Thrombocytopenia
- Low platelet count from many different causes
- Most common ophthalmic manifestion: retinal hemorrhages; occur commonly when platelet count falls below 20,000/mm3
- Patients have blurred vision if retinal hemorrhage located at fovea or notice dark spot if hemorrhage is near fovea
- Hemorrhages may be...
- Dot-blot within retina
- Flame-shaped in retinal surface nerve fiber layer
- Bubble-shaped or boat-shaped between retina and vitreous
- White-centered ("Roth spots")
- Refer only if patient complains of visual symptoms
- Retinal hemorrhages resolve spontaneously within weeks, but may recur if platelet count remains low
- Vision usually recovers to normal as hemorrhage clears, but foveal hemorrhages may leave behind slightly distorted vision
- Transfusions to raise platelet count necessary only if visual loss is severe and persistent
