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Tuesday, September 20, 2016

Systemic Conditions Causing Eye Signs:

Examining the Eye is an important part of general physical examination. The eye can be a host to many diseases and certain systemic disorders can be diagnosed by identifying the specific signs in the eye. A brief review of the systemic conditions causing eye signs is given below:

1. Granulomatous disorders: Syphilis, Tuberculosis, sarcoidosis, leprosy, brucellosis and toxoplasmosis may inflame either the front chamber (anterior uveitis/iritis) or back chamber. (posterior uveritis/choroiditis).



2. Systemic inflammatory diseases: may manifest in any part of the eye.

  • iritis in ankylosing spondilytis
  • Reiter's conjunctivitis in Reiter's syndrome
  • Scleritis or episcleritis in rheumatoid arthritis, vasculitis and SLE

3. Keratoconjuctivitis sicca: is a reduction in tear formation. It causes gritty feeling in the eyes and a dry mouth (due to associated decreased saliva production). It is found on its own as in Sjogren syndrome or with other diseases like SLE, RA, sarcoidosis. It is tested by the Schirmer filter paper test (,5mm in 5 min) and treated by artificial tears.



4. Hypertensive Retinopathy: Increased Blood pressure accelerates atherosclerosis in the retinal vessels. The hardened arteries are shiny (silver wiring) and nip veins where they cross ( AV nipping). Narrowed arterioles may become blocked causinglocalized retinal infarction seen as cotton wool spots. Leaks from these in severe hypertension manifest as hard exudates or macular edema. Papilloedema or flame hemorrhage suggest malignant hypertension requiring urgent treatment.



5. Vascular Occlusion: Emboli passing through retinal vasculture may cause retinal artery occlusion causing global or segmental retinal pallor. 
Roth spots are small retinal infarcts that occur in infective endocarditits. 
In dermatomyositis, there is orbital edema with retinopathy showing cotton wool spots.



6. Hematological disorders: Retinal hemorrhages occur in leukemia, comma shaped conjunctival hemorrhages and retinal new vessel formation may occur in sickle cell disease. Optic atropy is seen in pernicious anemia.

7. Metabolic disease: 
  • Diabetes mellitus can lead to diabetic retinopathy and cataracts. 
  • Exopthlmos is seen in hyperthyroidism, 
  • Lens opacities are seen in hypoparathyroidism. 
  • Conjuctival and corneal calcifications can occur in hypercalcemia. 
  • In gout , conjuctival urate deposits may cause sore eyes. 
8. Systemic Infections:
  • Septicemia may spread to vitreous causing endopthalmitis. 
  • Syphilis can cause iritis (also pigmented retinopathy if congenital).
  • Systemic fungal infections can affect the eye in the immunocompromised or in IV drug abusers
  • Cotton wool spots on their own indicate HIV retinopathy.
  • Kaposi sarcoma may affect the lids or conjunctiva. 

3 comments:

  1. Hello, my name is Betty. i was diagnosed of HIV virus 4 years back. Before then, i was dating this Derrick guy. we had something great going on. Our love life only lasted for 8 months. the sixth and seven month of our relationship, i began feeling very weak every now and then. But i never suspected anything until I kept on experiencing different symptoms like having sore throats, constant headache, body weakness e.t.c. I decided to go for a medical check up. I was tested HIV positive. when the doctor broke the news to me, it was as if my whole world had crumbled. it dawned on me then that Derrick has been lying to me. i was very mad to an extent i almost committed suicide. But there was nothing i could do, other than weep and weep. ever since then, i have been spending heavily on medications, going from one medical clinic or the other so I can look healthy. Though since i was a kid, i love herbs a lot. i take herbal tea with grandma while growing so i am quite familiar with herbs. early last year, i was on the internet and on a particular health blog, to check for herbal medication as alternative. I saw many comments and read many testimonies. Until i came across a particular testimony on how Dr.ugo cured a patient from herpes simplex virus using pure natural herbs. i reached out to the doctor because I also was thinking Herpes had no cure. I told him about my HIV status.He encouraged me not to panic that he will help me get my deliverance. he prepared some herbs and sent them to me. The herbs were in four 70ml bottles and I took them morning and night. i used as he directed, and in less than three weeks, i started having appetite to eat plenty of food and i gained back my strength. the fourth week,I consumed all the herbal meds. He encouraged me to go for a test which i did. This time, the result was negative. I quickly contacted the doctor and informed him of the news. I immediately asked him to prepare for Derrick too. He did and sent it. Today, me and Derrick are HIV free. All thanks goes to God Almighty for healing us through Dr.Ugo. if you are having any kind of sickness at all, Dr.Ugo is the right person to talk to and i assure you, you will be glad you did. His email: ugoherbalhome@gmail.com you can also write him on WhatsApp +2348104990619.

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  2. Nice blog
    Have been totally convinced that HIV,and many others dangerous diseases can be best cured using the Herbal Medicine. Dr.Akpu the great and powerful herbalist cured me with his Herbal remedy. I'm Linda,15 years from Texas. I was born with HIV. I lost parents at my teenager age when I was 4th. I had to grew up with my mum only Sister, whom I loved so much. She was so worried about my life as my condition was her mature problem in life. I had taken lots of antiviral treatment to get ride of the virus not believing what there said HIV has no cure. I was on the internet when i came across blogs of testimony about a lady who where cured of a 7 years diagnose of Herpes by this powerful Herbalist, Dr.Akpu.I wrote down his mail @ Dr.akpupowerherbscenter@gmail.com
    I told my Aunt,luckily it was the same Dr,we where referred to few months back by my pastor in church whom members have being testifying about of his cure We did contacted him and explained my problem to him.He prepared the medicine and sent to me with details of how to use and apply. After a while, I began to feel more strong than never before, I felt so lucky and happy when my Doctor congratulated me that he could found no HIV virus again in me. I knew I was free cos my body was so strong. His herbal medicine should have saved my parents life, i said!
    Thanks so much for reading my article, you should share your testimony if you have cure as well
    Dr.akpupowerherbscenter@gmail.com
    Is the solution

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  3. Cured from herpes 2 weeks ago

    His result is 100% guarantee.

    R.buckler11 ((@gmail.com ))…………………

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