Analysis of child abuse and neglect.

Child abuse and neglect is a problem that has existed for many years. Federal guidelines and state laws make it necessary for the optometrist to be aware of the definitions that describe abuse and neglect. In addition, it is necessary to review the characteristics of the child and caregiver to ascertain who may be at risk. Physical signs, such as specific types of fractures, burns, scalds, and bruises, should act as a key to suspected abuse. The most frequent ocular sign of abuse is intraocular hemorrhage. Other ocular manifestations include periorbital edema, ecchymosis, and retinal detachment, to name a few. Sexual abuse is also of concern. If a sexually transmitted disease is present in a young child, abuse should not be ruled out. It is the responsibility of the health care provider to report any suspected episodes of child abuse and neglect.