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 similarity of the conjunctival changes.