010. Eye disease in systemic conditions

Question 1

How do granulomatous disorders affect the eye

Give examples of some granulomatous diseases

Answer 1

Cause Anterior uveitis or posterior uveitis

Syphillis, T, sarcoidosis, leprosy, brucellosis

Question 2

The following are eye conditiosn that occur in systemic disease. Which diseases correspond to the eye disease:

Iritis

Uveitis

Conjunctivitis

Scleritits/Episcleritits

Answer 2

Iritits- ankylosing spondylitit, reactive arthritis

Uveitis- Bechet’s (vasculitits)

Conjuctivitiis- reactive arthritis,

Scelrtitis/episcleritis- IBD, RA, Vasculitis, SLE

Question 3

What is hypertensive retinopahty

Answer 3

Increased blood pressure leads to damage to the retinal vessels

Question 4

Describe the signs and symptoms of hypertensive retinopathy

Answer 4

Shiny, hardened arteries with nip sections where they cross

Blocked arterioles may cause localised retinal infarction

papilloedema or flame heamorrhage suggests accelerated hypertension

Question 5

Describe the signs of retinal vein occlusion?

Answer 5

Central vein occulsion- fundus looks like a stromy sunset

Branch vein occlusion- changes are confined to the wedge of the retina

Question 6

Which diseases cause the following eye conditions?

Retinal heamorrhage

Conjuctival heamorrhage and new vessel formation

Optic atrophy

Answer 6

Retinal heamorrhage- leukaemia

Conjuctival heamorrhage and new vessel formation- sickle cell disease

Optic atrophy- MS or pernicious aneamia

Question 7

What are the signs of HIV eye disease?

Answer 7

CMV retinitis- may occur in those with AIDS

Cotton wool spots- HIV retinopathy

Question 8

What are the differentials of a red eye?

Answer 8

Acute glaucoma

Anterior uveitis (iritis)

Conjuctivitis

Subconjuctival heamorrhage

Question 9

How does acute glaucoma present?

How is it treated?

Answer 9

Red eye completely red with high intra-ocular pressure

IV acetazolamide (just learn glaucoma treatment)
Pilocarpine drops (decreases eye pressure)

Question 10

Discuss the presentation of anterior uveitis

How is it treated?

Answer 10

Redness mostly marked aroudn the cornea. Typically unilateral

Steroid eye drops and mydriatic (eye dilator)

Question 11

If an individual had conjuctivitis how would it present

How is it treated?

Answer 11

Often bilateral mobile inflammation with discharge

Most do require treatment
Chloramphenicol eye drops (antibiotic)

Question 12

Subconjuctival haemorrhage. Explain how this disease would manifest

How is it treated?

Answer 12

Bright red sclera with rim around limbus

Looks alarming but will resolve spontaneously. Check B and consider if warfarin may have caused