Based on this study of perpetrator-confessed AHT, RHs are present in most (94%) but not all cases. Importantly, there may be fewer than 5 per eye or they may be restricted to one eye (in 18% of cases). Thus, AHT could be present (as defined by perpetrator confession and nonocular clues) if RHs were strictly uniocular and if RHs were confined to one eye. We acknowledge that a confession may be driven by a persuasive array of clinical features and a persuasive interviewer and that confessions are not always reliable. In this study, however, we took the statements given by the alleged perpetrator at face value. The confessions ranged from statements admitting to only mild shaking of the child to statements of severe shaking and slamming the child into a wall.