Eye Exercises for People With Cataracts

Easy Clear Vision

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Easy Clear Vision Overview


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Macular Degeneration and Cataracts

The eye is at particular risk of oxidative damage due to high oxygen concentrations, large amounts of oxidizable fatty acids in the retina, and exposure to ultraviolet rays. In Western countries, age-related macular degeneration (AMD) is the leading cause of blindness among older people. Cataracts are also widespread among the elderly and occur when the lens is unable to function properly due to the formation of opacities within the lens. These develop when proteins in the eye are damaged by photooxidation these damaged proteins build up, clump, and precipitate. It has been proposed that antioxidants may prevent cellular damage in the eye by reacting with free radicals produced during the process of light absorption. The results of intervention trials in this area have also been mixed. The Age-Related Eye Disease Study in the United States investigating the effects of combined antioxidant vitamins C (500 mg), E (400IU), and -carotene (15 mg) with and without 80 mg zinc daily for 6...

TABLE 4 Eye Disease in GCA

A retrospective study of eye disease occurring in 161 patients over a 17-year period provides a useful perspective of this complication (15). Visual manifestations occurred in about 26 of patients, and loss of vision in at least one eye occurred in about 15 (Table 4). Twenty-four patients had permanent vision loss in 92 of these, anterior ischemic optic neuritis was the cause. Central retinal artery occlusion occurred in 8.3 of patients as the cause of permanent visual loss, and occipital infarction caused by vertebral basilar stroke occurred in one patient (4.2 ). These authors noted that patients positive for HLA-DRB1 * 04 had visual manifestations more commonly than those who did not the phenotype was found in 42 of patients versus 26 of controls (15).

Principles for organizing an eye health system for the care of diabetic retinopathy

Accuracy of examination results If diabetic retinopathy is suspected after screening, a decision must be made about the overall management for a given level of diabetic retinopathy. In many developing countres, there are too few persons to provide even basic eye care to the population, let alone specialized eye care for patients with diabetes and related blindness prevention. Involving non-ophthalmic health care providers in varous aspects of eye care for patients with diabetes is a viable alternative. Appropriate follow-up intervals Significant problems have been encountered in ensurng regular follow-up of patients with diabetic retinopathy High rates of follow-up have, however, been reported with the use of vans and trained photographic readers using reference standard photographs to provide immediate feedback to patients. By directly addressing patient convenience, access and feedback, this system might serve as a model for a 'marketing' approach for patient-centred detection of...

Evaluation and improvement of eye care for patients with diabetes mellitus

In assessing approaches to improving the care system, it is important to (i) determine the purpose of the proposed system, for example, to screen for a threshold referral level of retinopathy or to provide guidance in management (ii) assess the performance of the system relative to that of the gold standard, in order to identify trade-offs (ii) assess the success and actual performance of different eye care systems in various settings and (iv) understand how patients perceive the benefits of the system. From the perspective of health policy, it should be shown that a traditional or non-traditional proposal for care offers significant benefits over the existing system, sufficient to justify any additional costs. The performance of systems for eye care for patients with diabetes, even in developed countres, leaves much to be desired. Application of a systems approach to the current systems indicates that alternatives should be explored to improve performance in every area of eye care...

Ophthalmic Diseases

AAV vectors may be well suited for efficient long-term treatment of ocular diseases because they efficiently and stably transduce retinal pigment epithelium and photoreceptor cells following subretinal injection (93,252-257). Retinitis pigmentosa (RP) is a group of inherited retinal degenerative diseases that lead to progressive reduction in visual field extent and impairment of visual acuity. The disease is triggered by mutations in various genes that cause degeneration and death of photoreceptors by apoptotic pathways (258). Control of angiogenesis in the retina is essential to the preservation of vision. Ocular neovascularization (NV) is a major threat to vision and a complicating feature of many eye diseases, including proliferative diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. Regulation of vascularization in the mature retina involves a balance between endogenous positive growth factors (e.g., vascular endothelial growth factor), and...

Conduct International research into systemic deficiencies in health and eye care that contribute to blindness from

Improvements to increase the cost-effectiveness of eye care for diabetes patients are a global necessity. Blindness due to diabetic retinopathy occurs in part because factors important to both patients and health care providers have not been recognized or incorporated into current diabetes education, screening and treatment programmes. Systems analyses are needed in various cultures to understand better why patients with diabetic retinopathy go bind, particularly when the technical knowledge and services to prevent the condition exist. Operations research is needed for comprehensive, evidence-based characterization of the contributions of significant factors and their interactions to blindness among patients with diabetic retinopathy. Within a standardized protocol, focus group methods can give detailed insight about bind and non-blind patients with retinopathy, members of their families or social support systems and diabetes and eye care providers, including information on the actual...

Alternatives in eye care for patients with diabetes mellitus

All treatment should be consistent with uniform international standards. The International Council of Ophthalmology guidelines for diabetic retinopathy care (52) (See Annex 4.) give detailed information about the expected performance of ophthalmologists who treat diabetic retinopathy. Education can improve the performance of health care providers, including non-eye care professionals, although long-term data on persistence are lacking. Use of photographic standards might be an alternative that would also enhance the performance of all systems to detect and follow-up cases of diabetic retinopathy.

Management Of Dry Eye Disease

An effective strategy for the management of dry eye disease includes attention to the patient's lifestyle and specific pharmacologic intervention. The aggravating factors to dry eye and predisposition to symptoms of irritation are well known. Smoking has been identified as a risk factor.35 Such activities as prolonged reading, prolonged staring at a video display terminal, airplane flight, and the use of antihistamines or anticholinergic medications all increase symptoms by worsening tear film stability and volume.36,37 Often simple modification of these behaviors or the use of room humidifiers to increase ambient humidity helps to reduce symptoms, but rarely do such adjustments completely control symptoms. Ensuring that there is no intercurrent blepharitis or inflammation of the anterior eyelid margin is essential. Nevertheless, topical or systemic medications are necessary adequately to treat the disease. The guidelines proposed by the Delphi Panel and the Dry Eye Workshop based on...

Agerelated Cataract Prevention

Age-related cataract is an important public health problem because approximately 50 of the 30-50 million cases of blindness worldwide result from leaving the condition untreated (Jacques 1999). The mechanisms that bring about a loss in transparency include oxidation, osmotic stress, and chemical adduct formation (Bunceetal 1990). Besides traditional risk factors such as diabetes, nutrient deficiency is also being considered, particularly those with antioxidant properties. Cataract was shown to be associated with riboflavin deficiency in animals in the 1930s and subsequently with deficiencies of amino acids, vitamins and some minerals (Wynn & Wynn 1996). This has been confirmed in human studies whereby lens opacities have been associated with lower levels of riboflavin, vitamins A, C and E, iron, and protein status (Leske et al 1995, Mares-Perlman et al 1995). Glutathione reductase is a key enzyme involved in lens protection. Riboflavin levels indirectly influence glutathione...

Prevention Of Cataracts

Numerous observational and prospective clinical studies have been performed to examine the effect of vitamin C alone or in combination with other antioxidants on cataract. Several epidemiological studies have identified an association between vitamin C and cataract incidence (Ferrigno et al 2005, Jacques & Chylack Jr 1991, Jacques et al 1988, Valero et al 2002) however, studies investigating whether supplementation is protective have produced mixed results (Chasan-Taber et al 1999, Chylack Jr et al 2002, Hammond & Johnson 2002, Jacques et al 1997, 2001, Kuzniarz et al 2001, Seddon et al 1994, Taylor et al 2002).

Present Understanding Of Dry Eye Disease And Implications For Therapy

Nomenclature Eye Picture

A recent international workshop designed to collate and critique in an evidence-based manner the accumulated knowledge concerning dry eye disease and its treatment published a comprehensive report in 2007.1 The Dry Eye Workshop provided guidance to clinicians and researchers regarding the definition, classification, epidemiology, and research findings, and treatment guidelines for dry eye disease. The consensus definition of dry eye disease was stated to be that dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.2 This definition expands the scope of the disease to include effects on visual acuity and discomfort and damage to the ocular surface through both inflammation of the tissues and hyperosmolarity of the tear film.3 The classification...

Uveitis and Visual Impairment

About 80 to 90 of patients with uveitis are positive for ANA. ANA-positive girls presenting with oligo-articular disease below the age of two years have up to a 95 likelihood of developing chronic anterior uveitis. Uveitis can cause other forms of eye pathology such as glaucoma and cataracts. Iatrogenic cataract formation from long-term steroid use may also be troublesome in patients requiring oral corticosteroids for disease control.

B12 Deficiency and Vision Problems

For example, a twenty-nine-year-old female presented with bitemporal hemianopsia. She had normal MRI and CT scans and normal visual evoked potentials (VEP). B12 deficiency was found to be the cause of her visual impairment 4 Some patients have experienced improvement and partial recovery of vision after B12 therapy. John, a fifty-four-year-old male, was diagnosed with cortical basal ganglionic degeneration and had visual field loss. After B12 treatment, his visual acuity improved by 80 percent.

Cataracts and Photoreceptors

Several micronutrients, especially those that can have antioxidant functions in living tissues, have recently been investigated in relation to possible protection against degenerative eye diseases, such as cataract. Studies in animal models have suggested, albeit indirectly, that riboflavin status may be important here, and several recent epidemiologi-cal studies, including an intervention study in one region of China, have supported the suggestion that


Although a high intake of beta-carotene containing foods has been associated with the prevention of cataracts, the role of supplementation is uncertain. An assessment of dietary beta-carotene intake in a subgroup of 472 non-diabetic women, aged 53-73 years, who participated in the Nurses' Health Study found that the odds of posterior subcapsular cataracts was 72 lower in those with the highest intakes of beta-carotene who had never smoked, whereas beta-carotene intake and cataract risk were not associated in current or past smokers (Taylor et al 2002). This finding is contrasted with findings from intervention studies that have found that beta-carotene may help prevent cataracts in smokers (Christen et al 2003, 2004). Two years of beta-carotene treatment was found to have no large beneficial or harmful effect on the development of cataract in a randomised, double-masked, placebo-controlled trial of 39,876 female health professionals aged 45 years or older who participated in the...

Eye Strain

A double-blind study involving 75 patients with eye strain caused by viewing a computer screen found that GSE 300 mg daily significantly improved objective and subjective measures (Bombardelli & Morazzoni 1995). Grapeseed extract (Endotelon' ) has also been shown significantly to improve visual adaptation to and from bright light in a dual centre study involving 100 volunteers (Boissin et al 1998, Corbe et al 1988). A dose of 200 mg daily over 5 weeks was used. It has been proposed that GSE increases rhodopsin content of the retina or accelerates its regeneration after exposure to bright light.

Eye Problems

Cataracts In cataracts damage to the protein of the lens of the eye clouds the lens and impairs vision. Oxidation of the lens from exposure to the sun and other sources in the environment is partly responsible for the destruction and nothing can reverse the situation once it has developed. Nutrient deficiencies, selenium, for example, may contribute to cataract formation. Symptoms are blurred or hazy vision, seeing spots, or the feeling of a film over the eye. Vitamin C supplementation may help improve vision. Glutathione, an antioxidant, is found to be especially lacking in cataracts as well as vitamin C, vitamin E, and folic acid. Vitamin A and the carotenoids are important for eye health, lutein a carotenoid is found in the lens. Foods containing these antioxidants are fruits and vegetables, spinach and other green leafy vegetables, broccoli, asparagus, legumes, avocados, oranges, dark berries, plums, and cherries. The herb bilberry is high in antioxidants, 240 to 480 mg of extract...

Evidence Report Endorsements

Green, M.D., M.P.H., American Academy of Family Physicians, Jack P. Whisnant, M.D., American Academy of Neurology, Barry N. Hyman, M.D., F.A.C.P., American Academy of Ophthalmology, Lisa Mustone-Alexander, M.P.H., P.A., American Academy of Physician Assistants, Henry Guevara, B.S.N., R.N., C.O.H.N.-S., American Association of Occupational Health Nurses, Edward D. Frohlich, M.D., American College of Cardiology, Sheldon G. Sheps, M.D., American College of Chest Physicians, Ron Stout, M.D., American College of Occupational and Environmental Medicine, Jerome D. Cohen, M.D., American College of Physicians, Carlos Vallbona, M.D., American College of Preventive Medicine, James R. Sowers, M.D., American Diabetes Association, Inc., Mary C. Winston, Ed.D., R.D., American Dietetic Association, Daniel W Jones, M.D., American Heart Association, Roxane Spitzer, Ph.D., F.A.A.N., American Hospital Association, Nancy Houston Miller, B.S.N., American Nurses' Association, Linda Casser, O.D.,...

Topical Application of Drugs

While the importance of tailoring vehicles to drugs in percutaneous delivery was recognized, so too was the possibility of enhancing absorption by physical means such as electrophoresis or iontophoresis, an effect demonstrated for strychnine in 1888 and for dyes in 1890, but as recalled by Rothmann dramatically demonstrated by Leduc at the start of the twentieth century 112 rabbits painted with a solution of strychnine nitrate survived while those to which an electrophoretic current was applied died. There was considerable interest in the use of iontophoretic techniques in ophthalmology 113 . Fleming refers to it as iontotherapy 114 when used for the medication of the cornea, the bulbar conjunctiva, or the everted eyelids. A device for inserting medicaments into the body by iontophoresis was the subject of a US Patent in 1934 115 . Later work confirmed this effect 116 not only with dyes but with sulfonamides 117 . The more recent interest in iontophoresis has its origins in this work....

Indications Indian Gum Arabic Tree

(f KAB WO3) Burn (f SKJ WO3) Cancer (f BIB JLH) Cancer, ear (f JLH) Cancer, eye (f JLH) Cancer, liver (f JLH) Cancer, spleen (f JLH) Cancer, testes (f JLH) Cataract (f GHA) Catarrh (f GHA HH2) Childbirth (f DEP) Chill (f ZUL) Cholecystosis (f BIB EB22 173) Cholera (f SKJ WO3) Cold (f GHA) Colic (f KAB) Condyloma (f BIB) Congestion (f BIB) Conjunctivosis (f DEP NAD) Cough (f DEP KAB NAD) Cramp (f BOU) Cystosis (f DEP) Dermatosis (f BOU WO3) Diabetes (f1 BOU DEP GHA SUW WO3 ZUL) Diarrhea (f GHA GMH PH2 SUW) Dysentery (f BIB DEP SUW) Dyslactea (1 X15283686) Dyspepsia (f ZUL) Dysuria (f KAB) Edema (1 X8982438) Enterosis (f1 DEP X15476301) Fever (f BIB BOU UPW) Flu (1 FNF) Fracture (f KAB) Fungus (1 WO3) Gastrosis (f DEP) Gingivosis (f BOU DEP PH2) Gonorrhea (f1 DEP KAB ZUL) Hemorrhoid (f BIB KAB PH2) Hepatosis (f1 BIB WO3 PR14 510 X11054840) High Blood Pressure (f1 BOU ZUL) HIV (1 X10189947) Hypersalivation (f DEP) Impotence (f NAD UPW) Induration (f BIB JLH) Infection (1 WO3 ZUL...

How This Book Is Organized

Chapter 7 shows you how certain core beliefs darken and distort your view of yourself, your world, and your future as surely as eyeglasses with the wrong prescription muddle normal sight. We include tools for regrinding your life-lenses so you see things more clearly. Finally, in Chapter 8, you have the opportunity to practice mindfulness and acceptance more techniques for handling troubling thoughts.

What does Oxidant Stress Cause

Oxidant stress, through its effects on key biological sites and structures, is implicated in chronic noncommunicable diseases such as coronary heart disease, cancer, cataract, dementia, and stroke (Figure 4). Oxidant stress is also thought to be a key player in the aging process itself. A cause-and-effect relationship between oxidant stress and aging and disease has not been confirmed, however, and it is very unlikely that oxidant stress is the sole cause of aging and chronic degenerative disease. Nonetheless, there is evidence that oxidant stress contributes substantially to age-related physiological decline and pathological changes. Consequently, if it is accepted that oxidant stress is associated with aging and degenerative disease, then opposing oxidant stress by increasing antiox-idant defense offers a potentially effective means of delaying the deleterious effects of aging, decreasing the risk of chronic disease, and achieving functional longevity. For this reason, there has...

Safey Issues Related to Inhaled and Systemic Corticosteroids

The GINA document states that, in adults, systemic side effects rarely occur with daily doses of < 500 mg of BDP or equivalent doses of other ICSs. Higher doses of ICSs are associated with increased risk for bruising, cutaneous laxity, cataracts and glaucoma (in some studies), decreased bone mineral density and adrenal suppression. The expert committee admits that the actual clinical impact of ICS agents on osteoblastic activity and on adrenal suppression has not yet been determined (5). For this reason, specific recommendations for prevention of osteoporosis (in contrast to NAEPP) are not provided. children receiving long-term ICS. The committee also reported that long-term observational studies in children receiving ICS therapy for six years failed to show significant effects on bone mineral density or on incidence of subcapsular cataracts or glaucoma. The GINA committee could identify no evidence to support a risk of fracture in young children on ICS agents. However, most of the...

Agerelated Macula Degeneration

A high intake of beta-carotene-containing foods has been associated with the prevention of ARMD and observational and experimental data suggest that carotenoid supplements may delay progression of both ARMD and vision loss. This is supported by the findings from the ARED Study, an 11 -centre, double-masked clinical trial involving 3640 participants with ARMD that found supplementation with vitamin C 500 mg, vitamin E 400 IU, beta-carotene 1 5 mg and zinc 80 mg for 6 years significantly reduced the development of advanced ARMD and moderate visual acuity loss (Kassoff et al 2001). Although beta-carotene and other nutrients may have been found to be beneficial for preventing ARMD, the carotenoids lutein and zeaxanthin appear to provide the most protection (see Lutein zeaxanthin monograph).

Medication Treatment and Management

An Optic View of ADD If corrective lenses did not exist No well-meaning parent could hope to resist A pill that enabled their child to see And increase that child's ability For better sight and clear vision No, this would not be a tough decision. Then why wouldn't the same analogy Apply to the problem of ADD For brains are a lot like eyes, I believe. . . They both need to focus in order to see Medication as treatment might be prevented If ADD lenses were someday invented.

Differential Diagnosis

Multiple diseases can present with findings similar to those seen with Adamantiades-Behget's disease and should be considered when a patient presents with recurrent oral or genital ulcers, inflammatory eye disease, or other manifestations of vasculitis. Included in the differential diagnosis are systemic lupus erythematosus (Chapter 1), seronegative spondyloarthropathies, inflammatory bowel disease (Crohn's or ulcerative colitis) (Chapter 20), herpes or other viral infections (Chapter 10), other forms of vasculitis (Chapter 8), and inflammatory skin diseases such as pemphigus vulgaris or pemphigoid lesions (Chapter 37). All patients presenting with oral and genital ulcerations should undergo testing for herpes simplex virus using culture or polymerase chain reaction methods, to ensure that viral infection is not present. Retinal vasculitis observed by ophthalmologist Skin lesions

Nutrition and Disease

White South Africans (Dutch descendants called Afrikaaners), Europeans, and Asian Indians in Africa have diets similar to their countries of origin. In urban areas, however, the diet of (black) Africans is increasingly dependent on meat, much like the diet of some West African pastoral tribes, as well as on empty calories from prepackaged foods similar to those found in the West. The result is an unbalanced diet. In many parts of Africa, the traditional diets of indigenous peoples are often inadequate in essential vitamins, minerals, and protein, which can lead to a variety of diseases. Micronutrient deficiencies, particularly vitamin A, iodine, and iron deficiencies, which can result in vision impairment, goiter, and anemia, respectively, are prevalent throughout much of Africa, particularly in the arid areas where the soil is deficient either naturally or due to overuse.

Light and Chemical Energy

Light absorption and possibly scavenging of destructive oxygen species by the xanthophylls lutein and zeaxanthin are also important in the macula of the primate eye. Lutein and two isomers of zeaxanthin are selectively accumulated in the macula, creating a yellow area of the retina responsible for high visual acuity (smaller amounts are also found in the lens). Both carotenoids absorb light of about 450 nm 'blue light,' thus filtering light to the light receptors behind the carotenoid layer in the macula. Filtering blue light can reduce oxidative stress to retinal light receptors and chromatic aberration resulting from the refraction of blue light. A similar filter effect may occur in the lens, but the concentration of the xanthophylls is much lower, and further protection occurs with age when the lens yellows. Whether scavenging of destructive oxygen species by these carotenoids is useful here is unproven, but the retina is an area of higher blood flow and light exposure than other...

Complications And Prognosis

Uveitis has numerous complications, which often cause visual loss. Treatment of uveitis can also contribute to these complications. Glaucoma may arise from a pressure response to corticosteroid therapy cataracts may develop from long-term use of these agents. Appropriate management of these complications provides the best opportunity for avoiding adverse visual outcomes. Band keratopathy is a complication specifically associated with JRA and is treated by chelation and excimer laser (Fig. 1D). CME is the most common cause of decreased visual acuity in patients with posterior uveitis (Fig. 1E). Finally, other complications may result from systemic treatments (1,14,16). Prognosis is best in patients with anterior uveitis. In one study, 4 of patients with anterior uveitis lost at least 25 of visual acuity, while 43 and 40 of patients with posterior uveitis and panuveitis, respectively, developed this complication (2).

CoGans Syndrome Introductiondefinition

The principal features of CS are interstitial keratitis (IK) and vestibuloauditory neuronitis. This syndrome was reported in 1945 by David Cogan, an ophthalmologist at the Harvard Medical School, who meticulously described the medical history and findings of four patients with recurrent nonsyphilitic IK and Meniere's-like vestibuloauditory symptoms. The ocular component of CS subsequently expanded to include other types of eye

Hydrocarbon Carotenoid bCarotene

Carotenoid Cardiovascular disease Cataract Macular degeneration Lung cancer Prostate cancer Carotenoid Cardiovascular disease Cataract Macular degeneration Lung cancer Prostate cancer Excellent food sources of fi-carotene include carrots, winter squash, red-orange sweet potato, and various types of dark green leafy vegetables. No deficiency or toxicity has been observed from dietary fi-carotene intake, although very rarely high intakes can be associated with yellow pigmentation of the skin as carotenoids are stored in adipose tissue. Supplements containing fi-carotene are common. In the Women's Health Initiative, the largest observational intervention study in postmenopausal women to date, approximately 50 reported using a supplement containing fi-carotene. This trial included both a clinical trial and observational study involving more than 160 000 women. The Physicians' Health Study II also included fi-carotene as one of its interventions to determine the balance of risks and...

What are the symptoms of MS Which symptoms are most common

Glaucoma Although visual problems are less common at onset of illness, they become relatively common over the lifetime of patients with untreated MS. A physician should always evaluate visual symptoms, especially double vision or blurring of vision accompanied by pain in one or both eyes. MS-caused blindness is uncommon. Glaucoma is a more common cause of blindness.

Clinical Manifestations

For patients with IK alone, the most common ocular complaints are pain, redness, and photophobia. Other eye symptoms may include excessive tearing, foreign body sensations, and blurry vision. Conjunctivitis, anterior uveitis, episcleritis, scleritis, and retinal vasculitis may be accompanied by eye pain, redness, photophobia, or reduced visual acuity. Acute angle glaucoma and proptosis have also been described in a few cases. The ophthalmological findings of IK may be relatively mild and evanescent and may consist of faint, peripheral, subepithelial corneal infiltrates. These lesions are similar to those of keratitis caused by adenovirus and chlamydia. The corneal lesions can evolve to a patchy granular infiltrate, localized predominately in the posterior cornea. The cornea can later vascularize and opacify with persistent inflammation, although such opacities occur in less than 5 of adequately treated patients.

Prognosis for Children with Pauciarticular Onset JA

The majority of children with true pauciarticular-onset disease will be able to carry out fully functional lives in every way. The prognosis for children with significant eye disease will depend on their ultimate visual status this is best discussed with the treating ophthalmologist (see Chapter 6).

Polyarticularonset Juvenile Arthritis

Laboratory findings in children with polyarticular-onset arthritis are highly variable. Some have entirely normal laboratory tests, while others have elevated ESR and low hemoglobin. A small percentage of children with polyarticular-onset are RF-positive and should be considered as having an early onset of adult-type rheumatoid arthritis. However, RF may be found in a number of other conditions (see Chapter 22) and should not be relied on to establish this diagnosis. A positive test for rheumatoid factor in a child less than ten years of age is far more likely a false positive result or an indication of another illness than a sign of early-onset RF-positive polyarticular arthritis. The test for ANA may also be positive in children with polyarticular-onset disease. Although their risk of eye disease is lower than that of ANA-positive children with pauciarticular-onset disease, ANA-positive children with polyarticular disease also have an increased risk of uveitis and should have an...

Systemiconset Juvenile Arthritis

Pauciarticular- and polyarticular-onset arthritis affect girls more frequently than boys. In systemic-onset arthritis, the sex ratio is equal. In pauciarticular-and polyarticular-onset disease, a positive ANA test is common and eye disease is frequent. Both ANA and eye disease are rare in systemic-onset juvenile arthritis. Rheumatoid factor should not be present in children with systemic-onset arthritis. If RF is found in a child being investigated for systemic-onset disease, it is more likely that the cause of the symptoms is an infection.

The Effect of Experience on Brain Development

One way that experience affects brain development is by determining which synapses are retained during the process of synapse elimination. Useful synapses are kept, while surplus ones are lost. This type of learning through selective synapse elimination is thought to happen only at certain points in development. This means that there are some types of learning that may only occur during certain points in development, sometimes called sensitive or critical periods. If certain synaptic connections are not laid down early in life, they are less likely to become established later in life. For example, some children are born with cataracts (a clouding of the lens that prevents patterned light from reaching the eye's receptor cells) and experience visual deprivation during the first months of life until the cataracts are treated. These children, even when tested years after vision has been restored, show some difficulties in face recognition, according to a study by Daphne Maurer and her...

Eye Complications of Juvenile Arthritis and Related Conditions

The key to preventing serious eye damage in children with JA is careful screening for the presence of inflammatory cells by an ophthalmologist (a medical eye doctor). This is done with a special instrument called a slit lamp, which is not regularly available in the office of physicians who do not specialize in eye disease. An additional quick and easy test recommended by some ophthalmologists is for parents to shine a flashlight in the child's eyes at bedtime one night each week. If you shine a light in a normal child's eye, you will see the pupil (black center) shrink dramatically. It should shrink in a perfect circle. If one eye does not shrink or the circle is irregular, this might be evidence of eye involvement. Whatever the cause, any child whose pupils do not shrink equally when you shine a light in them should be evaluated by an ophthalmologist. This test may detect the onset of inflammation in the eye occurring between screening tests, but it is not a substitute for the...

A uniform classification system should be adopted

It is recommended that the International Clinical Classification of Diabetic Retinopathy (See Annex 3.), which provides a sound scientific bass for a uniform grading system, be used as an acceptable minimum standard for assessing diabetic retinopathy in programmes for prevention of blindness. This system provides a simplified but sound scientific basis for uniform grading by general ophthalmologists who have a basic understanding of diabetic retinopathy and skills in evaluating the retina. It has been adopted by the International Council of Ophthalmology and by many member societies.

Can I go blind with MS

Although visual loss accompanying attacks of MS, diagnosed as optic neuritis or retrobulbar neuritis, may occasionally be severe, blindness is unusual. There may be a small blind spot left after an attack, and occasionally, this may be large enough to interfere with vision. Glaucoma, which is another type of eye disease, unrelated to MS, is more common as a cause of blindness in MS patients. My vision problems range from a bit of blurriness to a complete lack of sight. I inherited extreme myopia I wear contact lenses and glasses even in the shower. Before MS, changes in my vision required new prescriptions and picking out the least offensiveframes. MS vision symptoms and Myopia nearsightedness inability to see distant objects without corrective lenses.

Complications of Nonspecific Spondyloarthropathies

Complications that do not involve the joints (extra-articular complications) are most common in children who have one of the associated conditions that are discussed below. However, a few specific complications are well recognized to occur in children with nonspecific spondyloarthropathies. Acute anterior uveitis is the most common. This is a painful eye disease involving the front of the eye. Often the eye appears very red, and vision may be affected. This is quite different from the silent eye disease of children with pauciarticular-onset arthritis. Although it may be mistaken for pinkeye (conjunctivitis), it will not respond to antibiotic drops and requires care by an ophthalmologist.

Micronutrient Deficiency

Cataract clouding of the lens of the eye Vitamin A. Vitamin A is necessary to develop a strong immune system and proper eyesight. Vitamin A deficiency (VAD) not only causes blindness and visual impairment (e.g., cataract), but also growth retardation and susceptibility to infections. When VAD is not detected early, it may make a child more prone to illness and even death. In Asia alone, it is estimated that 125 million children under five years of age are currently at risk, and 1.3 million are reported to be vitamin A deficient.

Pathophysiology of Psychosis and Risk Factors

The precise anatomic substrate of hallucinations and psychosis is unknown, but may be due in part to visual dysfunction. PD patients who hallucinate perform slightly worse on visual acuity testing (mean visual acuity 20 45) than nonhalluci-nators (20 33) (17) and have greater impairment in color vision and contrast sensitivity (41). Furthermore, visual evoked potentials are abnormal in PD patients with visual hallucinations (42). Other structures in the brain may also be involved. One reported patient experienced formed visual hallucinations after bilateral subthalamic

How is a diagnosis of MS made

The doctor asked whether I had ever had any prior events of weakness or numbness. By the time we went through his questions and my answers, a pattern of unexplained, often ignored, yet classic MS symptoms was evident. Previously, when a medical problem would get too bothersome, I would finally make an appointment with a doctor. Inevitably, the symptom went away I was too busy to keep the appointment before it went away or an explanation emerged, and thus, I canceled the appointment. I was a typical over-achiever working, making Christmas decorations by hand, entertaining my husband's corporate clients, starting a soup kitchen at our church, and keeping in touch with family each day. Fatigue was apparently due to hard work at law school and around-the-clock hours as a hostile takeover lawyer in the 1980s. Weakness in my right hand was explained as a side effect from writing a law review article and having a lumpectomy. Changes in my vision were thought to be due to long hours and the...

Control of Blood Glucose Level

Irrefutable evidence exists that better control of blood glucose concentration reduces the risk of developing long-term complications from diabetes. This is especially true of microvascular complications such as retinopathy (eye disease), nephropathy (kidney disease), and nerve damage in both type 1 and type 2 diabetes. Control of blood glucose also reduces the risk of macrovascular disease (heart disease, stroke, and peripheral vascular disease), although the contribution of blood glucose to these complications is less strong.

Selection of Dietary Assessment Measure

A third important objective of dietary survey data is to gain a better understanding of the correlates of nutrient intake, but with respect to individual characteristics that may be associated with lower versus higher intake and the extent to which intake is associated with indicators of health. For many nutrients, the day-to-day variation in intake is considerable, and multiple days would be required to achieve stable estimates of intake at the individual level. Without this, the misclassification of individuals in the distribution leads to a weakening in the ability to see associations that may truly be there. An extreme example is vitamin A, which tends to be concentrated in a few foods. If one frequently has liver and carrots, but happened not to on the day of the recall, that individual would be classified as having low vitamin A intake when their usual intake is quite large. Conversely, one who almost never eats these foods, but happened to have liver on the day of the recall...

Systemic Side Effects

A number of different systemic adverse effects have been observed with ICS, including reduced bone mineral density and an increased risk of fracture, adrenal suppression, cataracts, easy bruising, and thin skin (55-58). Of these effects, the bone, adrenal, and eye effects are considered to be the most clinically important and represent the primary systemic outcome measures considered in this review. The interpretation of the dose-response studies that have investigated these effects have been limited by inadequate power with small numbers of subjects, use of indirect measures of function or structure, inadequate time periods of study, confounding by previous oral and ICS use, and the lack of placebo-controlled, randomized studies in which more than one dose of ICS has been investigated.

Pharmacological Uses of Vitamin E

Animal studies show some protective effects of tocopherol supplements against a variety of radical-generating chemical toxicants, and it has been assumed that vitamin E may similarly be protective against a variety of degenerative diseases that are associated with radical damage, including cancer, cardiovascular disease, cataracts, and neurodegenerative diseases. Vitamin E and Cataracts There is good evidence that cataracts are the result of oxidative damage to a-crystallin in the lens of the eyes, and therefore high intakes of antioxidants might be expected to be beneficial. Of 10 controlled trials, 5 showed a protective effect of vitamin E supplements, and 5 showed no effect (Institute of Medicine, 2000).

Neurological Effects

Reduced visual acuity, poor neurodevelopment and ill effects on behaviour. Breast-fed infants generally receive sufficient DHA if the maternal diet is adequate, but it is not known whether formula-fed infants receive adequate amounts if their formula does not contain PUFAs.

Historical Cultivation And Usage

Abrus precatorius plants are seen growing wild throughout all tropical forests, and are propagated through seeds. Traditionally the seeds were used for decorative and gold-weighing purposes. The plant is used in traditional herbal formulations to treat many ailments, mainly scratches, sores, and wounds caused by dogs, cats, and mice. In addition, it is also used to treat leucoderma, tetanus, and rabies (Chopra et al., 1956). The dry seeds are powdered and taken one teaspoonful once a day for 2 days to cure worm infections. Various African and Indian tribes use the powdered seeds as oral contraceptives. They have also been used against chronic eye diseases, and particularly against trachoma (Acharya, 2004). As well as the seeds, the leaves and roots of the plants are also used for medicinal purposes.

Other Physiological Effects

The extremely low rate of CHD in countries with high consumption of olive oil, for instance, suggests the benefits of substituting this fat for other fats. This kind of analysis has been expanded further by noting that MUFA intake is inversely associated with total mortality as well as with CHD. Some effects may well be because of the amount of anti-oxidant vitamins olive oil contains. Vegetable oils are the most important source of a-tocopherol in most diets, and olive oil contains about 12mgper100g. Evidence indicates that a-toco-pherol functions as a free-radical scavenger to protect cellular membranes from oxidative destruction. Oxidative stress has been linked to an increased risk of many chronic diseases, including atherosclerosis, cancer, and inflammatory disorders. Other injuries such as cataract and reperfusion injury are also associated with an increase in oxidative stress and a decrease in antioxidant activity. A large body of evidence suggests a beneficial effect of MUFA...

Future Work Conclusions and Recommendations

Today, more is known about the mechanisms and functions of n-3 fatty acids than other fatty acids. It is evident that Western diets are relatively deficient in n-3 fatty acids and that they contain much higher amounts of n-6 fatty acids than ever before in the evolution of human beings. Research has shown that DHA is essential for the development of the premature infant relative to visual acuity, visual function, and maturation. In the full-term infant, DHA may influence visual acuity and neural pathways associated with the developmental progression of language acquisition. These findings have led to the inclusion of DHA and AA in infant formulas in most countries around the world.

Evaluate use by health care workers of standardized reference photographs and direct ophthalmoscopy as a lowcost

As noted in section 5, this approach, involving general health care workers, probably offers an acceptable level of performance, as observed in other areas of eye care delivery (e.g. trachoma). Demonstrating that this is the case will be essential to its widespread adoption and acceptance by the societies and populations that might benefit most from such services. This information will also be necessary to provide the basis for informed decisions about trade-offs between cost and performance.

The Effectiveness of Early Intervention Services for Children with Special Needs

In addition, the results of research have demonstrated that when children with special needs receive early intervention services, they tend to live more productive lives, score higher on standardized assessments, and contribute more to society. Often, the effects of their disability are lessened while new skills are learned. Children with disabilities who receive early intervention are less likely to develop a secondary disability as a result of not attending to the primary disability. For example, a child with a visual impairment is often delayed in cognitive and motor skills because he does not use the environment as a learning tool. Early intervention services can minimize these secondary delays by teaching the child to explore the environment and learn.

Complications Of Sjogrens Syndrome

The most common complications of Sjogren's syndrome are a direct result of the dry eyes. Dry eyes are easily scratched, and the scratches (corneal abrasions) are both painful and ultimately damaging to the lens of the eye. These children need frequent monitoring by an ophthalmologist. The dry mouth results in a very high frequency of cavities, as saliva normally helps wash away the bacteria responsible for tooth decay. These complications can become quite serious, and it is important to make sure children use artificial tears and artificial saliva if they need them. Special toothpastes and medicines to increase saliva production also help.

How can I rationalize surgically changing my insides and risking significant complications even death just to lose

An article in the Journal of the American Medical Association (January 8, 2003) reported that marked obesity in a man aged twenty to thirty could reduce his life expectancy by up to thirteen years. An extremely obese woman in this same age range might expect to lose up to eight years compared to her normal-weight friends. These are not small numbers. People who are overweight are more likely to develop obesity-related illnesses such as heart disease, pulmonary hypertension, stroke, diabetes, sleep apnea, and arthritis. And obese people are much more likely than lean people to develop blood clots in the legs and lungs, gallstones, pancreatitis, abdominal hernia, fatty liver, polycystic ovary syndrome, high blood pressure, arthritis, gout, lower back pain, infertility, urinary incontinence, and cataracts.

N3 Polyunsaturated Fatty Acids

Studies in rodents and nonhuman primates have consistently demonstrated that prolonged feeding with diets containing very low amounts of a-linolenic acid result in reductions of visual acuity thresholds and electro-retinogram A and B wave recordings, which were prevented when a-linolenic acid was included in the diet (Anderson et al., 1974 Benolken et al., 1973 Bourre et al., 1989 Neuringer et al., 1984, 1986 Wheeler et al., 1975). A variety of changes in learning behaviors in animals fed a-linolenic acid-deficient diets have also been reported (Innis, 1991). These studies have

Physiological roles of NBCe1 in ocular homeostasis

Activity was largely suppressed by adenovirus-mediated transfer of a specific hammerhead ribozyme against NBCe1, consistent with a major role of NBCe1 in overall bicarbonate transport by the lens epithelium 13 . The lens is an avasuclar tissue, and the transport by lens epithelium may be essential for the maintenance of lens homeostasis and integrity 48 . A study in lens epithelial cell layers indeed detected an active fluid transport from their anterior to posterior sides against a hydrostatic pressure 49 . Probably, the transport activity of NBCe1 in lens epithelium may be essential for the lens homeostasis and transparency. Indeed, the pRTA patients with NBCe1 mutations often presented with cataracts. Most of the pRTA patients with NBCe1 mutations also presented with glaucoma. Immunohistological analysis detected the expression of NBCe1 in human trabecular mesh work cells 13 . The electrogenic transport activity compatible with NBCe1 was also reported in human trabecular mesh work...

Growth and Neural Development

Recent large, randomized trials did not find differences in visual evoked potential, visual acuity, or tests of mental and psychomotor development through at least the first 18 months in term infants fed formulas supplemented with DHA or DHA plus arachidonic acid (Auestad et al., 1997, 2001 Lucas et al., 1999 Scott et al., 1998). These studies used formulas with at least 1.1 percent a-linolenic acid and had linoleic a-linolenic acid ratios close to 10 1. In the study by Scott and coworkers (1998), indices of early vocabulary development were lower in infants fed formula with DHA, but not in those fed formulas lacking DHA and arachidonic acid or containing both DHA and arachidonic acid. Birch and coworkers (1998, 2000) reported better visual evoked potential, but not visual acuity, and higher Bayley mental developmental indices scores in infants fed formulas with DHA or DHA plus arachidonic acid than in infants fed standard formula. Carlson and coworkers (1996a) on the other hand,...

Fat Absorption and Aging

Visual acuity 2, 4, 6, 9, 12 mo Visual acuity 2, 4, 6, 9, 12 mo Visual acuity 6, 17, 26, 52 wk visual acuity than infants fed Sweep VEP acuity better in infants fed supplemented formulas than in infants fed standard formula at 6, 17, and 52 wk, but not 26 wk Visual acuity not different between groups

Hearing problems genetic 239

Usher's syndrome type II A condition that begins with a profound congenital deafness followed by a gradual loss of vision that often reaches complete blindness. This is one form of retinitis pigmentosa, in which pigment is deposited in and damages the light-sensitive portion of the eye. Originally described in 1959, the syndrome may account for 10 percent of all cases of congenital deafness. Although there is no treatment, regular exams by an ophthalmologist are recommended for all deaf children, as they can help identify Usher's syndrome early (usually before age six). Scientists have identified genes causing all three types of Usher syndrome to five different places on the chromosomes.

Genetics of Prader Willi Syndrome

Fulfillment of diagnostic criteria and genetic testing confirm in individuals suspected with PWS. In 1993, age-stratified diagnostic criteria were published by Holm et al. PWS is very likely in children < 3years of age with 5 points (3 from major criteria) or in those > 3 years of age with 8 points (4 from major criteria). Major diagnostic criteria for PWS (1 point for each) include infantile central hypotonia, feeding difficulties in infancy, accelerated weight gain in early childhood, hypgonadism, developmental delay and typical facial features (narrow bifrontal diameter, almond palpebral fissures, narrow nasal bridge, down-turned mouth). Current minor diagnostic criteria for PWS (1 2 point each) include decreased fetal movement, sleep apnea, short stature, hypopigmenta-tion, small hands feet, narrow hands with straight ulnar border, esotropia myopia, thick saliva, skin picking and speech problems. Other commonly reported features of individuals with PWS include high pain...

Diabetes Complications

African Americans experience higher rates of diabetes-related complications such as eye disease, kidney failure, and amputations. They also experience greater disability from these complications. The frequency of diabetic retinopathy (disease of the small blood vessels in the retina causing deterioration of eyesight) is 40 to 50 percent higher in African Americans than in white Americans. In addition, the rate of diabetic retinopathy among Mexican Americans is more than twice that of non-Hispanic white Americans. Furthermore, African Americans with diabetes are much more likely to undergo a lower-extremity amputation than white or Hispanic Americans with diabetes. Little is known about these complications in Asian and Pacific Islander-Americans.

Marian W Fischman

METHANOL Methanol is the simplest alcohol, containing only one carbon atom, four hydrogen atoms, and one oxygen atom (CH3OH). It is also called methyl alcohol, WOOD ALCOHOL, carbinol, wood naphtha, wood spirit, pyroxylic spirit, and pyroligneous alcohol or spirit. It is a flammable, potentially toxic, mobile liquid, used as an industrial solvent, in antifreeze, and in chemical manufacture. Ingestion may result in severe acido-sis, visual impairment, and other effects on the central nervous system. Methanol does not produce significant inebriation unless a very large amount is consumed.

Macular Pigment Development

Generally accepted that macular pigment density decreases with age however, there are conflicting results. In one prospective, observational study involving 390 patients, macular pigment density was not found to change significantly with age, even when elderly subjects with cataracts and ARMD were considered (Ciulla & Hammond 2004). Other studies, however, have found that macular pigment does indeed decline with age in both normal eyes (Beatty et al 2001, Bernstein et al 2002) and those with ARMD (Bernstein et al 2002) and Stargardt macular dystrophy (Zhao et al 2003), but not in retinitis pigmentosa or choroideremia (Zhao et al 2003).

Agerelated Macular Degeneration

Recent studies have produced encouraging results for people with pre-existing ARMD. Improvements of up to 92 in visual acuity tests were observed when subjects consumed a diet designed to contain approximately 1 50 g of spinach 4-7 times a week (Richer 1999), and in 30 patients with early ARMD and visual acuity of 6 9 or better daily supplementation with lutein, vitamin E and nicotinamide for 180 days improved macular function (Falsini et al 2003). The results from the Lutein Antioxidant Supplementation Trial provide further support for lutein supplementation in ARMD (Richer et al 2004). This was a double-blind, randomised, placebo-controlled study involving 90 subjects with atrophic ARMD who were given 10 mg lutein, 10 mg lutein plus broad spectrum antioxidants vitamins minerals, or placebo Lutein and Zeaxanthin 812 examined for changes in macular pigment density (MPD), photostress recovery, contrast sensitivity, and visual acuity. Both the lutein and lutein + antioxidant groups...

Applications To Health Promotion And Disease Prevention

Herbal eye-drop preparations made from Emblica officinalis, Carum copticum, Terminalia bellerica, Curcumalonga, Ocimum sanctum, Cinnamomum camphora, Rosa damascene, and meldespumapum have been used in ophthalmic disorders, namely conjunctivitis, conjunctivitis xerosis, degenerative conditions, and following cataract surgery. It was found to have a useful role in infective, inflammatory, and degenerative ophthalmic disorders (Mitra et al., 2000).

Reducing Risk Of Macular Degeneration

Lycopene supplements are sometimes used to reduce the risk of developing macular degeneration and generally support eye health. In general, It Is taken In combination with other carotenoids, such as zeaxanthin and lutein, for this indication for which there is supportive evidence (Cardinault et al 2005). Few studies are available to determine whether lycopene as a sole agent exerts clinically significant protective effects. One cohort study of 1 59 older people found no inverse association between lycopene intake and 5-year incidence of early age-related macular degeneration (ARMD) (Flood et al 2002). Alternatively, a recent study comparing 34 patients with ARMD to 21 control subjects found that of the serum carotenoid concentrations measured, only lycopene was decreased significantly in the serum LDLand HDL fractions (P< 0.05).

The use of Ultra Short Pulse Lasers USPLs in dentistry

Even with the higher repetition rates and the application of air-water coolant during the cutting process, commercially high intensity infrared lasers still cannot cut dental hard tissues with the same speed or the same precision than those promoted by drills (White et al., 1994). In this way, studies were performed to verify the possibility of using ultra short pulse lasers (USPLs) for cutting dental hard tissues, considering the success of using the USPL for precise cutting in industry and in medicine (ophthalmology) (Niemz, 2004). concerning the use of USPLs for medical applications started more than 15 years ago. In fact, one of the first studies that report the use of lasers with pulse widths of ps and fs was performed by Stern et al. (1989), relating applications for corneal ablation. Since then, efforts were made to understand the effects of these lasers on biological tissues and to develop of practically applicable systems. Although the majority of the studies report the use...

The origins of lifelenses

On the road to understanding and changing your life-lenses, it helps to reflect on what caused you to acquire the lenses you look through in the first place. When you understand these origins, you can release the notion that you're crazy, weird, or messed up. Self-forgiveness releases energy that you can use for grinding new lenses for better vision.

The Rebirth of the Laboratory School Challenge and Opportunity

Problems that are worthy of attention and study. While educators are the classroom experts, researchers offer expertise in identifying reliable strategies for testing ideas. In turn, administrators and policy makers create the guidelines to support research and classroom practice identified as best practices. To that end, the MBE Research Schools Network (RSN) is a practical infrastructure for making the goals, concerns and constraints of all parties transparent. To develop this partnership, we set out to meet four objectives a) develop a clear vision b) build trusting relationships c) set a standard for rigorous research and scholarship and d) promote meaningful assessment tools.

Nonophthalmic health professionals

Having to see yet another doctor (an ophthalmologist) presents an additional burden (59). Thus, being able to see just one doctor for comprehensive diabetes care enhances the continuity of care and thus the ability to receive higher quality care. General practitioners are usually best paced to situate the risk for vision loss for each patent as part of the overall care strategy for diabetes, as the known rsk factors for retinopathy are among the conditions managed by the general practitioner or endocrinologist. Awh, Coupes & Javitt (66) conducted pre- and post-educational assessments of 10 university-affiliated physicians (five in family practice, three internists and two endodcrmologists), who examined 20 patients. In the pre-test, 80 found that pupil dilatation for direct ophthalmoscopy was both unfamiliar and uncomfortable, and only one physician could name a medication used for dilatation. The mean score on a written examination on eye conditions and diabetes was 49 30 were...

Distinguishing the past from the present

Life-lenses develop from emotionally significant events in childhood, and they make sense when viewed in conjunction with those events. Your world has no doubt changed a great deal over the years, but you probably still look through many of the same old lenses. And those lenses don't give you a clear vision of present-day reality. The life-lenses you see through were largely ground by circumstances and events rooted in your childhood, events over which you had little control. Thus, you don't deserve blame for carrying your lenses around. However, you do own the responsibility for doing something about regrinding your lenses. Regrinding life-lenses is slow, arduous work that takes patience, but the new, clear vision that results from your efforts is worth the wait.

Lymphocytic choriomeningitis virus LCMV A

Mice and hamsters are the primary sources of LCMV infections. Humans acquire this virus by direct contact with infected rodents or by inhaling the virus. So far, more than 49 infants around the world have been diagnosed with congenital LCMV. However, experts really are not sure how many infants have been affected by LCMV before birth because doctors do not routinely look at LCMV as a possible cause of congenital blindness or retardation. In one instance, twin girls from Cochise County, Arizona, were born to a mother who had unknowingly contracted LCMV during pregnancy. one girl was born with vision problems and the other has seizures and severe developmental delays. More than 90 percent of the babies who have contracted the LCMV virus before birth have had adverse effects, the most common of which were vision problems. other problems include neurological conditions such as and decreased visual acuity.

Poison Control Centers

When a sharp line needs to be drawn between legalization and prohibition, it is useful to say that a drug is legal if it is legal for that substance to be produced and distributed for unsupervised consumption by a significant portion of the population (e.g., all adults). By this definition making marijuana available for medical use is not legalization if prescriptions are restricted to those experiencing specific, medically-diagnosed conditions (glaucoma), but it would be if any adult could write his or her own prescription. Likewise by this definition the Netherlands has legalized retail production, distribution, and use of marijuana, although wholesale (large-volume) marijuana production and distribution is still prohibited. Most other drugs in most countries are either clearly legal or clearly prohibited by this definition.

Allergic rhinosinusitis

A more effective approach to nasal congestion and inflammation is the use of a topical nasal corticosteroid spray. This class of agent is the most potent and effective modality for the treatment of allergic rhinitis and is effective against all of the manifestations of this disorder (8). Common side effects include local nasal irritation and occasional thrush. Less common, but possibly important in the case of long-term use, are an increase in incidence of glaucoma, cataracts, and osteoporosis. These drugs diminish the inflammatory influx of cells into the nasal mucosa and diminish the strength of the local allergic response.

Technical issues in the use of standard photographic images

In 2004, the American Academy of Ophthalmology concluded that, in the United States, single-field photography is adequate for screening for the purpose of detecting diabetic retinopathy but not for management (73) What is 'acceptable' necessarily varies from society to society in relation to the acceptable 'error' or 'miss' rates and the associated costs of achieving specific performance levels. Most studies indicate that performance levels with photographic systems are at least as good as or better than those of examinations by physicians and health care providers other than experienced retina specialists (75). Sufficient evidence therefore exsts that different societies and countres can adopt different technical performance standards and thus use different techniques. Some will want to do everything possible to avoid misclassification and thus use dilated seven-field photography, while others will adopt the seemingly opposite approach of using a single-field photograph through an...

Hazard Identification

Studies on the effects of L-histidine on taste and smell acuity in humans have produced conflicting results. Henkin and coworkers (1975) reported decreased taste and smell acuity in six patients given 8 to 65 g of histidine d for up to 24 days. In view of the increased urinary excretion of zinc and a decreased concentration of serum zinc, the authors postulated that the effects of histidine administration were due to a zinc-deficient state. In a study of eight healthy men given 4 g d of histidine for 2 weeks, no effects on smell or taste acuity were reported (Schechter and Prakash, 1979). Similarly, Geliebter and coworkers (1981) failed to find any effect of L-histidine on taste and smell after oral dosing of L-histidine between 24 and 64 g d for 4 weeks. Even at the lower dose (4 g d), adverse effects such as headaches, weakness, drowsiness, and nausea were reported, while at the highest doses (24 and 64 g d) anorexia, painful sensations in the eyes, and changes in visual acuity were...

Preventing Diabetic Complications

As quercetin has been shown to inhibit aldose reductase, the first enzyme in the polyol pathway, a theoretical basis exists for its use in the prevention of long-term diabetic complications such as cataracts, nephropathy, retinopathy and neuropathy (Chaudhry et al 1983). Quercetin may also provide beneficial effects in people with diabetes by decreasing oxidative stress and preserving pancreatic beta-cell integrity (Coskun et al 2005).

NickE Goeders Revised by Nicholas DeMartinis

Culturally approved non-medical psychoactive drugs include alcohol, nicotine (tobacco), and caffeine. Psychoactive drugs that have been determined to have a high potential for harm and little medical benefit include heroin, hallucinogens, and some older sedative-hypnotics such as methaqualone. Marijuana has traditionally been placed in this category, but recent research has demonstrated potential effectiveness for medical problems including glaucoma, nausea, and weight loss associated with cancer or AIDS.

Case Conceptualization

A representative chain analysis of events surrounding C. N.'s self-injury is as follows Her mother made a demand with which C. N. did not want to comply and about which she then felt guilty. She then argued with her boyfriend, while he was drunk, about his failure to meet her needs and about his alcohol use. Because her boyfriend did not exhibit any reaction, C. N. first felt hurt, unacknowledged, and powerless, then intense rage. She was physically violent toward her boyfriend (punching his face, slamming his head into the ground, kicking him, purposely breaking his eyeglasses), and he did not fight back. She then felt intense guilt and told herself that she was just like her physically abusive mother. C. N. then took sedatives to escape her feelings of guilt. As a consequence, she then stayed in bed and missed several days of work due to fatigue and depression associated with drug use. Another consequence was that her boyfriend then spent time with her cleaning up and repairing...

Use of photographic systems by nonphysician nonprofessional providers

The use of non-physician health care professional examiners for detecting diabetic retinopathy has been coupled with use of photographic systems in the United Kingdom (84,85). The performance of trained photographic readers using a Polaroid camera system has matched or exceeded that of physicians and optometrcs. An accuracy of more than 90 in staging retinopathy has been reported with a modified Early Treatment Diabetic Retinopathy Study system that is similar to the International Clinical Diabetic Retinopathy system used by the American Academy of Ophthalmology and the International Council of Ophthalmology Use by ancillary health care workers (and physicians) of a reference card or set of photographs in grading the severity of disease has been validated in the care of trachoma and other eye diseases, such as with the WHO trachoma grading card and primary eye care chart. The principle has also been used in numerous randomized controlled trals to achieve consistency in grading the...

National Association for the Visually Handicapped

The only nonprofit health agency in the world solely dedicated to providing assistance to those with partial vision loss (the hard of seeing). The association works with millions of people worldwide coping with difficulties of vision impairment and providing anything from large-print books to the latest information on a particular condition.

Necrotizing enterocolitis

Often young nearsighted children do not realize that they have a visual problem. Symptoms include squinting, holding the head at an unusual angle, eye rubbing, sitting too close to the Tv, and clumsiness. Many parents do not notice the problem until the child starts school, when it quickly becomes apparent that there are problems in seeing the blackboard. Many parents first discover a problem during a school vision screening. Correction for nearsightedness includes wearing glasses or contact lenses. Because a child's eyes grow and change quickly during the first seven years of life, youngsters this age may need vision checks every six months. Because contact lens require more difficult care, they are rarely prescribed for young children.

Safety Concerns Regarding Cardivascular Gene Therapy

It is theoretically possible that VEGF may exacerbate pro-liferative and or hemorrhagic retinopathy in patients with diabetes in view of the high VEGF levels demonstrated in the ocular fluid of patients with active proliferative retinopathy leading to loss of vision (109). To date, this adverse effect of therapeutic angiogenesis has not been observed. The local delivery of naked plasmid DNA encoding for VEGF-1 or VEGF-2 to more than 100 patients (one-third with diabetes and remote retinopathy) treated at our institution with up to 4-year follow-up did not effect the visual acuity or fundoscopic findings as evidenced by serial funduscopic examinations pre-and post gene transfer by an independent group of retinal specialists.

What is diabetic retinopathy

Diabetic retinopathy is damage to the eye that results from chronically untreated or inadequately treated high blood sugar. In its more advanced form, it can result in severe visual loss or blindness if untreated, and this can occur suddenly without warning. It is the leading cause of blindness in working age adults in the United States and more than 20,000 people become blind as a result of diabetes each year. In order to prevent this, all people with diabetes should periodically be screened with an eye exam or photography of the Although it has clearly been shown that the rate of progression of diabetic retinopathy is related to the control of the blood sugar, there are several other factors involved. There is a hereditary tendency, so that if a close relative with diabetes developed retinopathy, you are more likely to do so. You should inform your eye doctor, who will be especially vigilant. Control of blood pressure has been shown to delay worsening of retinopathy and control of...

Dietary Guidelines for Health Function and Disease Prevention

The additional susceptibility of older persons to chronic degenerative diseases makes adherence to these healthful dietary patterns, throughout the periods in the life span preceding the older years, more relevant. Recent epidemiological research has shown that compliance or behavior concordant with healthy eating guidelines are associated with lower later life incidences of certain cancers, cataracts, diabetes, hypertension, stroke, and cardiovascular diseases, as well as overall survival. There is intense interest in whether and how diet and nutrition influence the maintenance of cognitive function with aging.

Side Effects of Corticosteroids

The side effects of corticosteroids are numerous and very common. They include Cushing's syndrome, fluid retention, increased appetite and weight gain, truncal obesity (skinny arms and legs but increased fat on back and stomach), moon face (fat cheeks), stretch marks, acne, growth retardation, bone-weakening calcium loss, avascular necrosis, muscle weakness, poor blood sugar control (diabetes), cataracts, increased intraocular pressure, increased infections, oral and vaginal thrush, atherosclerosis, extra hair growth, and mood changes. In addition to these common side effects, corticosteroids also may cause high blood pressure, inflammation of the pancreas, and pseudotumor cerebrae (increased pressure in the brain, associated with severe headaches and visual problems).

Appropriate followup intervals

Once diabetes mellitus has been diagnosed and patients have had an initial eye assessment, of any kind, they must continue eye care. As there is no cure for diabetes mellitus, prevention of vsion loss requires regular examinations. Nevertheless, there are significant problems in ensurng appropriate follow-up. The shortfall in efforts to ensure approprate follow-up is illustrated by studies showing that only 68-85 of patients referred for treatment start the treatment, and only 85 who start treatment compete it (43-45), indicating that 28-42 of patients who are referred for treatment do not receive the necessary care. The fact that over 40 of patients with diabetes who are referred for treatment do not actually compete it has not been addressed in educational and intervention programmes. Merely concentrating on ensurng that patients are examined (and that those examinations are accurate) is not sufficient. In 1989, Olsen, Kassoff & Gerber (95) reported the results of a survey of...

Regulatorypolicy Issues

Inarguably, ephedra is a drug with pharamacological actions that mirror the clinical effects of pharmaceutical grades of ephedrine, pseudo-ephedrine, and phenylpropanolamine. The prior classification of ephedra as a nutritional product was inappropriate and potentially dangerous to consumers who view such products as the same as multivitamin or mineral supplements. Because of their easy availability on health food and drugstore shelves and via the Internet, many ephedra products were used without consultation with a physician or pharmacist. Some consumers may have underlying diseases, whether known or unknown, that can be exacerbated by the sympathomimetic actions of ephedra alkaloids, such as the relatively common conditions of hypertension, diabetes, hyperthyroidism, psychiatric and seizure disorders, coronary and cerebral artery disease, renal dysfunction, glaucoma, and prostatic hypertrophy. In fact, many of these conditions are comorbidities of obesity, which is one of the...

Longterm side effects

The transplant center was very clear about all of the potential problems. That was good, for it prepared me. My attitude is watch for them, hope they don't happen, but if they do, then live with them. JaNette has lost about 50 percent of her lung capacity, probably from the radiation. She has to do daily treatments to keep her lungs from tightening up. She still is on cyclosporin one-and-a-half years later and flares up with the GVHD rash periodically. She can no longer tolerate gamma globulin, so her counts go down sometimes and she gets pneumonia. I know that she may get cataracts, develop heart problems, and many other things. But she had an easy time with the transplant, she's a happy third-grader, she's alive, and we feel so, so very lucky.

Problems with the eyes

Some children treated with total body radiation develop cataracts. How the radiation is administered affects the childs chance of developing this complication. If the total body radiation (TBI) is given in one dose, approximately 80 percent of children develop cataracts. If the TBI is given in smaller doses over several days (fractionated), the chance of developing cataracts is much lower (20 percent). Almost all protocols now use fractionated TBI. My 8-year-old daughter is six years out from the full body radiation used to prepare her for bone marrow transplant. She had the first of two cataract surgeries Tuesday. It was an outpatient procedure, and she was a real trooper. The doctor was able to insert a permanent replacement lens, which is a good thing since it means we don't have to do the contact lens thing. I can't wait for the day when radiation is no longer a treatment for cancer Until then I have to acknowledge begrudging thanks, because it saved my baby's life.

Laser Optical Coherence Tomography LOCT

LOCT is a noninvasive, noncontact imaging technique that produces highresolution longitudinal cross-sectional tomographs of ocular structures in real time, consequently facilitating more precise diagnoses. LOCT has been well documented as an imaging diagnosis in the early detection of glaucoma.22,23 It is also a valuable technique in the evaluation and treatment of patients with retinal disease,24,25 particularly certain macular abnormalities such as cysts, holes, pseudoholes, and puckering. Before LOCT, more limited tools (i.e., clinical examination and fluorescence angiography) were available to evaluate During the routine LCD selection process in 2003, the medical policy team weighed the options of combining individual state-specific policies on LOCT and policy retirement, because contractors need to periodically review existing LCDs to determine whether they are achieving their objectives of high-quality adjudication of claims. After consultations with both general...

Principles in assessing methods of care

Secondly for evaluation, the performance of the system relative to that of the gold standard must be known, so that the trade-offs can be identified. In the case of diabetic retinopathy the practice guidelines of the International Council of Ophthalmology (52) and the American Academy of Ophthalmology (50) prescrbe observation by a trained, experienced observer or a full seven-field photographic interpretation according to the standards of the Wisconsin Reading Center as the gold standard. Thus, any study of the value of a system, such as remote telemedicine care in diabetic retinopathy, must establish its performance and reliability relative to either of these gold standards. Nevertheless, no system is perfect at the outset. I a new approach offers added advantages, such as better access to care, reaching more people with diabetes at a lower unit cost, then a level of technical performance that is at least as good as (or perhaps lower than) current care even i not up to the gold...

The Lamp of Your Body

Does bright light bother your eyes Eat less sugar and eat more cucumbers. Trouble driving at night Eat more carrots. Are your eyes dry Potassium will help. Are cataracts blurring your vision Have your calcium and phosphorus level checked by your healthcare provider. The ratio should be ten parts calcium to four parts phosphorous. An imbalance with excessive calcium may result in a cloudy lens. We encourage eating grains and protein to lower the calcium. Eat whole foods.

Eyes Windows to the Soul

Are you bothered by spots or floaters in front of your eyes Commonly called vitreous floaters, these annoying events are often self-correcting by adding one organic carrot, raw or grated, on your mixed green salad. overworked and stressed livers are the storage house of the fat soluble vitamin A that is critical for proper eye health. Minimize toxic foods and beverages that promote liver stress. Have your healthcare physician rule out any other cause for peace of mind. And then enjoy your new level of health.

Agenda purpose and expected outcome

Issues in eye care in diabetics Eye care deficiencies contributing to blindness from diabetic retinopathy Improving integration of eye care within diabetes management Training of general practitioners in diabetic retinopathy detection Detection and referral within diabetes care clinics Detection within eye care clinics (prmary, secondary tertiary) Community-based screening modes Identify core diabetic retinopathy related eye health education messages for integration with diabetes patient education materials.

Different Perspectives On Living With An Illness

Although I am in excellent general health (with a little arthritis), I have had a few bumps and bruises along the sugar road. In 1975, I went through a rather scary time with proliferative retinopathy. Lasers were still very new and technology was minimal. Luckily, I found a healer in Dr. Charles Campbell at the Harkness Eye Institute at Columbia Presbyterian Hospital in New York City. He saved my eyes. I have met many physicians over the years, but only a few I consider healers. Dr. Campbell was the first. As a result of all the powerful laser and cryotherapies when I was diagnosed, along with good diabetes management, my eyesight still serves me well today. There are a few reminders left such as poor night vision, poor left peripheral vision, and shaky depth perception. These things, though, are a small price to pay and a petty inconvenience. causing pain and complications with my everyday living. Just as I enter my 50th year of living with diabetes, I have had a major complication...

Improvement Knowledge

The health care system has an aim to improve the health of the patients it serves. This care is made through several processes, such as diagnostic services, assessments, plans of care, and delivery of care at the ward or in the clinic. All these processes include many steps that need to be analyzed and understood in greater detail before we plan to change and redesign processes for improved performance and outcomes. The clinical microsystems are the essential building blocks of the larger health care systems. The microsystem is the local context where patients and families, health care teams, support staff, information, and processes meet to provide care for a particular group of patients. In a pediatric hospital there are many microsystems, such as allergy, rheumatology, and diabetes clinics, neonatal intensive care units, and units for infectious disease. These different microsystems will interact horizontally with each other in planned and unplanned ways. A rheumatology patient,...

Visual Anatomy and Physiology

The visual field is represented in an orderly manner along the surface extent of the striate cortex with more space allocated for central than for peripheral vision. Each cell in the striate cortex is sensitive to a relatively small region of the visual field, the receptive field area of the cell. By virtue of elaborate excitatory and inhibitory connections, the input from the lateral geniculate nucleus is reorganized are common. Each cell discharges optimally when an eye movement of a certain direction and amplitude is executed each region in the colliculus represents different directions and amplitudes of eye movements arranged in an orderly fashion. Electrical stimulation elicits saccadic eye movements with very low currents. The superior colliculus plays a central role in the generation of saccadic eye movements. However, several other structures, including regions in the occipital and parietal lobes, the frontal eye fields, and the medial eye fields in the frontal lobe also...