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OCULAR MANIFESTATION OF SYSTEMIC DISEASES

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ocular manifestation of systemic diseases

Why Eye Evaluation?

The primary care physician frequently encounters patients with ocular symptoms and signs that may signal serious underlying systemic disorders. In such cases, the Ocular manifestation of systemic disease as obtained from an ocular examination may aid in the diagnosis and management of the underlying systemic disease. Alternatively, patients known to have systemic diseases may develop ocular problems that require the attention of an eye care profession. For these reasons, the primary care physician should be familiar with the common ocular complications of frequently encountered systemic diseases as there often ocular manifestation of systemic diseases. And as well encourage for regular routine eye evaluation and check.

To provide a framework for approaching ocular manifestations of systemic disease, there is need for ocular evaluation or eye evaluation. 

This program is organized according to these list of systemic diseases with ocular manifestation: 

  • Congenital,
  •  Traumatic,
  •  vascular, 
  • neoplastic, 
  • autoimmune, 
  • idiopathic, 
  • infectious, 
  • metabolic/endocrine, and 
  • drugs/toxins.

To avoid overlooking pathology of the eye in systemic diseases, it is important that the primary care physician or Optometrist considers performing an eye examination for each patient. The complete eye evaluation should include:

 1. Visual acuity 

2. External examination (lids and orbit) 

3. Pupils (including assessment for relative afferent pupillary defect) 

4. Motility examination 

5. Examination of anterior segment (conjunctiva, sclera, cornea, anterior chamber, and lens) 

6. Dilated ophthalmoscopy 

7. Visual fields Patients with visual symptoms need an ophthalmologic referral because ocular findings such as anterior chamber inflammation, corneal dendrites, or retinal pathology can be easily missed.

In addition, there should be due considerations of eye diseases and treatment options to save sight.

OCULAR MANIFESTATION OF CONGENITAL DISORDERS

Ocular manifestation is a feature of numerous congenital syndromes, including Down syndrome, Marfan syndrome, myotonic dystrophy, tuberous sclerosis, metabolic disorders involving lysosomal storage and carbohydrate metabolism, and neurofibromatosis. An ocular examination may provide key findings in an effort to establish a definitive diagnosis with key monitoring of ophthalmic manifestation in systemic diseases.

Examples of Congenital disorders with ocular manisfestations

Neurofibromatosis 

ocular manifestation of neurofibromatosis
ocular manifestation of neurofibromatosis

Classical neurofibromatosis (NF1) is among the most common inherited disorders in humans, with an estimated incidence of 3 in 10,000. 

The disease is characterized by 

• 6 or more hyperpigmented skin macules (café-au-lait spots; see the slide, left) 

• 2 or more cutaneous neurofibromata or 1 plexiform neurofibroma

 • Melanocytic hamartomata of the iris (Lisch nodules; see the slide, right) 

• Multiple “freckles” in the intertriginous areas 

• Distinctive osseous lesions (eg, sphenoid dysplasia, pseudoarthrosis or thinning of the long bone cortex)

 • Glioma of the anterior visual pathway

 • Patient history of a first-degree relative with NF1 Ophthalmic manifestations of classical neurofibromatosis may commonly involve the eyelid, iris, orbit, and optic nerve. 

The iris Lisch nodules may be one of the key signs in screening individuals. Ninety-five percent of individuals with NF1 will have Lisch nodules by the time they are 6 years old. 

OCULAR MANIFESTATION OF TRAUMATIC DISORDERS 

Shaken Baby Syndrome and the eyes

action of shaken baby syndrome
fundus of shaken baby syndrome
fundus of shaken baby syndrome

The shaken baby syndrome is increasingly evident in our society. Injuries in a child with a history that is not appropriate for the injury sustained should raise a suspicion of child abuse. Ocular manifestation of this syndrome can be detected with a dilated fundus examination may reveal  form of preretinal, intraretinal (including white centered hemorrhages), or vitreous hemorrhages. Photographic documentation of retinal findings should be obtained immediately, as these findings may be fleeting. 

OCULAR MANIFESTATIONS OF VASCULAR DISEASES

Systemic Hypertension

fundus of hypertensive patient
fundus of hypertensive patient

Systemic diseases such as hypertension is a cardio vascular disease that affect the retinal, choroidal, and optic nerve circulations. A variety of retinal vascular changes can be seen in this systemic disease; these depend in part on the severity and duration of the hypertension. Ocular manifestation of systemic diseases such as hypertension include retinal changes in form of flame-shaped hemorrhages in the superficial layers of the retina and cotton-wool patches caused by occlusion of the precapillary arterioles with ischemic infarction of the inner retina. Long-standing hypertension can produce arteriolar sclerotic vascular changes, such as copper or silver wiring of the arterioles, as shown by the two arrows on the right, or arteriorvenous nicking. Another ocular manifestation sign of chronic hypertension in the fundus of a hypertensive patient is lipid exudates resulting from abnormal vascular permeability, as shown by the arrow at left. More ominous in this photograph is swelling of the optic disc as its most common ocular manifestation, seen here by the blurring of the temporal disc margins. This is the hallmark of malignant hypertension, which carries a poor prognosis for the patient’s health if left untreated. BP must be emergently controlled to decrease the risk of developing heart and renal failure and hypertensive encephalopathy as well as stroke and permanent vision loss. 

Embolic Disease 

cholesterol emboli eye
cholesterol emboli eye

Emboli to the ophthalmic circulation can lodge in the ophthalmic artery or the central retinal artery, producing severe loss of vision that can be transient or permanent (left). In the elderly, the most common source of emboli is fibrin and cholesterol from ulcerated plaques in the wall of the carotid artery. The so-called Hollenhorst plaque is a refractile cholesterol embolus that lodges at an arterial bifurcation, as shown in the right-hand slide.

cholesterol emboli eye
cholesterol emboli eye

Emboli of cardiac origin may come from calcified heart valves in patients with a history of rheumatic fever, from an atrial myxoma, or from fibrin-platelet emboli in patients with mitral valve prolapse, as seen here in this left eye with superotemporal branch retinal artery occlusion. This is cholesterol based systemic disease with ocular manifestation.

Cholesterol emboli eye presents with sudden, persistent visual loss may be due to occlusion of the central retinal artery, and emergency ophthalmologic evaluation is indicated. Ophthalmoscopic examination will reveal narrowed retinal arterioles and a pale retina. Edema with loss of retinal transparency in all areas except the fovea gives rise to the appearance known as the “cherry-red spot” (left). All these ocular manifestation can be prevented if detected early. Compare that appearance with a normal fundus (right). Emergency treatment is directed to decreasing intraocular pressure and to vasodilation in an attempt to allow the obstructing embolus to pass into less critical, smaller-caliber vessels.

central retinal artery occlusion
central retinal artery occlusion

Other sources of emboli include talc in intravenous drug abusers, as seen here in the macula, and fat in patients with long bone fractures. Talc emboli do not typically cause occlusion or ischemia although rarely they may be associated with retinal neovascularization.  

Central Retinal Vein Occlusion

central retinal vein occlusion
central retinal vein occlusion

Another cause of painless vision loss is a central retinal vein occlusion (CRVO). This vision loss may be mild to profound and is often due to macular edema. The onset of a CRVO is usually rapid. Ophthalmic examination will reveal retinal hemorrhages and cotton-wool spots. The findings of severe vision loss or an afferent pupillary defect indicate a greater risk for the ischemic type of CRVO, which carries a poor prognosis and is more highly associated with rubeotic glaucoma. Fifty percent of patients who have a CRVO have open-angle glaucoma and/or systemic hypertension. A systemic workup in patients with a CRVO should include measurement of blood pressure and exclusion of other vasculopathic risk factors. Blood workup to rule out coagulopathies (including Factor V deficiency), hyperlipidemia, collagen vascular diseases, and paraneoplastic syndromes may be considered.

Migraine: Ocular Migraine

migraine visual sypmtoms

Migraine is a transient vasospastic phenomenon affecting the cerebral and/or ocular circulations. Paroxysmal neurologic or visual symptoms include scintillations, amaurosis fugax, transient cortical blindness, and transient homonymous hemifield loss, which consists of nasal field loss in one eye and temporal field loss in the other. Migraine symptoms, which are presumably due to focal cortical or ocular ischemia, may last from 15 to 45 minutes.

In classic ocular migraines, these visual symptoms are followed by an intense, throbbing headache. Common migraine is a periodic headache of varying intensity without a preceding aura. Complicated migraine occurs when frequent severe migraine headache results in a persistent visual or other neurologic deficit. However, the visual phenomena may occur without headaches, which is called ocular or acephalgic migraine or migraine equivalent. A treatable vascular disease such as vasculitis or arteriovenous malformation needs to be considered in the differential diagnosis of acephalgic migraine. 

The Migraine treatment depends on the frequency of the episodes and can be directed to preventing attacks rather than aborting them. Episodes that occur less frequently than once a month may not require treatment. Fortunately, the paroxysmal ocular phenomena rarely lead to permanent visual deficits, but patients with visual loss during attacks should probably have an ophthalmologic evaluation. Discontinuation of oral contraceptives should be considered, as they may trigger vascular occlusive disease in migraine patients.

OCULAR MANIFESTATION BLOOD DYSCRASIAS  

A blood dyscrasia is any abnormal or pathologic condition of the blood. Ocular manifestation of blood dyscrasias include hyperviscosity syndromes, thrombocytopenia, and all forms of anemia, including sickle cell anemia.

 Hyperviscosity Syndromes

fundus with blood dyscrasias

Patients with such as polycythemia, multiple myeloma, dysproteinemia, and leukemia may present with visual complaints. These include amaurosis fugax and permanent visual loss.

Initial fundus changes are retinal vein dilation, retinal hemorrhages, and varying amounts of disc edema (as seen in this fundus).

Leukemia

ocular photo of leukamia
ocular photo of leukamia

Patients with leukemia may present with a hemorrhagic type of retinopathy, as seen here. Note both the retinal and the preretinal hemorrhages (see arrows). The hemorrhages are presumably due to thrombocytopenia of leukemia. White centered hemorrhages may indicate metastatic leukemic infiltration of the retina.

Direct leukemic infiltration of the optic nerve 

Direct leukemic infiltration of the optic nerve can cause pronounced optic nerve swelling and vascular congestion with edema and hemorrhages of the surrounding retina, as seen here. This can rapidly lead to blindness if not treated promptly with radiation. Periodic dilated funduscopic examination is recommended for asymptomatic patients with hyperviscosity syndromes, and referral to an ophthalmologist is indicated if any ocular symptoms or signs develop.

ocular manifetstaion in leukamia
ocular manifetstaion in leukamia

Sickle Cell Anemia : How does sickle cell disease affcets the eyes

Sickle cell retinopathy occurs most frequently in the HbSC form of the disease but may also be seen in the HbSS form and in sickle thalassemia. Sickle cell retinopathy is not seen in patients with sickle cell trait only.

fundus of a sickle cell anaemia
fundus of a sickle cell anaemia

Sickling can produce retinal arterial occlusions, especially in the retinal periphery, as shown by the arrows in the slide (left). The retinal ischemia can lead to peripheral (“sea fan”) neovascularization (as seen in this slide, right), vitreous hemorrhage, and tractional retinal detachment. Panretinal laser photocoagulation may be necessary to expedite regression of the neovascular process. General anesthesia can produce sickling and thereby increase the risk of arterial occlusive disease. Sickle cell eyes treatment should begin with ophthalmologic evaluation because patients may be asymptomatic, even in advanced stages of the retinopathy, due to the peripheral location of the retinal changes, which can only be visualized via indirect ophthalmoscopy through a dilated pupil.

NEOPLASTIC EYE DISEASE: WHAT IS NEOPLASM IN THE EYE

The most common ocular tumors or type of intraocular malignancy in adults is metastatic carcinoma, arising from primaries in the breast or lung in women and in the lung in men. Patients are often asymptomatic but may present with decreased or distorted vision.

Iris Metastais
Iris Metastais

An easily detected iris mass is visible in this patient with metastatic lung carcinoma. An irregularly shaped pupil, iritis, or blood in the anterior chamber may signal a metastatic nodule, as seen here.

Choroidal metastases  from breast cancer

choroidal metastasis from breast cancer
choroidal metastasis from breast cancer

Because of its rich vascular supply, the choroid is the most common site for ocular metastasis. Choroidal metastases may be solitary or multiple and may affect one or both eyes. Typically they appear as creamy-white lesions, as seen in this patient with metastatic breast cancer. Associated leopard spotting may also be detected. Choroidal metastases are often subtle and difficult to detect with direct ophthalmoscopy and may require referral to an ophthalmologist if suspected or if visual loss or visual distortion develops. Treatment options include local radiation and chemotherapy.

Because ocular metastases may represent the smallest clinically detectable lesions of disseminated carcinoma, an ophthalmologist monitoring these lesions at regular intervals may help to assess the efficacy of systemic treatment. However, prognosis for survival after detection of an intraocular metastasis is generally poor, with a mean length of survival of 6 to 9 months. Retinoblastoma is one of the most metastatic tumors of the retina.

AUTOIMMUNE DISORDERS THAT AFFECT THE EYES

Certain autoimmune disorders, such as connective tissue diseases, thyroid eye disease, and myasthenia gravis, can initially present with ocular manifestations only. Thus, it is extremely important for the primary care specialist to screen for those disorders in patients with the most common ocular symptom (dry eyes) so that these patients can receive the appropriate treatment as early as possible in the course of these diseases.

Ocular manifestation of Connective Tissue Disorders (Collagen Vascular Diseases)

Connective tissue disorders have various ocular manifestations, the most common being tear deficiency leading to dry eyes, or keratoconjunctivitis sicca. The symptoms of dry eyes include burning, a foreign-body or gritty sensation, and photophobia.

Sjögren’s syndrome, the complex of dry eyes and dry mouth, may occur in isolation or in association with a connective tissue disorder. Specific antibodies such as anti-SS-A (or antiRo) may be associated with Sjögren’s syndrome. 

Artificial tears are the primary treatment for mild to moderate keratoconjunctivitis sicca. Generally, to be efficacious, they must be used several times a day on a regular basis. Numerous commercial preparations are available, and the patient’s preference is sometimes the best criterion for selecting a given agent. Patients with severe dry eyes or with sensitivity to preservatives should be steered to one of the preservative-free lanolin-free formulations. Nighttime administration of lubricating ointment may also be helpful. Occlusion of the lacrimal drainage puncta can aid retention of tears. Environmental modifications include humidifiers, goggles, and side shields on glasses. Recent advances demonstrate the efficacy of anti-inflammatory agents, administered in topical form. 

Tear film distortion in

Severe tear deficiency may be unresponsive to routine use of artificial tears and can result in corneal epithelial breakdown, ulceration, and even perforation, as seen here. Consultation by an ophthalmologist is indicated for patients with tear deficiency states who have persistent pain or visual loss. 

Ankylosing Spondylitis: Does it cause uveitis?

Up to 25% of patients with ankylosing spondylitis have one or more attacks of iritis, a form of intraocular inflammation, which may precede the clinical arthritis. Patients typically present with ocular symptoms such as; photophobia, redness, and decreased vision. Patients with symptoms or signs suggestive of iritis (shown here) should be referred for evaluation by an ophthalmologist.

Iritis usually responds to treatment with topical corticosteroids and dilating agents. However, topical corticosteroids should be prescribed only with the advice of an ophthalmologist, because long-term corticosteroid therapy can lead to glaucoma, cataract formation, or exacerbation of ocular infections, and, in some connective tissue disorders, to ocular perforation.

Most common ocular manifestation in patients with Rheumatoid Arthritis

The ocular manifestation of rheumatoid arthritis are most often seen in patients with more active and severe forms of the disease and in those with extra-articular complications. Aside from dry eyes, other common ocular manifestations are inflammation of the episclera and sclera, peripheral corneal ulcers, and uveitis. 

Episcleritis is inflammation of the superficial tissue overlying the sclera. Typically patients complain of mild to moderate pain and tenderness, and there is localized or diffuse redness of the eye. 

episcleritis
episcleritis

Scleritis (inflammation of the sclera) may sometimes appear clinically similar to episcleritis. However, severe, deep pain is a distinguishing feature of scleritis. 

scleritis
scleritis

Scleritis may be characterized by active inflammation with redness, as seen on the left, and severe pain. It can progress to necrosis, as seen on the right, and subsequent perforation of the sclera (necrotizing scleritis). 

Scleromalacia perforans consists of scleral melting in a white, quiet eye. This condition also can lead to ocular perforation. 

Peripheral corneal ulceration is another manifestation of rheumatoid arthritis that may result in ocular perforation. Patients with rheumatoid arthritis who develop peripheral corneal ulceration or scleritis have an associated risk for developing potentially lethal systemic vasculitis. Primary care physicians should monitor patients with active rheumatoid arthritis for symptoms and signs of episcleritis, scleritis, and corneal ulcers; patients who develop these ocular conditions should be referred to an ophthalmologist for treatment.

Juvenile Rheumatoid Arthritis

Ocular involvement in juvenile rheumatoid arthritis typically occurs in patients with a mild form of the disease, the so-called pauci-articular form, and in patients who are rheumatoid-factor negative and ANA positive. Ocular complications may occasionally be the presenting feature of this disease and do not correlate with the severity or course of the systemic signs. The characteristic triad of late ocular complications in juvenile rheumatoid arthritis consists of iritis, cataract, and, as seen here, band keratopathy, which consists of whitish deposits of calcium in the cornea. Band keratopathy is a late sequela of many forms of chronic intraocular inflammation. Iritis or iridocyclitis can occur in up to 15% of patients with JRA and causes few symptoms or signs. The iritis is usually chronic, causing secondary cataract formation and glaucoma. All patients with JRA should be screened and followed by an ophthalmologist.

Systemic Lupus Erythematosus

Patients with systemic lupus erythematosus (SLE) can have many of the same ocular manifestations associated with rheumatoid arthritis, such as dry eyes, scleritis, and peripheral corneal ulceration. The most common severe manifestations of SLE, however, involve the vasculature of the retina and optic nerve.

A variety of retinal complications can occur in SLE, including retinal vasculitis with cotton wool spots, as seen here, and hypertensive retinopathy secondary to renal involvement. Lupus anticoagulant or phospholipid antibody syndrome is a variant characterized by a higher incidence of thrombotic episodes, which may cause vascular occlusions and may require anticoagulant therapy. 

Lupus vasculitis can also involve the optic nerve, resulting in ischemic optic neuropathy. Note the pale, swollen nerve in this young woman, who presented with visual loss due to ischemic optic neuropathy as the initial manifestation of SLE. Ophthalmologic evaluation is indicated for patients who have central nervous system involvement or visual symptoms. Detection of retinal vasculitis can also assist, in certain instances, in establishing the diagnosis of SLE.

Polyarteritis or Periarteritis Nodosa 

This condition is a widespread inflammatory disease affecting small and medium-size blood vessels, most commonly in middle-aged men. In addition to dry eyes, the ocular manifestations are peripheral corneal ulceration, scleritis, associated hypertensive retinopathy, and primary retinal vasculitis similar to that seen in patients with SLE. Other connective tissue diseases associated with ocular inflammation are Reiter’s syndrome, Wegener’s granulomatosis, and Behcet’s disease. Wegener’s can be associated with anterior or posterior scleritis and/or retinal vasculitis including retinal vascular obstruction. The classic triad of Behcets includes hypopyon uveitis, arthritis and oral ulcers. Fulminant occlusive retinal vasculitis with progressive retinal necrosis may warrant aggressive immunosuppressant therapy.

Sarcoidosis 

Sarcoidosis, a multisystem disorder of unknown etiology, is characterized in part by granulomatous inflammation of many organs. This disease more commonly affects the African-American and Hispanic populations. Ocular involvement occurs in about 25% of patients presenting with other features of sarcoidosis. 

The most common ocular presentation is granulomatous uveitis, characterized in part by large clumps of cellular deposits on the endothelial layer of the cornea, which are called keratic precipitates (left). 

Choroiditis and retinal vasculitis, usually segmental, may occur in a small percentage of patients. The typically gray, perivenous infiltrates are characteristically called “candlewax drippings” (right). Optic disc involvement is rare but may occur in patients with central nervous system involvement. Edema or granuloma of the optic nerve may be present. 

Many of these changes are difficult to detect with direct ophthalmoscopy, and dilated ophthalmologic evaluation is indicated for all patients who have sarcoidosis with suspected ocular involvement. Treatment of the ocular problems is similar to treatment of the systemic disease and often includes the use of topical, injectable, or systemic corticosteroids. 

Giant Cell (Temporal) Arteritis

Giant cell, or temporal, arteritis is a systemic vasculitis that usually affects people over age 60. Although almost any artery can be involved, this disease has a predilection for large and medium sized vessels, particularly the superficial temporal, ophthalmic, and proximal portion of the vertebral arteries. The symptoms include headache, scalp tenderness, jaw pain and difficulty in chewing (claudication), the polymyalgia rheumatica complex (myalgia, weight loss, anorexia, and fever of unknown origin), and acute visual loss. Palpation of the temporal artery may reveal tenderness, a lack of pulsations, and enlargement or nodular thickening of the vessel. 

Ischemic optic neuropathy, or infarction of the optic nerve head, is the most common presentation of giant cell arteritis; it is associated with severe unilateral loss of vision, a relative afferent pupillary defect or Marcus Gunn pupil, and, as shown here, a pale, swollen optic nerve head. 

Cranial motor nerve palsy is the initial ophthalmic presentation of giant cell arteritis in about 10% of patients; it is due to nerve ischemia resulting from occlusion of the vascular supply to the nerve. Most commonly, the third cranial nerve is affected, producing ptosis and outward deviation of the eye on the involved side (as seen here), with sparing of the pupil. In the elderly, a cranial nerve palsy should raise suspicion of giant cell arteritis, especially if accompanied by headache or pain.  

If giant cell arteritis is suspected, a STAT erythrocyte sedimentation rate and c-reactive protein must be obtained, followed by a temporal artery biopsy. A low or normal sedimentation rate does not exclude this diagnosis, especially if the patient is taking nonsteroidal anti-inflammatory agents for other reasons. (Up to 20% may have a normal sedimentation rate.) Fluorescein angiography is a photographic test that can reveal characteristic deficits in the choroidal circulation of the eye. Histopathologic examination of the temporal artery typically reveals a patchy, granulomatous inflammatory reaction that involves the media and the adventitia of the artery. 

A potentially blinding disease, giant cell arteritis usually affects the second eye in a matter of hours or days if untreated. Therefore, this condition is considered an emergency, and treatment must be initiated empirically without waiting for the laboratory results. Therapy consists of high daily doses of systemic corticosteroids, which are gradually tapered according to serial sedimentation rates and the patient’s symptoms, both of which are monitored closely. Recent studies suggest that there is a more rapid response if patients are begun on intravenous corticosteroids for 24 to 48 hours before switching to oral corticosteroids. Corticosteroids should be started before the biopsy, as biopsy results will not be affected for a number of days. Patients suspected of having giant cell arteritis are best managed jointly by the primary care physician, rheumatologist, and ophthalmologist.

Thyroid Disorders

Ocular abnormalities are common in patients who suffer from thyroid dysfunction. Thyroid ophthalmopathy is not always correlated with serum thyroid hormone levels and may occur even in patients who are euthyroid. It is important to remember that the eye disease may continue to progress after thyroid function tests have returned to normal. All of the ocular manifestations should be closely followed in conjunction with an ophthalmologist.

Thyroid eye disease can vary in its severity and presentation. It can involve the eyelids, orbit, extraocular muscles, cornea, conjunctiva, and optic nerve. Ocular involvement can be unilateral or bilateral.

Lid retraction causes the patient to have a widened palpebral fissure, as seen on the left. Sometimes the sclera is exposed above or below the corneoscleral limbus; this is termed scleral show. The patient on the right exhibits soft tissue involvement, with eyelid fullness and injection of the conjunctiva.

Thyroid ophthalmopathy can cause proptosis, or exophthalmos (left). The extraocular muscles can become enlarged secondary to lymphocytic infiltration. This can lead to diplopia from restriction of eye movements. The muscle most commonly affected is the inferior rectus muscle, which causes restriction on attempted up gaze (shown at right, in patient’s left eye). 

In severe cases, vision loss can occur. Proptosis and lid retraction can lead to corneal damage, as seen on the left. Sight loss can also occur due to optic nerve compression. The optic disc may appear swollen, as in the clinical photograph on the right, or may be atrophic. In early stages of optic nerve compression, the optic nerve can appear normal. 

In severe cases, vision loss can occur. Proptosis and lid retraction can lead to corneal damage, as seen on the left. Sight loss can also occur due to optic nerve compression. The optic disc may appear swollen, as in the clinical photograph on the right, or may be atrophic. In early stages of optic nerve compression, the optic nerve can appear normal.

Computed tomography of the orbit may demonstrate proptosis, as seen in the left scan, and extraocular muscle swelling or enlargement, as seen in both scans.

Thyroid ophthalmopathy typically occurs in two phases that should be jointly managed by the primary care physician and the ophthalmologist. The first phase is characterized by acute congestive changes and lasts an average of 2 years. Treatment in this phase is directed toward preserving sight and providing symptomatic relief. Medical treatment for corneal problems includes the use of tear substitutes in the form of drops or ointments. For the extraocular muscle or optic nerve involvement during the acute congestive phase, intermittent high doses of corticosteroids may be employed. If this therapy fails, orbital irradiation or surgical decompression may be required to save deteriorating vision. 

The second phase is marked by cicatricial changes in the eyelids, extraocular muscles, or orbit. Treatment may consist of surgically correcting the ocular muscle deviation, the functional abnormalities, or the cosmetic deformities. 

Myasthenia Gravis

Myasthenia gravis is a myopathy that may occur at any age. It is an autoimmune disease affecting the acetylcholine receptors, causing a conduction defect at the neuromuscular junction. About 75% of patients present with ocular manifestations, including bilateral ptosis (as seen in this patient), limited eye movements, and/or diplopia. Among these patients, approximately 20% will have only ocular manifestations. Any patients with ptosis and diplopia of unclear etiology, especially if variable and worsening with fatigue, should be presumed to have myasthenia gravis. Referral to a neurologist may be necessary because of systemic involvement, including apnea and choking due to involvement of respiratory and pharyngeal muscles. 

IDIOPATHIC DISORDERS

Intracranial Hypertension

The most common ocular manifestation of intracranial hypertension is optic disc swelling, which in this condition is referred to as papilledema. The visual symptoms of papilledema are often mild or absent; the most common are transient visual obscurations, which can range from mild blurring to complete visual loss, usually lasting only a few seconds. Ophthalmoscopy typically reveals marked disc swelling and vascular engorgement, as seen here.

Common causes of intracranial hypertension include brain tumor, meningitis, venous sinus thrombosis, hydrocephalus and the entity pseudotumor cerebri, or idiopathic intracranial hypertension. Pseudotumor cerebri may be associated with vitamin A or vitamin D intoxication, tetracycline therapy, and steroid withdrawal. Pseudotumor cerebri has a propensity to occur in young, obese women, and in most cases a precipitating factor is not found. Disc edema can also be caused by conditions that are not associated with increased intracranial hypertension, such as sarcoidosis, syphilis, tumor, and pseudo-disc edema from causes such as optic nerve head drusen (shown). 

Multiple Sclerosis

Within 5 years of an episode of optic neuritis, more than 40% of women aged 20 to 40 will manifest signs and symptoms of multiple sclerosis. Optic neuritis presents as an acute, painful vision loss in one or both eyes occurring over a few days to two weeks. It may be the initial manifestation of multiple sclerosis. After one episode, 70% of eyes with optic neuritis recover spontaneously within 3 to 6 months. The Optic Neuritis Treatment Trial demonstrated that patients treated with intravenous methylprednisolone, 250 mg every 6 hours for 3 days, followed by 1 day of oral prednisone, had a more rapid visual recovery than a placebo-treated control group. By 1-year follow-up, however, there was no statistically significant difference between the treated group and the control group. In addition to intravenous methylprednisolone, another medication that has been shown to be of benefit is interferon beta-1a. A multicenter trial of interferon beta-1a (Avonex) showed a reduction of recurrent MS attacks, slowing of cognitive deterioration, and lessening of disease activity, as measured by gadolinium-enhanced MRI.  

INFECTIOUS DISORDERS

Acquired Immunodeficiency Syndrome (AIDS)

Dry eyes are very common in patients with AIDS, but they are a nonspecific finding. The three most common classic lesions are retinal cotton-wool spots, cytomegalovirus (CMV) retinitis, and Kaposi’s sarcoma of the eyelid or conjunctiva.

Cotton-wool patches, which are due to obstruction of the precapillary arterioles with infarction of the superficial retina, are the most common ocular finding in patients with HIV infection. Associated intraretinal hemorrhages may also be present and these findings are collectively referred to as HIV noninfectious retinopathy.

Patients with AIDS can develop infectious retinitis secondary to a variety of opportunistic organisms. Ocular manifestation of systemic diseases in HIV/AIDS patients, often come in form cytomegalovirus (CMV) retinitis, as seen in this patient, which is characterized by discrete, fluffy, white retinal necrotic patches with hemorrhages. Because cytomegalovirus retinitis can begin in the retinal periphery, patients with AIDS should be referred for ophthalmologic evaluation evaluation especially if symptomatic or with reduced T-cell counts.

CMV retinitis therapy has evolved significantly. The incidence of CMV retinitis has decreased tremendously with the advent of HAART (Highly Active Anti-Retroviral Therapy). If CMV retinitis is detected in a patient who is not on HAART, the patient must be immune reconstituted with anti-retroviral medications. Induction IV ganciclovir or foscarnet is also necessary, and intravitreal injections of ganciclovir may be considered. As cytomegalovirus infection is usually a systemic infection, intravenous therapy is usually the treatment of choice. The primary care physician and the ophthalmologist must work closely together to monitor efficacy of therapy and side effects of the treatment. As CD4 counts increase and viral load decreases to an acceptable level, IV and intravitreal ganciclovir administration may be withheld as long as the CD4 counts remain above 100. If patients develop CMV retinitis on HAART or have no response to IV therapy, then ganciclovir implants and intravitreal injections are necessary.

In patients with AIDS, opportunistic infections such as CMV retinitis occur predominantly when CD4 counts fall below 50 cells/ml. However, other retinal infections such as syphilis, toxoplasmosis, herpes simplex virus, or varicella-related retinitis (acute retinal necrosis syndrome) may occur in immunocompromised or immunocompetent eyes. 

OCULAR MANIFESTATION OF METABOLIC/ENDOCRINE DISORDERS

Diabetes 

Diabetes commonly produces significant ocular complications that may lead to blindness as an Ocular manifestation of systemic disease , if not recognized and treated. Diabetic retinopathy is now the leading cause of new blindness in adults aged 20–74 in the United States. Because of its ophthalmologic significance, diabetic retinopathy is covered in detail in Diabetes and Eye Disease, a separate educational program in this series, and is not discussed further here.

DRUGS/TOXINS  

Ocular manifestation of systemic diseases could sometimes be as a result of the medications these patients take to treat the disease conditiion. Significant ocular side effects including vision loss can be caused by systemic medications, for example, toxic retinopathy can be caused by thioridazine, chloroquine, hydroxychloroquine, and tamoxifen, and toxic optic neuropathy can be caused by ethambutol, isoniazid, and fluoroquinolones. 

Imole Noble Educational Foundation (INEF) 2021 Undergraduate Scholarship Award For Nigerian Students

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scholarships

Imole Noble Educational Foundation (INEF) is now accepting applications from eligible Nigerian undergraduate students for its 2021 Scholarship Award.

The scholarship is opened to brilliant indigent students who are in 100 to 200 level in public universities across the 6 geo-political zones in Nigeria. Winners of the scholarship would be awarded financial aid throughout their undergraduate studies.

This is in fulfilment of the Founder’s life long burden for the plight of the less privileged in the society.

INEF Undergraduate Scholarship details

Type: Undergraduate

Country: Nigeria

Course of study: not specified

Level : 100 & 200L

Institution: not specified

State of origin: not specified

Deadline : October 10, 2021

Requirements for INEF Undergraduate Scholarship Qualification

  • Applicants must be in either 100 or 200 level in public universities in Nigeria and
  • Applicants must have had a minimum of 5As, and 3Bs in O’level result(s), in not more than 1 (one) sitting.

Documents for Application

  • O’level result,
  • Admission Letter,
  • Departmental registration form,
  • School ID Card, and Two (2) recent passport photographs with name at the back page.

Application Deadline

October 10, 2021

How to Apply

Interested and qualified candidates should addressed and send their “Application Details” to:

The Trustees,

Imole Noble Educational Foundation,

P.O. Box 139, G.P.O,

Marina, Lagos State.

Application Details

Applicants should indicate the following in their Application: Name, School, Course of Study, Level, State of Origin, Phone Number, and Email Address, with copies of the following documents above

Interview date, Process and Venue for INEF Undergraduate Scholarship

Successful applicants across the 6 geo-political zones will be contacted via their email address.

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Study-In-Canada: 2022 University of Waterloo Arthur F. Church Entrance Scholarships

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canada scholarship

The application for the undegraduate schoalsrhip in the university above is now open. We are accepting applications for the next academic year. So interested candidate.

The value goes for $10,000 each, and are awarded annually to outstanding students coming into first engineering.

Awarded students are selected on the basis of their academic excellence, extracurricular achievements as assessed through the admission information form and an online video interview

Scholarship Summary

  • Host: Arthur F. Church
  • Study Abroad: study in Canada
  • Category: undergraduate scholarship 
  • Eligible Countries: All Countries 
  • Reward: $10,000
  • Deadline: Not Specified 
  • Scholarship Alerts: To receive Scholarship Alerts on

Scholarship Requirements

In order to be eligible to apply for the scholarship, applicants must note:

  • Scholarships are for Domestic (Canadian) and International prospective students.
  • Students enrolling to pursue an undergraduate degree program in the field of Computer Engineering, Systems Design Engineering and Mechatronics Engineering at the university.
  • Candidates must be completed a year 12 with a minimum of 70% marks or equivalent.
  • An applicant must have a strong and excellence academic background.
  • English Language Requirement: Candidates whose national language is not English may need to provide proof of English language proficiency by means of TOEFL or IELTS test.

Scholarship Duration and Reward

This sponsorship is enabled by Arthur F. Church to encourage excellent and exceptional students to attend Waterloo and assist their scholarly pursuits.

Value: 

$10,000

Required Documents

Documents that will be required include

Academic details,

 Language ability score or certificate scan, 

Copy of the passport or maybe a personal information card

Method of Application

Use the link below to apply for the Scholarship 

Interested candidates must first secure an undergraduate admission into the University.

Candidates’ selection will be done by the selection committee which will be automatic upon admission and dependent on the information supplied on the application form.

Deadline: Not Specified

APPLY HERE

Check infohealthedu for more Opportunities

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See what is unique about wearing our Summer contact lenses

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summer contact lens
color variant to maintain your beauty

SUMMER Contact lenses, for your everyday use. For cosmetic and Prescription purposes. Change your eye color, change your World. Look different and express yourself by mere changing your eye color. Weather friendly and durable.  Summer contact lens comes in clear and colored forms. 

There could regular contact lenses out but with using summer contact lens we give you a patient/client specific care and attention. Our contact lenses come with these benefits although not limited to it:

  • Improved Viewing Ease: 

Pateients with summer contact lenses enjoy a wider viewing space and ease, this translates to increased efficiency at work and movement while wearing summer contact lens.

  • Better Eye Comfort: 

With the cutting edge nanotechnology, summer contact lenses are produced with high level biocompatible materials which leaves the patients/clients with 98% comfortability. There is less lens rotation, dislodgement and irritation.

  • Wider Visual Access: 

Summer contact lens offers you 98% access your normal visual space. This means that with summer , you tend to still see all corners of your environment .

  • Feeling Of Normalcy: 

With the lens materials being biocompatible, you earn the feeling of not even putting on anything. This makes you not be conscious of any disturbing material on the eyes.

  • Aesthetic Perks: 

This has been the killer nature of summer contact lenses. They come in beautiful designs and presentation upon wear. Summer lenses leave you with that desired glowing look which makes you attractive and unavoidably appealing to your peers and environment. Do you have an eye scar or unpleasant eye look? Summer contact lenses provide excellent masking look over it and leaves you with the desired outlook.

Are you a lover of contact lenses? Convert your spectacle prescription to a Summer contact lens now. 

Do you have eye problem, and you are tired of wearing glasses, Summer contact lenses got you.Our contact lenses come in various forms such as those with prescription for correction of vision errors, therapeutic lenses and cosmetic contacts lenses to enhance your looks and fit your task.

We are indeed unique with our care for you as we have Optometrists who can advise you on how to go about our Summer contact lenses.

Still looking for something more or you want to get this cutting age contact lens?

or call  08101793936 for more enquiries or purchases

We have your quality contact lens preservative solution available

Display of various colors in stock

Testimonials from our clients

Elegant looks with our Summer contact lens

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Colored Contacts: All About Colored Contact Lenses

Coloured Contact Lenses

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APPLICATION FOR NNPC/ ADDAX PETROLEUM 2021 HOST COMMUNITY SCHOLARSHIP

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Addax/NNPC scholarship


Addax Petroleum Development (Nigerian) Limited (APDNL), operator of NNPC/ADDAX Production Sharing Contract (PSC) in pursuance of its Corporate Social Responsibility invites suitably qualified applicants from its host communities to apply for the 2020/2021 Host Community Tertiary Scholarship Scheme.

Category of Award
Strictly for candidates from APDNL Host Communities

Carefully read the Requirement/Eligibility

Applications should be submitted on or before September 15, 2021.
The examination date will be communicated to shortlisted candidates only

Note

  • Application for NNPC/Addax Host Community Scholarship is FREE.
  • SCHOLASTICA is the official platform for the NNPC/Addax Petroleum 2021 Host Community Scholarship
  • Beware of fraudulent websites when applying for the NNPC/Addax Host Community Scholarship online. Such websites may ask you to make some payments in the course of the application.
  • E-mail applications are NOT accepted. 
  • Any candidate found to have presented false documents will be disqualified or withdrawn at any level of the scholarship process. 
  • Only shortlisted candidates will be invited for the Remote Online Proctored CBT Examination 

Requirements

To qualify for consideration, applicants MUST be:

  • Registered Full TIME undergraduates in Nigerian Tertiary Institutions
  • Certified 100 level students at the time of application (Only students admitted in 2020/2021 academic session)
  • For OND students, the award will be for 2 years only

NOTE: The following categories of students should not apply:

  • 200 level students and above
  • HND students
  • Current beneficiaries of similar Awards from other Companies and Agencies

Only Indigenes of APDNL Host Communities in Rivers, Akwa Ibom and Imo States SHOULD apply for the Host Communities Merit Award.
NOTE: The aptitude test will take place online using remote proctoring CBT application and the date of the test will be communicated only to shortlisted candidates. 

How to apply

Application is open to 100 level students only.

1. Before you start this application, ensure you have clearly scanned copies of the following documents

  • Passport photograph with white background not more than 3 months old (450px by 450px not more than 200kb)
  • School ID Card
  • O’level Certificate
  • Admission Letter
  • Birth Certificate
  • Proof of Local Government Area of Origin
  • JAMB Result

2. Ensure the documents are named according to what they represent to avoid mixing up documents during upload
3. Ensure you attach the appropriate documents when asked to upload
4. Ensure to provide valid Email and Phone Contact for effective communication 

To apply, follow the steps below:
1.    Click on “Apply Now” tab.
2.    Click on “Register Now” to create an account. 
3.    Proceed to your email box to activate your account 
4.    Click on https://candidate.scholastica.ng/schemes/addaxscholarship to return to Scholarship site 
5.    Enter your registered email and password to upload your information. 
6.    Enter your personal information, National Identification Number (if available), educational information, other information and upload required scanned documents. 
7.    Ensure the name used in application matches the names on all documentation in same order. Upload a sworn affidavit or certificate if otherwise. 
8.    Ensure you view all documents after uploading, to eliminate errors during uploading. 
9.    When asked to upload photo, a passport photograph with a white background is preferable. 
10.  Recheck application information to avoid errors 
11.  Click “Apply Now” to submit information 
12.  You will receive an email and a sms that confirms your application was successful. 
13.  Return to www.scholastica.ng, enter your Email and Password to download your profile and proceed to have your Head of Department sign the document. 
14.  Upload a scanned copy of the signed profile, this would be used for verification. 
15.  If National Identification Number (NIN) number was not available in step 6, to obtain your National Identification Number (NIN) 

  • Visit http://ninenrol.gov.ng to register and learn more about the National Identity Number   
  • Click “Create Account” and fill in the required  fields   
  • Login with Email and Password to complete the form   
  • After completion, schedule a date for photo and finger print capture   
  • Visit any of the capture centres https://www.nimc.gov.ng/?q=nin-registration-centres  to complete the registration process and obtain your National Identity Number   
  • You can also do your total registration at the NIMC office 

16. Return to https://candidate.scholastica.ng/schemes/addaxscholarship and update application with National Identification Number (NIN) to ensure completion

Note: 
Multiple applications attract a disqualification penalty from the Scholarship Board
Obtaining NIN is not compulsory in order to complete your application

For more scholarship updates and information

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https://infohealthedu.com/thompson-rivers-university-international-diversity-awards-canada-2021-2022/
Statement of Purpose

Vitamin D, a remedy for colon cancer

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vitamin D helps to remedy colon cancer

Vitamin D May Prevent Colon Cancer

Foods rich in vitamin D may help protect younger adults against carcinoma, researchers report.

While carcinoma is decreasing overall, cases among younger adults are on the increase. The trend increases with a decline in vitamin D intake from foods like fish, mushrooms, eggs, and milk.

There is growing evidence of a link between vitamin D and risk of carcinoma death, but little research on whether vitamin D intake is related to the danger of young-onset (before age 50) carcinoma.

“Because vitamin D deficiency has been steadily increasing over the past few years, we wondered whether this might be contributing to the rising rates” of carcinoma in younger people, 

The study found that vitamin D intake of 300 IU per day or more — roughly like three 8-ounce glasses of milk — was related to roughly a 50% lower risk of developing young-onset carcinoma (said study co-senior author Dr. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute in Boston).

Higher vitamin D intake was also related to a lower risk of probably precancerous colon polyps detected before age 50.

The findings are supported by data from quite 94,000 women who were a part of a long-term study that began in 1989. They were 25 to 42 years old when the study began.

The study — recently published online within the journal Gastroenterology — is the first to form the connection between vitamin D levels and risk of young-onset carcinoma, researchers said.

They didn’t find a big link between vitamin D intake and carcinoma risk after age 50, and that they said more study is required to work out if vitamin D provides greater protection against young-onset carcinoma than against it afterward.

“Our results further support that vitamin D could also be important in younger adults for health and possibly colorectal cancer prevention,” Ng said.

She said it’s critical to know the danger factors related to young-onset carcinoma so informed decisions about lifestyle and diet are often made and high-risk individuals can receive earlier screening.

The findings could lead to recommendations for higher vitamin D intake as a cheap addition to screening tests to stop carcinoma in adults under 50, researchers said.

Recent case-controlled studies have established that there is an inverse correlation between serum levels of vitamin D and the incidence of polyps and adenomas in the colon, consistent with the inverse correlation between dietary vitamin D3 intake or sunlight exposure and human colorectal cancer. This is significant because a large segment of the human population suffers from vitamin D3 insufficiency or deficiency, which is particularly prevalent among colon cancer patients. Indeed, numerous studies have suggested that higher vitamin D3 levels are associated with lower colon cancer incidence, reduced polyp recurrence, and better overall survival of colon cancer patients

Vitamin D and its analogs reduce the growth of colon cancer xenografts and inhibit tumorigenesis in several genetic models of intestinal cancer. In agreement, dietary initiation of colon cancer in rodents, a model of sporadic colon cancer, is prevented by supplementation with vitamin D3 and Ca

The Chemistry of Vitamin D

The biologically active form of vitamin D3,1α,25(OH)2D3 (1,25D3), is obtained by 25-hydroxylation of vitamin D3 in the liver and 1α-hydroxylation in the kidney, liver, or other tissues. Hydroxylation of 25(OH)D3 by CYP27B1 yields the hormonally active form 1,25(OH)2D3, which is metabolized to less active metabolites by CYP24A1 . While the levels of CYP21B1 are reduced in some cancers, the levels of CYP24A1 are increased in cancer cells, which may contribute to the resistance of some tumors to 1,25D.

NSAIDs Match Steroids for Cataract Surgery Inflammation

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prevent post cataract surgery inflammation

Prevent Cataract Post-operative inflammation

Nonsteroidal anti-inflammatory drugs (NSAIDs) given as eye drops appear to work as well alone as they do in combination with steroids to prevent swelling of the macula after cataract surgery, researchers say.

The anti-inflammatory eye drops work just as well whether administered before or after surgery and are more effective than a sub-Tenon implant that elutes steroids, said Jesper Erichsen, MD, Ph.D., a researcher at Rigshospitalet Glostrup in Denmark.

“Maybe it would be preferable to have NSAID eye drops as the standard approach, and then you could add steroid eye drops if they are needed,”

Pseudophakic cystoid macular edema, a common complication of cataract surgery, can affect visual acuity. Researchers believe that it results from inflammation that disrupts the blood–ocular barrier and leads to the leakage of fluid into the retina.

To prevent it, surgeons prescribe anti-inflammatories, but there is no consensus on which ones to use, said Erichsen. “It would be a nice thing if there was a standard of care. But it seems to me that this differs quite a lot. “

Steroid eye drops have a long track record for this purpose and are considered more potent than NSAIDs, but they have been associated with increased intraocular pressure (IOP).

Because some patients have trouble administering eye drops, various slow-release depots and injections have been developed.

And some research has suggested that starting the prophylaxis before surgery is more effective.

To put various approaches to test, Erichsen and colleagues recruited 470 patients at Rigshospitalet Glostrup who were undergoing cataract surgery. They randomly assigned 94 patients to each of the five groups.

In the preoperative combination group — which served as the control group — the steroid and NSAID combination eye drops were started 3 days before surgery. In the postop combination group, the steroid and NSAID combination eye drops were started the day of surgery.

In the preop NSAID group, NSAID monotherapy was initiated 3 days before surgery. In the postop NSAID group, NSAID monotherapy was initiated on the day of surgery.

In the subtenon group, a subtenon depot of dexamethasone phosphate 0.5 mL was administered after surgery.

All eye drops were administered 3 times per day until 3 weeks after surgery. As the NSAID, the researchers used a ketorolac 0.5% solution. As the steroid, they used a prednisolone 1% solution.

At follow-up — 3 days after the surgery, 3 weeks after surgery, and 3 months after surgery — the researchers found no difference in mean central subfield thickness (CST) or corrected distance visual acuity (CDVA) between the preop NSAID group and the groups that received preop or postop combination eye drops.

IOP decreased in all groups. After 3 days and 3 weeks, IOP was higher in both combination groups than in both NSAID monotherapy groups, but that difference had faded by 3 months.

More than half the subtenon group needed additional topical anti-inflammatory drops, suggesting that this approach is not sufficient, Erichsen said.

“This is an important study to further help optimize the postoperative regimen for cataract surgery,” said Francis Mah, MD, co-director of refractive surgery at Scripps Clinic in La Jolla, California.

“It adds more support toward not needing steroids, especially in this modern-day and age where we’re doing modern-day sophisticated cataract surgery, generating a lot less inflammation, ” he told Medscape Medical News.

Mah said he would have liked to see data on the outcomes as early as the first day after surgery.

Subtenon depots are not the best approach to dropless anti-inflammatory prophylaxis because they can cause red spots and discomfort, he explained. An intracanalicular dexamethasone insert and an intraocular dexamethasone injection are both less invasive, but there are challenges to reimbursement for these treatments in the United States, he noted.

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Get Hired with one of the skills below to work and stay in Canada: Apply Now

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40 HOTTEST OPTOMETRY AND HEALTHCARE SEMINAR, THESIS RESEARCH TOPICS

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research topics in optometry

These are current and trending research areas of the 40 hottest optometry and healthcare seminars, thesis research topics which span across different supervisors’ current research interests. Undergraduates and postgraduates can both benefit from modelling after these topics to build their seminar and thesis presentations.

  1. Quantitative analysis of tear film fluorescence and discomfort during tear film instability and thinning (click here for content aid)
  1. The visual impact of the Optical aberrations associated with tear break-up. (click here for content aid)
  1. Contact Lens performance on Dry Eye patients (Click here for content aid)
  1. Recent global treatments for dry eye disease: A Review ( click here for content aid)
  1. Epidemiological burden of dry eye diseases: patient-reported outcome (Click here for content aid)
  1. Measurement of the time course of optical quality and visual deterioration during tear break-up (Click here for content aid)
  2. The Effect of Contact Lens Wear and a Near Task on Tear Film Break-Up. (Click here for content aid)

Also Read:

OPTOMETRY PROJECT/THESIS TOPICS
OPTOMETRY SEMINAR TOPICS
  1. The Relationship between tear instability and hyperosmolarity in dry eye syndrome. ( Click here and also here for content aid)
  1. Assessing the risk of ocular infections and common pathogens prevalent among young adult females on make-over. 
  1. Improving contact-lens-related dryness symptoms with silicone hydrogel lenses. (Click here for content aid)
  1.  Methodologies to diagnose and monitor dry eye disease. (Click here for content aid)
  1. Spatial repeatability and temporal progression of tear breakup. (Click here for content aid).
  1. Tear breakup dynamics: A technique for quantifying tear film instability. (Click here for content aid).
  1. Use of retroillumination to visualize optical aberrations caused by tear film break-up (Click here for content aid)
  1. Lysosomal hydrolase staining of conjunctival impression cytology specimens in keratoconus. (Click here for content aid).
  1. Predicting optical effects of tear film breakup on retinal image quality using the Shack-Hartmann aberrometer and computational optical modelling. (Click here for content aid).
  1. The optical and visual impact of tear break-up in human eyes. (Click here for content aid)
  1. Identification and regulation of bicarbonate transport mechanisms in the retinal tissues
  1. Evaluation of lactate: H+ cotransporters and interaction with HCO3- and carbonic anhydrase mediated buffering Role of SLCA411 in Corneal Endothelial function
  1. Biology of soluble adenylyl cyclase in corneal endothelium and other eye tissues
  1. Role of cAMP and calcium-mediated signal transduction pathways in regulating ion and fluid transport
  1. Accommodative Behavior of Young Eyes Wearing Multifocal Contact Lenses. (Click here   for content aid)
  1. Focus correction in an apodized system with spherical aberration. Click here for content aid 
  1. Modeling the effects of Secondary Spherical Aberration On Refractive Error, Image Quality and Depth of Focus. Click here for content aid.
  1. Effect of Ocular Transverse Chromatic Aberration on Detection Acuity for Peripheral Vision. Click here for content aid.
  1. Polychromatic Refractive Error from Monochromatic Wavefront Aberrometry. Click here for content aid. 
  1.  Chromatic aberration and polychromatic image quality with diffractive multifocal intra-ocular lenses. Click here for content aid
  1. Impact of contact lens zone geometry and ocular optics on bifocal retinal image quality. Click here for content aid 
  1. Linking binocular vision neuroscience with clinical practice. Click here for content aid
  1. Influence of spherical aberration, stimulus spatial frequency, and pupil apodization on subjective refractions. Click here for content aid 
  1. Retinal image quality during accommodation. Click here for content aid
  2. Spherical aberration and the sign of defocus. Click here for content aid.
  3. Use of adaptive optics imaging to investigate the retina. Click here for content aid.
  1. Improved imaging of the eye’s angle with clinical instrumentation. Click here for content aid. 
  1. Isocapnia blocks exercise-induced reductions in ocular tension. Click here for content aid.
  1. Water drinking Effect on Intraocular pressure. Click here for content aid. 
  1. A clinical evaluation of preview pressure phosphene tonometry in children. Click here for content aid
  1. “Comparing small pupil and multifocal strategies for expanding the depth of focus of presbyopic eyes. Click here for content aid.
  1. Liquid Crystal Spatial Light Modulators for Simulating Zonal Multifocal Lenses. Optometry and Vision Science. Click here for content aid.
  2. Diagnosis and management of temporal arteritis: A review and case report. Click here for content aid.

These 40 HOTTEST OPTOMETRY AND HEALTHCARE SEMINAR, THESIS RESEARCH TOPICS are not entirely exhaustive but are here to offer you useful insights on possible ways you could fashion your seminar or thesis topics to carry out your study.

For assistance in writing your research, kindly click here to chat with our admin.

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Mastercard Foundation AfOx Scholarships- UNIVERSITY OF OXFORD

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mastercard university of oxford scholarship program

The University of Oxford and the Mastercard Foundation have an innovative and ambitious partnership under the Mastercard Foundation Scholars Program and the Africa Oxford Initiative (AfOx). The partnership is set to provide 400 young African scholars with a fully-funded opportunity to pursue taught Masters degrees in programmes related to pandemic preparedness and recovery at the University of Oxford.  You can apply for Mastercard Foundation AfOx Scholarships- UNIVERSITY OF OXFORD now.

Apply here

Deadline: Depends on the program, however, most deadlines are on the 20th Jan. 2023

The Scholarship funds a rigorous one-year taught Master’s course at Oxford aimed at equipping the Scholars with relevant technical, entrepreneurial and leadership skills and connecting them to world-leading resources in their respective sectors. Key elements of the scholarship programme include adequate support and preparation for students to take up their studies, intensive emphasis on life skills beyond academia and support for a lifelong network of alumni. Each Scholar will benefit from the highest calibre training in specific disciplines critical to solving pressing problems, including food systems, health sciences, sustainable water and energy systems, governance and public policy, and entrepreneurship, among others. Their programs will centre the four AfOx themes relevant to Africa’s Agenda 2063 and the Sustainable Development Goals: Healthy People, Integrated Societies, Green Futures, and Innovation for Prosperity. Mastercard Foundation AfOx Scholarships- UNIVERSITY OF OXFORD

The scholarship specifically emphasises groups who have historically been under-represented, including but not limited to female scholars, people from refugee and displaced backgrounds and scholars with accessibility needs.  A cohort of 20 Mastercard Foundation AfOx Scholars– UNIVERSITY OF OXFORD. studying various academic disciplines, including global health, engineering, public policy, law, and refugees and forced migration Studies, began their studies in the 2022 academic year. This group of emerging African leaders come from 13 African counties and are members of 9 Oxford colleges.

THIS MASTER’S SCHOLARSHIP COVERS:

  • Covering tuition fees and living expenses for international students.
  • Provides logistics support, including an economy return flight, visa and Immigration Health Surcharge fees, settling down allowance, and access to a Thrive Fund for emergencies.
  •  

Apply also:

Mastercard Scholar program: University of Edinburgh
University of Edinburgh Mastercard Foundation Scholars Program 2023

ELIGIBILITY CRITERIA

  1. All students with an African nationality and residence who receive a conditional offer from the University will be eligible for the scholarship.

2. The scholarship emphasises explicitly groups who have historically been under-represented, including but not limited to female scholars, people from refugee and displaced backgrounds and disabled scholars. Necessary residence considerations will be made for students from refugee and displaced backgrounds.

3. To be considered for this scholarship, submit your application for graduate study to the University of Oxford via the graduate admissions portal by the deadline for your chosen course of study. Please read the Application Guide in detail ahead of making the application. We strongly recommend you submit your application form and all of your supporting documents at least a week before the December/January  for your course.

4. Eligible candidates who receive a conditional offer from their course will be then invited to apply for the AfOx Graduate Scholarship Program. All invited candidates will be expected to fill in the AfOx Graduate Scholarship questionnaire during the application process.

5. Shortlisted candidates will be interviewed virtually before decisions are made, and the timelines will be communicated at the interview stage.

University of Oxford

Apply here for Mastercard Foundation AfOx Scholarships- UNIVERSITY OF OXFORD

PS: Basic Document to Keep Ready?

  • Transcript
  • Degree Certificate
  • English Test result or a waiver for English-speaking countries
  • Personal Statement.

Need help in writing or proofreading your personal statement? Click here

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Related Contents:

OCULAR MANIFESTATION OF SYSTEMIC DISEASES

University of Edinburgh Mastercard Foundation Scholars Program 2023

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Mastercard Scholar program: University of Edinburgh
Scholarship

University of Edinburgh Mastercard Foundation Scholars Program 2023 will provide 1 year full-time on-campus scholarship, 3 year part-time online Master’s scholarships & 2-year part-time postgraduate Diploma scholarships to students living or working in Africa with great academic and leadership potential but few educational opportunities.

Mastercard Scholar program 2023
University of Edinburgh Mastercard Foundation Scholars Program 2023

The University of Edinburgh is recruiting exceptional young people committed to pursuing their studies digitally to apply for an Online Scholarship at the University of Edinburgh. Online studies are an excellent way to earn a qualification, while at the same time continuing to work flexibly and live at home. Online qualifications though the University of Edinburgh are fully equivalent to degrees taught on campus.

Study with us at Edinburgh

Applicants can apply for either:

  • Online Masters (part-time over 3 years) OR
  • Online Post-graduate Diploma (part-time over 2 years)
  • On-Campus Learning Scholarships

On-Campus Learning Scholarships: University of Edinburgh Mastercard Foundation Scholars Program 2023

Online Scholarship……

ON-CAMPUS SCHOLARSHIP: University of Edinburgh Mastercard Foundation Scholars Program 2023

On-campus scholarship…..

The Scholars Program at the University of Edinburgh will provide 1 year postgraduate on-campus scholarships to students living or working in Africa with great academic and leadership potential but few educational opportunities.

On top of the full scholarship (tuition fees, accommodation, travel and living costs stipend), the Scholars Program facilitates a transformative leadership programme to inspire and support Scholars in making changes in their communities and countries on their return home.

Apply also:

Study-In-Canada: 2022 University of Waterloo Arthur F. Church Entrance Scholarships
WORKERS NEEDED IN SAUDI ARABIA- CRAFTS MEN & ENGINEERS CAN APPLY

Eligibility Criteria for the Mastercard Foundation Scholars Program

You must meet the eligibility criteria to apply:

  • Applicants must qualify academically for admission to the University of Edinburgh for a relevant degree programme listed above. You will generally need to have achieved the equivalent of a UK Second Class (Upper) Bachelor’s (Hons) degree or higher. Find out more about the postgraduate entry requirements for your country
  • Applicants must have graduated from undergraduate study before December 2022 and must be in possession of a degree certificate and official, final transcript to upload alongside their application
  • Applicants must be residents and citizens of a Sub-Saharan African country
  • Applicants must be without the financial means to study oversees independently
  • We particularly welcome applications from female scholars, scholars from refugee and displaced backgrounds, and scholars with disabilities (see FAQs below for further information)
  • Applicants must demonstrate a track record of leadership and service within their community
  • If applying for the Masters programme: Applicants should not have previously completed a postgraduate degree and should not be enrolled (or apply to enrol) at a separate university whilst on the Mastercard Foundation Scholarship
  • If applying for the PG diploma: Applicants can either have an undergraduate or Master’s degree from a Sub-Saharan African university (provided they will graduate from either degree before December 2022). If you have a Master’s degree, our admissions team will review you first degree (undergraduate) to meet the post graduate diploma entry requirement. The MCF team will review your Master’s degree transcripts to confirm the graduation date and location of your University.
  • Applicants must be 35 or under on the 1 September 2023

Application deadline for the Mastercard Foundation Scholars Program

The deadline for the MasterCard Foundation Scholars Program is on Friday 27 January 2023.

Application Process for the Mastercard Foundation Scholars Program

  • You must qualify academically for admission to the University of Edinburgh. We prefer that applicants apply to this scholarship before applying to the University.

Apply here

For More Information: Visit the University of Edinburgh Mastercard Foundation Scholars Program 2023/2024

PS: Basic Document to Keep Ready?

  • Transcript
  • Degree Certificate
  • English Test result or a waiver for English-speaking countries
  • Personal Statement.

Need help in writing or proofreading your personal statement? Click here

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10 Shocking habits that make you age faster

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Although aging is inevitable and a part of life, some habits can either slow down aging or make one age faster. 

Collagen and elastin are proteins in the body that give firmness and elasticity to the body and skin. Collagen offers strength and rigidity, while elastin provides elasticity to the skin—ability of the skin to snap back into shape after stretching. With age, the amount of collagen and elastin produced by the skin is greatly reduced. These proteins also break down with age. Wrinkles, dry and sagging skin are the results. These are natural occurrences, however, some environmental and lifestyle factors contribute to the early breakdown of these proteins leading to early onset of wrinkles, sagging skin and other signs of aging.

As widely believed, genetics have a role to play in premature aging but not as much as habits and lifestyle. According to a study, environmental and lifestyle factors account for nearly 80 percent of aging in people as compared to genetic factors that account for only 20 percent. That is to say that while genetics is a factor, looking younger or older than we actually are is entirely up to us!

Here are some of the seemingly harmless habits that can make one to age faster and look older than they really are;

1.Too Much Sun Exposure:

 It is estimated that 90 percent of skin aging by environmental factors is caused by the effects of sun rays. Also, scientists are of the opinion that the first and most common type of skin wrinkling is caused by chronic sun damage. Underneath the skin reside collagen and elastin, which are proteins that help keep the skin firm. Exposure of the skin to UV rays of the sun causes damage to these proteins leading to sagging and wrinkling of the skin. To delay premature aging, protection from the sun is of utmost importance. The body does need some amount of sunshine as it is a good source of vitamin D, however, this vitamin can be obtained through other means, like adding some vitamin D-rich foods to your diet. If you must go out in the sun, ensure you apply sunscreen on your face and other exposed body parts. Also, avoid going out in the sun between 10am to 3pm when the sun rays are believed to be the strongest. 

2. Not Dealing With Stress: 

Stress is unavoidable in humans and as such, one must find a way to combat stress. The major stress hormone, Cortisol, damages the elastin and collagen in the skin that gives the skin its firmness. More stress comes with higher cortisol than the body can handle, which causes less-than-normal production of elastin and collagen. The result is a sagging and early formation of skin wrinkles. Prolonged stress can also cause inflammation leading to reduced ability of the body to repair itself. This can cause early aging of the skin.

3. Alcohol:

 The body needs the right amount of water to function properly. Alcohol causes dehydration of the skin. Excessive alcohol consumption leaves one dehydrated and this can lead to organ damage and dry skin. Alcohol is also linked to a reduction in vitamin and collagen levels, causing a person’s skin to lose elasticity and become wrinkled.

4. Smoking: 

It is a well-known fact that smoking is bad for health and predisposes one to illnesses like heart disease and lung cancer. However, the skin is not left out. The nicotine in cigarettes causes the blood vessels in the skin to narrow, hence the skin does not get the needed oxygen and nutrients it needs for a healthy skin. Also, smoking causes inflammation of the skin, activating enzymes that damage elastin and collagen. This will leave one with wrinkles and sagging skin.

5. Not Getting Enough Sleep: 

Sleep allows the brain and body to undergo processes of renewal and recovery which in turn promotes better physical and mental performance. Sleep deprivation has been linked to reduced skin elasticity, uneven pigmentation and dark circles under the eyes. Research has shown that just a single night of insufficient sleep can make an older adults’ cells age quicker. If you do not get the recommended 8-9 hours of sleep, you are unknowingly speeding up your aging process.

6. Lack of Regular Exercise:

 Exercise improves blood circulation to the body. It gives the skin a healthy look by improving blood flow to the skin, which boosts oxygen levels and the delivery of nutrients to the skin. This promotes skin elasticity as it provides the right conditions for collagen production. This keeps away wrinkles, leaving the skin tight. People who do not exercise are not doing their skin any good as studies have shown that people who exercise show fewer signs of aging than people who do not exercise.

7. Not Drinking Enough Water:

 Water makes up roughly 45-75% of the human body and is essential for collagen production. About 60 percent of the weight of collagen is made up of water. When one is not getting enough water, the collagen breaks down and this can lead to aging. Wrinkles, lines and other signs of aging become visible. 

8. Not Eating Healthy Foods:

 Eating healthy foods not only helps one to live longer but to also look younger. When one doesn’t eat right, it shows. Junk foods, processed meats, refined carbohydrates and sugary snacks are bad for aging. Studies have shown that sugar disrupts the ability of collagen to repair itself. Sugar also dehydrates the natural supply of collagen and elastin, causing the skin to lose elasticity prematurely.  For a healthy and youthful look, incorporate proteins, fresh fruits and leafy, colorful vegetables in your diet. To prevent premature aging, consider eating lots of egg whites, fish and other collagen-rich foods that help in collagen production. 

9. Too Much Intake Of Caffeine: 

Too much caffeine inhibits the enzyme, prolidase, that plays an important role in the synthesis of collagen in the body. This negatively affects collagen production. Also, caffeine affects the length of time it takes for an individual to sleep and the quality of sleep, this cuts into the period of restorative sleep for a radiant skin. Too much caffeine can also result in dehydration as it causes one to excrete fluids, making the skin dull.

10. Repetitive Facial Expression: 

Smile and frown lines when excessive can leave wrinkled lines

Repetitive facial expressions (smiling, frowning, squinting) with muscle contractions can cause wrinkles when done an excessive amount of time. When you repeatedly activate these muscles, the lines you create with the same expressions remain. The wrinkles appear as lines around the mouth from smoking and sipping out of a straw, crow’s feet at the edge of eyes from smiling, creases at the forehead from raising brows. One can try to avoid these movements to prevent wrinkles. 

Genetics play a vital role in how quickly one ages, but habits are a much bigger factor. Getting rid of these habits may not reverse the already-existing signs of aging, but you are on the right path to slowing down your aging process.

10 Shocking habits that make you age faster

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Although aging is inevitable and a part of life, some habits can either slow down aging or make one age faster. 

Collagen and elastin are proteins in the body that give firmness and elasticity to the body and skin. Collagen offers strength and rigidity, while elastin provides elasticity to the skin—ability of the skin to snap back into shape after stretching. With age, the amount of collagen and elastin produced by the skin is greatly reduced. These proteins also break down with age. Wrinkles, dry and sagging skin are the results. These are natural occurrences, however, some environmental and lifestyle factors contribute to the early breakdown of these proteins leading to early onset of wrinkles, sagging skin and other signs of aging.

As widely believed, genetics have a role to play in premature aging but not as much as habits and lifestyle. According to a study, environmental and lifestyle factors account for nearly 80 percent of aging in people as compared to genetic factors that account for only 20 percent. That is to say that while genetics is a factor, looking younger or older than we actually are is entirely up to us!

Here are some of the seemingly harmless habits that can make one to age faster and look older than they really are;

1.Too Much Sun Exposure:

 It is estimated that 90 percent of skin aging by environmental factors is caused by the effects of sun rays. Also, scientists are of the opinion that the first and most common type of skin wrinkling is caused by chronic sun damage. Underneath the skin reside collagen and elastin, which are proteins that help keep the skin firm. Exposure of the skin to UV rays of the sun causes damage to these proteins leading to sagging and wrinkling of the skin. To delay premature aging, protection from the sun is of utmost importance. The body does need some amount of sunshine as it is a good source of vitamin D, however, this vitamin can be obtained through other means, like adding some vitamin D-rich foods to your diet. If you must go out in the sun, ensure you apply sunscreen on your face and other exposed body parts. Also, avoid going out in the sun between 10am to 3pm when the sun rays are believed to be the strongest. 

2. Not Dealing With Stress: 

Stress is unavoidable in humans and as such, one must find a way to combat stress. The major stress hormone, Cortisol, damages the elastin and collagen in the skin that gives the skin its firmness. More stress comes with higher cortisol than the body can handle, which causes less-than-normal production of elastin and collagen. The result is a sagging and early formation of skin wrinkles. Prolonged stress can also cause inflammation leading to reduced ability of the body to repair itself. This can cause early aging of the skin.

3. Alcohol: The body needs the right amount of water to function properly. Alcohol causes dehydration of the skin. Excessive alcohol consumption leaves one dehydrated and this can lead to organ damage and dry skin. Alcohol is also linked to a reduction in vitamin and collagen levels, causing a person’s skin to lose elasticity and become wrinkled.

4. Smoking: 

It is a well-known fact that smoking is bad for health and predisposes one to illnesses like heart disease and lung cancer. However, the skin is not left out. The nicotine in cigarettes causes the blood vessels in the skin to narrow, hence the skin does not get the needed oxygen and nutrients it needs for a healthy skin. Also, smoking causes inflammation of the skin, activating enzymes that damage elastin and collagen. This will leave one with wrinkles and sagging skin.

5. Not Getting Enough Sleep: 

Sleep allows the brain and body to undergo processes of renewal and recovery which in turn promotes better physical and mental performance. Sleep deprivation has been linked to reduced skin elasticity, uneven pigmentation and dark circles under the eyes. Research has shown that just a single night of insufficient sleep can make an older adults’ cells age quicker. If you do not get the recommended 8-9 hours of sleep, you are unknowingly speeding up your aging process.

6. Lack of Regular Exercise:

 Exercise improves blood circulation to the body. It gives the skin a healthy look by improving blood flow to the skin, which boosts oxygen levels and the delivery of nutrients to the skin. This promotes skin elasticity as it provides the right conditions for collagen production. This keeps away wrinkles, leaving the skin tight. People who do not exercise are not doing their skin any good as studies have shown that people who exercise show fewer signs of aging than people who do not exercise.

7. Not Drinking Enough Water: Water makes up roughly 45-75% of the human body and is essential for collagen production. About 60 percent of the weight of collagen is made up of water. When one is not getting enough water, the collagen breaks down and this can lead to aging. Wrinkles, lines and other signs of aging become visible. 

8. Not Eating Healthy Foods:

 Eating healthy foods not only helps one to live longer but to also look younger. When one doesn’t eat right, it shows. Junk foods, processed meats, refined carbohydrates and sugary snacks are bad for aging. Studies have shown that sugar disrupts the ability of collagen to repair itself. Sugar also dehydrates the natural supply of collagen and elastin, causing the skin to lose elasticity prematurely.  For a healthy and youthful look, incorporate proteins, fresh fruits and leafy, colorful vegetables in your diet. To prevent premature aging, consider eating lots of egg whites, fish and other collagen-rich foods that help in collagen production. 

9. Too Much Intake Of Caffeine: 

Too much caffeine inhibits the enzyme, prolidase, that plays an important role in the synthesis of collagen in the body. This negatively affects collagen production. Also, caffeine affects the length of time it takes for an individual to sleep and the quality of sleep, this cuts into the period of restorative sleep for a radiant skin. Too much caffeine can also result in dehydration as it causes one to excrete fluids, making the skin dull.

10. Repetitive Facial Expression: 

Repetitive facial expressions (smiling, frowning, squinting) with muscle contractions can cause wrinkles when done an excessive amount of time. When you repeatedly activate these muscles, the lines you create with the same expressions remain. The wrinkles appear as lines around the mouth from smoking and sipping out of a straw, crow’s feet at the edge of eyes from smiling, creases at the forehead from raising brows. One can try to avoid these movements to prevent wrinkles. 

Genetics play a vital role in how quickly one ages, but habits are a much bigger factor. Getting rid of these habits may not reverse the already-existing signs of aging, but you are on the right path to slowing down your aging process.

WORKERS NEEDED IN SAUDI ARABIA- CRAFTS MEN & ENGINEERS CAN APPLY

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Jobs are currently available for the following positions:

  • Helpers
  • Masons
  • Operators
  • Painters
  • Welders
  • Steel Fixers
  • Scaffolders
  • Plumbers
  • Electricians
  • Civil Engineers
  • Site Engineers
  • Safety Engineers

REQUIREMENTS

  • CV
  • Full length picture on white background
  • Scanned data page of international passport
  • Trade test certificate
  • Skill carder.

Charges may include Visa, Ticket, processing fees, trade test certificate.

For more enquiries on how to apply, contact the team on: 08121426063

How to Put on a Healthy 10KG in a Month

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Gain 10kg in 1 month

There are more obese people in the world than underweight people. Much attention is given to the ills of being obese but being underweight is just as bad, if not worse. Research has it that individuals who are clinically underweight face higher risk of complications than obese individuals.

According to a study comparing underweight and normal-weight individuals, underweight individuals have nearly twice the risk of death. So you should be worried if you are loosing weight without even trying!

If you are reading this blog, chances are that you would like to put on a little bit of weight. The idea is not to stuff yourself full of junk, you don’t want to be obese and be saddled with problems that comes with obesity. You want to gain weight the healthy way. Now you have come to the right place!

What it means to be underweight 

Underweight is having a body mass index below 18.5. It is estimated to be less than the body mass needed to sustain optimal health. 

The Body Mass Index(BMI) is the recommended measure of a person’s weight by the Centre for Disease Control and other health authorities. It is a means of determining whether

a person is underweight, healthy weight or overweight. You can calculate your BMI using this BMI calculator.

BMI estimates the body fat by comparing a person’s weight to the height. For example, a person weighing 100kg may be considered overweight if they are very short but may be seen as healthy weight if they are very tall. This may not hold true for athletes who have muscles. Muscles weigh more than fat. A fat person may weigh considerably lower than a muscular person.

The range of BMI are;

Underweight: less than or equal to 18.5

Healthy weight: 18.5 to 24.5

Overweight: 24.5 to 29.5

Obese: Above 30

Health Risks of being underweight

Being underweight has been linked to some health problems and risks, problems even worse than those associated with overweight. Some of the health risks of being underweight are;

Malnutrition: An underweight person most likely do not have enough nutrients in the body for normal body functions. This lack of nutrients may lead to a wide range of health problems.

Impaired immune function: An underweight person may get sick frequently because the body has little or no nutrient materials necessary to fight off infections. The person is more susceptible to all kinds of illnesses because the body’s defense system is weak. 

Osteoporosis: Being underweight can cause low bone mineral density. This leads to excessive bone loss, making bones more brittle and prone to fracture. This is mostly common in women. 

Irregular menstrual cycle: Women who are underweight may have absent, delayed or irregular menstruation. This may lead to infertility.

Premature births: Research has shown that pregnant women who are underweight have high risk of having premature babies i.e birth delivery before 37 weeks.

Impaired growth and development: Delays in growth and development are mostly seen in underweight children. Children need nutrients for the proper development of the brain and other body organs. Underweight children most likely have delays in their growth and developmental milestones.

Hair and skin problems: As a result of lack of enough nutrients in underweight people, they usually experience hair loss and breakage, dry skin and other skin problems.

Surgical complications: Studies have shown that people with low BMI are at increased risk of surgical and post-surgical complications. This is attributed to infections and delayed wound healing caused by low hemoglobin. Another study linked low BMI with increase in the incidence of post-operative deaths in the first year following a lower extremity bypass surgery.

Heart diseases: Some nutrients such as calcium and potassium are important for a healthy heart. If these nutrients are lacking or there is an imbalance of these nutrients, it can cause irregular heartbeats. According to a study, people who are underweight are more likely to develop heart disorders than normal weight people.

Fatigue: Underweight people tend to feel tired all the time. This is because they lack calories from food that gives energy.  

Anaemia: Low blood count is mainly found in underweight people especially when iron is found absent or in insufficient quantity. This can cause a feeling of tiredness, constant headaches and dizziness.

Causes of Being Underweight

  • Being underweight can be caused by a variety of factors.  Some of the causes include;
  • Improper diet: Lack of proper balanced diet can result in a person being underweight.
  • Eating disorder: These are mental conditions that result in unhealthy eating habits. They include anorexia nervosa, bulimia nervosa, etc.
  • Hyperactive thyroid: An overactive thyroid (hyperthyroidism) produces too much hormones that boost metabolism. The body quickly burns calories leading to unhealthy weight loss.
  • Celiac disease: Celiac disease is the most severe form of gluten intolerance. When people with this disease eat foods containing gluten, the immune system attacks the lining of the intestine leading to inflammation. The villi, which absorbs nutrients in food, is also affected. Weight loss results and the individual ends up malnourished regardless of a healthy appetite or diet.
  • Diabetes: Having uncontrolled diabetes (mainly type 1) can lead to severe weight loss. Here, the body cells attack the insulin-producing organ, pancreas. Without insulin, the body can’t make use of glucose leading to high glucose levels. The unused glucose is excreted as urine, and the body burns fat and muscle for energy. This leads to weight loss.
  • Cancer: Cancerous tumors often burn large amounts of calories and can cause someone to lose a lot of weight. Weight loss is believed to be one of the earliest signs of cancer.
  • Infections: Certain infections can cause someone to become severely underweight. This includes parasites, tuberculosis and HIV/AIDS.
  • Inflammatory bowel disease: This is simply a severe inflammatory disorder of the digestive tract. It puts the body in a constant form of catabolism(using up energy), leading to weight loss.

If the weight loss is unexplained and unintentional, it is important to pay a visit to your doctor to rule out any underlying health problems. 

How to Gain a Healthy Weight

A clinically underweight individual may want to gain weight for health reasons, a normal weight individual may be looking to gain a little bit of muscle mass, and athletes may wish to attain a weight goal. Whatever the reason may be, the same principle applies. 

Now, eating too much processed, sugary and fatty foods is not the way to go about it. It is unhealthy and can cause harm to your body in the long run. You want to gain a balanced and well-proportioned muscle mass, and not a flabby, unhealthy fat. The idea is to gain weight the healthy and safe way.

If you want to gain weight the healthy and safe way, the following tips would do you a whole lot of good; 

Change Eating Habits

Some eating habits are enemies of healthy weight gain and should be avoided as much as possible.

1. Avoid drinking water or any fluids just before meals. Drinking water or fluid may make a person feel full, lose appetite, or it may leave less room for food. Drink water or fluids at least 30 minutes before and after meals.

2. Eat several small meal portions: Some persons may not have appetite for large meals. Eating several small portions allows you get some calories in, without stuffing yourself full.

3. Use bigger plates to eat:  Using smaller plates to eat can cause someone to eat less food. Go for a bigger plate so as to eat more food.

4. Use spices, condiments and sauces: Some people naturally have low appetite for food making it hard for them to eat more. Making your food tasty helps.

5. Eat proteins before vegetables: If you have both protein and vegetables in your meal, eat the proteins first. Eating vegetables first may leave little or no room for the proteins which are crucial for weight gain.

Foods That Make You Gain Weight

There are varieties of foods available to make someone gain weight. However, instead of stuffing yourself full with sweet and unhealthy fat that can cause health problems in the long run, go for high-calorie foods that provide energy and help build muscle mass. 

Studies have shown that protein is the single most important nutrient for gaining healthy weight. Muscle is made up of protein. For a healthy weight gain, one should aim for muscle and not fat. Without protein, most calories end up as fat. Whole Milk: Milk is a complete food with a great mix of carbohydrates, protein, fats, calcium, carbs and minerals. Studies have shown that milk can lead to a greater mass gain than other protein sources. It works even better when combined with lifting weights. Milk or milk shakes is highly recommended after a workout if building muscle is the goal.

Whole eggs: This is one of the healthiest foods for building muscle. It contains a balance of protein, healthy fats and calcium. Most of the nutrients are contained in the yolk but it is important to eat whole eggs. They are full of nutrients and one can eat as much eggs as possible. 

Red meat: Red meat is a rich source of leucine that is essential for boosting muscle mass. Steak and other red meats contain protein and fat, and are crucial for building muscle and helping with weight gain. Eating red meats is known to help in muscle building and weight gain.

Rice: Rice is an excellent source of carbohydrates that is essential for gaining weight. Rice is a dense-calorie food, a cup contains about 200 calories, and one can get enough carbs in a single meal.

Whole-grain breads: Whole grain bread is made up of complex carbohydrates that promote weight gain. Also, the proteins and eggs as ingredients in bread contribute to muscle growth and healthy weight gain

Dried fruit: Dried fruits are a high-calorie snack with natural high sugar content. This makes them good contributors of weight gain.  They also contain antioxidants and micronutrients. One would think that the lack of moisture in dried fruits means loss of nutrients, but the fibers and nutrients remain intact. In fact, the lack of moisture leaves a concentrated mix of nutrients in the dried fruits making it a great source of nutrients.

Avocados: Avocados contain more calories than most fruits and this makes it a good choice for a person who is looking to gain healthy weight. It also contains healthy fat, minerals, vitamins and antioxidants

Healthy fats and oils: Healthy fats and oils like extra virgin olive oil, coconut oils and avocado oils contain high calories. Incorporating them in foods help one to gain weight fast.

Fatty and Oily fish: Salmon is rich in healthy fats and excellent for weight gain. Omega-3 fatty acids present in these fishes is significant for weight gain. Salmon and oily fish also contain proteins that can be used to build muscle.

Dark chocolate: Dark chocolate contains antioxidants and has many health benefits. It has high calorie density. It is recommended that a person looking to gain weight should opt for dark chocolates that contain at least 70 percent cocoa.

Cheese: Cheese is high in calories and fat. It is also a good source of proteins. Full-fat cheese is best for someone who wants to gain weight.

Nuts and nut butters: These are great choices if weight gain is the priority, especially if there are no added sugars or oils in the nut butter. As a matter of fact, the only ingredient in the nut butter should be the nuts itself. If in doubt, raw nuts are better options. They have the most health benefits.

Healthy cereals: Processed and high sugar cereals should be avoided as they contain unhealthy fats. Healthy cereals such as granola is a high calorie-dense food and rich in antioxidants, fibers and protein. When making choice of cereals, go for the ones with most fibers.

Other foods to include in your diet in your quest to build muscle and gain weight the healthy way are;

Potatoes and  starch.

Cereal bars.

Yoghurt.

Protein shakes.

Protein supplements.

Lifestyle modifications

Some lifestyle factors may have effect on your ability to gain weight faster. You may want to; 

Avoid smoking: Smoking suppresses appetite. If you must, avoid smoking at least two hours before meal. Smokers tend to weigh less than non-smokers. Avoiding or giving up smoking may lead to weight gain.

Limit caffeine intake: Limiting caffeine is a good thing if you are on a journey to gain weight. Caffeine may suppress appetite, making one not to feel hungry when the person should be trying to get in as much high-calorie, nutrient-dense food, as possible.

Avoid fasting: To gain weight, one should be about eating more calories than the body burns. You may not achieve significant weight gain with fasting.

Get enough sleep: Proper sleep patterns is important for muscle building. Get as much sleep as you can.

Exercise

This may seem counterproductive as exercise is known to burn calories, but it is essential if you are looking to add muscle. This way, the extra calories are used to build muscle and not end up as fat cells. Some exercises help build muscle mass which in turn helps in weight gain. Exercise also increases appetite.

Weight lifting: The use of dumbbells to perform some type of exercises like squats, help to build muscle. The extra calories from foods can be used to build muscle and not just fat. This should be done with the help of an expert trainer to prevent one from taking on more than one can handle. Over time, the weights can be increased.

Don’t over exercise: Keeping track of routine exercise is important so as not to have the opposite effect of burning calories, leading to weight loss. Eating more helps to strike a balance.

Limit Cardio: If the goal is to build muscle, one should go easy on the cardio. Cardios are important for general health and overall circulation but they burn fat. According to a study, cardio helps to burn calories and limits the potential for muscle growth.

Summary

Increasing your calorie intake is important for weight gain. It means that you are taking in more calories than you burn. A calorie calculator helps to estimate the calorie needs of a person. It may vary by a few hundred calories but it gives an idea of whether you are eating too much or too little.

Gaining weight is not as easy as it seems, it can be very challenging. The body has a certain measure of weight and as such, the body tries to resists changes by regulating appetite and metabolism rate.

If you are looking to gain weight, you should expect that the body may try to resist changes by reducing appetite and boosting metabolism. Weight gain requires conscious efforts as one may need to try to eat despite not feeling hungry.

In all, eating sufficient high-calorie, nutrient-dense foods and doing regular exercises are the best ways to go about gaining weight safely and fast.

If a person is not able to gain significant weight after weeks of religiously following this guide, a visit to the doctor is important to rule out any underlying  health problems.

Edited by:

Njoku Calista

7 MAJOR FRUITS THAT WILL KEEP YOUR IMMUNE SYSTEM TO THE TOP

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Do you know that strong immune system increases your life span? What you eat everyday either boost your immunity or deteriorate it. Do you know that taking fruits at least three times a week can make you not to fall sick every day? It has been proven that someone who eats fruits everyday rarely contract diseases. Today, I have vividly written down the 7 best fruits that will always make your immune system healthy and strong. Time to increase your life span, just concentrate and keep on reading because you will be marvelled at last.

Pause a moment! What is a Fruit?

A fruit is a flowering plant that is encompassed with seed and are edible. Then what are these 7 healthiest fruits that you should be taking regularly?

1. Citrus fruit

These are edible fruits like orange, lemon, grapefruit, pomelos and limes manufactured by Citrus plants and associated subfamily. It has been proven that citrus fruits have low calories and are rich in vitamins and plant compounds. Do you know that constantly taking of citrus fruits prevents you from kidney stones, cancer or any other health problems? Yes! Grapefruit is one of the best citrus fruits loaded with potassium, fiber and beta carotene which the body transformed to vitamin A (Retinol) which helps the body naturally in fighting illness and diseases. It helps the immune system to work properly and function efficiently because it contains vitamin C (Ascorbic acid). It helps the skin in fighting free radicals, repairing and refreshing the skin giving it the coolness it requires. It is also a fat burning substance.

Precaution:

Citrus fruits are meant to be taken one or two per day as excess consumption of it causes diarrhea, nausea, vomiting, or any other health related issues.

2. AVOCADO

Avocado contains rich nutrients like potassium, omega 3s, Vitamin E, C, and K. It also has riboflavin, folic acid ( Vitamin B9) and magnesium. It reduces fat and enhances low density lipoprotein cholesterol levels ( bad cholesterol levels) especially in obese and overweight people that might cause the increase of cardiovascular diseases.

Precaution:

It should be taken moderately because eating large quantities results to bloating, stomach upset, weight gain or any other health issues. Please take one or two a day.

3. APPLE

It is a pome fruit which are edible and gives numerous health benefits. It is a simple fruit fiber and antioxidants. A person who eats apple at least two times a day is not liable to suffer from any chronic diseases like cancer, heart diseases, kidney diseases, diabetes, etc. According to researches being made, it has been discovered that apple when eaten on empty stomach every morning extremely boost your immune system.

Precaution

Don’t take more than one or two a day. Excess consumption of it is hazardous to the body.

4. BANANA

Banana is a wonderful fruit people normally belittled. It has a lot of nutrients that improves your blood sugar and support your digestive health. It also helps in satisfying your tooth and keep you healthy. Banana contains nutrients that support heart health, for example, fiber, potassium, folate, antioxidants, Vitamin C.

Precaution

It is not good to mix sub-acidic fruits like apples with sweet fruits, example banana as it restrained digestion and also causes headache, nausea etc. It’s not meant to be taken on an empty stomach. Eat one or two per day as excess of it increases the risk of cardiovascular diseases.

5. WATERMELON

Watermelon makes you stay hydrated which helps in keeping your immune system cool and healthy. It lowers inflammation, kidney diseases, stomach ache etc, as it flushed toxic substances from the body. It also helps in relieving muscle soreness and helps the skin to appear fresh and smooth.

Precaution

It should be taken moderately.

6. CARROTS

Taking carrots in moderation is very good for your health as it lowers the risk of cancer, balance the level of cholesterol and heart health. It contains Vitamin A and it is nice to be taken on an empty stomach because the body will easily absorb the essential nutrients.

Precaution:

Taking its surplus courses carotenemia and increases your sugar level.

7. COCONUT

Consuming average coconut everyday gives you the best oral health. Someone who takes coconut at least half of it when broken into two makes one to feel relaxed and healthy.

Fruits are really good to the body and extremely helps in boosting the immune system. If you love taking fruits, you will rarely falls sick and helps in digesting your food easily. Most fruits like the ones mentioned above keeps you far from cardiovascular diseases, diabetes, obesity, cancer or any other chronic diseases. Do you want your life span to be increased? Start now to take fruits daily.