Ophthalmic assessment in endocrine disease

Visual symptoms are commonly reported by patients in the endocrine clinic. Separating the benign and reversible from sight-threatening disease relies heavily on examination. In this review, we offer a practical framework for ophthalmic assessment in endocrine disease, aimed at the non-ophthalmologist working without specialist equipment. We discuss visual acuity, intraocular pressure, colour vision, pupillary response, visual fields, eye movement assessment. We also discuss some of the specific external and fundal signs that are important not to miss, including optic disc swelling and relative afferent pupillary defect (RAPD). Emphasis throughout is on the small number of bedside tests that may identify those patients needing urgent ophthalmic and neuro-ophthalmic review.