Eye Pathology

Exam Cram

Overview of disorders of the Eye

In particular reference to internal medicine conditions

Primary Eye Conditions

Anterior Uveitis

• Presentation: unilateral painful red eye, visual impairment

• Management: steroids topically/ systemic

• Associations: Ankylosing Spondylitis 

Episcleritis

• Presentation: gritty discomfort in eye, erythematous lesion, unilateral (normal acuity)

• Management: self resolving (NSAIDs)

• Associations: Ulcerative Colitis , Crohn's Disease 

Scleritis

• Presentation: severe pain worse with eye movement, may affect vision

• Management: 1. NSAIDs, 2. steroids

• Associations: Rheumatoid Arthritis 

Lens dislocation

• Upwards: Marfan's Syndrome 

• Downwards: Homocystinuria 

Holmes Adie Pupil 

• Sluggish pupil reactions to light

• Also absent deep tendon reflexes

• Damage to parasympathetic pathway

• Causes: benign viral infection

Infections

• Bacterial

  • Chlamydia 

  • Gonorrhea 

• Viral

  • Herpes Simplex (HSV) : dendritic ulcer

  • HIV & CMV (Cytomegalovirus) 

• Fungal

Medical Conditions

Eye Examination signs 

Strokes & loss of visual field defect

• Localising the lesion

Papilloedema

• Raised ICP

• Associations: 

  • Meningitis & Encephalitis , 

  • Stroke , Subarachnoid Haemorrhage , Subdural Haematoma (SDH) , Extra Dural Haematoma , 

  • Brain cancer

  • IIH (Idiopathic Intracranial Hypertension) , Normal Pressure Hydrocephalus 

Diploplia

• Myasthenia Gravis 

Optic neuritis

• Multiple Sclerosis (MS) 

Proptosis

• Graves- thyroid eye disease

Nystagmus

• Posterior Stroke 

Cranial Nerves

CN 3 palsy

CN 4 palsy

CN 6 palsy

Horner's Syndrome

• Pancoast Tumour 

Notes

Acute Angle Glaucoma 

Diabetic retinopathy

Conjunctivitis

Macular degeneration

Retinoblastoma

Retinal detachment

• Floaters (floaters can be normal)

Visual loss

• Central retinal vein occlusion

• Central retinal artery occlusion

• Giant Cell Arteritis 

Transient visual loss

• Migraine

• TIA

References and Resources

1. Dr Tim Root: https://timroot.com/stuff/OphthoBook.pdf

Created in 2024.