Disease External eye findings Fundoscopic findings
Systemic lupus
erythematosis
(SLE)
l Eyelid nodules
l Conjunctivitis
l Scleritis
l Internuclear ophthalmoplegia
l One and a half syndrome (a conjugate
horizontal gaze palsy in one direction
and an internuclear ophthalmoplegia
in the other)SL:
l Keratoconjunctivitis sicca
l Uveitisl Cotton-wool spots
l Roth spots
l Hard exudates
l Macular ischemia
l Retinal neovascularization
l Papillitis
l ChorioretinitisFigure 16 Cotton-wool spots
(see color insert).Disease External eye findings Fundoscopic findings
Wegener’s
granulomatosis
l Conjunctival suffusion
l Bilateral eyelid edema
l Eyelid nodules
l Painful ptosis
l Necrotizing sclerokeratitis (corneal
ulceration)
l Proptosis
l Orbital cellulitis
l Orbital pseudotumor
l Painful dacryoadenitis/ dacryocystitis
l CN palsies (can involve any, but most
common are CN II, VI, VII)SL:
l Posterior uveitisl Cotton-wool spots
l Retinal hemorrhages
l Retinal vasculitis
(perivascular sheathing)
l Central retinal artery
occlusion
l Central/branch retinal vein
occlusionFigure 17 Retinal vasculitis
(see color insert).Disease External eye findings Fundoscopic findings
Temporal arteritis/
giant cell arteritis
(TA/GCA)
l Decreased visual acuity
l Amaurosis fugax
l Relative afferent pupillary defect
l Horner’s syndrome
l ScleritisSL:
l Marginal corneal ulcerationl Cotton-wool spots
l Central retinal artery
occlusion
l Chorioretinal scarring
(secondary to choroidal
infarctions)Ophthalmologic Clues to Infectious Diseases and Their Mimics in Critical Care 73