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Ocular manifestations that occur directly or indirectly as result of a pathologic process that involves other parts of the body, in a pediatric population, will be discussed here. While a myriad number of systemic conditions have ocular manifestations, its importance cannot be undermined because it has implications for both diagnosis and treatment. Often, the eye findings can give a clue to the systemic diagnosis and at other times, not managing the eye manifestations can lead to irreversible blindness although the systemic condition was treated well. So, it is important for all clinicians dealing with pediatric population to be aware of ocular manifestations of the common systemic conditions. The authors discuss the ocular manifestations of the following systemic conditions: Genetic and chromosomal anomalies, phakomatoses, metabolic disorders, infectious diseases, craniofacial anomalies, muscular disorders, inflammatory disorders and miscellaneous.

Background and aims The body is one unit and the ultimate care of a patient with a multisystem disease such as lupus requires the integrated care of several specialists. Systemic lupus has some potentially blinding ocular complications such as lupus retinopathy. Early detection of these complications by the ophthalmologist can help salvage vision of the patient. Moreover, some cases present first to the ophthalmologist, so an ophthalmologist trained in detecting the ocular manifestations of multisystem diseases can refer the patient promptly to the rheumatologist and help minimise the disease-associated morbidity. The aim of this study was to describe the ocular manifestations of lupus in patients who presented to the main university hospital in Alexandria from July 2014 to March 2016. Methods A prospective study was conducted and included 128 patients with lupus. A thorough ophthalmic examination was conducted by the author using the slitlamp biomicroscope and a fundus lens Results Out of the 128 patients, 61 patients had lupus retinopathy at time of presentation or developed it de novo during the period of the study. Thirty two patients had lupus keratopathy. And eighty one patients had dry eye of various degrees of severity, 3 of them culminated into potentially sight threatening corneal ulcers. Communication with the treating rheumatologists was done and an overall 81% improvement in ocular lupus patients was achieved by the end of the study. One patient lost one eye due to late presentation Conclusions Lupus is a potentially blinding disease requiring full cooperation between the ophthalmologist and the rheumatologist.

Orientador: Carlos Eduardo Leite Arieta Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas Resumo: Objetivo: Avaliar o impacto de lentes de contato gelatinosas na superfície ocular. Métodos: Trata-se de um estudo descritivo, transversal, realizado no ambulatório de oftalmologia de um hospital universitário em Campinas (SP - Brasil) composto por amostra não probabilística, constituída por 81 participantes, divididos em dois grupos: usuários de lentes de contato (61) e não usuários de lentes de contato (20), submetidos à avaliação da superfície ocular quanto aos aspectos objetivos (menisco lacrimal, hiperemia conjuntival, tempo de ruptura do filme lacrimal não invasivo ¿ Non Invasive Break Up Time - NIBUT, meibomiografia, teste de Schirmer, tingimento da superfície ocular com colírio de fluoresceína e lisamina verde e tempo de ruptura do filme lacrimal invasivo ¿ Break Up Time - BUT) e subjetivos (questionários OSDI - Ocular Surface Disease Index - e Questionário de olho seco em usuários de lente de contato de 8 ítens - Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) e, posteriormente, comparados estatisticamente. Resultados: 14 variáveis quanto aos aspectos objetivos e subjetivos foram avaliadas e comparadas, apresentando os seguintes resultados, demonstrados em média±desvio padrão entre o grupo de não usuários e o grupo de usuários de lentes, respectivamente: Menisco lacrimal [0,256±0,076 x 0.295±0,168 p=0,380]; Hiperemia Total [0.65±0.361 x 1.298±0.41 p=0,001]; Hiperemia Bulbar Temporal [0.625±0.4 x 1.492±0.536 p=0,001]; Hiperemia Bulbar Nasal [0.62±0.321 x 1.443±0.55 p= 0,0001]; Hiperemia Limbar Temporal [0.475±0.243 x 0.91±0.438 p= 0,0001]; Hiperemia Limbar Nasal [0.43±0.184 x 0.939±0.398 p=0,0001]; NIBUT [8.445±3.27 x 7.24±4.02 p=0,0032]; Meibomiografia Inferior [16.25±14.68 x 30.738±22.543 p=0,0068]; Meibomiografia Superior [22.5±11.18 x 38.115±18.6 p=0,0005]; BUT [10.55±3.89 x 7.705±4.63 p=0,0023]; Fluoresceína [0.4±0.503 x 2±1.77 p=0,0001]; Schirmer [20.05±9.822 x 20.721±10.985 p=0,8086]; Lisamina verde [0.3±0.47 x 1.803±0.891 p=0,0001]; OSDI [1.18±1.632 x 13.589±12.52 p=0,0001]. A aplicação do CLDEQ-8 (apenas no grupo de usuários de lentes) obteve média±desvio padrão de 13,26±6,92 pontos. Conclusões: Em relação ao desfecho de alterações oculares entre usuários e não usuários de lentes de contato foram observadas diferenças estatisticamente significativas para a maioria das variáveis, sugerindo que a população de usuários de lentes de contato estudada apresentou mais alterações na superfície ocular, comparado a de não usuários. Os usuários de lentes apresentaram média de escore consideravelmente elevado no CLDEQ-8 suscitando a magnitude de olho seco nessa população Abstract: Purpose: To evaluate the impact of soft contact lenses on the ocular surface Methods: This is a descriptive, cross-sectional study carried out in an ophthalmology outpatient clinic of a university hospital in Campinas (SP - Brazil), composed of a non-probabilistic sample, consisting of 81 participants, divided into two groups: contact lenses wearers (61) and non-contact lens wearers (20) submitted to ocular surface evaluation for objective aspects (tear meniscus, conjunctival hypremia, Non Invasive Break Up Time - NIBUT, meibography, schirmer's test, ocular surface staining with fluorescein and green lissamine, invasive break up time - BUT) and subjective aspects (OSDI and CLDEQ-8 questionnaires) and then statistically compared. Results: 14 variables regarding objective and subjective aspects were evaluated and correlated, presenting the following results on average±standard deviation between the group of non-users and the group of users of contact lenses, respectively: Tear meniscus height [0,256±0,076 x 0.295±0,168 p=0,380]; Total hyperemia [0.65±0.361 x 1.298±0.41 p=0,001]; Temporal Bulbar Hyperemia [0.625±0.4 x 1.492±0.536 p=0,001]; Nasal Bulbar Hyperemia [0.62±0.321 x 1.443±0.55 p= 0,0001]; Nasal Limbal Hyperemia [0.43±0.184 x 0.939±0.398 p=0,0001]; Temporal Limbal Hyperemia [0.475±0.243 x 0.91±0.438 p= 0,0001]; NIBUT [8.445±3.27 x 7.24±4.02 p=0,0032]; Lower Meibography [16.25±14.68 x 30.738±22.543 p=0,0068]; Upper Meibography [22.5±11.18 x 38.115±18.6 p=0,0005]; BUT [10.55±3.89 x 7.705±4.63 p=0,0023]; Fluorescein [0.4±0.503 x 2±1.77 p=0,0001]; Schirmer [20.05±9.822 x 20.721±10.985 p=0,8086]; Lissamine [0.3±0.47 x 1.803±0.891 p=0,0001]; OSDI [1.18±1.632 x 13.589±12.52 p=0,0001]. The CLDEQ-8 application (only in the lens user group) obtained a mean±standard deviation of 13.26±6,92 points. Conclusions: Regarding the outcome of ocular changes between wearers and non-wearers of contact lenses, statistically significant differences were observed for most variables, suggesting that the group of wearers studied showed more changes in the ocular surface compared to non-wearers. Lens users had a significantly elevated score on CLDEQ-8 raising the magnitude of dry eye in this population Mestrado Oftalmologia Mestre em Ciências Médicas

İnflamatuvar barsak hastalıkları (İBH) etyolojisi ve patogenezi tam aydınlatılamayan, gastrointestinal sistemle ile sınırlı olmayıp diğer organ ve sistemleri de etkileyen sistemik bir hastalıktır. Ekstraintestinal manifestasyonlar(EİM) birçok organ ve sistemi etkilemektedir. EİM sıklığı ile ilgili birçok çalışma olmasına karşın ülkemizde bu konuda çalışmalar sınırlıdır. Bu çalışmadaki amacımız EİM sıklığını hastanemizde takip edilen İBH hastalarında belirlemek ve daha önce yapılan çalışmalarla karşılaştırmaktır. Ocak 2014 ile aralık 2016 tarihleri arasında Gazi Üniversitesi Hastanesi Gastroenteroloji polikliniğinde takip olan hastaların kayıtları retrospektif olarak incelendi. İBH olan 393 hasta çalışmaya dahil edilirken hastaların 276‟sında ÜK, 117 sinde CH tanısı mevcuttu. Hastaların 171‟i kadın 222‟si erkek hastalardan oluşuyordu. İBH da ortalama yaşı 44,72 iken, ÜK ortalama yaşı 47,09 ve CH ortalama yaşı 39,13 idi. CH hastaları anatomik tutulum yerine ve klinik tipine göre gruplandırılırken, ÜK hastaları da anatomik tutulum yerine göre gruplandırıldı. EİM varlığının demografik özellikler, tanı grupları, cinsiyet, anatomik tutulum yerleri, CH klinik tipleri ve fistül tipleri ile ilişkisi incelendi. EİM alt gruplarının ÜK ve CH‟ da dağılımı, birbiriyle ilişkisi, cinsiyet ve yaş grupları ile ilişkisi değerlendirildi. Ayrıca İBH tanısına göre EİM ortaya çıkış süreleri belirlendi.Çalışmamızda 393 hastanın 139‟unda en az bir tane EİM görülürken, sıklık %35,4 olarak saptandı. En sık görülen EİM hepatobiliyer manifestasyonlarken, alt gruplar incelendiğinde en sık EİM hepatosteatozdu. ÜK ile CH karşılaştırıldığında EİM sıklığı CH‟ da ÜK göre daha sık saptandı. EİM sıklığı cinsiyetler arasında benzerdi. EİM varlığı ile tanı grupları, anatomik tutulum yeri, CH klinik tipi, fistül tipleri arasında anlamlı ilişki saptanmadı. EİM tek tek değerlendirildiğinde ÜK‟ de hepatosteatozun proktit olan hastalarda, DVT‟nin ise ekstensif kolit olan hastalarda sıklığı daha yüksek bulundu. CH‟da ise EN ve sakroileit kolonik tutulumda, aftöz stomatit ileokolonik tutulumda daha sık saptandı. Nefrolitiazis penetran+ strüktüran CH‟da sıklığı yüksek bulundu. Tip 1 periferik artropati, sakroilei, psöriazis, hepatosteatoz, kolelitiazis sıklığı CH‟ da daha yüksekken, PSK ise sadece ÜK hastalarında görüldü. Tip 2 periferik artrit, sakroileit, EN, aftöz stomatit kadın cinsiyette sıklığı artmıştı. Yetişkin yaş grubuna göre geriatrik grupta DVT ve pulmoner tutulum sıklığı yüksek saptandı. EİM birbiriyle ilişkisi değerlendirildiğinde doğru orantılı ilişki görülmezken bazı EİM‟larda diğer EİM‟lerin görülme sıklığında anlamlı azalma saptandı. Inflammatory Intestinal Disease (IBD) is not limited to the gastrointestinal system and affects all organs and systems; and its etiology and pathogenesis have not been enlightened yet. Although there are many studies conducted on the frequency of EIM, the studies conducted in our country are limited. The aim of the present study was to determine the frequency of EIM in the IBD patients followed-up in our hospital and to compare the results with previous studies. The records of the patients who were followed-up in the Gazi University Hospital, Gastroenterology Policlinic between January 2014 and December 2016 were examined retrospectively. 393 patients who had IBD were included in the study. 276 of these patients had UC, and 117 had CD diagnosis. 171 of the patients were female, and 222 of them were male. While the mean age of the patients with IBD was 44,72 ; it was 47,09 in UC; and 39,13 in CD. The CD patients were grouped according to clinical types instead of anatomical involvement, and the UC patients were grouped according to their anatomical involvement areas. The relation between EIM and demographical properties, the diagnosis groups, gender, anatomic involvement areas, CD clinical types and fistula types was examined. The distribution of the EIM sub-groups in UC and CD was examined in terms of their relations with each other, and with gender and age groups. In addition, the EIM emergence durations were determined according to the IBD diagnosis.At least one EIM was observed in 139 of the 393 patients, and the frequency was determined to be 35,4%. The most frequent EIM was hepatobiliary manifestations. When the sub-groups were examined it was observed that the most frequent EIM was hepatosteatosis. When UC and CD were compared it was observed that the EIM frequency was more frequent in the CD when compared with UC. The EIM frequency was similar between genders. No significant relation was detected between the existence of EIM and diagnosis groups anatomical involvement areas, CD clinical type fistula types. When EIM was analyzed one by one, it was observed that the frequency of hepatosteatosis in UC in patients with proctitis, and the DVT in patents with extensive colitis. In CD, in EN and sacroiliitis colonic involvement, the aphthous stomatitis ileocolonic was detected more frequent in the involvement. The frequency of nephrolithiasis penetrant + structural was found to be higher in CD. The frequency of Type 1 peripheric arthropathy, sacroiliitis, psoriasis, hepatosteatosis, cholelithiasis were found to be higher in CD; however, they were observed only in UC patients in PSK. The frequency of Type 2 peripheric arthritis, sacroiliitis, EN, aphthous stomatitis were increased in female gender. The DVT and pulmonary involvement frequency was determined to be higher in the geriatric group when compared with the adult group. When the relation of EIM was analyzed it as observed that there were no relations in direct proportion, and a significant decrease was observed in the prevalence of other EIMs in some EIMs. 139

Ophthalmic findings are common features of neurodegenerative disorders and, in addition to being clinically important, have emerged as potentially useful biomarkers of disease progression in several conditions. Clinically, these visual system abnormalities can be a clue to diagnosis, as well as being a prominent cause of disability in affected patients. In this Review, we describe the various afferent visual system and other ophthalmic features of inherited neurodegenerative disorders, including the muscular dystrophies, Friedreich ataxia, the spinocerebellar ataxias, hereditary spastic paraplegia, Charcot-Marie-Tooth disease, and other conditions. We focus on the expanding role of optical coherence tomography in diagnostic imaging of the retina and optic nerve head, and the possible use of ophthalmic findings as biomarkers of disease severity in hereditary neurodegenerative disorders. In addition, we discuss the ophthalmic manifestations and treatment implications of mitochondrial dysfunction, which is a feature of many inherited neurodegenerative diseases.

Ocular inflammatory diseases can present as isolated conditions but also as part of systemic inflammatory diseases. Anterior uveitis is closely related to SpA and shares the common genetic background of HLA-B27. Other ocular manifestations, such as episcleritis and scleritis, may also occur, although less frequently. Therefore, ocular involvement has been included as one of the important clinical features of SpA in the recently published classification criteria for axial and peripheral disease. However, there are a wide variety of aetiologies for ocular diseases and this must be considered in assessment of SpA.

This case report describes the retinal optical coherence tomography (OCT) findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly. Este relato de caso descreve os achados da tomografia de coerência óptica (TCO) da retina de uma criança com microcefalia e atrofia macular presumivelmente causada por infecção intra-uterina pelo vírus Zika. Tomografia de coerência óptica demonstrou camadas externas da retina e atrofia coriocapilar, incluindo a camada nuclear externa e zona de elipsóide, associada a hiperreflectividade do epitélio pigmentar da retina e aumento de penetração da tomografia de coerência óptica em camadas mais profundas da coróide e esclera. Uma grande preocupação associada com esta infecção é o aumento aparente da incidência de microcefalia em fetos nascidos de mães infectadas com o vírus Zika. É cada vez mais difícil ignorar o surto de microcefalia congênita observada no Brasil. Recentemente, foram descritos achados oculares em crianças com microcefalia associados à infecção pelo vírus Zika intra-uterino. Este é o primeiro relato de tomografia de coerência óptica com atrofia macular em uma criança com microcefalia associada a infecção presumida por vírus Zika.

This case report describes the retinal optical coherence tomography (OCT) findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.

Sjogren syndrome (SjS) is a systemic autoimmune disease that primarily affects the exocrine glands (mainly the salivary and lacrimal glands) and results in the severe dryness of mucosal surfaces, principally in the mouth and eyes. This disease predominantly affects middle-aged women, but can also be observed in children, men and the elderly. The clinical presentation of SjS is heterogeneous and can vary from sicca symptoms to systemic disease (characterized by peri-epithelial lymphocytic infiltration of the affected tissue or the deposition of the immune complex) and lymphoma. The mechanism underlying the development of SjS is the destruction of the epithelium of the exocrine glands, as a consequence of abnormal B cell and T cell responses to the autoantigens Ro/SSA and La/SSB, among others. Diagnostic criteria for SjS include the detection of autoantibodies in patient serum and histological analysis of biopsied salivary gland tissue. Therapeutic approaches for SjS include both topical and systemic treatments to manage the sicca and systemic symptoms of disease. SjS is a serious disease with excess mortality, mainly related to the systemic involvement of disease and the development of lymphomas in some patients. Knowledge of SjS has progressed substantially, but this disease is still characterized by sicca symptoms, the systemic involvement of disease, lymphocytic infiltration to exocrine glands, the presence of anti-Ro/SSA and anti-La/SSB autoantibodies and the increased risk of lymphoma in patients with SjS.

The current study aimed to analyze through a literature review evidence of association between ocular changes and non-syndromic cleft lip and/or palate (NSCL/P). A literature review was carried out in accordance with the Cochrane Collaboration Group protocol. PubMed, Scopus, Academic Google and ISI Web of Science databases were systematically searched. A total of 16 studies were accessed, and three made up the final sample.All three studied ocular abnormalities in patients with NSCL/P.The articles found ocular abnormalities in 6.21%, 17.54% and 1.03% of patients respectively.The presence of ocular abnormalities in patients with NSCL/P was significant in this systematic review, but the articles all agreed that future studies should explore the possibility of a greater occurrence of ocular changes in individuals with NSCL/P.

The current study aimed to analyze through a literature review evidence of association between ocular changes and non-syndromic cleft lip and/or palate (NSCL/P). A literature review was carried out in accordance with the Cochrane Collaboration Group protocol. PubMed, Scopus, Academic Google and ISI Web of Science databases were systematically searched. A total of 16 studies were accessed, and three made up the final sample.All three studied ocular abnormalities in patients with NSCL/P.The articles found ocular abnormalities in 6.21%, 17.54% and 1.03% of patients respectively.The presence of ocular abnormalities in patients with NSCL/P was significant in this systematic review, but the articles all agreed that future studies should explore the possibility of a greater occurrence of ocular changes in individuals with NSCL/P. RESUMO O presente estudo teve como objetivo analisar evidências de associação entre as alterações oculares e fissuras lábio palatinas não sindrômicas (FL/PNS), através de uma revisão da literatura. Foi realizada a revisão da literatura com pesquisa sistemática, observando o protocolo de colaboração com o Grupo Cochrane. PubMed, Scopus, Google Acadêmico e ISI-Web of Science. A partir de16 estudos acessados, 3 compuseram a amostra final. Todos os trabalhos da amostra final relataram alterações oculares em pacientes com FL/PNS. Os artigos relataram respectivamente alterações oculares em 6,21%, 17,54% e 1,03% dos pacientes. A presença de alterações oculares em pacientes com FL /PNS foi significativa nesta revisão sistemática, mas todos os três artigos sugerem que futuros estudos deverão explorar a possibilidade de que haja um aumento de alterações oculares em indivíduos com FL/PNS.

Clinical presentations associated with vitamin A deficiency persist in poor regions globally with the same clinical features as those described centuries ago. However, new forms of vitamin A deficiency affecting the eyes, which have become widespread, as a result of modern societal habits are of increasing concern. Ophthalmic conditions related to vitamin A deficiency require the combined attention of ophthalmologists, pediatricians, internists, dermatologists, and nutritionists due to their potential severity and the diversity of causes. As the eyes and their adnexa are particularly sensitive to vitamin A deficiency and excess, ocular disturbances are often early indicators of vitamin A imbalance. The present review describes the clinical manifestations of hypovitaminosis A with an emphasis on so-called modern dietary disorders and multidisciplinary treatment approaches. The present review also discusses the relationship between retinoic acid therapy and dry eye disease. RESUMO As apresentações clínicas associadas à deficiência de vitamina A persistem em regiões pobres ao redor do mundo com os mesmos achados clínicos descritos há séculos. No entanto, novas formas de problemas causados pela vitamina A afetam os olhos, estão associados com os hábitos da sociedade moderna e tem causado preocupação. Eles exigem a atenção dos oftalmologistas, pediatras, internistas, dermatologistas e nutricionistas, devido à sua gravidade e diversidade de causas. Uma vez que os olhos e seus anexos são órgãos muito sensíveis à deficiência e excesso de vitamina A, manifestações oculares podem ser indicadores precoces do desequilíbrio de vitamina A. Essa revisão traz as manifestações clínicas de hipovitaminose A enfatizando os chamados distúrbios dietéticos modernos e formas de abordagem multidisciplinar. E também traz evidências sobre a relação entre a terapia com ácido retinóico e doença do olho seco.

Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.

Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.A rosácea é uma condição cutânea crônica, que possui apresentações clínicas variáveis. Apesar de considerada uma doença dermatológica, os olhos podem ser acometidos em 58-72% dos casos, causando inflamação palpebral e da superfície ocular. Aproximadamente um terço dos pacientes desenvolve acometimento corneano, podendo causar baixa visual significativa. Diagnóstico precoce e tratamento adequado são de extrema importância, devido à significativa morbidade ocular que a doença pode causar. Não há, até o momento, um teste diagnóstico para rosácea. O diagnóstico da rosácea ocular depende da observação das manifestações clínicas, o que pode ser bastante desafiador em até 90% dos pacientes, em que os achados cutâneos são discretos ou inexistentes. Nesta revisão, descrevemos os mecanismos fisiopatológicos propostos na literatura, manifestações clínicas, diagnóstico e tratamento da rosácea ocular, assim como abordamos a necessidade de um teste diagnóstico.

The relationship between the eye and psoriasis has been recognized for decades, but the precise eye manifestations in patients with psoriasis and psoriatic arthritis are only recently coming to light. Psoriatic eye findings may include conjunctivitis, dry eye, episcleritis, and uveitis, all of which may precede articular changes. Uveitis, seen in 7% to 25% of psoriatic arthritis patients, may be recognized by the presence of conjunctival injection, photophobia, pain, lid swelling, or otherwise unexplained visual changes. Early recognition is paramount because its natural course may lead to vision loss. Immunopathogenesis has shown evidence for T-helper cell (Th) type 1 (Th1) and Th17 involvement in the pathogenesis of uveitis according to the murine experimental autoimmune uveitis model. Corticosteroids are the primary treatment modality; however, increasing emphasis has been placed on immunomodulators and biologics for more intractable cases. Referral to an ophthalmologist is essential for definitive diagnosis and treatment.