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COMMENTS AND OPINIONS
A Bubble Must Be Blown—Reply
Jane D. Kivlin, MD;
Kenneth B. Simons, MD
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In reply
Drs Gardner and Galaznik have stated their opinion that the ocular findings in our 10 accidentally injured patients were likely to be the result of changes in intracranial pressure and intravascular pressure rather than the result of mechanical forces from the motor vehicle crash itself. We stated that both the mechanical mechanism and increased venous pressure mechanism could apply in our patients in lines 3 through 6, right column, page 803.1 Terson syndrome, Valsalva retinopathy, and vein occlusion are rare conditions in children and have rarely caused retinal hemorrhage in them. In the work of Smith, Kearns, and Sayre2 cited by Dr Gardner, only 1 of the 2 monkeys whose intracranial pressures were raised artificially had retinal and optic nerve sheath hemorrhages, which were discontinuous, and only 1 of the 9 dogs developed a small retinal hemorrhage.
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RELATED ARTICLE
Retinal Hemorrhages in Children Following Fatal Motor Vehicle Crashes: A Case Series
Jane D. Kivlin, Melissa L. Currie, V. Jordan Greenbaum, Kenneth B. Simons, and Jeffrey Jentzen
Arch Ophthalmol. 2008;126(6):800-804.
ABSTRACT
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RELATED LETTER
A Bubble Must Be Blown
Horace B. Gardner
Arch Ophthalmol. 2009;127(3):347.
EXTRACT
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