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Bilateral Lens Dislocation in Marfan syndrome - Slit Lamp Ocular Examination

Dr. Sebastian Vega @oftalmopo

#Bilateral #Lens #Dislocation
Bilateral Lens Dislocation ... in Marfan syndrome ... - Slit Lamp Ocular ... #Marfan #syndrome ... #Ocular #PhysicalExam
Isocoria - Pupillary Defects - Differential Diagnosis Algorithm
Relative Afferent Pupil Defect
 • Optic Neuritis
 • Ischemic
Tumor • Retinal detachment ... Syphilis (light-near dissociation ... Midbrain (Parinaud's Syndrome ... Diagnosis #Algorithm #Causes
Vision Loss - Differential Diagnosis
Chronic: 
  - Cornea: Scarring, Edema
  - Lens: Cataracts
Cataracts - Macula: Macular ... Painless: Lens Dislocation ... , Retinal Detachment ... Differential #Diagnosis #causes
Blurry Vision - Differential Diagnosis Framework

Anatomical Approach to Eye Disease:
1. Lids/Lashes
2. Extraocular Muscles/Motility
3. Conjunctiva/Sclera
4. Cornea
5. Anterior
Ocular Adverse Effects ... edema • Lens dislocation ... Retina: • Detachment ... • Sjögren’s syndrome ... ophthalmology #causes
Iridodonesis

Physical examination revealed iridodonesis, or “dancing” of the iris, which was elicited by rapid movement of
total or partial dislocation ... with Marfan’s syndrome ... Iris #SlitLamp #PhysicalExam ... Ophthalmology #Signs #Ocular
Upper Extremity Dermatomes and Myotomes
Motor Function
Shoulder:
 • Abduction - C5,C6 (axillary)
 • Adduction - C6, C7,
Erb's Palsy is caused ... hand" ± Horner Syndrome ... Carpal Tunnel Syndrome ... Anterior Shoulder Dislocation ... sensory #motor #arm #physicalexam
Adie's Pupil on Physical Exam

Adie's pupil is a neurological disorder characterized by a tonically dilated pupil
., light-near dissociation ... It is caused by ... infection which causes ... #Adies #Pupil #PhysicalExam ... ophthalmology #neurology #syndrome
Adie's Pupil
What? Unknown nature & benign
 • Regular and mildly dilated pupil (4-6mm);
 • Light-near dissociaton;
Holmes-Adie Syndrome ... no light-near dissociation ... • Other causes ... #Adies #Pupil #PhysicalExam
Causes of Knee Effusions - Differential Diagnosis Framework

Knee Effusion Red Flags:
1. Fever/Chills/Joint pain/Night sweats/Weight loss
	- DDX:
		-
Causes of Knee Effusions ... Seronegative Reactive Syndrome ... fracture - Patellar dislocation ... Knee #Effusions #causes ... diagnosis #msk #physicalexam
Behcet's Syndrome - Treatment
Ulcers:
 • Treatment: Topical steroids
 • Prevention: Colchicine
 • Azathioprine for refractory disease
Arthritis:
Behcet's Syndrome ... refractory lesions Ocular ... by case) • Surgery ... Behcets #disease #Syndrome ... #Treatment #management