Arteriovenous fistulas involving the lung, liver, and mucous membranes are associated with multiple telangiectasias in patients with the hereditary hemorrhagic telangiectasis (Osler-Weber-Rendu syndrome).49 Cornelia de Lange's syndrome is characterized by bushy, confluent eyebrows, downward-slanting eyes, a small mandible, low-set ears, hirsutism, long eyelashes, a broad, flat, upturned nose, severe growth and mental retardation, and a peculiar chicken wing extremity with a single thumblike digit (Fig. 10-3). A ventricular septal defect (VSD), patent ductus arteriosus, pulmonic stenosis, anomalous venous return, or ASD may be present.
Kapha-types, those in whom the biological water-humor predominates, are usually short and stocky. Sometimes they are tall but they always possess a large frame. Their skin is thick and flesh well developed. They tend towards corpulence or obesity. They will hold excess weight and water unless they work hard to prevent it. They possess well developed chests. Their eyes are large, white and attractive, with large lashes. Their hair is abundant and thick. Their teeth are large, white and attractive. They sleep easily, often excessively and may be lazy. They suffer from cold and dampness but possess strong endurance. Water-types tend to accumulate phlegm and suffer most from bronchial and pulmonary disorders. They also accumulate water and suffer from edema and weak kidneys. They are most prone to overweight. This is from the influence of the Moon or Jupiter which rules them.
White hair including eyelashes and eyebrows eye exam shows nystagmus and poor development of macula with red iris and pupil skin is pink-white with lack of pigmentation throughout body numerous actinic ( SOLAR) keratoses on face and scalp as well as on dorsum of hands ulcerated lesion with indurated edges on dorsum of hand with hyperpigmentation.
Slit lamp exam check cleanliness of contact lens, check tear film, check lid and lash position rash, hordeolum, chalazion, lice nits in lashes, conjunctival injection, conjunctival chemosis, conjunctival dryness, conjunctival concretions, papillae, episcleral nodule, broken or exposed sutures, corneal dryness, keratitis, foreign body
Possible concurrent slit lamp findings rash, lice in lashes, lash crusting, conjunctival edema, conjunctival dryness, papillae, episcleral nodule, discharge, poor tear film, little or no movement of contact lens, deposits on contact lens, corneal edema, corneal erosion or other breaks, keratitic precipitates, cell and flare, narrow or closed angles, mid dilated pupil, miosis