An ocular manifestation of a systemic disease is an ocular condition that directly or indirectly results from a pathologic process from another part of the body. Ocular manifestations can occur in various systemic diseases in pediatrics. However, ocular manifestations are difficult to recognize especially in pediatric diseases because most clinicians ignore ocular involvement of systemic diseases. Ocular manifestations can be the first findings of systemic disease in some pediatric disease, and numerous ocular manifestations can be associated with amblyopia, which is a disorder of sight. Therefore we must be able to recognize the ocular manifestations for diagnosis and management of pediatric systemic diseases.Although we cannot deal with ocular manifestations of all pediatric systemic disease in this paper, we have reviewed particular diseases that are may be of interest to the general physician and pediatric ophthalmologists. This paper aims to review the ocular manifestations of various pediatric diseases.
HYPERTHYROIDISMHyperthyroidism is caused by over secretion of thyroid hormone; during childhood, it is caused by Graves' hyperthyroidism, the most common cause of pediatric hyperthyroidism [1]. In children, the incidence of Graves' disease is about 1:10,000 [2]. Graves' hyperthyroidism is an autoimmune disorder; secretion of thyroidstimulating immunoglobulin that binds to and triggers the Gprotein-coupled thyroid-stimulating hormone (TSH) receptor results in diffuse enlargement of the thyroid gland. Other etiologies of hyperthyroidism include gain-of-function germline mutations in the TSH receptor, which are detected in both familial and sporadic cases of non-autoimmune hyperthyroidism. These subjects, whose disease can occur in the infantile period or in later childhood, have a hyperplastic thyroid gland with goiter and decreased levels of TSH.Childhood onset Graves' ophthalmopathy is uncommon and occurs mostly in girls. Pediatric diseases are important because diagnosis and care for these can be complex. Among them, specific diseases have been associated with ocular involvement. This review presents the ocular manifestations of various pediatric diseases relevant to the clinician. An array of ocular manifestations of hyperthyroidism, hypoparathyroidism, diabetes mellitus, porphyria, cystinosis, mucopolysaccharidosis, Wilson disease, juvenile idiopathic arthritis, systemic lupus erythematosus, Marfan syndrome, Weill-Marchesani syndrome are describ ed. In this review we will review ocular manifestations of systemic pediatric diseases for comprehensive understanding of eye involvement. With this review, authors can recognize the ocular manifestations for diagnosis and management of pediatric systemic diseases.
