Sickle cell disease is an inherited blood disorder that affects hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body.
Normally, red blood cells are flexible and disc-shaped, allowing them to move easily through blood vessels. With sickle cell disease, red blood cells can become stiff and crescent- or “sickle”-shaped. These cells can block blood flow through small blood vessels, reducing the delivery of oxygen to tissues throughout the body.
Sickle cell disease can cause pain crises, anemia, infections, stroke, kidney problems, and other complications. It can also affect the eyes.
How Can Sickle Cell Disease Affect Your Vision?
The tiny blood vessels that supply the eyes can also be affected by sickled red blood cells. When blood flow is blocked, the retina, the part of the eye that processes visual information can become damaged.
Some people with sickle cell disease may have retinal changes without noticing symptoms at first. That is why regular eye examinations are an important part of caring for your overall health when you have sickle cell disease.
Possible eye-related complications can include:
- Blockage of retinal blood vessels
- Retinal damage or ischemia from low oxygen
- Growth of abnormal blood vessels of the eye
- Vision changes or vision loss from retinal detachment.
What Does the Research Show?
Two studies provide important information about how sickle cell disease can affect the eyes.
Study 1: Retinopathy and disease severity
One recent study evaluated 96 patients with sickle cell disease, with an average age of about 31 years.
The researchers found a significant relationship between age and the severity of retinopathy, meaning that older patients demonstrated to have more severe retinal changes. They reported that the relationship between systemic severity and retinopathy was particularly strong, supporting the importance of early eye screening and integrated care for people with sickle cell disease.
Study 2: Ocular findings in 1,904 patients
A larger study used data from the Cooperative Study of Sickle Cell Disease and included 1,904 patients with major sickle cell hemoglobinopathies, including HbSS, HbSC, and Sβ-thalassemia.
The participants underwent detailed eye examinations under standardized conditions.
The study found that:
- 96.4% of patients had best-corrected visual acuity better than 20/40 in their better-seeing eye.
- Vascular changes in the conjunctiva, the clear tissue covering the white part of the eye, were the most common abnormal finding, occurring in 54.1% of patients.
- Peripheral retinal artery occlusion was the most common reported ocular complication, detected in 20.3% of patients in both eyes and 6.9% in one eye.
These findings show that significant retinal and vascular changes can occur in people with sickle cell disease even when overall visual acuity may still be good.
Why Are Regular Eye Exams Important?
Sickle cell disease affects the body’s smallest blood vessels, including those supplying the eye.
An eye examination allows your ophthalmologist to look for changes in the retina and other parts of the eye that may not cause noticeable symptoms right away.
Early detection can help your eye doctor monitor changes over time and determine whether additional evaluation or treatment is needed.
If you have sickle cell disease, make sure your eye doctor knows about your diagnosis. Your eye health is an important part of your whole-body health.
Community Awareness
My daughter’s, Shreya Pradhan, nonprofit organization, Wellness Wayfinder is conducting health awareness workshops for students in middle and high school to raise awareness of diseases like sickle cell which can sometimes be silent diseases to the general public.
Check out her website to see photos from their Sickle Cell awareness workshop which was on September 17th with guest speakers from VCU and donate to her organization if you want to support her and Wellness Wayfinder.
Protect Your Vision Healthspan
Sickle cell disease requires ongoing care, and managing the condition involves a multidisciplinary approach. Treatment may include hydration, pain management, blood transfusions when appropriate, disease-modifying medications such as hydroxyurea, and other treatments depending on each person’s health needs.
Your eye care is another important part of that picture.
If you or a loved one has sickle cell disease, don’t wait for a change in vision before paying attention to your eye health.
Call Eye Doctor MD, PC at (804) 270-3333 to schedule a comprehensive eye examination with Dr. Pradhan.
Know someone living with sickle cell disease? Share this newsletter with your family and friends who may benefit from this information.
Your eyes are part of your whole-body health. Taking care of them is an important part of taking care of you.
For more information on caring for your vision and whole-body health, subscribe to our YouTube channel.
Sources:
https://www.nhlbi.nih.gov/health/sickle-cell-disease
https://pmc.ncbi.nlm.nih.gov/articles/PMC12462166
https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876
https://pubmed.ncbi.nlm.nih.gov/37746969
Dr. Shilpi Pradhan is a board-certified ophthalmologist, cornea specialist, and founder of Eye Doctor MD PC. Beyond providing advanced clinical treatments for dry eye disease, she guides patients in adopting targeted lifestyle changes to improve both their eye health and overall whole-body wellness. As one of the first Virginia ophthalmologists board-certified in Lifestyle Medicine (2020) and a member of the American College of Lifestyle Medicine (ACLM), Dr. Pradhan combines modern ocular care with evidence-based nutrition and habit changes to support long-term Vision Healthspan.