This document discusses myopia (nearsightedness), including its definition, causes, risk factors, prevalence, and interventions to reduce progression. It notes that myopia is highly prevalent worldwide and is influenced by both genetic and environmental factors like education level, time spent outdoors, and ambient lighting exposure. Current interventions discussed include increasing time outdoors, pharmacological options like atropine, and optical treatments, but there remains no definitive approach to halt progression.
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
Pediatric Ophthalmic dispensing in different visual problemsRaju Kaiti
Pediatric dispensing, introduction, different from adult dispensing, frame selection, lens selection, special case fitting, Do's and Dont's, Measurements, Down's syndrome, albinism, aphakia, strabismus, syndromes
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
Pediatric Ophthalmic dispensing in different visual problemsRaju Kaiti
Pediatric dispensing, introduction, different from adult dispensing, frame selection, lens selection, special case fitting, Do's and Dont's, Measurements, Down's syndrome, albinism, aphakia, strabismus, syndromes
The presentation presents some treatment modalities as regards AI.This is to keep you thinking more on how to approach a case of AI in terms of management.
The presentation presents some treatment modalities as regards AI.This is to keep you thinking more on how to approach a case of AI in terms of management.
http://igolenses.co.uk
This short US paper reviews the evidence of clinical trials conducted to date where short-sighted children have undergone Overnight Vision Correction (OVC) treatment and tries to draw conclusions on the effectiveness of the treatment in slowing down or halting the further development of short-sightedness as well as in terms of the safety risks - if any - associated with OVC.
Myopia is considered to be a leading cause of visual impairment. Furthermore, the prevalence of myopia young adolescents has increased substantially over the
past few decades. Although myopia was identified more than two thousands years ago, a consistently effective approach to myopia control for all patients still eludes
clinicians
Clinical study of fundal changes in high myopiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
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Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
A lay forum lecture about digital eye strain, dry eye disease in children, myopia and stopping myopia, other refractive errors, common causes of eye consults, some eye myths, the truth about blue light filter in glasses, and a little bit about presbyopia and cataract for parents of Xavier School Nuvali, July 31, 2022
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Section 1: The worldwide problem of myopia and theories regarding its
development.
Section 2: Up to date interventions used to reduce the development and
progression of myopia.
3.
4. Five immediate priorities
Cataract
Trachoma
Onchocerciasis
Childhood blindness
Refractive errors and low vision
5.
6.
7. Myopia defined as > -1:
6 years old: 0.5%
12 years old: 5%
Lower in rural areas
8. Conclusion: Family history of myopia and myopia at younger age
were predictors for progressive myopia in teenaged Omani children
9. Cause
Refractive
Axial
Age of onset
▪ Childhood: <7 years
▪ Juvenile onset (a.k.a school myopia): 7-14 years
(progresses 0.5D per year)
▪ Adult onset: >20 years
10. Severity:
Myopia
High Myopia: Power > -6 or AL >26.5mm
Pathological myopia (aka. Degenerative): Power > -8 or AL >32.5mm
OR better:
Pathological myopia is high myopia accompanied by characteristic
degenerative changes in the sclera, choroid, and retinal pigment
epithelium, with compromised visual function. (Duke-Elder, 1970)
14. The most common eye disorder in the world that require
treatment
Refractive wear
Hospital visits to monitor or treat the disease and its sequelae
Causes a lot of visual disability/productivity
16. The process in the developing eye in which the refractive
power of the anterior segment and the axial length of the eye
adjust to reach emmetropia.
Ref: AAO BCSC2015 (volume No. 6 : Paediatric Ophthalmology
and Strabismus)
17.
18.
19. “if myopia presents before age 10
years, there is a higher risk of
eventual progression to myopia of
6.00 D or more”
20. Mild with the rule
astigmatism is normal.
However, not “against the
rule”
21. Visual acuity:
VEP studies show that 20/20 vision is reached as early as 6 months.
Preferential looking (PL) studies show that 20/20 is reached between 3-5
years.
Discrepancy is probably due to the higher cortical processing required for
the PL vision test
33. Having higher education/more intense education and living in the
city and is associated with higher prevalence of myopia.
WHY??
1) Near work especially close distance activities
What is living in the city got to do with myopia???
34.
35.
36.
37. Having higher education/more intense education and living in the city
and is associated with higher prevalence of myopia.
WHY??
1) Near work especially close distance activities
2) Decreased exposure to sunlight, high level ambient lighting.
38. - Twins studies
-
Up to date analysis of the genetic basis of myopia is divided into two clusters of mutations:
1) Mutations affecting the outer retinal layer involving the photoreceptors
2) Mutations affecting the scleral ECM.
However, it seems that studies show that the environmental factors are stronger in school
myopia
Both parents myopic 50%
One parent myopic 30%
Non 10%
(Morgan , 2012)
39. 1) Mechanical tension theory
2) Retinal blur (through
accommodative lag theory)
Brensten
et.al 2010
42. 2 RCTs underway
“Children who spend more
time outdoors are less likely
to be, or to become myopic,
irrespective of how much
near work they do, or
whether their parents are
myopic”
Uncertain if it reduces
progression
(French et al. 2013)
43. Atropine
Lowers progression
Not through blocking
accommodation
Side-effects: glare,
photophobia, reading blur,
rebound effect.
Similar results with less
side-effects: Low dose
atropine 0.01%,
pirenzepine.
44. Progressive additional &
peripheral hyperopic defocus
lenses: Little or no effect, and
effect is static
Orthokeratology: Reshaping
the cornea overnight.
However, effects might not be
sustained
Microbial keratitis!
45. Myopia is a huge public health problem
Genes and environmental factors (near work and reduced
outdoor time) are aetiological factors
Interventions:
Primary prevention: Increased time outdoors and reduce near work
Secondary prevention (reduce progression): Atropinization & ?optical
46. Ashby R, Ohlendorf A, Schaeffel F.The Effect of Ambient Illuminance on the Development of Deprivation Myopia in Chicks.
Investigative Ophthalmology &Visual Science 2009;50(11):5348-54.
Berntsen DA, Mutti DO, Zadnik K. Study ofTheories about Myopia Progression (STAMP) Design and Baseline Data. Optometry and
vision science : official publication of the American Academy of Optometry 2010;87(11):823-32.
Duke-Elder S, Abrams D. Pathological refractive errors. In: Duke-Elder S, ed. Systems of ophthalmology. St. Louise: Mosby, 1970
French AN, Ashby RS, Morgan IG, Rose KA.Time outdoors and the prevention of myopia. Experimental Eye Research 2013;114:58-68.
Holden BA, FrickeTR,Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global Prevalence of Myopia and High Myopia andTemporal
Trends from 2000 through 2050. Ophthalmology;123(5):1036-42.
Ip JM, Saw S-M, Rose KA, Morgan IG, Kifley A,Wang JJ, et al. Role of Near Work in Myopia: Findings in a Sample of Australian School
Children. Investigative Ophthalmology &Visual Science 2008;49(7):2903-10.
McBrien NA, Moghaddam HO, Reeder AP. Atropine reduces experimental myopia and eye enlargement via a nonaccommodative
mechanism. Invest Ophthalmol Vis Sci 1993;34(1):205-15.
McCarthy CS, Megaw P, Devadas M, Morgan IG. Dopaminergic agents affect the ability of brief periods of normal vision to prevent
form-deprivation myopia. Exp Eye Res 2007;84(1):100-7.
Morgan I, Rose K. How genetic is school myopia? Progress in Retinal and Eye Research 2005;24(1):1-38.
Morgan IG, Ohno-Matsui K, Saw S-M. Myopia. The Lancet 2012;379(9827):1739-48.
Moriyama M, Ohno-Matsui K, Hayashi K, Shimada N,YoshidaT,TokoroT, et al.Topographic analyses of shape of eyes with pathologic
myopia by high-resolution three-dimensional magnetic resonance imaging. Ophthalmology 2011;118(8):1626-37.
Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, SmithW, et al. Outdoor activity reduces the prevalence of myopia in children.
Ophthalmology 2008;115(8):1279-85.
Editor's Notes
I never thought that this topic is huge, tremendous amount of research, billions of dollars go into this.
I thought by this presentation, I can shed some light into this topic.
WHO Global magnitude of visual impairment caused by uncorrected refractive errors in 2004
Childhood mostly familial or associated with syndroms
Juvenile and adult onset is more associated with environmental
Posterior manifestation of pathological myopia:
Vitreous syneresis: Decrease in the collagen and hyaluronic acid.
Tilting of the optic disc
peripapillary chorioretinal atrophy
lacquer cracks-spontaneous ruptures of the elastic lamina of the Bruch membrane that appear yellowish white,
Isolated, round, deep subretinal hemorrhages that clear spontaneously and usually result from the occurrence or extension of a lacquer crack and not from CNV.
Forster- Fuchs spots-dark spots due to sub retinal or intraretinal RPE hyperplasia, Presumably developing in response to a small CNV that does not progress
Posterior staphyloma-localized ectasia of the sclera, choroid, and RPE
Elongation and atrophy of the ciliary body
Gyrate areas of atrophy of the RPE and choroid
Cystoid, paving-stone, and lattice degeneration
Thinning or hole formation in the peripheral retina
Thinning and rearrangement of the collagen layers of the sclera
CNV
Severely distorted shape
Posterior staphyl-omas are not common in highly myopic children, but the prevalence of staphyloma is high (80–90%) in highly myopic people over the age of 40 years
The axial length increases by approximately 4 mm in the first
6 months of life and by an additional2 mm during the next 6 months. During the second
(age 2 to 5 years) and third (age 5 to 13 years) phases, growth slows, with axial length
increasing by about 1 mm per phase.
Similarly, the cornea grows rapidly during the first year of life (Fig 15-2) . Keratometry values change markedly in the first year, starting at approximately 52.00 D at birth, flatten-ing to 46.00 D by age 6 months, and reaching adult measurements of 42.00- 44.00 D by age 12 Months.
Mild corneal clouding may be seen in healthy new-borns and is common in premature infants. It resolves as the cornea gradually thins, de-creasing from an average central thickness of 691um at 30- 32 weeks' gestation to 564 um at birth.
In general, eyes are hyperopic at birth, become slightly more hyperopic until age 7 years, and then experience a myopic shift toward plano until the eyes reach their adult dimensions, usually by about age 16 years.
Changes in refractive error vary widely, but if myopia presents before age 10 years, there is a higher risk of
eventual progression to myopia of 6.00 D or more.
6-7 years
15-24yrs
Like you lot!
So it does not seem to be accommodation as such, maybe close distance work.
Chicks occluded one eye. The occluded eyes were injected with……..
Results, atropine reduces AL by a non-accommodative mechanism.
Like you lot!
Placing a translucent diffuser over the eye of a chick causes the eye to grow excessively, resulting in form-deprivation myopia. For chickens kept on a 12:12 h light/dark cycle, removing the diffuser for 3 h during the light period protects against the excessive growth, but if the bird is kept in the dark for this 3-h period, the protective effect is abolished. Injecting dopamine agonists into the eye during this 3-h dark period restores the protective effect, which can be blocked by dopamine antagonists injected just prior to diffuser removal in the light. These responses are mediated by D2 receptors, suggesting that the protective effect of normal vision against form-deprivation is mediated through the stimulation of dopamine release and activation of D2-dopamine receptors.
ADTN is non-specific dopamine agonist.
Blurred vision or the inability to appropriately use blur cues initiates myopic progression.
Hyperopic defocus, where the conjugate point of the object of regard is behind the retina, is a putative stimulant to eye growth that moves the retina toward the conjugate point.
Hyperopic defocus is supported by animal model that if you put minus lenses in front of chicks eyes, the eye responds by increasing axial length.
The mechanical tension theory is supported by the distorted shape of the myopic eye.
Suggested that atropine acts of M4 muscrinic receptors
High: 0.5%
Medium: 0.1%
Low: 0.01%
Pirenzepine is a selective anti-muscrinic with little effect on pupil and accommodation.
Hyperopic defocus theory, peripherally without compromising central vision.
Orthokeratology: Myopic peripheral defocus: