An, A Persistent painless eyelid hematoma as an atypical ocular manifestation in Thalassemia trait: A Case Report

Abstract

ABSTRACT

Background:  Thalassemia is the commonest haemoglobinopathy worldwide which can affect any organ in the body. Ocular manifestations reported include decreased visual acuity, colour vision anomalies, cataract, visual field defects and optic neuropathy.

Objective:To report an atypical ocular manifestation of thalassemia, who presented with persistent painless  lower lid bruising.

Method:Case report

Results: A seven-year-old boy with no known medical illness presented with painless right eye lower lid bruising for the past one year. The patient denied any history of trauma. There were no other ocular or systemic symptoms and the child was otherwise well. Visual acuity was 6/6 in both eyes. There was black discolouration of the right eye lower lid, which extended to the temporal upper lid. No swelling or proptosis was noted. The bruising did not increase with Valsalva manouever. Further examination of the right eye was normal. Examination of the left eye was unremarkable. Systemic examination revealed a round black discolouration of the skin measuring 1.5cm in diameter over the left mid-thoracic region. Retrospective history from patient’s mother noted the trunk discolouration appeared shortly after the right eyelid bruising and has persisted until now. The patient was diagnosed as  thalassaemia carrier via peripheral blood film and haemoglobin electrophoresis testing. In conclusion, persistent painless eyelid discolouration should raise suspicion of bleeding disorders.

Conflicts of interest:The authors report no conflicts of interest.

Keywords: Thalassemia, Ocular manifestation