In the United States, it has been estimated that roughly four to six per cent per cent of child abuse victims present first to an ophthalmologist. In a case study in the April issue of the Journal of American Association of Paediatric Ophthalmology and Strabismus, doctors at the University of Washington and the Seattle Children’s Hospital describe a case of a 13-month-old girl who was initially diagnosed with corneal abrasion and a mild infection. She was eventually identified as a victim of child abuse.
“In retrospect, there were clinical and laboratory findings that might have raised concerns about child abuse earlier in the course of the condition,” says senior author Avery H. Weiss, MD, Seattle Children’s Hospital.
The child presented with left lower eyelid swelling, sensitivity to light, increased tearing and reduced vision. She was treated with topical and oral antibiotics, but her condition progressively worsened over the course of two weeks.
During a three-day stay in the hospital, her condition improved and she was discharged. Despite continued therapy, the irritation and inflammation persisted. She was then brought to a local trauma hospital a brain haemorrhage and bruising consistent with child abuse. The patient’s antibacterial eye drops were found to have been laced with household bleach.