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Cohort studyJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Ophthalmic outcomes and follow-up after inpatient hospital discharge in children with abusive head trauma.

Akanksha Malepati, Brenton T Bicknell, Trisha Agrawal … Krupa H Patel

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OphthalmologyCohort study

Less than half of children with abusive head trauma complete ophthalmic follow-up.

Ophthalmic outcomes and follow-up after inpatient hospital discharge in children with abusive head trauma.

Akanksha Malepati et al. · Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Purpose

To evaluate outpatient ophthalmic follow-up after hospital discharge in children with abusive head trauma (AHT) and identify factors associated with follow-up adherence, and, secondarily, to describe ophthalmic findings in patients who returned for follow-up.

Methods

The medical records of pediatric patients with AHT who received inpatient ophthalmic evaluation and were advised to obtain outpatient follow-up were reviewed retrospectively.

n = 74 patients

49%

Results

less than half of children with abusive head trauma completed eye check-ups

n = 74 patients

More results

Most patients (69.9%) resided in very low or low COI neighborhoods.

Median distance to the nearest pediatric ophthalmologist was 30.9 miles (IQR, 10.0-57.7).

COI distribution was not associated with follow-up adherence (P = 0.37).

More results

However, children in very low-, low-, or moderate-opportunity neighborhoods lived farther from care than those in high or very high-opportunity neighborhoods (median, 38.6 miles [IQR, 19.6-59.6] vs 5.3 miles [IQR, 3.3-13.1], resp.) (P < 0.001 [Mann-Whitney U test]).

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Conclusion · 1 of 2

Outpatient ophthalmic follow-up after AHT is inconsistent despite frequent detection of visual abnormalities when follow-up occurs. Limited access to pediatric ophthalmologists may contribute to gaps in continuity of care.

Conclusion · 2 of 2

Strategies to improve follow-up are needed for this vulnerable population.

Post

Ophthalmic outcomes and follow-up after inpatient hospital discharge in children with abusive head trauma.

Less than half of children with abusive head trauma complete ophthalmic follow-up.

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