Ocular Complications Among Patients with Beta-Thalassaemia Major and Intermedia: A Comparative Study from Pakistan

Beta-thalassemia is associated with systemic complications from chronic anemia, iron overload, and long-term transfusion therapy, which may also affect ocular structures. This study aimed to compare the frequency and patterns of ocular complications between patients with β-thalassemia major and β-thalassemia intermedia. This comparative cross-sectional study included 30 patients (60 eyes) with β-thalassemia major or β-thalassemia intermedia, recruited via convenience nonprobability sampling. All participants underwent comprehensive optometric and ophthalmic evaluation, including assessments of visual acuity, intraocular pressure, stereopsis, tear break-up time, visual field testing, and slit-lamp examination of the anterior and posterior segments. Serum ferritin levels were also recorded, and statistical analysis was performed using SPSS version 21. The mean age of participants was 20.67 ± 7. 44 years, and 60% were female. Serum ferritin levels were significantly higher in patients with β-thalassemia major than in those with β-thalassemia intermedia (4056. 47 ± 2415. 28; p < 0. 001). Uncorrected visual acuity and superior visual field extent were significantly better in the intermedia group (0. 913 ± 0. 196 decimal and 52. 67 ± 7. 74 degrees, respectively; p < 0. 05). Tear break- up time was significantly longer in the major group (9. 87 ± 4. 25 seconds) than in the intermedia group (6. 27 ± 3. 91 seconds; p < 0. 005). Patients receiving chelation therapy for more than 5 years had significantly lower tear break-up time values (p = 0. 04). Lenticular abnormalities were observed in 10% of eyes in both groups, whereas vitreous condensations and peripheral fundus atrophic changes were more frequent in β-thalassemia intermedia. In conclusion, patients with β-thalassemia major have higher serum ferritin levels and poorer visual function, whereas certain posterior segment changes appear more prevalent in β-thalassemia intermedia. These findings highlight the importance of regular ophthalmic screening in patients with thalassemia.