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Cross-sectionalPediatric emergency care · 2026

Performance and Yield of Retinal Examinations in Cases of Suspected Physical Abuse Without Intracranial Injury.

Irene Hamlin, Karli Breeden-Carino, Cindy W Christian … M Katherine Henry

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OphthalmologyCross-sectional

Retinal examinations rarely find retinal hemorrhages in abuse evaluations without intracranial injury

Performance and Yield of Retinal Examinations in Cases of Suspected Physical Abuse Without Intracranial Injury.

Irene Hamlin … M Katherine Henry

Pediatric emergency care · 2026

Background

Retinal hemorrhages (retinal hemorrhages) are reported as rare in children with concerns for physical abuse without intracranial injury (intracranial injury).

Purpose

We sought to assess factors associated with performing a retinal examination in young children without intracranial injury and describe the yield of these examinations.

Methods

We performed a retrospective, multicenter cross-sectional study of children younger than 2 years undergoing subspecialty physical abuse evaluations between February 2021 and August 2023.

n = 2591 children

Results

1.5%

few examined children had bleeding in the back of the eye

n = 2591 children

More results

Performance of a retinal examination was significantly associated with younger age, in-person CAP evaluation, transfer status, CAPNET site, presence of high-risk bruising, presence of high-risk fractures, presence of subconjunctival hemorrhage, evidence of head trauma, and ill appearance.

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Conclusion · 1 of 2

Retinal examinations rarely reveal retinal hemorrhages in young children without intracranial injury who are undergoing abuse evaluations, suggesting that these examinations may be safely deferred in this population.

Conclusion · 2 of 2

Retinal examinations may be warranted in cases of suspected strangulation or other signs of ocular trauma.

Post

Performance and Yield of Retinal Examinations in Cases of Suspected Physical Abuse Without Intracranial Injury.

Retinal examinations rarely find retinal hemorrhages in abuse evaluations without intracranial injury

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