* Taking a problem-based approach, this unique book tackles the broad range of ocular manifestations of systemic diseases
? For each condition, self-assessment questions encourage the reader to think about the presentation, before moving on to the detailed answers, furthering their understanding
? Emphasis throughout is on the interpretation of radiological, biochemical and haematological investigations, and an electrodiagnostic section features ECGs, VEPs, electromyography and other neurological investigations
? The evidence-based approach outlines important clinical trials and their relevance to clinical practice
? Recommended further reading directs the reader to comprehensive review articles This generously illustrated text provides in a concise format, a self-assessment evidence based text for ophthalmologists and physicians, covering the ocular manifestations of systemic disease. It highlights the physical signs of systemic diseases relevant to the ophthalmologist and details the medical management of the underlying systemic disorders. For trainee ophthalmologists studying for the MRCOphth, and for physicians studying for the MRCP, this book provides a comprehensive knowledge resource and study guide. Practitioners will find it a ready reference and a valuable self-assessment tool. CONTENTS: Preface; Foreword; Acknowledgements; Fundi; Optic disks; Ocular motility; Visual fields; Faces; Hands; Skin lesions; Biochemistry and haematology; Radiology; Electrodiagnostics
Preface
Acknowledgements
Sect. 1
Fundi
1
1.1
Diabetic maculopathy
3
1.2
Preproliferative retinopathy
7
1.3
Proliferative retinopathy
10
1.4
Hypertensive retinopathy
14
1.5
Retinal macroaneurysm
17
1.6
Branch retinal vein occlusion
19
1.7
Exudative retinal detachments secondary to hypertension
23
1.8
Retinal cholesterol embolus
25
1.9
Branch retinal artery occlusion
28
1.10
The ocular ischaemic syndrome
30
1.11
Central retinal vein occlusion
32
1.12
Bilateral central retinal vein occlusions in leukaemia
34
1.13
Sickle cell retinopathy
37
1.14
Roth spots in bacterial endocarditis
40
1.15
HIV microvasculopathy
42
1.16
Cytomegalovirus retinitis
44
1.17
Acute retinal necrosis
48
1.18
Toxoplasma retinochoroiditis
50
1.19
Retinal vasculitis
53
1.20
Behcet's retinal vasculitis
57
1.21
Ocular lymphoma
60
1.22
Tuberculous chorioretinitis
62
1.23
Syphilitic chorioretinitis
65
1.24
Vogt-Koyanagi-Harada syndrome
67
1.25
Choroidal metastases and tamoxifen retinopathy
69
1.26
Retinal angiomas in von Hippel-Lindau disease
72
1.27
Astrocytoma
75
1.28
Retinitis pigmentosa
77
1.29
Hydroxychloroquine retinopathy
79
Sect. 2
Optic Discs
81
2.1
Papilloedema: Idiopathic intracranial hypertension
83
2.2
Pseudopapilloedema secondary to optic disc drusen
86
2.3
Demyelinating optic neuritis
89
2.4
Non-arteritic anterior ischaemic optic neuropathy
93
2.5
Giant cell arteritis
96
2.6
Glaucomatous disc cupping
99
Sect. 3
Ocular Motility and Lid Disorders
101
3.1
IIIrd nerve palsy
103
3.2
IVth nerve palsy
106
3.3
VIth nerve palsy
109
3.4
Lower motor neurone VIIIth nerve palsy
112
3.5
Bilateral internuclear ophthalmoplegia
115
3.6
Myasthenia gravis
117
3.7
Chronic progressive external ophthalmoplegia
120
3.8
Thyroid eye disease
123
3.9
Progressive supranuclear palsy
125
3.10
Carotid-cavernous sinus fistula
127
Sect. 4
Visual Fields
131
4.1
Bilateral centrocecal scotomas
133
4.2
Junctional scotoma
135
4.3
Bitemporal hemianopia
136
4.4
Optic tract lesion
140
4.5
Incongruous hemianopia secondary to a parietal lobe lesion
141
4.6
Complete homonomous hemianopia with macular sparing
143
Sect. 5
Faces
145
5.1
Acromegaly
147
5.2
Graves' disease
149
5.3
Hypothyroidism
153
5.4
Cushing's syndrome
155
5.5
Systemic lupus erythematosus
158
5.6
Wegener's granulomatosis
161
5.7
Parkinson's disease
164
5.8
Myotonic dystrophy
167
Sect. 6
Hands
169
6.1
Rheumatoid hands
171
6.2
Psoriatic nail pitting
175
6.3
Sclerodactyly
177
6.4
Arachnodactyly
179
6.5
Clubbing
181
6.6
Acromegalic hands
183
6.7
Tendon xanthomata
185
6.8
Syringomyelia
187
6.9
Motor neurone disease
189
Sect. 7
Skin Lesions
191
7.1
Cafe au lait spots and neurofibromata
193
7.2
Ash leaf spots
195
7.3
Pemphigoid and ocular cicatricial pemphigoid
196
7.4
Erythema multiforme
199
7.5
Pseudoxanthoma elasticum
201
7.6
Ehlers-Danlos syndrome
203
7.7
Erythema nodosum and pretibial myxoedema
204
7.8
Necrobiosis lipoidica diabeticorum and diabetic dermopathy
206
7.9
Herpes zoster ophthalmicus
210
7.10
Kaposi's sarcoma
212
Sect. 8
Biochemistry and Haematology
213
8.1
Urea and electrolytes: renal failure
215
8.2
Urea and electrolytes: Addison's disease
217
8.3
Liver function tests: cirrhosis
219
8.4
Thyroid function tests: thyrotoxicosis
221
8.5
Thyroid function tests: hypothyroidism
223
8.6
Fasting blood glucose and glucose tolerance tests
224
8.7
HbA[subscript 1C]
225
8.8
Diabetes and hypertension
228
8.9
Full blood count: acute lymphocytic leukaemia
230
8.10
Full blood count: pernicious anaemia
232
8.11
Clotting screen: excessive anticoagulation with warfarin
234
8.12
Clotting screen: inadequately treated haemophilia
236
Sect. 9
Radiology
237
9.1
Angiogram of a posterior communicating artery aneurysm and intracavernous carotid aneurysm
239
9.2
CT scans of occipital lobe infarct and occipital lobe haemorrhage
241
9.3
Demyelination on a T[subscript 2]-weighted MRI
244
9.4
Sellar and suprasellar lesions
246
9.5
Cerebellar infarcts MRI
249
9.6
Sphenoid ridge meningioma
252
9.7
MRI of a chiasmal glioma and CT scan of bilateral nerve sheath meningiomas
254
9.8
CT scan of bilateral acoustic neuromas
257
9.9
Orbital MRI and CT scans of thyroid eye disease
259
9.10
CT scan of orbital cellulitis
262
9.11
Multiple lytic skull lesions in myeloma
265
9.12
Bilateral hilar lymphadenopathy
267
9.13
Barium follow through: Crohn's disease
269
9.14
Osteoporosis: T10 crush fracture
271
Sect. 10
Electrodiagnostics
275
10.1
ECG: acute myocardial infarction
277
10.2
ECG: 2:1 heart block
279
10.3
Repetitive nerve stimulation: myasthenia gravis
281
10.4
Visually evoked potentials: optic neuritis
283
10.5
Nystagmus waveform: congenital idiopathic nystagmus
286
Index
289