AUTHOR=Patil Rajvardhan Ravindra , Acharya Sourya , Karwa Vineet , Dhondge Rushikesh , Shaikh Suhail , Kothari Manjeet TITLE=Case Report: Expanding the ocular horizon: subperiosteal orbital hematoma and Roth spots in known case of sickle cell disease JOURNAL=Frontiers in Hematology VOLUME=Volume 4 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/hematology/articles/10.3389/frhem.2025.1558509 DOI=10.3389/frhem.2025.1558509 ISSN=2813-3935 ABSTRACT=Sickle cell disease is a prevalent haemoglobinopathy that is hereditary. People with sickle cell disease frequently experience vaso-occlusive crises, which lead to substantial morbidity from end-organ ischaemia and infarction. Numerous organs, including the bones, brain, lungs, spleen, retina, and penis, may be affected. As a result, symptoms may include painful bone crises, cerebrovascular accidents, acute chest syndrome, sequestration crises, retinal haemorrhage, and priapism. In sickle cell disease, subperiosteal orbital haemorrhage is a rare vaso-occlusive crisis (VOC). Roth spots (white-centred, flame-shaped retinal haemorrhages), occurring commonly in subacute bacterial endocarditis, can also be seen in leukaemia, pre-eclampsia, and hypertensive retinopathy. A 19-year-old male patient with sickle cell disease (HbSS) presented to the hospital with ptosis and swelling in his right periorbital region 3 days after being brought to the hospital for a sickle cell crisis. It was later determined to be an acute subperiosteal orbital hematoma along with Roth spots, an uncommon clinical manifestation of sickle cell disease, only after a thorough clinical and radiological assessment.