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Gastro Exam
 
 

The Eyes

 
 
 
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Overview

There are several pathognomonic and diagnostic signs to be found on inspection of the eyes.

Xanthelasma

  • Look For

  • Yellowish plaques on the eyelids.
  • Significance

  • May be benign or indicative of lipid metabolism disorders.

Scleral Icterus

  • Look For

  • Yellowness of the conjunctiva overlying the sclera.
  • Significance

  • A relatively sensitive indicator of jaundice, occurring prior to the development of colour change in the skin.

Conjunctival Pallor

  • How to Elicit

  • Pull the lower eyelid downward and inspect the inner eyelid. Conjunctival pallor is present if there is loss of the normal redness of the anterior rim of the conjunctiva.
  • Significance

  • A sign of severe anaemia.

Kayser-Fleischer Rings

  • Look For

  • Brown / yellow / gold rings at the margin of the cornea and sclera, encircling the outer iris.
  • Significance

  • An indicator of Wilson's disease, a recessive disorder of copper metabolism resulting in excessive copper deposition.
  • Manifestations of Wilson's Disease

  • Hepatic - chronic liver disease, cirrhosis
  • Corneal - Kayser-Fleischer Rings
  • Basal ganglia - Parkinsonism
  • Renal - renal failure
  • Red blood cells - haemolytic anaemia
  • Psychiatric - severe depression
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