COVID-19 lockdown measures induced severe iron-deficiency an
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Central retinal vein occlusion (CRVO) is a common retinal vascular disease. The pooled 10-year global cumulative incidence of retinal vein occlusion is 1.63%. Cases of iron-deficiency anaemia (IDA)-induced CRVO were previously documented in the literatures. The mechanism of thrombosis in IDA may be due to anaemia-induced hypoxia leading to injury of endothelial cells in the retino-choroidal circulation, reactive thrombosis and coagulation dysregulation. Examples of other life-threatening complications of IDA that were reported include strokes and pulmonary embolism.7 Furthermore, as many as half of women who have IDA develop amenorrhea.

A 23-year-old woman presented with reduced left eye vision over 1 week and amenorrhea for 4 months. She was diagnosed with severe iron-deficiency anaemia causing central retinal vein occlusion and amenorrhea. During the lockdown, there was a change in her diet with greatly reduced iron intake. Iron is an essential mineral for retina metabolism and function. Iron supplementation was done with improvement in her vision. This case demonstrates the potential impact of lockdown measures on nutrition and health. Education of the general population on maintaining appropriate nutrition during periods of movement restriction is important and that nutritional evaluation and supplementation should be considered in patients with drastic changes in dietary pattern.

Learning points
- Lockdown measures during the COVID-19 pandemic can have significant impact on dietary patterns and lead to malnutrition.

- Consider iron-deficiency anaemia in patients presenting with sudden onset of central retinal vein occlusion and amenorrhea.

- Nutritional evaluation and supplementation may be considered in patients with drastic dietary pattern changes during quarantine measures due to COVID-19 pandemic.