RT Journal
A1 Becker H, Gupta BK
T1 REcognizing abusive head trauma in children
JF JAMA
JO JAMA
YR 1999
FD October 20
VO 282
IS 15
SP 1421
OP 1422
DO 10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
AB 
Examining small infants can be done easily in the hospital. Vision can
be assessed by close observation of fixation and following patterns. The pupillary
reflexes should be examined carefully for sluggish pupils or a defect in the
afferent pupillary response. External signs of periorbital edema, ecchymosis,
or lid lacerations may be seen. Palpation of the orbital rim may reveal the
characteristic step-off of a previous orbital floor fracture. A traumatic
sixth-nerve palsy may result in esotropia. A variety of anterior segment findings,
including conjunctival lacerations, corneal abrasions, traumatic cataract,
or hyphema with attendant intraocular pressure changes, may be noted.