... 5-18 years and 254 parents of children aged 2-18 years It was the mother who answered the questionnaire in 92.52% ofthe sample, and it was the father in 7.48% ofthe sample No parent in the patient ... questionnaire in 89.5% ofthe sample, it was the father in 4.57% ofthe sample, and it was someone else in 6.28% ofthe sample Distribution of all participants in terms of gender and age group is shown ... age range of children and adolescents from to 18 years of age The development, refinement and validation ofthe original instrument and linguistic validation to a number of European and other languages...
... degrees of clinician-reported symptom severity These findings demonstrate the clinical validity ofthe EAPIQ The EAPIQ scales correlated higher with the scales ofthe miniRQLQ than with the items of ... for the EAPIQ is warranted Use ofthe EAPIQ in future research may contribute to a greater understanding ofthe impact of ocular allergies on patients' lives and ultimately lead to the use of ... in the areas that are of greatest importance to the patients themselves Authors' contributions PB, JW CB and LA conceived the study and participated in the design ofthe study MA, WB, PB and...
... localization of CGD subtypes are shown in the bottom ofthe figure There are several components of NADPH oxidase: of these the cytochrome-b558 heterodimer is located in the membrane and consists ofthe ... to the subtypes, and severity ofthe associated macrophage defect [22] In the majority of patients, the production of superoxides is undetetectable andthe manifestations are therefore early and ... understand these immune interactions and predisposition to autoimmunity and infectious disease Diagnosis and Treatment The approach to the diagnosis of CGD is shown in Table Many ofthe clinical and...
... the Heart and Stroke Foundation of Ontario, andthe Center for Safety Research, the Department of Critical Care Medicine, andthe Research Institute at the Hospital for Sick Children, Toronto The ... at the time the child was in the responding nurse's care From the prospectively documented CCRT data, we abstracted the items ofthe Bedside PEWS score, the nature ofthe consultation andthe ... from the Ontario Ministry of Health and Long Term Care and an Early Researcher Award from the Ontario Ministry of Research and Innovation This work was supported by Grant in Aid Funding from the...
... categories ofeye care personnel: full-time eye care workers, integrated eye care workers and community-based eye care workers (medical and non-medical) [5,6] The route of delivery andthe type ofeye ... protection, and improvement of population eye health [3] Theeye care workforce has been identified as the bedrock of "VISION 2020: The right to sight", the global initiative for the elimination of avoidable ... 63 (mean = 36.1 years, SD = years) The age and sex distribution of workers are shown in Table The distribution of staff by cadre and LGA is shown in Table The comparison ofeye care personnel-to-population...
... components ofthe tear film The action of blinking spreads the film of tears over the whole surface oftheeyeand mixes the tears underneath the lids The tear film serves as an interface between the external ... inside theeye would continually decrease, andtheeye would collapse The flow of aqueous humor out oftheeye is driven by the pressure inside theeyeThe resistance to the flow of aqueous out ofthe ... cells The hardness oftheeye to touch is not determined by the toughness ofthe fabric ofthe eye, but by the fluid pressure inside theeye When the pressure is high, theeye is hard When the pressure...
... people of northern European descent Their diagnosis is obvious when they are visible as glittering particles upon the surface ofthe optic disc However, in many patients they are hidden beneath the ... fulminant papilledema Optic Disc Drusen These are refractile deposits within the substance ofthe optic nerve head (Fig 29-13) They are unrelated to drusen ofthe retina, which occur in age-related ... hypertension) The majority of patients are young, female, and obese Treatment with a carbonic anhydrase inhibitor such as acetazolamide lowers intracranial pressure by reducing the production of cerebrospinal...
... variety of genetic diseases, such as myotonic dystrophy, neurofibromatosis type 2, and galactosemia Radiation therapy and glucocorticoid treatment can induce cataract as a side effect The cataracts ... viewing light reflected from the fundus with an ophthalmoscope or by examining the dilated eye using the slit lamp The only treatment for cataract is surgical extraction ofthe opacified lens Over ... examinations is helpful In the patient with physiologic cupping, the large cup remains stable, whereas in the patient with glaucoma it expands relentlessly over the years Detection of visual field loss...
... by administration of panretinal laser photocoagulation at the appropriate point in the evolution ofthedisease For further discussion ofthe manifestations and management of diabetic retinopathy, ... deposits of clumped pigment in the peripheral retina, called bone spicules because of their vague resemblance to the spicules of cancellous bone, give thedisease its name (Fig 29-17) The name ... pigmentosa with black clumps of pigment in the retinal periphery known as "bone spicules." There is also atrophy ofthe retinal pigment epithelium, making the vasculature ofthe choroid easily visible...
... be considered if the cause remains unknown after careful review ofthe history and thorough examination oftheeye Figure 29-18 Proptosis When the globes appear asymmetric, the clinician must ... the appearance of enophthalmos True enophthalmos occurs commonly after trauma, from atrophy of retrobulbar fat, or fracture ofthe orbital floor The position ofthe eyes within the orbits is measured ... unilateral Orbital inflammation and engorgement ofthe extraocular muscles, particularly the medial rectus andthe inferior rectus, account for the protrusion ofthe globe Corneal exposure, lid...
... limitation of motility The width ofthe palpebral fissures is measured in primary gaze to quantitate the degree of ptosis The ptosis will be underestimated if the patient compensates by lifting the ... drooping ofthe eyelid Unilateral or bilateral ptosis can be congenital, from dysgenesis ofthe levator palpebrae superioris, or from abnormal insertion of its aponeurosis into the eyelid Acquired ... especially in older women The signs are more subtle andthe diagnosis is frequently missed The combination of slight proptosis, diplopia, enlarged muscles, and an injected eye is often mistaken for...
... persists in either eye after covering the opposite eye If it does, the diagnosis is monocular diplopia The cause is usually intrinsic to theeyeand therefore has no dire implications for the patient ... Examination ofthe pupil helps to distinguish between these two possibilities In Horner's syndrome, theeye with ptosis has a smaller pupil andtheeye movements are full In an oculomotor nerve palsy, the ... primary gaze, and then with the head turned and tilted in each direction In the above example, a cover test with the head turned to the right will maximize the fixation shift evoked by the cover...
... microvascular infarction ofthe nerve, somewhere along its course from the brainstem to the orbit Usually the patient complains of pain Diabetes, hypertension, and vascular disease are major risk ... compression (tumor, aneurysm) Miswiring of sprouting fibers to the levator muscle andthe rectus muscles results in elevation ofthe eyelid upon downgaze or adduction The pupil also constricts upon attempted ... to the oculomotor nerve complex Fibers exit the brainstem dorsally and cross to innervate the contralateral superior oblique The principal actions of this muscle are to depress and to intort the...
... generation of saccades to the contralateral side After hemispheric stroke, the eyes usually deviate towards the lesioned side because ofthe unopposed action ofthe frontal eye field in the normal ... affected later in the course ofthedisease Parkinson's disease, Huntington's chorea, and olivopontocerebellar degeneration can also affect vertical gaze The frontal eye field ofthe cerebral cortex ... vasculitis, and Whipple's disease are other important causes of supranuclear gaze palsy Disorders of vertical gaze, especially downwards saccades, are an early feature of progressive supranuclear palsy...
... One -and- a-half syndrome is due to a combined lesion ofthe medial longitudinal fasciculus andthe abducens nucleus on the same side The patient's only horizontal eye movement is abduction ofthe ... movement is abduction oftheeye on the other side Figure 29-19 Left internuclear ophthalmoplegia (INO) A In primary position of gaze the eyes appear normal B Horizontal gaze to the left is intact C ... disorders of vertical gaze are not fully elucidated, but lesions ofthe rostral interstitial nucleus ofthe medial longitudinal fasciculus andthe interstitial nucleus of Cajal cause supranuclear paresis...
... examination ofthe eyes Observation of nystagmoid movements ofthe optic disc on ophthalmoscopy is a sensitive way to detect subtle nystagmus Gaze-Evoked Nystagmus This is the most common form of jerk ... the eyes are held eccentrically in the orbits, they have a natural tendency to drift back to primary position The subject compensates by making a corrective saccade to maintain the deviated eye ... Architecture, projections, and intrinsic photosensitivity Science 295: 1065, 2002 Kanski JJ: Systemic Diseases andtheEye St Louis, Mosby, 2001 Leibowitz HM: The red eye N Engl J Med 343:345,...
... inflammation of both the anterior and posterior segments oftheeye Posterior uveitis is a manifestation of autoimmune diseases such as sarcoidosis, Behçet's disease, Vogt-Koyanagi-Harada syndrome, and ... rare and frequently misdiagnosed cause of a red, painful eye Susceptible eyes have a shallow anterior chamber, either because theeye has a short axial length (hyperopia) or a lens enlarged by the ... such as Candida, Pneumocystis carinii, Cryptococcus, Aspergillus, herpes, and cytomegalovirus (see Fig 175-1); and other diseases such as syphilis, Lyme disease, tuberculosis, cat-scratch disease, ...
... endocarditis, but they also appear in leukemia, diabetes, and many other conditions Endophthalmitis also occurs as a complication of ocular surgery, occasionally months or even years after the operation ... reveals zones of whitened, edematous retina following the distribution of branch retinal arterioles Complete occlusion ofthe central retinal artery produces arrest of blood flow and a milky retina ... term refers to a transient ischemic attack ofthe retina (Chap 364) Because neural tissue has a high rate of metabolism, interruption of blood flow to the retina for more than a few seconds results...
... ("blood and thunder" appearance), infarction, and visual loss Venous occlusion ofthe retina is often idiopathic, but hypertension, diabetes, and glaucoma are prominent risk factors Polycythemia, ... worsening The optic disc appears swollen and surrounded by nerve fiber layer splinter hemorrhages (Fig 29-9) AION is divided into two forms: arteritic and nonarteritic The nonarteritic form of AION ... that high doses of glucocorticoids can be instituted immediately to prevent blindness in the second eye Symptoms of polymyalgia rheumatica may be present; the sedimentation rate and C-reactive...