The eye in systemic disease Flashcards
Define what ophthalmoplegia is
Paralysis of the muscles within or surrounding the eye.
What are some of the causes of visual lesions at the optic nerve ?
- Ischaemic Optic Neuropathy - (one associated with GCA etc)
- Optic neuritis
- Tumours (rare)
What are the causes of lesions at the optic chiasm ?
- Pituitary tumour
- Craniopharyngioma
- Meningioma
What are some of the causes of lesions along the optic tracts and radiations ?
- Tumours (primary or secondary)
- Demyelination
- Vascular anomalies
What are some of the causes of lesions at the occipital cortex?
- Vascular disease (CVA)
- Demyelination
What are the features suggestive of giant cell arteritis ?
- Headache
- jaw claudication
- Malaise
- Raised P.V.
What is the importance of knowing about GCA in ophthalmology ?
Without prompt treatment it leads to blindness
What condition is GCA associated with ?
Polymyalgia rheumatica (PMR)
What are the features of thyroid eye disease ?
Extraocular:
- Proptosis
- Lid signs - retraction, oedema, lid lag, pigmentation
- Restrictive myopathy - a degenerative disorder of extra-ocular muscles
Ocular:
- Anterior Segment, chemosis (swelling (or edema) of the conjunctiva), injection, exposure, glaucoma
- Posterior Segment - choroidal folds & optic nerve swelling
What is the most common occular manifestation of SLE?
Occular inflammation & Keratoconjunctivitis Sicca (dry eyes)
What are the potential occular manifestations of RA?
- Dry eyes (Keratoconjunctivitis Sicca)
- Scleritis
- Corneal melt (shown in pic)
What is the triad of features seen in patients with sjorgens syndrome?
- Dry eyes (keratoconjunctivitis sicca)
- Dry mouth (xerostomia - shown in pic)
- Rheumatoid Arthritis (usually)
What is anterior uveitis ?
This is inflammation of the middle layer of the eye. This layer includes the iris (colored part of the eye) and the adjacent tissue, known as the ciliary body
What are the clinical features of anterior uveitis ?
Symptoms:
- pain
- photophobia
Signs:
- red eye
- cells in anterior chamber
- posterior synechiae (Adhesions between posterior iris and the anterior lens surface)
- keratitic precipitates (an inflammatory cellular deposit seen on corneal endothelium)
What is shown in this pic and what is it a sign of ?
Keratitic percipitates - a sign of anterior uveitis
What is shown in this pic and what is it a sign of ?
Posterior synechiae - a sign of anterior uveitis
What are the clinical features of posterior uveitis ?
- Usually painless
- “floaters”, small specks, flakes, or clouds that move through the field of vision
- decreased vision.
