Unilateral ischaemic retinopathy and bilateral subdural haemorrhage in an infant with non-accidental injury: An ophthalmological approach.

Introduction: Non-accidental injury (NAI) is not an uncommon problem worldwide, which leads to significant morbidity and mortality in infants and younger children. The presence of retinal or subdural haemorrhages, or encephalopathy with injuries inconsistent with the clinical history is highly suggestive of NAI.

Case Presentation: In this article, we report a case of an infant who presented to the casualty department with sudden onset of recurrent generalised tonic-clonic seizures. There was no history of trauma or visible external signs. She was found to have bilateral subdural haemorrhages and atypical unilateral ischaemic retinopathy. Retinal photocoagulation was performed with subsequent resolution of vitreous and retinal haemorrhages. However, visual recovery in that eye remains poor.

Conclusion: A high index of suspicion of NAI is required in infants with intracranial haemorrhage and unilateral retinal haemorrhages.