One of the less-than-satisfying tasks of being an ophthalmologist is getting that call from the pediatric intensive care unit after a child suspected of being abused is admitted. One of the routine exams performed in such a case is a dilated eye exam. Certain findings in the retina used to be a gold standard in making this diagnosis. But, thankfully, lately it has been more widely realized that such findings are only a single piece of the puzzle. They don't rule anything in or anything out; other than that the retina sustained a significant injury. It is not our job as eye doctors to make conjectures in these cases as to what happened.
But when we do see it, it's sad nonetheless. Any more, by the time we are getting called to do the exam, a pretty extensive history has already been undertaken and there is something there that made somebody suspect abuse. This, more than anything else, is probably most useful information that can be gathered. Interacting with parents or the accused during the process is extremely uncomfortable. We walk in the room and there is usually one of two responses.
The first is the catatonic response. The parent that doesn't want to interact much with me, or even the child. Are they guilty or simply in shock at the accusations? The second is the "Oh my God, what do you see, is he gonna be all right?" parent. These are hard to interact with simply because I don't know how much to divulge or to whom. That's when I become the catatonic one.
Just save it. Don't do it in the first place.
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