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A Case Series

Jane D. Kivlin, MD; Melissa L. Currie, MD; V. Jordan Greenbaum, MD; Kenneth B. Simons, MD; Jeffrey Jentzen, MD

Arch Ophthalmol. 2008;126(6):800-804.

Objective  To demonstrate the severity of ocular findings in young children who died of injuries due to motor vehicle crashes.

Methods  Case series of 10 children younger than 3 years who were fatally injured in motor vehicle crashes between January 1, 1994, and December 31, 2002. All children underwent autopsy that included eye examination. All available medical and autopsy records, pathology slides and photographs, and police and traffic department reports were reviewed for each case.

Results  Eight patients had retinal hemorrhages, which extended into the periphery in 13 eyes and were bilateral in 7 patients. Three patients had elevated circular retinal folds. Six patients had hemorrhages below the internal limiting membrane, but no patients had deeper splitting of the retina. Nine patients had optic nerve sheath hemorrhages.

Conclusion  The association of extensive, sometimes severe, ocular hemorrhages with fatal accidental trauma, compared with previous reports of accidental trauma with no or few hemorrhages, indicates the severity of injury required to cause hemorrhages of this magnitude.

Author Affiliations: Departments of Ophthalmology (Drs Kivlin and Simons) and Pathology (Drs Simons and Jentzen), Medical College of Wisconsin, and Milwaukee County Medical Examiner's Office (Dr Jentzen), Milwaukee; Department of Pediatrics, University of Louisville, Louisville, Kentucky (Dr Currie); and Children's Healthcare of Atlanta, Atlanta, Georgia (Dr Greenbaum).

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RELATED LETTERS

Optic Nerve Sheath Hemorrhages, Increased Intracranial Pressure, and Retinal Hemorrhages in Central Nervous System Trauma
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Arch Ophthalmol. 2009;127(3):346-347.
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A Bubble Must Be Blown
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Arch Ophthalmol. 2009;127(3):347.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Optic Nerve Sheath Hemorrhages, Increased Intracranial Pressure, and Retinal Hemorrhages in Central Nervous System Trauma
Galaznik
Arch Ophthalmol 2009;127:346-347.
FULL TEXT  

A Bubble Must Be Blown
Gardner
Arch Ophthalmol 2009;127:347-347.
FULL TEXT  

A Bubble Must Be Blown--Reply
Kivlin and Simons
Arch Ophthalmol 2009;127:347-348.
FULL TEXT