This joint clinical guideline provides a comprehensive review of the ophthalmic features of abusive head trauma in infants and children. It draws on a structured appraisal of the available evidence to support ophthalmologists in assessing retinal and ocular findings in the context of suspected child maltreatment.
The guideline examines the mechanisms of injury, including the forces involved in retinal haemorrhage, and outlines the typical patterns seen in abusive head trauma. It makes clear that while retinal haemorrhages are strongly associated with abusive injury, no single ocular sign is diagnostic in isolation. Findings must be interpreted alongside clinical, radiological and systemic evidence.
Detailed sections cover clinical features, investigation methods and pathology, as well as conditions that may mimic abusive head trauma such as accidental injury, birth-related haemorrhage and systemic disease. The guidance also sets out good practice for ophthalmologists, including documentation standards, timing of assessment and working within safeguarding frameworks.
This resource supports consistent, evidence-based assessment and reporting, recognising the significant clinical and legal implications of diagnosis in this area.