Conjunctival congestion: a novel clinical sign in older children with Tetralogy of Fallot

Tetralogy of Fallot is the most common cyanotic heart disease in children. While doing echocardiographic examination of children with Tetralogy of Fallot, we observed that many older children with this condition had congestion in their bulbar conjunctiva, easily recognizable even from some distance. This observation led us to design and perform a research study in order to find out the presence of conjunctival congestion in children with Tetralogy of Fallot. 85% of children in the ≥ 5-years of age group had conjunctival congestion without any ocular symptom. This novel clinical finding can act as an adjunct clinical sign for recognizing Tetralogy of Fallot in older children.