R L Altman1, S Forman, D A Brand. 1. Department of Pediatrics, New York Medical College and Westchester Medical Center, Valhalla, NJ 10595, USA. robin_altman@nymc.edu
Abstract
PURPOSE: An apparent life-threatening event (ALTE) refers to the sudden occurrence in an infant of a breathing abnormality, color change, or alteration in muscle tone or mental status. The finding of retinal hemorrhage in an infant who has experienced an ALTE strongly suggests the possibility of shaken baby syndrome. Previous ALTE studies have reported the frequency of this specific ocular abnormality but have not reported other ocular findings and their possible diagnostic significance. METHODS: This study reviews ophthalmologic findings from a series of 120 patients with ALTE who underwent eye examinations as part of their inpatient evaluation. Details of the history, physical examination, diagnostic testing, and discharge diagnosis were abstracted from the medical record while the patient was in the hospital. RESULTS: Ten patients (8.3%) had positive findings, including retinal hemorrhages in four of the six patients with shaken baby syndrome, the only ophthalmologic finding that helped establish the cause of an ALTE. CONCLUSIONS: Since the funduscopic examination can help identify child abuse as the cause of an apparent life-threatening event, ophthalmologists play a critical role in the early evaluation of infants who have experienced such an event.
PURPOSE: An apparent life-threatening event (ALTE) refers to the sudden occurrence in an infant of a breathing abnormality, color change, or alteration in muscle tone or mental status. The finding of retinal hemorrhage in an infant who has experienced an ALTE strongly suggests the possibility of shaken baby syndrome. Previous ALTE studies have reported the frequency of this specific ocular abnormality but have not reported other ocular findings and their possible diagnostic significance. METHODS: This study reviews ophthalmologic findings from a series of 120 patients with ALTE who underwent eye examinations as part of their inpatient evaluation. Details of the history, physical examination, diagnostic testing, and discharge diagnosis were abstracted from the medical record while the patient was in the hospital. RESULTS: Ten patients (8.3%) had positive findings, including retinal hemorrhages in four of the six patients with shaken baby syndrome, the only ophthalmologic finding that helped establish the cause of an ALTE. CONCLUSIONS: Since the funduscopic examination can help identify child abuse as the cause of an apparent life-threatening event, ophthalmologists play a critical role in the early evaluation of infants who have experienced such an event.