A systemic disease is a disease that involves the entire body or many of the organs of the body. An ocular manifestation of a systemic disease is how that disease affects the eyes. Indeed, many times an eye exam can result in the diagnosis that someone not only has an eye disease, but that he has a systemic disease that is causing vision problems.
Sarcoidosis
Sarcoidosis is an inflammatory disease, but physicians are not sure what causes it. One hypothesis is that something in the environment triggers inflammation in a person who is genetically susceptible. The trigger could include bacteria, viruses or pollen, according to Lee Newman, M.D., professor of Preventive Medicine and Biometrics at the University of Colorado in "The Merck Manual for Healthcare Professionals." People with this disease have granulomas, especially in the lungs. These are collections of white blood cells that form a group to fight off infection. They may also have uveitis, or the inflammation of the uveal tract in the eye. This includes the iris, a structure next to it called the ciliary body and the choroid. The choroid is the layer beneath the white part of the eye. People with uveitis may have pain, a sensitivity to light and blurry vision. The eyes are very susceptible to inflammation.
Systemic Lupus Erythematosus
Systemic lupus erythematosus is an autoimmune disease that affects many organs in the body. In an autoimmune disease, the immune system attacks its own body instead of protecting it against foreign substances. From 15 to 50 people for every 100,000 people have this disorder, writes Bevra Hahn, M.D., professor of Medicine in the David Geffen School of Medicine at the University of California in "Harrison's Principles of Internal Medicine." They may have arthritis, neurological problems, kidney disease, blood disorders, heart problems and a rash on the cheeks that worsens in sunlight. Systemic lupus erythematosus may also cause dry eyes and conjunctivitis, or the inflammation of the membrane inside of the eyelid and in the front part of the eye. Neither condition is serious. If people develop optic neuritis or retinal vasculitis, they can become blind within a matter of days or weeks. Optic neuritis is the inflammation of the optic nerve. Retinal vasculitis is the inflammation of the retinal blood vessels in the eye.
Multiple Sclerosis
Similar to systemic lupus erythematosus, multiple sclerosis is an autoimmune disease in which the immune system attacks the nerves in the central nervous system, or the brain and spinal cord. As explained by Elizabeth Corwin, Ph.D., in "Handbook of Pathophysiology," this results in slow signals from the brain and spinal cord. People with multiple sclerosis, or MS, usually have neurological symptoms that "come and go." Their arms and legs may feel weak, they may have tingling sensations and have problems with their bladder. The ocular manifestations include optic neuritis, double vision and a disorder called internuclear ophthalmoplegia, in which both eyes cannot follow an object that is moving horizontally.
References
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Sarcoidosis
