Sickle Cell Retinopathy

Sickle cell retinopathy otherwise known as sickling hemoglobinopathies is an ocular presentation of sickle cell disease. It is due to frequent complication of the sickle cell disease and which if not managed properly can lead to blindness. The sickle-shaped red blood cells get clogged in blood vessels and impair blood flow to certain parts of the body of which the retina is part of. This can damage the retina as retinopathies can occur in sickle cell diseases with blockages in vessels supplying the eyes. People with sickle cell C type disease are the most likely to develop severe retinopathies whereas it is less common in the carriers of the disease. The clogging of sickle-shaped red cells in the small blood vessels, in the different structures of the anterior and posterior segments of the eye, lead to characteristic damage. In the anterior segment, the conjunctiva has dark red comma-shaped vessels that are typically transient, patches of ischemic atrophy often extending from the pupillary edge to the collarette and occasionally rubeosis on the iris.

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The clinical manifestations vary depending on the presence or absence of vaso-proliferative changes. Therefore, this disease can be classified as non-proliferative sickle cell retinopathy (NPSR) and proliferative sickle cell retinopathy (PSR). The retinal changes that occur in non-proliferative sickle cell retinopathy is secondary to vaso-occlusion and local ischemia. Salmon patches which are orange-red mid-periphery superficial intraretinal hemorrhages are initiated by vascular occlusion. The salmon patches can be elevated or flattened and the hemolysis of red blood cells results in the orange-red colour. They resolve to leave schisis cavities containing retractile deposits of black sunbursts spots when the Retinal Pigment Epithelium is sufficiently stimulated. Again there is optic disc sign of ‘sickling’ where dark red blots on the disc surface due to small vessel occlusion. Venous changes occur with tortuosity due to peripheral arteriovenous shunting. Silver wiring of arterioles in the peripheral retina and corkscrewing of peripheral vessels may be seen. A concave depression in the temporal macular retina (Macular depressing sign) could also be present due to thinning of the retinal pigment epithelium and occlusions in the choroidal circulation with associated breaks in Bruch’s membrane are known to cause Angioid streaks (occur in up to 6%). Lastly the non-proliferative stage presents with peripheral areas of whitening or darkening in the retina.

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The ocular complications of Proliferative Sickle Cell Retinopathy are more characteristically seen in HbC (SC) and SThal disease rather than in SS disease. The development is usually insidious with no symptoms unless vitreous hemorrhage or retinal detachment occur. * Sickle Cell Retinopathy may generally present with redness, ocular pain, reduce Acuity, floaters and flashes and or peripheral visual field loss.

What is @bettervision about?

@bettervision is is a project initiated by @nattybongo and friends to give back to the society the knowledge and skill acquired through the Optometric Studies in Kwame Nkrumah University of Science and Technology, Ghana.It is an outreach system where we visit the less privileged communities to offer free eye screening services and education to the people within the community

AIMS AND OBJECTIVES
To reduce or prevent vision loss through diseases such as glaucoma, cataract and refractive errors.

To enlighten the majority of the Ghanaian population about the importance of proper visual care.

To conscientize people on the need for regular eye checks

To get more people to have their wards screened within the Critical periods of a Child’s Vision Development; thus from ages 3 to till about 10 years.

To help the blind and people with low vision live a better life within the society through education of the general public to stop stigmatization.

To help in the fight of extreme poverty that puts the health of people at risk

Our greatest gratitude goes to @fundition @adollaraday @surfyogi @girlsfoundation @bleepcoin @ackza @indigoocean @nanzo-scoop @steemstem @demotruk @pennsif @steem-ambassador @kasho and @wafrica for helping to make the aims and objectives of @bettervision a reality.