To the Editor.
—The article by Garty et al1 in the October Archives presented the case reports of two children in whom sickle cell vaso-occlusive crisis was associated with periorbital swelling and frontal and orbital bone infarction. The relative infrequency of these findings in patients with sickle cell makes the article an important addition to our understanding of sickle cell eye disease. To the authors' knowledge, "periorbital bone infarction, as a part of the differential diagnosis of periorbital hematoma and as part of the possible ocular manifestations in patients with sickle cell anemia, has not previously been described."Periorbital bone infarction in sickle cell disease has been noted by others,2 although these reports do not specify that periorbital hematoma was present. The usual clinical setting is said to be one of systemic sickle cell crisis accompanied by frontal headache and eye pain, often with lid edema and proptosis
Fletcher ME. Sickle Cell Eye Disease. Arch Ophthalmol. 1985;103(2):175. doi:10.1001/archopht.1985.01050020027006