Tag Archives: Eye

Retinoblastoma

Definition:
Retinoblastoma is an eye cancer that begins in the retina — the sensitive lining on the inside of your eye. Retinoblastoma most commonly affects young children, but can rarely occur in adults.
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Our retina is made up of nerve tissue that senses light as it comes through the front of your eye. The retina sends signals through your optic nerve to your brain, where these signals are interpreted as images.

A rare form of eye cancer, retinoblastoma is the most common form of cancer affecting the eye in children. Retinoblastoma may occur in one or both eyes.

In the developed world, Rb has one of the best cure rates of all childhood cancers (95-98%), with more than nine out of every ten sufferers surviving into adulthood.

Retinoblastoma is rare and affects approximately 1 in 15,000 live births. In the UK, around 40 to 50 new cases are diagnosed each year.

Most children are diagnosed before the age of five years old. In the UK, bilateral cases usually present within the first year with the average age at diagnosis being 9 months. Diagnosis of unilateral cases peaks between 24 and 30 months.

Classification:
There are two forms of the disease; a heritable form and non-heritable form (all cancers are considered genetic in that mutations of the genome are required for their development, but this does not imply that they are heritable, or transmitted to offspring). Approximately 55% of children with Rb have the non-heritable form. If there is no history of the disease within the family, the disease is labeled “sporadic”, but this does not necessarily indicate that it is the non-heritable form.

In about two thirds of cases,  only one eye is affected (unilateral retinoblastoma); in the other third, tumours develop in both eyes (bilateral retinoblastoma). The number and size of tumours on each eye may vary. In certain cases, the pineal gland is also affected (trilateral retinoblastoma). The position, size and quantity of tumours are considered when choosing the type of treatment for the disease.

Symptoms:
The most common and obvious sign of retinoblastoma is an abnormal appearance of the pupil, leukocoria. Other less common and less specific signs and symptoms are: deterioration of vision, a red and irritated eye, faltering growth or delayed development. Some children with retinoblastoma can develop a squint, commonly referred to as “cross-eyed” or “wall-eyed” (strabismus). Retinoblastoma presents with advanced disease in developing countries and eye enlargement is a common finding.

Depending on the position of the tumors, they may be visible during a simple eye exam using an ophthalmoscope to look through the pupil. A positive diagnosis is usually made only with an examination under anesthetic (EUA). A white eye reflection is not always a positive indication of retinoblastoma and can be caused by light being reflected badly or by other conditions such as Coats’s Disease.

In a photograph, the photographic fault red eye may be a sign of retinoblastoma, if in the photograph it is in one eye and not in the other eye. A more clear sign is “white eye” or “cat’s eye”.

The child’s vision may also start to deteriorate and the eye may become  inflamed and sometimes painful.

In two-thirds of cases the cancer is unilateral (affecting one eye). In the rest it’s bilateral.

In 95 per cent of children, the tumour develops before the age of five. Occasionally, babies are born with a retinoblastoma. There’s an increased risk of developing other tumours later in life.

Causes:
Cause of retinoblastomaIn children with the heritable genetic form of retinoblastoma there is a mutation on chromosome 13, called the RB1 gene.The genetic codes found in chromosomes control the way in which cells grow and develop within the body.  If a portion of the code is missing or altered (mutation) a cancer may develop.

The defective RB1 gene can be inherited from either parent; in some children, however, the mutation occurs in the early stages of fetal development. It is unknown what causes the gene abnormality; it is most likely to be a random mistake during the copy process which occurs when a cell divides.

Inherited forms of retinoblastomas are more likely to be bilateral; in addition, they may be associated with pinealoblastoma (also known as trilateral retinoblastoma) with a dismal outcome. The genetic codes found in chromosomes control the way in which cells grow and develop within the body.

Several methods have been developed to detect the RB1 gene mutations.  Attempts to correlate gene mutations to the stage at presentation have not shown convincing evidence of a correlation

Complications:
Recurrent retinoblastoma
Children treated for retinoblastoma have a risk of cancer returning in and around the treated eye. For this reason, your child’s doctor will schedule follow-up exams to check for recurrent retinoblastoma. The doctor may design a personalized follow-up exam schedule for your child. In most cases, this will likely involve eye exams every few months for the first few years after retinoblastoma treatment ends.

Additionally, children with the inherited form of retinoblastoma have an increased risk of developing other types of cancers in any part of the body in the years after treatment. For this reason, children with inherited retinoblastoma require long-term follow-up with a cancer doctor (oncologist).

Diagnosis:
Tests and procedures used to diagnose retinoblastoma include:

*Eye exam. A doctor who specializes in diagnosing and treating diseases of the eye (ophthalmologist) will likely conduct an eye exam to determine what’s causing your child’s signs and symptoms. For a more thorough exam, the doctor may recommend using anesthetics to keep your child still.

*Imaging tests. Scans and other imaging tests can help your child’s doctor determine whether retinoblastoma has grown to affect other structures around the eye. Imaging tests may include ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI), among others.

*Consulting with other doctors. Your child’s doctor may refer you to other specialists, such as a doctor who specializes in treating cancer (oncologist), a genetic counselor or a surgeon.

Treatment:
Treatment of retinoblastoma varies from country to country.  The first priority is to preserve the life of the child, then to preserve the vision and thirdly to minimize any complications or side effects of the treatment. The exact course of treatment will depend on the individual case and will be decided by the ophthalmologist in discussion with the paediatric oncologist.

Many treatment options exist, including chemotherapy (administered locally via a thin catheter threaded through the groin, through the aorta and the neck, into the optic vessels), cryotherapy, radioactive plaques, laser therapy, external beam radiotherapy and surgical removal of the eyeball.  Any combinations of these treatments may be adopted.

In recent years, there has been an effort to find alternatives to enucleation and radiation therapy.

Prognosis;
Treatment for retinoblastoma has one of the highest success rates of all childhood cancers – nine out of ten children can be cured.

Prevention:
In most cases, doctors aren’t sure what causes retinoblastoma, so there’s no proven way to prevent the disease.

Prevention for families with inherited retinoblastoma
In families with the inherited form of retinoblastoma, preventing retinoblastoma may not be possible. However, genetic testing enables families to know which children have an increased risk of retinoblastoma, so eye exams can begin at an early age. That way, retinoblastoma may be diagnosed very early — when the tumor is small and a chance for a cure and preservation of vision is still possible.

If your doctor determines that your child’s retinoblastoma was caused by an inherited genetic mutation, your family may be referred to a genetic counselor.

Genetic testing can be used to determine whether:

*Your child with retinoblastoma is at risk of other related cancers
*Your other children are at risk of retinoblastoma and other related cancers, so they can start eye exams at an early age
*You and your partner have the possibility of passing the genetic mutation on to future children

The genetic counselor can discuss the risks and benefits of genetic testing and help you decide whether you, your partner or your other children will be tested for the genetic mutation.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/cancer/retinoblastoma1.shtml
http://en.wikipedia.org/wiki/Retinoblastoma
http://www.mayoclinic.com/health/retinoblastoma/DS00786
http://trialx.com/curebyte/2011/06/02/retinoblastoma-photos-and-a-listing-of-clinical-trials/

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Ways to Improve Your Eyesight

Yahoo Health has collected some tips you can use to sharpen your vision. Here are some of them:
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1. Eat Right
Vitamins A, C, E, and minerals like copper and zinc are essential to eyesight. Antioxidants protect your macula from sun damage, and foods rich in sulfur, cysteine, and lecithin help protect the lens of your eye from cataract formation. The omega-3 fat DHA provides structural support to cell membranes that boost eye health.

2. Limit Environmental Toxins
External factors that contribute to eye damage include fluorescent lights, computer screens, environmental allergens, and chlorine in swimming pools.

3. Sleep
Getting enough sleep is essential for eye health. Sleep time allows your eyes to fully rest, repair, and recover.

You may click & see more :

Source: Yahoo Health May 20,2011

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Erythrasma

Definition:
Erythrasma is a bacterial infection caused by the bacteria Corynebacterium minutissimum. It occurs most often between the third and fourth toes, but it can also frequently be found in the groin, armpits, and under the breasts. Because of it’s color and location, it’s often confused with a fungal infection like jock itch. Erythrasma is more common in the following populations:

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It is prevalent among diabetics, the obese,elderly, and People in warm, moist climates   and is worsened by wearing occlusive clothing.

Symptoms:
The main symptoms are reddish-brown slightly scaly patches with sharp borders. The patches occur in moist areas such as the groin, armpit, and skin folds. They may itch slightly and often look like patches associated with other fungal infections, such as ringworm.

Erythrasmic patches are typically found in intertriginous areas (skin fold areas – e.g. armpit, groin, under breast) – with the toe web-spaces being most commonly involved.

The patient is commonly otherwise asymptomatic.

Causes:
Erythrasma is caused by the bacteria Corynebacterium minutissimum.

Erythrasma is more common in warm climates. You are more likely to develop this condition if you are overweight or have diabetes.

The patches of erythrasma are initially pink, but progress quickly to become brown and scaly (as skin starts to shed).

Diagnosis:
At times, your doctor can diagnose erythrasma based on its typical appearance. But more often, your doctor will need to perform other tests to help make the diagnosis. The best way for your doctor to tell the difference between erythrasma and a fungal infection is to do a Wood’s Lamp examination on the rash. Under the UV light of a Woods Lamp, erythrasma turns a bright coral red, but fungal infections do not.

Other tests that may help include:
*A simple side-room investigation with a Wood’s lamp:It is additionally useful in diagnosing erythrasma. The ultraviolet light of a Wood’s lamp causes the organism to fluoresce a coral red color, differentiating it from fungal infections and other skin conditions.

•Gram Stain: A way to identify bacteria from a sample of the scale. Unfortunately, this bacteria is difficult to get to stick to the slide so it requires a special technique.

•KOH Test: This is a test used to identify fungal elements. This test might be done to confirm that there is no fungus present.

•Skin Biopsy: A sample of tissue is removed and evaluated under a microscope. In erythrasma, the bacteria can be seen in the upper layer of the specimen.

Treatment:
Since this is a bacterial infection, erythrasma is best treated with antibiotics, and fortunately several antibiotics fit the bill.

The following are antibiotics that are typically prescribed for erythrasma:
•Erythromycin 250mg four times a day for 5 days
•Clarithromycin 1gm once
•The antifungal creams miconazole, clotrimazole and econazole, but not ketoconazole
•Topical antibiotics like clindamycin or erythromycin twice a day for 2 weeks

Gently scrubbing the skin patches with antibacterial soap may help them go away.

Prognosis:
Complete recovery is expected following treatment.

Prevention:
These measures may reduce the risk of erythrasma:

•Maintaining good hygiene
•Keeping the skin dry
•Wearing clean, absorbent clothing
•Avoiding excessive heat or moisture
•Maintaining healthy body weight

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/erythrasma1.shtml
http://en.wikipedia.org/wiki/Erythrasma
http://www.nlm.nih.gov/medlineplus/ency/article/001470.htm
http://dermatology.about.com/od/infectionbacteria/a/erythrasma.htm

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Ectropion and Entropion

Definitions:

Ectropion:If the lower eyelid turns outwards, it starts to hang away from the eyeball and forms a small bucket or pocket.

This may not cause any problems. But as tears collect, the bucket overflows and the lower eyes may water constantly.

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In contrast, the middle part of the eyeball becomes exposed, dry and irritated, which may allow recurrent infections to occur.

When ectropion is due to ageing, usually both eyes are affected. If only one is affected, this may be the result of scarring on the eyelid or upper cheek. As this scar heals and tightens it tugs at the lower eyelid, pulling it down.

Ectropion can also occur when the nerve supplying the lower eyelid muscle has been damaged, causing the muscle to be paralysed.
Ectropion is also found in dogs as a genetic disorder in certain breeds.

Causes:
*Congenital
*Aging
*Scarring
*Mechanical
*Allergic
*Facial nerve palsy
*Anti-cancer treatments such as erlotinib, cetuximab, and panitumumab, which block the function of EGFR (the epidermal growth factor receptor).

Ectropion in dogs:…. CLICK & SEE
Ectropion in dogs usually involves the lower eyelid. Often the condition has no symptoms, but tearing and conjunctivitis may be seen. Breeds associated with ectropion include the Cocker Spaniel, the Saint Bernard, the Bloodhound, and the Basset Hound. It can also result from trauma or nerve damage. Treatment (surgery) is only recommended if there is chronic conjunctivitis or if there is corneal damage. A small part of the affected lid is removed and then the lid is sewn back together.

Entropion :When the upper, lower or both eyelids turn inwards, the eyelashes can rub against the eyeball. This irritates the eye, which can feel painful and watery. Damage to the cornea, the clear front part of the eye, may cause an ulcer to develop that can lead to loss of vision if not treated.
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Entropion usually occurs as a consequence of the ageing process. In developing countries, however, infection affecting the inner surface of the eyelid is a relatively common cause. When this heals, it can leave scar tissue that pulls the outer border of the eyelid inwards.

In a condition called trichiasis, the eyelashes grow inwards, causing identical problems to entropion.

Symptoms:
*Redness and pain around the eye
*Sensitivity to light and wind
*Sagging skin around the eye
*Excessive tearing
*Decreased vision, especially if the cornea is damaged

Causes:
*Congenital
*Aging
*Scarring
*Spasm

Entropion in dogs……..CLICK & SEE
Entropion has been documented in most dog breeds, although there are some breeds (particularly purebreds) that are more commonly affected than others. These include the Akita, Pug, Chow Chow, Shar Pei, St. Bernard, Cocker Spaniel, Boxer, Springer Spaniel, Labrador Retriever, Cavalier King Charles Spaniel, Neapolitan Mastiff, Bull Mastiff, Great Dane, Irish Setter, Shiba Inu , Rottweiler, Poodle and particularly Bloodhound. The condition is usually present by six months of age. Entropion can also occur secondary to pain in the eye, scarring of the eyelid, or nerve damage. The upper or lower eyelid can be involved, and one or both eyes may be affected. When entropion occurs in both eyes, this is known as “bilateral entropion.”

Upper lid entropion involves the eyelashes rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye. Surgical correction is used in more severe cases. A strip of skin and orbicularis oculi muscle are removed parallel to the affected portion of the lid and then the skin is sutured. Shar Peis, who often are affected as young as two or three weeks old, respond well to temporary eyelid tacking. The entropion is often corrected after three to four weeks, and the sutures are removed.

Treatment:
Daily eye cleansing with boiled water that’s been allowed to cool, or with an eye wash solution from the pharmacist, can help to keep the eye clean and soothe any symptoms of irritation and soreness. Any infection can be easily treated with antibiotic drops or ointment.

It’s possible to have a minor operation on the eyelid to tighten the skin and muscles. The sooner this is done the better, to avoid further damage to the eye. You may be advised to tape the eye closed to protect it until surgery is performed.

The operation is usually done as a day case under local anaesthetic.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Ectropion
http://en.wikipedia.org/wiki/Entropion
http://www.bbc.co.uk/health/physical_health/conditions/entropion1.shtml
http://www.cosmeticeyelids.com/wea-gallery_ectropion.htm
http://www.eyeplasticsurgery.net/patientinfo/entropion.html

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Eyes are Unique Window to Predict Diseases

Looking people straight in the eye may or may not reveal their honesty — but the eyes *can* tell you about cholesterol, liver disease, or diabetes, if you know what to look for.

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Your eyes are a unique window into health. Yahoo Health has assembled a list of 14 things your eyes can tell you about your entire body.
Some of them are mentioned below:-

*Disappearing eyebrows : When the outer third of your eyebrow starts to disappear on its own, this is a common sign of thyroid disease.

*A stye that won’t go away : If it doesn’t clear up in three months, or keeps recurring in the same location, it could be a rare cancer called sebaceous gland carcinoma.

*Burning eyes, blurry vision while using a computer : This is the result of “computer vision syndrome” (CVS). The eyestrain is partly caused by the lack of contrast on a computer screen, and the extra work involved in focusing on pixels.

*A small blind spot in your vision, with shimmering lights or a wavy line : A migraine aura produces this disturbed vision. It may or may not be accompanied by a headache.

*Whites of the eye turned yellowish : This is known as jaundice. It appears in either newborns with immature liver function, or adults with problems of the liver, gallbladder, or bile ducts.

*Eyes that seem to bulge : The most common cause of protruding eyes is hyperthyroidism, which is overactivity of the thyroid gland.

*Sudden double vision, dim vision, or loss of vision : These are the visual warning signs of stroke.

*Blurred vision in a diabetic : Diabetics are at increased risk for several eye problems, but the most common is diabetic retinopathy, in which diabetes affects the circulatory system of the eye. It’s the leading cause of blindness in American adults.

For the rest of the list, click on the link below.

Sources: Yahoo Health February 3, 2011

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