To the Editor:As an ophthalmologist, I was very interested in the article by Gabaeff and the response by Greeley.1,2 Greeley is familiar with the contributions Vinchon has made in this area, even referencing one of his articles. Since this response was written well after Vinchon’s paper concerning “spontaneous” intracranial and intraocular hemorrhage, this reference would appear highly relevant.3 For example, Vinchon points out the importance of increased cerebral spinal fluid spaces. Greeley correctly notes the case from Rooks had such spaces but then says the child did not have hydrocephalus, when in fact extra-axial fluid collections are just one of many names given to this condition, benign external hydrocephalus (BEH) being another. Greeley “having board certification in both general pediatrics and child abuse pediatrics, and having experience and training in clinical research and medical literature appraisal” is certainly aware of this. He also has previously discussed this very problem in a response to one of my articles.4 Greeley appears unaware of the importance of this when he says Gabaeff’s comment concerning non-abuse reasons for this combination is “not supported by the medical literature.” He also accuses Gabaeff of not citing anything when talking about the American Academy of Ophthalmology’s role in this area. In fact Gabaeff says “as discussed above,”a very definite self citation. If Greeley does not believe Gabaeff’s previous statements were adequately supported, this is an entirely different matter. In light of Piatt’s previous paper and Vinchon’s recent verification of this problem, Gabaeff’s concerns that chronic SDH in infants may be being misdiagnosed as abuse seems appropriate.5