Abstract

Introduction: Anemia is a frequent haematological ailment presenting with diverse ophthalmic manifestations. It can involve  any  part of the eye and adnexa but principal features are conjunctival pallor and retinal haemorrhages retinal arteriolar and venous tortuosity, cotton wool spots, roth’s spots, macular star and papilledema. This study evaluates the incidence of ocular manifestations in anaemia, relation between incidence of retinal haemorrhages with degree of severity of anaemia and prerequisite for fundus examination in all patients with anemia.

Objective: To evaluate the incidence of ocular manifestation in anemia and to evaluate correlation between the incidence of retinal haemorrhages and degree of severity of anemia.

Methodology: This prospective observational study was done in the department of Ophthalmology at GMC Rajouri from January 2019 – April 2019. A total of 96 patients, age group 18-50 years, diagnosed with nutritional anemia were included in our study after gaining written informed consent. Comprehensive haematological work up was done to exclude patients with anaemia other than nutritional cause. Evaluation of anterior segment of eye was done by slit lamp bio microscope. Evaluation of posterior segment of eye was done the help of direct/indirect ophthalmoscope/slit lamp biomicroscopy with +90D lens after full dilatation of pupil with Tropicamide eye drops.

Results: Out of total 96 patients with nutritional anaemia iron deficiency was seen in 52(54.16%) patients, megaloblastic anaemia was seen in 16(16.66%) patients and dimorphic anaemia was seen in 28(29.16%) patients. In our study we found that conjunctival pallor was the commonest ocular manifestation in anaemia and was present in all the cases. Patients with severe anaemia showed retinal haemorrhages in 26 (68.4%) patients. In our study incidence and severity of retinopathy was higher with higher grades of anaemia.

Conclusion: Conjunctival pallor and flame shaped haemorrhages are most common ocular manifestations in patients with nutritional anaemia. Presence of conjunctival pallor needs evaluation for anaemia. Incidence and severity of retinal manifestations depends upon severity of anaemia.

Keywords: Anemia, Iron deficiency anemia, Conjunctival pallor, retinal haemorrhages.