Retinal Haemorrhage in Children & NAI: When the Story and the Science Do Not Match in Family and Criminal Court Proceedings
- ijeeva
- Nov 22
- 2 min read
In Family Court proceedings, few moments are as important as identifying when the clinical evidence does not align with the history provided. In cases of suspected abusive head trauma, the ophthalmologist is often the first specialist to recognise this gap.
This brief insight explains why ophthalmic evidence is crucial under the Family Procedure Rules Part 25 and how it can guide the court when the reported mechanism appears inconsistent.
1. Retinal Findings Reveal the Force, Not the Story
Parents or carers may describe a minor fall, a sudden collapse, or an event that seems innocuous. However, the eye can record forces that far exceed such explanations.
Patterns such as:
• widespread retinal haemorrhages
• multi layered involvement
• or perimacular changes
are unlikely to result from everyday accident scenarios. Even unilateral findings may contradict the given account. When the described mechanism cannot generate the forces required to produce the observed pattern, this becomes a critical point for the court.
2. The Significance of an Inconsistent History in Safeguarding
In safeguarding medicine, inconsistency between the history and the clinical picture is a recognised red flag. Under FPR 25, this is the point at which the ophthalmologist’s neutral, probability based opinion is essential.
Retinal evidence does not accuse or defend. It provides an objective record of what forces were likely involved. This assists the court in separating uncertainty from implausibility.
3. Why Solicitors May Need Ophthalmic Input Early
Retinal findings can resolve within days. Delayed assessment risks the loss of crucial evidence. Early ophthalmic examination ensures:
• accurate documentation
• exclusion of rare medical mimics
• and timely advice on whether the mechanism merits wider investigation, like NAI
For local authorities, guardians, and family solicitors, this can influence early case strategy, threshold decisions, and expert instruction planning.
Conclusion
In suspected abusive head trauma, retinal findings provide objective evidence that can clarify whether the reported mechanism is plausible. Under both FPR 25 and Criminal Court procedures, the court relies on ophthalmic experts who can interpret these findings impartially and translate complex retinal patterns into clear, probability based opinion. Early specialist assessment ensures that the court has reliable evidence on which to base its decisions.
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