Sir,

This is an interesting case which highlights one of the many presentations of Thrombotic thrombocytopenic purpura which also include retinal haemorrhages, oculomotor nerve palsies, pupil abnormalities as well as our case of retinal vascular occlusion and the case of choroidal vasculopathy as described by the authors. It is important to recognise this spectrum of presentations, as Thrombotic thrombocytopenic purpura can be fatal if not diagnosed and treated promptly.