Eyeing systemic disease

February 1, 2008

Ocular abnormalities can serve as signposts for systemic illness in children and adolescents. Here is a sampling of what to watch for.

Key Points

In addition to its fascinating role in the process of vision, the eye can also reflect abnormalities within the body itself. Indeed, several systemic disorders may result in abnormalities of the eye. These changes, be they subtle or drastic, can serve as vital clues to underlying disease. This article will review several of the ocular signs of systemic disease seen within the pediatric population. A series of patients will be described, their ocular abnormality illustrated, and underlying disease discussed. For many of the conditions addressed here, cooperation and communication between pediatrician and ophthalmologist is critical for optimal management of ocular conditions that also impact overall health.

Eyelids and lashes

The conjunctiva

The conjunctiva is the thin layer of tissue that covers the eyeball. It is usually transparent, and the eyeball appears white due to the white sclera, which is visible through the conjunctiva. There are many capillaries in the conjunctiva. If the eye is irritated, these vessels become dilated, and the eye appears bloodshot.

The cornea

The cornea is the clear structure at the front of the eyeball. When functioning normally it is crystal clear, and therefore it is actually difficult to see. Despite being only 0.5 mm thick, the cornea is made up of several layers. The structure and metabolism of these layers, when functioning normally, allow the cornea to remain clear.