A person with the fat embolism syndrome may develop ocular findings that may range from minimal to severe.


Clinical features:

(1) recent (within a few days of) fracture of one or more long bones

(2) clinical features of fat embolism syndrome (petechial rash, respiratory symptoms, CNS changes unrelated to head injury, tachycardia, anemia, elevated ESR, etc., as described in Chapter 29)


Patients may have no or minor visual complaints. Severe cases may present as Purtscher's retinopathy (see previous section). Some patients may notice persistent paracentral scotomata.


Fundoscopic examination:

(1) bilateral cotton wool spots

(2) bilateral intraretinal hemorrhages

(3) lesions are usually small, peripheral and present in small numbers

(4) fat droplets may be seen in small blood vessels


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