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M. G. F. Gilliland, MD
Greenville, NC

Martha Waters Luckenbach, MD
Portsmouth, Va

Stephen J. Massicotte, MD; Robert Folberg, MD
Iowa City, Iowa

Arch Ophthalmol. 1991;109(3):321-322.

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

To the Editor.

—In discussing the pathologic changes in eyes of children who died after suspected child abuse, Elner et al¹ asserted "that such trauma may be repeated is indicated by positive stains for hemosiderin"; this statement provides an opportunity for medicolegal confusion and miscarriage of justice. According to one source,² hemosiderin, a breakdown product of hemoglobin from red blood cells, may be identified as early as 1 day after injury, although other authors³ are fairly circumspect and suggest that an interval of "several days" must pass before hemosiderin is deposited; macrophages that assemble ferritin into hemosiderin are identified at injury sites within 48 to 72 hours.

Certainly, the detection of hemosiderin may indicate repeated trauma, but hemosiderin may also be a marker of survival after one episode of trauma. A child may be traumatized once and survive long enough for hemoglobin to be metabolized into hemosiderin. . . . [Full Text PDF of this Article]

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