Physical abuse is a leading cause of serious head injury in infants. The true incidence of this global health problem is difficult to calculate, due to a multitude of factors such as the degree of suspicion, accuracy in reporting, and the unavailability of autopsy studies in some countries. Identifying child abuse can also be a double-edged sword; Developed countries that have structured child protection services tend to have more discrete abuse, while countries with more apparent abuse are unfortunately often the ones without proper protective services. Preventing child abuse is a challenging public health goal, and developing countries must first identify the magnitude of the problem within their community to properly address this issue. We as Ophthalmologists believe that ophthalmic examination in suspected child abuse cases is of significant importance due to the presence of specific and objective findings, which we discuss in the following review in terms of history, incidence, and pathophysiology. These findings should raise a high level of suspicion of child abuse, and will help identify these cases with minimal delay. Subsequently, we hope this further raises awareness of this unfortunate public health crisis amongst health practitioners, and eventually the community as a whole. Ultimately, these findings will assist us in developing strategies to increase the identification and reporting of child abuse, which should in turn lead to increased protection of children, and develop an open communication platform between families, physicians, and necessary government services.

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