The Eyes
November 26th, 2019
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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