Overview
There are several pathognomonic and diagnostic signs to be found on inspection of the eyes.
Conjunctival Pallor
Conjunctival pallor is a useful sign of severe anaemia.
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.
Horner's Syndrome
Horner's syndrome is a classic triad that occurs due to compression of the sympathetic chain. This may be due to a pancoast tumour in the apex of the lung, though there are several other causes to be aware of.
Look For
- Partial ptosis: drooping of the eyelid
- Miosis: constriction of the pupil
- Anhidrosis: lack of sweating
Causes of Horner's Syndrome
- Apical lung lesion (Pancoast syndrome)
- Brain lesion - hypothalamus, thalamus, pons, medullaTumour, bleed
- Spinal cord lesionTrauma, inflammation, AVM, demyelination, tumour, infarct
- Brachial plexus lesion
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