David D'Cruz says that the key to early diagnosis of systemic lupus
erythematosus (SLE) includes a "a complete systems review and
examination...". But he should have highlighted the importance of
fundoscopy.
The ocular fundus is the common meeting place of all systems, and it
is here that the living pathology of SLE: cotton wool spots, haemorrhages,
and sometimes disc changes, may be seen with an ophthalmoscope. Fundoscopy
clinched the diagnosis of SLE in a 14-year-old girl with paraplegia I saw
some years ago. It is the single most important part of the examination if
severe SLE (or the Hughes antiphospholipid syndrome) is suspected.
Competing interests:
I am a director and shareholder of Ophthalmos Ltd, a company that is making a lensfree ophthalmoscope
Rapid Response:
Fundoscopy in systemic lupus erythematosus
David D'Cruz says that the key to early diagnosis of systemic lupus
erythematosus (SLE) includes a "a complete systems review and
examination...". But he should have highlighted the importance of
fundoscopy.
The ocular fundus is the common meeting place of all systems, and it
is here that the living pathology of SLE: cotton wool spots, haemorrhages,
and sometimes disc changes, may be seen with an ophthalmoscope. Fundoscopy
clinched the diagnosis of SLE in a 14-year-old girl with paraplegia I saw
some years ago. It is the single most important part of the examination if
severe SLE (or the Hughes antiphospholipid syndrome) is suspected.
Competing interests:
I am a director and shareholder of Ophthalmos Ltd, a company that is making a lensfree ophthalmoscope
Competing interests: No competing interests