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recommended when the diagnosis of traumatic iritis is suspected, as it is often associated with other ocular injuries Management Dilating drops and topical steroids are the mainstay of treatment for traumatic iritis Because of the risks associated with their use, these therapies should only be prescribed in conjunction with ophthalmology consultation FIGURE 114.11 Retinal hemorrhages in abusive head injury A: Retinal hemorrhages as seen using the narrow view from a direct ophthalmoscope B: Retinal hemorrhages as seen using a wide-angle ophthalmoscope or retinal photography (Reprinted with permission from Gold DH, Weingeist TA Color Atlas of the Eye in Systemic Disease Baltimore, MD: Lippincott Williams & Wilkins; 2001.) Traumatic Versus Nonorganic Visual Loss Occasionally, the emergency physician is faced with a child who is feigning visual loss Nonorganic visual loss can also be idiopathic and transient, or associated with stress A full ophthalmologic examination with visual acuity testing, pupil function, visual fields, and anterior and posterior segment evaluation is required before considering nonorganic vision loss In the absence of other signs of ocular or head trauma, this diagnosis should be considered It may become necessary to “trick” the child into demonstrating that he or she can actually see Patients who are truly acutely blind should demonstrate some degree of anxiety and virtually complete inability to navigate in new surroundings When asked to write their names on a piece of paper, truly blind patients can so accurately, unlike children who are functionally blind who assume they are unable to write Children who are feigning visual loss but not complete blindness