Late ophthalmic manifestations of the shaken baby syndrome.

We examined six children between 12 and 55 months after an initial shaking injury to determine whether visually significant retinal abnormalities persisted, despite clearing of intraocular hemorrhage. In two children (age 21 months and 6.7 years at follow-up), visual acuity was reduced due to macular folds occurring in the region of previous large subhyaloid hemorrhages. A third child (age 3.2 years) had a midperipheral lacunar defect of the retinal pigment epithelium which was not visually significant. Cerebral injury was responsible for an apparent profound visual loss in three children. Our findings indicate that both macular folds and cortical injury are functionally significant complications of the shaken baby syndrome.