The development of a sickle-cell crisis remains one of the most interesting and fundamentally unsolved problems of sicklecell disease.1,2 Presumably, the erythrocytes sickle in the small vessels where the oxygen tension is lower, and one might expect a crisis to be accompanied by an increase in sickling in the vasculature of various parts of the body. The crisis is often characterized by episodes of generalized pain associated with fever. No hematological data exist which can be used to diagnose the presence of such a crisis. One logical approach to investigating the mechanism of crisis would involve doing in vivo studies of the capillary circulation in sickle-cell anemia patients in and out of crisis. The bulbar conjunctiva lends itself ideally to such a study. Scattered reports have described the occurrence and presented sketches of capillary dilatations in the conjunctiva of patients with either sickle-cell anemia or hemoglobin-C disease.3-6
FINK AI, FUNAHASHI T, ROBINSON M, WATSON RJ. Conjunctival Blood Flow in Sickle-Cell Disease: Preliminary Report. Arch Ophthalmol. 1961;66(6):824–829. doi:https://doi.org/10.1001/archopht.1961.00960010826008
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