CONJUNCTIVITIS ASSOCIATED WITH SYSTEMIC DISEASE

CONJUNCTIVITIS IN THYROID DISEASE

In orbital Graves' disease, the conjunctiva may be red and chemotic and the patient may complain of copious tearing. As the disease progresses, the chemosis increases, and in advanced cases the chemotic conjunctiva may extrude between the lids (Figure 5-20).

Treatment is directed toward control of the thyroid disease, and every effort must be made to protect the conjunctiva and cornea by bland ointment, surgical lid adhesions (tarsorrhaphy) if necessary, or even orbital decompression if the lids do not close enough to cover the cornea and conjunctiva.

GOUTY CONJUNCTIVITIS

Patients with gout often complain of a "hot eye" during attacks. On examination, a mild conjunctivitis is found that is less severe than suggested by the symptoms. Gout may also be associated with episcleritis or scleritis, iridocyclitis, keratitis, vitreous opacities, and retinopathy. Treatment is aimed at controlling the gouty attack with colchicine and allopurinol.

CARCINOID CONJUNCTIVITIS

In carcinoid, the conjunctiva is sometimes congested and cyanotic as a result of the secretion of serotonin by the chromaffin cells of the gastrointestinal tract. The patient may complain of a "hot eye" during such attacks.

10.1036/1535-8860.ch5

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