網膜剥離を発症したbattered child syndromeの1例

A case of battered child syndrome with retinal detachment

　白色瞳孔を呈したbattered child syndromeの1例を報告した．症例は4歳の女子で左眼に虹彩炎，前嚢下白内障，全網膜剥離による白色瞳孔がみられ，右眼は下耳側から下鼻側にかけて周辺部に強い網脈絡膜萎縮が認められた．これらの眼症状はいずれも反復して受けた鈍的外傷が原因と考えられ，battered child syndromeが疑われた．家庭環境を調査した所，母親による虐待を1歳半頃から受けていたことが明らかになった．眼科医は原因が曖昧な外傷が疑われる幼児の眼異常を発見した場合には本症候群の存在を念頭におき，重篤な障害を残す可能性を考え，児童相談所および福祉事務所に連絡して調査すべき責任がある．

A 4-year-old girl developed hyperemia in the left eye. We detected anterior subcapsular cataract and leukokoria due to total retinal detachment in her left eye. An extensive chorioretinal atrophy was located along the lower fundus periphery in the right eye. While there were no physical abnor-malities otherwise, she was found to be mentally retarded.

Since these ocular lesions were suspected to be caused by repeated blunt injuries, her mother was referred to a pediatric psychologist. The results led to the diagnosis of battered child syndrome.

It is emphasized that battered child syndrome should be considered in the presence of bilateral ocular lesions of unknown etiology in small children such as intraocular hemorrhage, retinal detachment or ecchymosis of the eyelid.