the eye in systemic disease Flashcards
what causes myotonic dystrophy?
AD mutation in dystrophia myotonica protein kinase geneDMPK
what are the symptoms of myotonic dystrophy?
Muscle wasting and weakness
Mournful facial expression (facial wasting, loose jaw)
Slurred speech (tongue/pharyngeal muscles involved)
Frontal baldness in males
what are the ocular symptoms of myotonic dystrophy?
Early-onset cataract, ptosis, hypermetropia
rare: mild ophthalmoplegia, pupillary light-near dissociation, pigmentary retinopathy, optic atrophy
what are ocular findings of NF type 1?
lisch nodules, optic glioma
how do you describe thyroid eye disease?
Bilateral, symmetrical
Peri-orbital swelling
Prominent eyes (proptosis + lid retraction)
Staring/frightened appearance ofeyes (Kocher sign) on focusing
Conjunctival injection
what ocular changes are seen in dermatomyositis?
Bilateral lilac eyelid discolouration
Swelling of eyelids and peri orbital skin
(this is heliotrope rash)
what would you do in an osce when you see Bilateral lilac eyelid discolouration and Swelling of eyelids and peri orbital skin?
examine hands to look for gottron’s papules –> dermatomyositis
what are the ocular changes in marfan’s syndrome?
disclocated lens
- classically supertemporal dislocation
what causes downward lens dislocation?
homocystinuria
what cornea changes are seen in RA?
scleromalacia perforans
peripheral ulcerative keratitis
what is the diagnosis when you see “mutton fat” keratitic precipiotates?
granulomatous anterior uveitis
what causes granulomatous anterior uveitis?
sarcoidosis
syphilis
TB
what are causes of infective inflammatory eye disease?
TB
Herpetic (zoster, simplex)
CMV
Toxoplasmosis
Syphilis
Lyme Disease
what are non-infective causes of inflammatory eye disease?
Idiopathic Syndromes
HLA-B27
Juvenile Arthritis
Sarcoidosis
Behcet’s Disease
what is the eye steroid response?
Cause a rise in intra ocular pressure (IOP) that may be asymmetrical
related to steroid potency
