Shaken Baby Syndrome – American Association for Pediatric Ophthalmology and Strabismus

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What is shaken toddler syndrome?

Shaken toddler syndrome (SBS), also recognised as non-accidental trauma (NAT) , is a diagnosis that could involve a blend of results like damaged extended bones these kinds of as arms or legs, skull fractures, brain bleeding and retinal hemorrhages. SBS takes place when a toddler is shaken regularly, generally by a frustrated caretaker in an hard work to silent an inconsolable toddler. A baby’s head is disproportionately significant and the blood vessels are fragile, which would make the brain and eyes more susceptible to bleeding from a shaking injury. Most youngsters who are victims of SBS are underneath just one yr of age, with many of them staying underneath six months of age. Accidents from SBS can lead to lasting visual and developmental disabilities, or even death.

Why is an eye evaluation performed?

The eyes are examined in suspected conditions of SBS as aspect of an over-all evaluation of a little one when abuse is suspected. An eye examination could demonstrate bleeding in the back again of the eyes. The bleeding could be previously mentioned, within just, or down below the retina (Figure 1). The levels of the retina could also be break up aside as a consequence of the injury (retinoschisis). The vitreous, or jelly-like filling inside of the eye, could also fill with blood.


Fig. 1: Blood vessels in toddlers are fragile which would make the brain and eyes more susceptible to bleeding from non-accidental trauma.

How is the inside of of the eye examined?

Dilating eye drops are administered to enlarge the pupils of the eyes to enable a see of the retina and vitreous. An oblique ophthalmoscope and a specialised lens are utilized to visualize the back again of the eyes. Images of the back again of the eyes are in some cases taken.

Are other assessments performed to assess for SBS?

An eye evaluation by a experienced examiner is aspect of an over-all analysis of a toddler when abuse is suspected. Other assessments could involve imaging assessments of the brain (CT or MRI), bone x-rays (to verify for old and new fractures), and a social solutions analysis. Blood assessments could also be performed to verify for other problems these kinds of as a bleeding ailment. Other professionals could also be involved if yet another medical condition is suspected.

Do toddlers put up with lasting destruction from shaken toddler syndrome?

Retinal hemorrhages generally solve without the need of remedy, but a vitreous hemorrhage could not. A vitreous hemorrhage can rapidly cause amblyopia (“lazy eye”) by blocking the eyesight out of the eye. Surgical procedure could be desired to very clear a vitreous hemorrhage in an try to reverse the amblyopia.

Long term destruction to eyesight can also happen as a consequence of direct injury to the eye or the brain. Harm to the brain is the key purpose for bad eyesight. Scarring of the retina or atrophy of the optic nerve could demonstrate up months following the injury and is ordinarily irreversible. Mind injury could also lead to developmental delays, seizures, paralysis, and even death. Practically a quarter of shaken infants can die from their injuries. For any little one suspected to have endured non-accidental trauma, the health practitioner is demanded by regulation in the US to report the situation to a designated governmental company.

In which can I study more about shaken toddler syndrome?

Up-to-date 05/2020