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Horace B. Gardner, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Kivlin et al¹ note "dome-shaped [retinal] hemorrhages" in 60% of their cases and attribute these to mechanical forces exerted on the retina by the vitreous during violent acceleration/deceleration and rotational ocular movement from severe motor vehicle accidents.

These "dome-shaped hemorrhages" are in fact bubbles. Bubbles are produced, not from vitreous traction, which may produce ridges (or "folds"), but by hydraulic forces—they are "blown."

All the ocular findings attributed to shaken baby syndrome have been produced without mechanical (acceleration/deceleration or rotational) forces. Thus, mechanical forces are not "necessary." Also, mechanical forces are not "sufficient" to produce many of the findings, such as the "hemorrhages at all levels" and vitreous hemorrhage noted in these patients, because mechanical forces cannot draw blood into the multiple retinal layers without blood vessels or into the avascular vitreous. Hydraulic forces are necessary to move blood into these areas. Hydraulic forces are indeed . . . [Full Text of this Article]

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