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Case Reports in Ophthalmological Medicine
Volume 2016 (2016), Article ID 5867850, 4 pages
http://dx.doi.org/10.1155/2016/5867850
Case Report

Orbital Infarction due to Sickle Cell Disease without Orbital Pain

1Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
2Robert Cizik Eye Clinic, Houston, TX, USA
3Moran Pediatric Eye Clinic, An Affiliate of the Robert Cizik Eye Clinic, Houston, TX, USA

Received 7 July 2016; Revised 7 October 2016; Accepted 24 October 2016

Academic Editor: Kostas G. Boboridis

Copyright © 2016 Cameron L. McBride et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sickle cell disease is a hemoglobinopathy that results in paroxysmal arteriolar occlusion and tissue infarction that can manifest in a plurality of tissues. Rarely, these infarcted crises manifest in the bony orbit. Orbital infarction usually presents with acute onset of periorbital tenderness, swelling, erythema, and pain. Soft tissue swelling can result in proptosis and attenuation of extraocular movements. Expedient diagnosis of sickle cell orbital infarction is crucial because this is a potentially sight-threatening entity. Diagnosis can be delayed since the presentation has physical and radiographic findings mimicking various infectious and traumatic processes. We describe a patient who presented with sickle cell orbital crisis without pain. This case highlights the importance of maintaining a high index of suspicion in patients with known sickle cell disease or of African descent born outside the United States in a region where screening for hemoglobinopathy is not routine, even when the presentation is not classic.