How to Identify Abuse Cases in Your Clinic

𝗖𝗼𝘂𝗹𝗱 𝗮𝗻 𝗘𝘆𝗲 𝗕𝗿𝘂𝗶𝘀𝗲 𝗕𝗲 𝗮 𝗖𝗿𝘆 𝗳𝗼𝗿 𝗛𝗲𝗹𝗽? A patient sits in your chair with a faint bruise near her eye. She says she “bumped into a cabinet.” The explanation is simple and plausible. But sometimes, behind a simple story lies a dangerous truth. Eye-care professionals are often the first to see signs of partner violence, not because patients disclose it, but because the evidence is written on their faces. Research shows women with ocular or orbital injuries caused by abuse face higher risks of repeated harm and even mortality. The stakes are high; your exam chair can become a frontline of defense. 𝗪𝗵𝘆 𝗲𝘆𝗲 𝗶𝗻𝗷𝘂𝗿𝗶𝗲𝘀 𝗺𝗮𝘁𝘁𝗲𝗿 𝗶𝗻 𝗮𝗯𝘂𝘀𝗲 𝗰𝗮𝘀𝗲𝘀 Not every bruise is abuse. But when bruising recurs, fractures don’t match the story, or injuries appear at different stages of healing, we must ask: could this patient be at risk? For many survivors, an eye exam is one of the rare moments they are separated from their partner and can speak privately with a trusted clinician. In that moment, what you notice and how you respond can make a difference. 𝗪𝗵𝗮𝘁 𝗰𝗹𝗶𝗻𝗶𝗰𝗶𝗮𝗻𝘀 𝗰𝗮𝗻 𝗱𝗼 ✅ 𝗣𝗿𝗶𝗼𝗿𝗶𝘁𝗶𝘀𝗲 𝗽𝗿𝗶𝘃𝗮𝗰𝘆. Always ensure a few minutes alone with the patient. ✅ 𝗔𝘀𝗸 𝗴𝗲𝗻𝘁𝗹𝘆, 𝘄𝗶𝘁𝗵𝗼𝘂𝘁 𝗷𝘂𝗱𝗴𝗺𝗲𝗻𝘁. Try: “I notice this injury, can you tell me what happened?” or “Sometimes injuries like this are caused by someone hurting you. Is that the case?” ✅ 𝗗𝗼𝗰𝘂𝗺𝗲𝗻𝘁 𝗰𝗮𝗿𝗲𝗳𝘂𝗹𝗹𝘆. Describe location, size, colour, and the patient’s own words in quotes. If safe and with consent, photograph the injury. ✅ 𝗖𝗼𝗻𝗻𝗲𝗰𝘁, 𝗱𝗼𝗻’𝘁 𝗰𝗼𝗲𝗿𝗰𝗲. Offer resources and options; respect the patient’s autonomy. 𝗕𝘂𝗶𝗹𝗱𝗶𝗻𝗴 𝗮 𝘀𝗮𝗳𝗲𝗿 𝗽𝗿𝗮𝗰𝘁𝗶𝗰𝗲 ✅ A simple clinic protocol for screening, documenting, and referring. ✅ Discreet resource cards or QR codes that patients can take safely. ✅ Staff training on trauma-informed language and safety planning. ✅ A partner network with local advocacy groups and hotlines. A black eye may be an accident. Or it may be a silent try for help. As clinicians, we’re trusted with vision; sometimes we’re asked to see what’s hidden. 𝗔𝗿𝗲 𝘆𝗼𝘂 𝗰𝗼𝗻𝗳𝗶𝗱𝗲𝗻𝘁 𝘆𝗼𝘂𝗿 𝗰𝗹𝗶𝗻𝗶𝗰 𝗰𝗮𝗻 𝗿𝗲𝗰𝗼𝗴𝗻𝗶𝘀𝗲 𝘁𝗵𝗲 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲 𝗮𝗻𝗱 𝗿𝗲𝘀𝗽𝗼𝗻𝗱 𝘀𝗮𝗳𝗲𝗹𝘆? U.S. readers: National Domestic Violence Hotline, 800-799-SAFE (7233) or text START to 88788. Outside the U.S.: please use your local crisis line. #EyeCare #PatientSafety #DomesticViolenceAwareness #Optometry #HealthcareResponsibility #VerovianCares

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