Introduction Anemia is defined by a low count of healthy red blood cells, low hemoglobin levels, or both. Anemic retinopathy is most likely to present in cases of severe anemia. In anemic retinopathy, retinal hypoxia can result in cotton wool spots, retinal hemorrhages, and retinal edema. A primary care optometrist’s understanding of the systemic workup and management of this condition can be lifesaving for patients. Case Report A 60-year-old man presented for an annual eye examination with a severely pale complexion and shortness of breath. His best-corrected visual acuity was mildly decreased in both eyes, and fundus examination revealed bilateral flame-shaped hemorrhages and cotton-wool spots. After his dilated examination, the patient was escorted by wheelchair to the emergency department, as his overall constitution worsened. An urgent complete blood count revealed a life-threatening microcytic anemia. The patient underwent multiple blood transfusions and was scheduled for an outpatient gastrointestinal workup. After the blood transfusions, his red blood cell counts improved significantly, as did his retinal findings. The initial gastrointestinal consultation was noncontributory, and the patient was lost to follow-up; however, his complete blood count remained relatively stable over the next year. Conclusion Severe anemia can be life-threatening or a sign of a life-threatening condition. Recognition of the retinal signs on dilated fundus examination and by optical coherence tomography is essential for the optometrist. In this adult patient, a general understanding of the necessary testing and systemic workup contributed to the prompt treatment and management of the patient.
Emily R Humphreys (Fri,) studied this question.