Eye and systemic diseases

Eye and systemic diseases

Thyroid ophthalmopathy:
The ocular signs of thyroid diseases arise from 2 sources:
1: sympathetic over activity that causing many of eyelid signs
2: increase volume of orbital contents
Signs:
Lid lag and lid retraction
Orbital congestion
Exophthalmos which is either unilateral or bilateral
Extra ocular muscles involvement which include the followings:
- Enlargement of muscles due to increase muco- polysaccharide content, (the size of the muscles may reach 6 times than the normal)
-contracture of the muscles involving the inferior rectus, the medial rectus result in limitation of ocular movement (restrictive myopathy)
e- Corneal involvement which include:
Exposure keratitis and ocular irritation as a result of rapid dryness of tear film
F-Optic nerve involvement: including papillitis and papilloedema
Parathyroid gland diseases:
Hypercalcemia:
Ocular findings: - ca crystals deposition in cornea and conjunctiva
Band shape keratopathy( in palpebral fissure)
Hypocalcaemia: leading to cataract

Disease of the blood
1-sickle cell disease:
The ocular lesions arise from intra vascular changes in the conjunctiva and retinal blood vessels
Conjunctival findings:
There are multiple, short comma shaped distorted capillary segments
Retinal findings:
Arteriolar occlusions , aneurysms, vascular dilatations and fibro vascular proliferations leading to vitreous hemorrhage.
2- Poly cythaemia:
The ocular findings related to blood hyper viscosity resulting in dilatation of conjunctival and retinal blood vessels, and central retinal vein occlusion
3-leukaemia:
The ocular features arise from infiltrations and hemorrhage involving the conjunctiva, sclera, retina and choroid
Clinical features:
Dilated tortuous retinal veins, yellow exudates, cotton wool spots, superficial and deep retinal hemorrhage, vitreous hemorrhage, papilloedema and Proptosis

Connective tissue disorders
Marfan syndrome: it is autosomal dominant
Ocular features: ectopia lentes (the lens dislocated upwards and nasally), myopia, retinal detachment and Keratoconus
Sjogren syndrome:
90% are females, the patient presented with xerostomia, chronic arthritis and dry eye (kerato conjunctivitis sicca)
C-rheumatoid arthritis:
Ocular features: Iritis, scleritis may lead to sclera melting (sclera malacia performance)
D-Juvenile rheumatoid arthritis:
Ocular findings are: Iritis (bilateral), cataract and band shape keratopathy