Massive suprachoroidal hemorrhage in dengue-associated HLH: A clinical image

Dengue fever can manifest with severe hemorrhagic complications, though ocular involvement is rare. We report a unique case of a 44-year-old male with dengue hemorrhagic fever complicated by secondary hemophagocytic lymphohistiocytosis (HLH) and severe thrombocytopenia, who developed a massive suprachoroidal hemorrhage culminating in spontaneous auto-evisceration and requiring surgical evisceration. To our knowledge, this is the first reported case of dengue-associated HLH presenting with such a catastrophic ocular complication. This case underscores the importance of early ophthalmic evaluation and multidisciplinary intervention in systemic viral illnesses.