DR. RIA SHARMA

DR. BRUTTENDU MOHARANA, DR. ANIZA NAGPAL, DR. BHAVANA SHARMA

Abstract

A 9 year old female child presented to the emergency with complaints of sudden onset of left eye proptosis associated with periorbital edema and diminution of vision since 2 days. Ocular examination showed BCVA (OD) 6/6 and 3/60 (OS). Left eye showed restriction of ocular movements, proptosis, chemosis, a quiet AC and a normal fundus. There was no history of recent trauma or fever; however, a positive history of sudden onset bilateral lower limb pain since 3 days was noted. CECT showed periorbital hyperintense collection consistent with a hematoma. CBC showed normocytic normochromic anemia, however, HPLC confirmed the diagnosis of sickle cell anemia. There was marked improvement in the proptosis and periorbital edema with the commencement of treatment with complete resolution at 2 weeks follow up. Orbital involvement is an uncommon finding in sickle cell disease, and combined with a normal CBC, posed an interesting diagnostic dilemma to the treating doctor.