, stroke, brain tumor, hypertension, diabetes and bleeding disorders.

The first step undertaken by doctors when there is a suspicion of abuse is to examine the child’s eye for damage (hemorrhage and other changes). The presence of damage is considered to be a proof of child abuse. The absence of a history of a high-speed car crash or fall is a strong indication for establishment of child abuse diagnosis.

The medical literature says that retinal hemorrhages in children are rare expect on occasions of child abuse. The result of the study is however in marked contrast to the above statement. May be it is time for pathologists and forensic experts to look more closely into other possibilities before a child abuse diagnosis is established.

'Many doctors have been taught to look for the hemorrhages when they suspect child abuse and often will diagnose child abuse without considering other possibilities. Our research shows that you see the hemorrhages in a variety of different situations in infants, children and adults,' said Dr. Lantz, senior researcher involved in th e study.


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