Undiagnosed Haemophilia Threatens Sight in India

India faces a substantial challenge with haemophilia, a genetic bleeding disorder, holding the second-largest global burden. While joint issues are commonly discussed, the severe impact on vision is often overlooked. Ocular bleeding accounts for 13% of bleeds in haemophilia patients, with posterior segment bleeding occurring in 1.8% and risking permanent sight loss.

Diagnostic challenges persist, with low awareness and few specialized labs contributing to delayed detection. Mild haemophilia frequently goes unnoticed until adulthood, surfacing after procedures like dental extractions or surgery. This lack of timely diagnosis is critical because unlike joint damage, vision loss is irreversible and requires immediate, precise intervention.

Preventing bleeds before they occur is paramount. Pre-operative checklists should include specific questions about bleeding history, and tests like APTT and factor assays are vital when ocular bleeding seems disproportionate to trauma. Establishing referral links between eye units and haemophilia treatment centers is essential to bridge this gap and avert preventable blindness.