diagnosed using tool in guideline Abnormality of the Eye Ophthalmologic Complication Slit-Lamp Examination Conjunctival Comma Sign None Request inclusion into relevant ontology. Dark red, comma- or corkscrew-shaped vascular fragment that appears to be isolated from neighboring blood vessels in the conjunctiva. Normally benign, this lesion can serve as the first diagnostic sign of sickle cell retinopathy. The conjunctival comma sign results from transient vaso-occlusive processes in the microvasculature of bulbar conjunctiva. It is not seen in sickle trait, but is common in SCD. Ballas et al 2010 Am J Hematol Sickle Cell Disease: The Clinical Care Guidelines of the Sickle Cell Unit