| Sumario: | Background: There is much debate on the implications of retinal hemorrhages observed in young children. The location and type of retinal hemorrhages can have important diagnostic significance in determining the cause, especially when there is suspicion of child abuse. Additionally, when retinal hemorrhages present with papilledema in children, it is a challenge to distinguish whether they are mutually exclusive or connected by a single etiology. Case Report: A three-year-old African American female presented for her first eye examination with complaints of tearing for one week. Binocular indirect ophthalmoscopy revealed bilateral disc edema, a pre-retinal hemorrhage OS, and scattered peripheral intraretinal hemorrhages OU. The patient was referred to the emergency room at LeBonheur Childrens Hospital for MR1 of head, neck, and orbits and for a neurology consult. MRI results confirmed papilledema and showed a subdural hemorrhage surrounding the left parietal and occipital lobes. Discussion: Due to the potential serious nature of possible etiologies, a prompt referral was made in this case and is the standard of care. It is also important for optometrists to recognize the different types of retinal hemorrhages and the implications they have in the course of the disease process, as well as to be familiar with the protocols for reporting suspected child abuse if it is potentially occurring.
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