Orthokeratology uses rigid gas permeable contact lenses worn overnight to temporarily reshape the cornea and reduce or eliminate low to moderate degrees of myopia and astigmatism. The lenses have a molding effect on the cornea through epithelial redistribution, allowing patients to be correction-free during the day. However, the effect is not permanent and vision returns to the pre-treatment level if lenses are not worn. Ortho-k treatment generally takes one month for effects to stabilize and is most effective for prescriptions between -1.00 to -4.50 diopters of myopia and up to -1.50 diopters of astigmatism.
Scleral lens is a large rigid contact lens with a diameter range of 15mm to 25mm. Its resting point is beyond the
corneal borders, and are believed to be among the best vision correction options for irregular corneas. Wearing scleral lens also can postpone or even prevent surgical intervention as well as decrease the risk of corneal scarring.
Scleral lens is a large rigid contact lens with a diameter range of 15mm to 25mm. Its resting point is beyond the
corneal borders, and are believed to be among the best vision correction options for irregular corneas. Wearing scleral lens also can postpone or even prevent surgical intervention as well as decrease the risk of corneal scarring.
Contact lens for congenital aphakia and other eye conditions for infants and toddlers. The slide presentation encompasses indications for CL fitting in paediatric, contact lens options, fitting techniques, challenges and contact lens as myopia control.
Scleral contact lenses , types, uses in various ocular conditions.
An in-depth and unbiased details of these lenses as a therapeutic and also as a drug - delivery system in modern ophthalmology.
A must read for all Ophthalmologists and Optometrists.
Contact lens for congenital aphakia and other eye conditions for infants and toddlers. The slide presentation encompasses indications for CL fitting in paediatric, contact lens options, fitting techniques, challenges and contact lens as myopia control.
Scleral contact lenses , types, uses in various ocular conditions.
An in-depth and unbiased details of these lenses as a therapeutic and also as a drug - delivery system in modern ophthalmology.
A must read for all Ophthalmologists and Optometrists.
Amwell Eye Care Team and Dr. Adam Zhao together aim to protect vision in the community. We focus to achieve a comprehensive eye care approach using advanced technologies in the field of eye care. Our services include a complete eye examination and vision function. We are committed to offering professional and convenient eye care easy to access. Schedule an appointment with us to diagnose eye disease.
Are you looking for a revolutionary way to treat the vision? Orthokeratology is the best apt solution for you. Get the best Ortho-K NJ service at Amwell Eye Care under the supervision of the experienced and great doctors. Visit today!
Amwell Eye Care Team and Dr. Adam Zhao together aim to protect vision in the community. We focus to achieve a comprehensive eye care approach using advanced technologies in the field of eye care. Our services include a complete eye examination and vision function. We are committed to offering professional and convenient eye care easy to access. Schedule an appointment with us to diagnose eye disease.
Wake up to clear and sharp vision without the risk of surgery. Dr Adam Zhao at Amwell Eye Care is the top certified Ortho-K provider in NJ. Call today!
Amwell Eye Care Team and Dr. Adam Zhao together aim to protect vision in the community. We focus to achieve a comprehensive eye care approach using advanced technologies in the field of eye care. Our services include a complete eye examination and vision function. We are committed to offering professional and convenient eye care easy to access. Schedule an appointment with us to diagnose eye disease.
Eye care that is new to children, and adults. Find what optometrists are doing that is new using the latest technology in vision care. Freedom from glasses and contacts in the daytime. Look and feel great!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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2. Orthokeratology (often abbreviated to ortho-k) is the use of
specifically designed rigid gas permeable contact lenses to alter
the shape of the cornea in order to reduce or eliminate low to
moderate degrees of myopia and astigmatism. Ortho-k lenses are
worn at night and then removed in the morning. This makes them
especially suitable for people working in dusty atmospheres or
taking part in activities such as water or contact sports. There is
also increasing interest in the potential use of the technique in
reducing myopic progression in young patients.
The lenses have a moulding effect on the cornea by a process of
epithelial redistribution. This is not permanent, hence the need for
nightly wear. If the lenses are left out, typically for two or three
consecutive nights depending on the original refractive error, the
original prescription returns.
3. It can take up to seven nights for the lenses to fully correct the refraction
and up to a month before the correction is stable for a useful period of
time. On average, 60-70 per cent of the correction is achieved after the
first night of wear; however, some people are more successful
with ortho-k lenses than others.
As the effects of ortho-k lenses are fully reversible, they are a good
compromise for people considering corrective laser eye surgery but who
have reservations about the permanent change in corneal shape and
thickness. The patient is correction-free during the day and only wears
the lenses when sleeping, reducing the possible discomfort of dry eyes or
variable vision during the day. Most successful prescriptions tend to be
between -1.00DS and -4.50DS and up to -1.50DC, but it is also possible
to correct up to -6.00DS and, with specialist toric periphery ortho-k
lenses, up to -2.50DC.
4. Ortho-k patients tend to be loyal customers
because you are the eye care professional
who enabled them to have correction-free,
comfortable, clear vision during the day.
Furthermore, as a planned replacement
programme, practitioner and patient develop
a good rapport early on in the treatment
5. Ortho-k lenses are RGP lenses with a flat
central zone and a reverse geometry curve.
They have a similar shape to a post-Lasik
cornea (Figure 2).
6. The fitting and aftercare of ortho-k lenses requires a significant amount of chair
time, which the patient and practitioner must be prepared for. The patient must
understand what happens to their eyes while wearing the lenses and confirm full
compliance with the fitting and aftercare procedure. It is only through regular
wear of the lenses and reliable attendance of aftercare appointments that they
will achieve their desired freedom from correction during the day. You cannot
have part-time correction with ortho-k lenses – it is all or nothing. When the
lenses are not worn, the myopia will return.
Myopia is corrected during the night-time wearing of the lenses but, in the first
few days or weeks, the full correction may not be maintained for the whole day. It
is important that the patient does not have too high an expectation of the lenses
in the early days. However, there is usually a very positive response from the
patient when, after a few nights, they no longer have to wear an optical correction
for most of the day. The ‘wow’ effect may not be the same as an initial response
after Lasik, as the end point is reached in progressive steps. A 60-70 per cent
reduction in correction might be expected after the first night of wear, meaning a
-3.00DS myope may only require a -1.00DS correction after one night. During
these early days, the residual correction can easily be corrected with daily
disposable lenses.
7. The first fitting appointment should include a full history and symptoms (including medical, ocular and contact
lens wearing history), refraction, corneal radius measurements, topography and a slit lamp examination (with
obvious particular emphasis on the front surface of the eye with and without fluorescein). If the patient is
currently an RGP wearer, they should leave their lenses out for 10-15 days before the fitting appointment to
ensure the cornea has returned to its ‘original’ shape. Most practitioners recommend less so for soft lens
wearers.
The information from this initial appointment and the data collected should help to decide upon the suitability
of the patient for ortho-k fitting. It is also a useful time to make an initial judgement about how realistic the
patient expectations are and it is important at this stage to keep the patient informed of the exact nature of
the process and likely outcome – all supported with careful record-keeping of what has been recommended.
Below we outline the ideal fitting profile:
A 4-5mm diameter centrally flattened zone that is centred on the pupil to give good visual acuity and contrast
sensitivity in normal lighting conditions
A concentric, regular steep ring zone in the mid-peripheral cornea around the central zone. The more regular
the ring, the better the lens centration
A peripheral cornea whose geometry is unchanged
After the fitting appointment the following criteria should be considered as likely to be suitable for ortho-k:
Spherical prescription of between -0.75DS and -4.50DS.
Cylindrical prescription up to -1.25DC ‘with the rule’ or -0.75DC ‘against the rule’.
Astigmatic spectacle refraction should be the same as the corneal astigmatism. Like fitting RGP lenses, any
lenticular astigmatism may reduce the visual acuity and quality.
8. Higher levels of myopia might not be easily corrected
due to the initial corneal eccentricity and required
epithelial reformation requirement.
Larger pupils (notably with higher refractive error).
Very flat corneas (flatter than radii of 8.20mm).
Corneal irregularities – as might be caused by, for
example, keratoconus, dystrophies, pterygia.
Very dry eyes – keratoconjunctivitis sicca (rheumatoid
arthritis is a contraindication, as might be some tear-
affecting medications).
Poor re-epithelialisation rates (for example in diabetes
or with some medications).
9. High motivation to be correction-free (professional or
occupation demands, sport, leisure).
Requirements to take part in activities that are
affected by wearing glasses or contact lenses.
An interest in, but concerns about, refractive surgery.
Myopic progression, especially in younger children.
Success may also be improved if the patient has a full
understanding about how ortho-k works, shows good
compliance, and is willing to attend the frequent
aftercare appointments in the first few weeks and
later attend half-yearly aftercares. They should also
be familiar with the expectation of changing their
lenses at least once a year.
10. The lenses are individually made to the specifications required by each patient. When all the
required information has been received by the supplier they will calculate the parameters and
produce the lenses. In about 80 per cent of patients, the first lenses will be the correct fit and
provide the correction required. If the patient has been correctly selected and all the
measurements accurately taken, it is only necessary in a minority of cases that the lenses need
changing.
To order the lenses the following information is required:
Refraction.
Back vertex distance.
Central corneal radii.
Total eccentricity at 30 degrees.
Eccentricity in the four meridians at 30 degrees.
Horizontal and vertical corneal diameter.
Topography picture and the make and model of the keratographer used. Now you just need to
wait for the lenses to arrive.
Once the contact lens is delivered the patient is asked to take an appointment.
After the initial fit consecutive three reviews in a time period of two months is given.
Also the patient is asked to follow proper care for the contact lenses.
And the patient is advised to visit if there are any complications further.