Retinal Haemorrhages in Infancy (Abusive Head Trauma Considerations)

Overview

Retinal haemorrhages in an infant or young child are a same-day finding, never an observation. The differential spans coagulopathy, leukaemia and other systemic disease, severe accidental trauma, residual birth haemorrhages in the first weeks of life, and abusive head trauma — and separating these is the job of a paediatric team with fundoscopy under controlled conditions, laboratory work-up and skeletal survey, not of a single practitioner in a consulting room. The optometrist's role is exact and limited: recognise, document objectively (number, layers, laterality, extent — with imaging where available), arrange same-day paediatric assessment, and follow local child-safety escalation pathways. This record describes findings and the obligations they create; it does not conclude causation, and nothing in it replaces the jurisdiction's own reporting framework.