Comma-shaped venular segments of conjunctiva in chronic granulocytic leukemia

Isolated comma or corkscrew-shaped venular segments in the conjunctiva have been felt to be diagnostic of sickle cell disease. External eye examination of a 34-year-old black man with a two-year history of chronic granulocytic leukemia revealed multiple small and medium-sized isolated conjunctival venular segments. Laboratory findings at the time of examination included a white blood cell count of 132,000/mm3 with 87% eosinophils, a hematocrit reading of 30%, and hemoglobin AA. Since whole blood hyperviscosity can be present in chronic granulocytic leukemia as well as sickle cell disease, this may account for the similarly of the conjunctival changes.