Ocular Manifestations of Systemic Diseases: The Eyes are the Windows of the Body

Abstract

An ocular manifestation of a systemic disease is an eye condition that directly or indirectly results from a disease process originating from another part of the body. There are many diseases known to cause ocular or visual changes as a result of systemic disease. Diabetes, for example, is the leading cause of new cases of blindness in those aged 20-74, with ocular manifestations such as diabetic retinopathy and macular edema affecting up to 80% of those who have had the disease for 15 years or more. Other diseases such as acquired immunodeficiency syndrome (AIDS) and hypertension are commonly found to have associated ocular symptoms. Physicians need to consider that systemic disease can involve the eyes and it is important for ophthalmologists to understand that they may be the first to suggest a diagnosis due to underlying systemic disease. According to the quote “The eyes are the windows of the soul”, ophthalmologists should view the eyes as not only windows of the soul but also a window to the physical state of the entire body. Systemic hypertension is a major risk factor for the development of retinal vascular diseases including hypertensive retinopathy, retinal vein or artery occlusion, and embolic events. High blood pressure also increases the risk for the development and progression of diabetic retinopathy. Signs of hypertensive retinopathy are predictive of target-organ damage including cardiovascular and cerebrovascular diseases [1]. High blood pressure affects the heart, kidney, brain, large arteries, and also the eyes. Retinal, choroidal, and optic nerve circulations undergo pathophysiological changes resulting in clinical signs referred to as hypertensive retinopathy, hypertensive choroidopathy, and hypertensive optic neuropathy. Systemic hypertension also increases the risk for the development of retinal vein and artery occlusion, retinal-arteriolar emboli, and diabetic retinopathy. Diabetic retinopathy is one of the common causes of blindness. It is an ocular manifestation of diabetes, which affects up to 80 percent of all patients who have had diabetes for 20 years or more. Diabetic macular edema is the most common cause of visual dimness in patients with diabetic retinopathy. Dr. Lee will discuss the challenges and current treatments to prevent the visual disturbance related to diabetic macular edema [2]. Systemic lupus erythematosus (SLE) is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. SLE is a potentially life-threatening multisystem disease that is commonly associated with ocular manifestations. The purpose of this review is to outline the ocular manifestations of SLE and treatments [3]. Ocular complications have been reported in up to one-third of patients with SLE. Ocular manifestations can be associated with significant morbidity and eye issues may play a role as a marker for systemic disease activity. Keratoconjunctivitis sicca is the most common ocular problem in patients with SLE. When ophthalmologists see patients complaining of dry eye symptoms, determining the underlying reason as to why these patients are suffering from dry eye symptoms is important. The hypo-secretion of tears is one cause of dry eye symptoms.