A vision in peril: Case series on unmasking rare ocular complications of dengue fever

Dengue, a common mosquito-borne viral fever, is usually self-limiting, but a minority of patients develop severe systemic and ocular complications. We report three rare cases of severe involvement of the ocular adnexa and globe associated with dengue fever. The first patient, a 24-year-old male, developed bilateral vision loss with retrobulbar hemorrhage and scleral melt requiring evisceration. The second case, a 30-year male, presented with painful right eye vision loss due to retro-orbital hematoma and ocular compartment syndrome. The third one, a 70-year-old male, exhibited unilateral proptosis, panuveitis, and scleral necrosis. Ocular involvement in dengue is poorly understood and may involve immune-mediated inflammation or hemorrhage secondary to thrombocytopenia. Platelet transfusion may also contribute. Manifestations range from subconjunctival hemorrhage to endophthalmitis. In our study, we found unusual and severe forms of ocular involvement in dengue fever. In conclusion, early management of patients with ocular symptoms in dengue is crucial to prevent irreversible damage. Further research is essential.