Do retinal haemorrhages occur in infants with convulsions?

Aim: To determine the prevalence of retinal haemorrhages in infants presenting with convulsions and admitted to hospital, and to consider whether this finding indicates shaken baby syndrome. Methods: Prospective study of children aged 15 days to 2 years admitted with a diagnosis of first convulsion over a 2-year period ( May 2004-May 2006). All infants were examined by an experienced ophthalmologist using indirect ophthalmoscopy within 72 h of admission. Results: 182 of 389 children seen in the accident and emergency department were admitted and two were found to have retinal haemorrhages. Both children were eventually diagnosed as being abused. Conclusions: Convulsions alone are unlikely to cause retinal haemorrhages in children under 2 years of age.