A 62-year-old woman with no significant past medical history was referred to the ophthalmologist on account of a 3-week history of blurred vision. Examination revealed visual acuities of 6/36 and 6/18 for her right and left eye, respectively. Anterior segments and intraocular pressures were normal but she had bilateral multiple widespread retinal haemorrhages with Roth spots (image on the left above). Full blood count showed a significantly high white blood cell count (WBC) at 542 × 10 9 /L, haemoglobin (Hb) 110 g/L and platelets 256 × 10 9 /L and a blood film appearance in keeping with chronic myeloid leukaemia (CML). Her BCR-ABL1 mutation screen was positive and her bone marrow did not show an excess of blasts. Chronic-phase CML was diagnosed and adequate treatment was instituted.A 40-year-old man was seen by the opticians for a visual assessment on account of 2-month history of blurring of central vision.
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