Eye Symptoms and Signs of Systemic Diseases

Essentials

Eye symptoms and signs may be the first indication of a systemic disease.
Paying attention to eye symptoms, and examining the eye
- may speed up diagnosis of the underlying disease
- will improve the visual prognosis through sufficiently early referral to an ophthalmologist (particularly in case of the early diagnosis and treatment of wet age-related macular degeneration).
Some ocular symptoms and signs can be detected by the examination methods used by a GP.
Ocular findings previously made by an ophthalmologist, together with other basic examinations performed by a GP, may lead to the diagnosis of a systemic disease.

Sjögren's syndrome Primary Sjögren's Syndrome
Skin disorders
- Rosacea Rosacea
- Atopy Investigation of Atopy
- Psoriasis Psoriasis
Menopause and endocrinological disorders
Thyroid function disorders
Systemic lupus erythematosus (SLE) Systemic Lupus Erythematosus (Sle)
Systemic sclerosis Systemic Sclerosis
Sarcoidosis Sarcoidosis
Primary biliary cholangitis (PBC) Primary Sclerosing Cholangitis

Diabetes Diabetes: Definition, Differential Diagnosis and Classification
- Previously undiagnosed acute type 1 diabetes
  - High blood glucose levels lead to swelling of the lens and transiently increased myopia.
- Poorly controlled diabetes or a history of several years of diabetes
  - Diabetic retinopathy, maculopathy, papillitis or cataract
Eye disease associated with thyroid function disorder
Systemic lupus erythematosus (SLE) Systemic Lupus Erythematosus (Sle)
Sarcoidosis Sarcoidosis
Giant cell arteritis (temporal arteritis) Giant Cell (Temporal) Arteritis
- Often including temporal pain and impaired general condition
Hypertensive crisis Hypertension: Investigations, Treatment Initiation and Non-Pharmacological Treatment
- Fundus haemorrhages
Cerebral infarction, cerebral aneurysm, tumour in the brain area (often with a localizable visual field defect)
Hypersensitivity to alcohol or to pharmaceutical agents
Endophthalmitis
Pseudotumor cerebri Headache in Children
Increased intracranial pressure Increased Intracranial Pressure
MS Multiple Sclerosis (Ms)
Cataract Cataract
- Ageing is the most common cause but there may be an underlying systemic disease or treatment accelerating the development of cataracts, such as diabetes, or long-term glucocorticoid therapy.

Increased risk of ulceration in patients with rheumatic diseases
Corneal dystrophy in association with the Meretoja disease http://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=11721&Disease_Disease_Search_diseaseGroup=meretoja
Keratoconus Keratoconus (Conical Degeneration of the Cornea)
Often in association with Down's syndrome

For systemic diseases predisposing to dry eye, see above.
Allergy, atopy, asthma
Stevens-Johnson syndrome Erythema Multiforme
Reiter's syndrome Reactive Arthritis
- Arthritis, conjunctivitis, urethritis
Sarcoidosis Sarcoidosis
- Small conjunctival granulomas, of which biopsies can be taken
Tuberculosis (rare)
Melanoma Melanoma
Sturge-Weber syndrome http://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=591&Disease_Disease_Search_diseaseGroup=Sturge-Weber-syndrome
- Haemangiomas and flame naevi

Scleritis
- Rheumatic diseases
- Polyarteritis nodosa Vasculitides
- Granulomatosis with polyangitis (Wegener's granulomatosis) Vasculitides

Diabetic retinopathy
Venous thrombosis
- Examination for thrombotic tendency in other parts of the body
Arterial thrombosis
- Examination for vascular diseases, monitoring of blood pressure, ECG by a GP
Acute leukaemia Acute Leukaemias in Adults