Total Loss Of Vision Research Articles

Rocket sports and injuries to the eye and adjacent structures

Rocket sports are growing in popularity year after year in every age group. Like any sport, these also involve an increased likelihood of injury. There are different types of injuries that can be sustained as a result of racquet sports, however, in this paper we will not focus on the most common ones. Instead, we will lean on injuries to the eyeball, which is one of the most delicate structures of the human body. Complications of eyeball injuries can have more or less serious consequences. The most serious may even be total loss of vision, but it is important to keep in mind the possibility of a relatively less serious complication, which, if inadequately treated or ignored, can also result in total blindness. The most common mechanical injury to the eyeball that occurs as a result of racket sports is hemorrhage (hyphema). Since ocular injuries are associated with a high risk of complications, it is recommended that PPE (personal protective equipment)should be an integral part of every athlete’s equipment.Interestingly, lenses or corrective glasses are not considered to be adequate forms of protection. On the contrary, during an impact, they can be damaged and cause an aggravation of the injury. It seems that the use of protective eyewear made of specially designed materials can significantly reduce the likelihood of complications of eye injuries. Equally important may be proper education and promotion of protective measures among players, both professional and amateur. The purpose of this study was to analyze the most common types of injuries to the eye and surrounding structures and the occurrence of possible complications, as well as to review of available methods of preventing these injuries.

A - 124 A Case of Lewy Body Dementia and Charles Bonnet Syndrome in a Patient with Bilateral Enucleation

Abstract Objective The patient presented with a history of blindness due to bilateral enucleation (age 10 and 23) and visual hallucinations for approximately 2 years. Approximately 30% of visually impaired individuals are affected by Charles Bonnet syndrome, characterized by complex visual hallucinations in visually challenged patients, possibly stemming from the brain’s attempt to fill the visual void. Additionally, she was diagnosed with Lewy Body dementia (LBD) 2 years prior by her neurologist, and she reported challenges with completing instrumental activities of daily living (IADLs). Method The patient was a left-handed 83-year-old woman, with a history of total blindness and bilateral enucleation, who presented with progressive memory loss 3–4 years prior, along with balance/gait disturbances for 1–1.5 years. The patient and her family sought neuropsychological testing to clarify her cognitive functioning in light of her physical and neurologic symptoms. Results Premorbid functioning was estimated in the low average range, with 11 years of education. Due to her total vision loss, neuropsychological evaluation was limited. Her cognitive profile was marked by impairments in immediate memory, delayed memory, recognition, executive functioning, and language. Conclusions In light of the patient’s marked cognitive deficits in memory, attention, and executive functioning, along with visual hallucinations (although also attributed to possible Charles Bonnet syndrome), balance/gait disturbances, fluctuating awareness, autonomic dysfunction (i.e., bladder/bowel control), and sleep changes (i.e., acting out dreams), her presentation is consistent with LBD, in the moderate stage of severity. Given the symptomatology, it raises the possibility the patient may be experiencing Charles Bonnet syndrome along with LBD.

Assistive products in pharmacy practice to optimize medications use for visually impaired patients: Focus groups to explore community pharmacists' opinions and expectations

BackgroundVisual impairment can significantly affect a person's ability to take medications safely. Therefore, pharmacists need to ensure safe and effective access to medication information, particularly through the use of assistive products, which are devices that compensate for partial or total vision loss. Although assistive products are used by visually impaired patients for activities of daily living, their use in medication management needs to be more widespread. ObjectiveThe study aimed to investigate community pharmacists' opinions and excpectations on the use of assistive products in pharmacy practice to optimize and secure medications use for visually impaired patients. The goal is to transfer these assistive products to pharmacy practice. MethodsFocus groups were conducted with 6 French-speaking community pharmacists via videoconference in Belgium, following the principle of participatory action-research. The participants were recruited voluntarily, and moderator's guides were developed to lead the discussion. The focus groups were recorded, transcribed verbatim, and analyzed in a double-blind fashion using thematic analysis. The data were organized by NVivo software. ResultsFour themes were identified: easy-to-use assistive products according to pharmacists, usefulness of assistive products in pharmacy practice, barriers to the use of assistive products, and potential solutions. According to community pharmacists, certain assistive products were deemed easy-to-use and transferable to pharmacy practice. ConclusionsThis qualitative study demonstrates the transferability of assistive products to pharmacy practice for visually impaired patients in medications use. The study taken into account the patient's profile and the multidisciplinary approach, which community pharmacists consider essential.

Immunogenetic and Environmental Factors in Age-Related Macular Disease.

Age-related macular degeneration (AMD) is a chronic disease, which often develops in older people, but this is not the rule. AMD pathogenesis changes include the anatomical and functional complex. As a result of damage, it occurs, in the retina and macula, among other areas. These changes may lead to partial or total loss of vision. This disease can occur in two clinical forms, i.e., dry (progression is slowly and gradually) and exudative (wet, progression is acute and severe), which usually started as dry form. A coexistence of both forms is possible. AMD etiology is not fully understood. Extensive genetic studies have shown that this disease is multifactorial and that genetic determinants, along with environmental and metabolic-functional factors, are important risk factors. This article reviews the impact of heavy metals, macro- and microelements, and genetic factors on the development of AMD. We present the current state of knowledge about the influence of environmental factors and genetic determinants on the progression of AMD in the confrontation with our own research conducted on the Polish population from Kuyavian-Pomeranian and Lubusz Regions. Our research is concentrated on showing how polluted environments of large agglomerations affects the development of AMD. In addition to confirming heavy metal accumulation, the growth of risk of acute phase factors and polymorphism in the genetic material in AMD development, it will also help in the detection of new markers of this disease. This will lead to a better understanding of the etiology of AMD and will help to establish prevention and early treatment.

Generation of Anterior Segment of the Eye Cells from hiPSCs in Microfluidic Platforms.

Ophthalmic diseases affect many people, causing partial or total loss of vision and a reduced quality of life. The anterior segment of the eye accounts for nearly half of all visual impairment that can lead to blindness. Therefore, there is a growing demand for ocular research and regenerative medicine that specifically targets the anterior segment to improve vision quality. This study aims to generate a microfluidic platform for investigating the formation of the anterior segment of the eye derived from human induced pluripotent stem cells (hiPSC) under various spatial-mechanoresponsive conditions. Microfluidic platforms are developed to examine the effects of dynamic conditions on the generation of hiPSCs-derived ocular organoids. The differentiation protocol is validated, and mechanoresponsive genes are identified through transcriptomic analysis. Several culture strategies is implemented for the anterior segment of eye cells in a microfluidic chip. hiPSC-derived cells showed anterior eye cell characteristics in mRNA and protein expression levels under dynamic culture conditions. The expression levels of yes-associated protein and transcriptional coactivator PDZ binding motif (YAP/TAZ) and PIEZO1, varied depending on the differentiation and growth conditions of the cells, as well as the metabolomic profiles under dynamic culture conditions.

The Role of Glutathione in Age-Related Macular Degeneration (AMD).

Age-related macular degeneration (AMD) is a chronic disease that usually develops in older people. Pathogenetic changes in this disease include anatomical and functional complexes. Harmful factors damage the retina and macula. These changes may lead to partial or total loss of vision. The disease can occur in two clinical forms: dry (the progression is slow and gentle) and exudative (wet-progression is acute and severe), which usually starts in the dry form; however, the coexistence of both forms is possible. The etiology of AMD is not fully understood, and the precise mechanisms of the development of this illness are still unknown. Extensive genetic studies have shown that AMD is a multi-factorial disease and that genetic determinants, along with external and internal environmental and metabolic-functional factors, are important risk factors. This article reviews the role of glutathione (GSH) enzymes engaged in maintaining the reduced form and polymorphism in glutathione S-transferase theta-1 (GSTT1) and glutathione S-transferase mu-1 (GSTM1) in the development of AMD. We only chose papers that confirmed the influence of the parameters on the development of AMD. Because GSH is the most important antioxidant in the eye, it is important to know the influence of the enzymes and genetic background to ensure an optimal level of glutathione concentration. Numerous studies have been conducted on how the glutathione system works till today. This paper presents the current state of knowledge about the changes in GSH, GST, GR, and GPx in AMD. GST studies clearly show increased activity in ill people, but for GPx, the results relating to activity are not so clear. Depending on the research, the results also suggest higher and lower GPx activity in patients with AMD. The analysis of polymorphisms in GST genes confirmed that mutations lead to weaker antioxidant barriers and may contribute to the development of AMD; unfortunately, a meta-analysis and some research did not confirm that connection. Unspecific results of many of the parameters that make up the glutathione system show many unknowns. It is so important to conduct further research to understand the exact mechanism of defense functions of glutathione against oxidative stress in the human eye.

A Comparative Review of Typical and Atypical Optic Neuritis: Advancements in Treatments, Diagnostics, and Prognosis.

Optic neuritis (ON) is a debilitating condition thatthrough various mechanisms, including inflammation or demyelination of the optic nerve, can result in partial or total permanent vision loss if left untreated. Accurate diagnosis and promptly initiated treatment are imperative related to the potential of permanent loss of vision if left untreated, which can lead to a significant reduction in the quality of life in affected patients. ONis subtyped as "typical" or "atypical" based on underlying causative etiology. The etiology of ON can be differentiated when appropriate diagnostic testing is performed. Using history taking, neuroimaging, and visual testing to localize the underlying pathology of ON in a time-sensitive manner is critical in mitigating these unsatisfactory outcomes. Herein, we examine the differences in presentation, pathophysiology, and treatments of typical ON causes, like multiple sclerosis (MS), and atypical causes such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) ON. The present investigation places focus on both neuroimaging and visual imaging in the differentiation of ON. Additionally, this review presents physicians with a better understanding of different presentations, treatments, and prognoses of ON.

UNSALVAGEABLE EYE: HOW CAN WE DO MORE?

Introduction : Unsalvageable eye, consisting of total visual loss, orbital wall fracture, and disfigured globe, is devastating for both patients and caretakers. This impairment is a challenge for ophthalmologists to manage. Although visual rehabilitation is impossible, the appropriate management results in outcome that would improve patient’s quality of life (QoL). We aim to report our successful case of orbital reconstruction with satisfactory outcome.
 Case Illustration : A 75-year-old male presented to our clinic with total visual loss of right eye (RE) after motorcycle accident three months prior. Examination revealed phthisical RE, partially-healed full-thickness inferior palpebral laceration, and inferomedial blow out fracture (BOF). Electroretinography and visual evoked potential examination showed a decrease of right optic nerve conduction. The patient expressed discontentment with his current physical condition. Simultaneous procedures of orbital floor and medial wall fracture repair using silicone block followed by lid reconstruction, and mucous membrane grafting for ocular surface were performed. An ocular prosthesis was fitted. The patient was pleased with the outcome.
 Discussion : Ophthalmologists are often left with little room to aid patients with this condition. More can be done to unsalvageable eye cases. This case shows that improvement of patient’s QoL can be achieved by orbital reconstruction and ocular prosthesis fitting.
 Conclusion : The main objective of managing unsalvageable eye is to restore patient’s orbital anatomical features, hence, improving his QoL.

Abstract 18126: A Rare Case of a Left Ventricular Papillary Fibroelastoma With an Initial Presentation of Unilateral Vision Loss

A 59-year-old female with hypertension presented with acute onset of decreased vision in the right eye. She reported waking up 3 days prior to admission with sudden onset of shadow in the right eye appearing like a falling curtain which eventually progressed to total visual loss. She also complained of headaches and palpitations. The patient denied pain, nausea, vomiting, photophobia, changes in speech, aphasia, facial weakness, arm or leg weakness or numbness. She states that this is her first experience of vision loss. At the time of admission, she was hypertensive to 170/100s and started on amlodipine 5mg and losartan 25mg. Neurology and ophthalmology were consulted for concerns of stroke and new vision loss. She was started on heparin drip, aspirin 81mg, atorvastatin 80mg, and methylprednisolone 1g. Ocular examination revealed right brachial retinal artery occlusion. MRI brain showed chronic microvascular changes, but no acute intracranial hemorrhage or infarction. CT angiogram of the neck showed mild soft plaque in right carotid bifurcation. Transthoracic echocardiogram revealed a 1.6cm x 1.6cm left ventricular mobile mass which appeared to be attached to the posteromedial papillary muscle and left ventricle ejection fraction of 60%. The patient underwent open heart surgery for removal of the mass. The mass was confirmed to be a papillary fibroelastoma attached to the left ventricular trabeculum. The mitral valve and subvalvular apparatus were not involved. New onset of stroke or acute vision loss is generally a result of thromboembolism. Most times it can be caused by a clot formed in a patient with atrial fibrillation. In other cases, it can be due to a ruptured cholesterol plaque. However, primary cardiac tumors are rare, especially ones on the papillary muscle. We presented a rare case of papillary fibroelastoma that possibly embolized causing acute unilateral vison loss. This case reinforces the importance of cardiac imaging in new stroke or acute vision loss.

Improving a method for determining the level of wear of the mark for people with visual impairments on Ukrainian hryvnia banknotes

The object of this study is the wear resistance of marks for people with visual impairments, which are printed by the intaglio printing method on Ukrainian hryvnia banknotes to identify the banknote denominations. The subject of the study is to determine the impact of wear on the recognizability of marks for people with visual impairments and the identification of banknote denominations by people with visual impairments. The paper considers the problem of inadequate assessment of the level of banknote wear by the systems of control and rejection of protected products from the point of view of banknote accessibility for people with visual impairments. An improved methodology for determining the level of wear of the mark for people with visual impairments on Ukrainian hryvnia banknotes is given, taking into account the indicator of its accessibility for all population groups, in particular for people with absolute vision loss, throughout the entire period of circulation. According to the developed methodology, artificial wear of banknotes was carried out according to three test options. The results of changes in the mass of banknotes, the microstructure of the surface of banknotes, the compressibility of marks for people with visual impairments (elasticity level), and the level of tactile identification of the denomination of banknotes by people with total vision loss were obtained. It was determined that during the artificial wear of banknotes, the main destruction of the mark takes place in the first cycle. After the second cycle of wear, there is an increase in the elasticity of the mark for people with visual impairments, a decrease in the level of its tactile sensation and the identification of the denomination of the banknote. Therefore, the properties of banknotes after the second cycle of wear have been determined to be critical for withdrawing such banknotes from circulation. The revealed regularities make it possible to adjust the parameters of intaglio printing during the production of banknotes and to adjust the sorting equipment to determine the suitability of banknotes for further circulation, taking into account the criterion of accessibility of banknotes for all groups of people.

Efficacy of High-Dose Steroid Therapy on Bilateral Total Visual Loss in a Patient with Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)

Efficacy of High-Dose Steroid Therapy on Bilateral Total Visual Loss in a Patient with Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)

Combined effect of carrying both CFH (rs1061170) and TGFβ1 (rs1800469) gene variants on the risks of various forms of age-related macular degeneration

Background: Age-related macular degeneration (AMD) is one of the most common disorders that can lead to total central vision loss after choroidal neovascularization or geographic atrophy (GA). Because the genetic component of the disease plays an important role in the pathogenesis, has an impact on the clinical presentation, and determines the response to treatment, studies on the genetic component of AMD are relevant for better understanding the molecular mechanisms underlying the pathogenesis. Purpose: To investigate associations among TGFβ1 C509T (rs1800469) and CFH T1277С (rs1061170) polymorphisms, their gene-to-gene interactions and the risks of various forms of AMD. Material and Methods: This was a case-control study. The case group included 61 patients with AMD. Of these, 31 were diagnosed with late dry AMD (GA), and 30, with wet AMD (neovascular AMD or nAMD). Patients with nAMD were divided into two subgroups of 14 patients with type 1 or occult subretinal neovascular membrane (SNM), the SNM1 subgroup and 16 patients with type 2 or classical SNM, the SNM2 subgroup. The control group was composed of 50 individuals with no eye disease and of an age distribution similar to that of the case group. Polymerase chain reaction (PCR) and restriction analysis of gene amplification products were performed to determine TGFβ1 rs1800469 and CFH rs1061170. Results: We found a significant effect of TGFβ1 C509T (rs1800469) and CFH T1277C (rs1061170) gene variants on the risks of various forms of AMD. CFH 1277TT genotype was associated with decreased AMD risk, whereas 1277CC genotype, with increased AMD risk (first and foremost, increased GA risk) (р less 0.05). TGFβ1 509CC genotype was associated with increased risk, whereas TGFβ1 509TT genotype, with decreased risk of both GA and SNM2. Conclusion: For the first time, a combined effect of gene variants of interest on the susceptibility to the development of AMD has been investigated, and synergism between these variants in increasing the risk of certain forms of the disease (e.g., GA) established. The results obtained create prerequisites for developing individualized prediction of risk and novel treatment strategies for the disease.

Topical Sustained-Release Dexamethasone-Loaded Chitosan Nanoparticles: Assessment of Drug Delivery Efficiency in a Rabbit Model of Endotoxin-Induced Uveitis.

Uveitis is an ocular illness that if not treated properly can lead to a total loss of vision. In this study, we evaluated the utility of HA-coated Dexamethasone-sodium-phosphate (DEX)-chitosan nanoparticles (CSNPs) coated with hyaluronic acid (HA) as a sustained ocular delivery vehicle for the treatment of endotoxin-induced-uveitis (EIU) in rabbits. The CSNPs were characterized for particle size, zeta potential, polydispersity, surface morphology, and physicochemical properties. Drug encapsulation, in vitro drug release, and transcorneal permeation were also evaluated. Finally, eye irritation, ocular pharmacokinetics, and pharmacodynamics were in vivo. The CSNPs ranged from 310.4 nm and 379.3 nm pre-(uncoated) and post-lyophilization (with HA-coated), respectively. The zeta potentials were +32 mV (uncoated) and -5 mV (HA-uncoated), while polydispersity was 0.178-0.427. Drug encapsulation and loading in the CSNPs were 73.56% and 6.94% (uncoated) and 71.07% and 5.54% (HA-coated), respectively. The in vitro DEX release over 12 h was 77.1% from the HA-coated and 74.2% from the uncoated NPs. The physicochemical properties of the CSNPs were stable over a 3-month period when stored at 25 °C. Around a 10-fold increased transcorneal-flux and permeability of DEX was found with HA-CSNPs compared to the DEX-aqueous solution (DEX-AqS), and the eye-irritation experiment indicated its ocular safety. After the ocular application of the CSNPs, DEX was detected in the aqueous humor (AH) till 24 h. The area under the concentrations curve (AUC0-24h) for DEX from the CSNPs was 1.87-fold (uncoated) and 2.36-fold (HA-coated) higher than DEX-AqS. The half-life (t1/2) of DEX from the uncoated and HA-coated NPs was 2.49-and 3.36-fold higher, and the ocular MRT0-inf was 2.47- and 3.15-fold greater, than that of DEX-AqS, respectively. The EIU rabbit model showed increased levels of MPO, TNF-α, and IL-6 in AH. Topical DEX-loaded CSNPs reduced MPO, TNF-α, and IL-6 levels as well as inhibited NF-κB expression. Our findings demonstrate that the DEX-CSNPs platform has improved the delivery properties and, hence, the promising anti-inflammatory effects on EIU in rabbits.

A LITERARY REVIEW ON TIMIR AND ITS MANAGEMENT

Shalakya Tantra is the main branch of Astanga Ayurveda, it deals with the etiology, diagnosis, prognosis, prevention and treatment of disease which are located above the clavicle region in which the eye is a highly specialized sense organ that primarily serves the function of vision. Drushti or vision is the most important Indriya/sense of human body according to Ayurveda. Visual disturbances are described in Ayurveda under the terms Timir, Kacha, and Linganasha and progresses to total vision loss. Timir is one of the ‘Drushtigataroga’, if it is not treated then it may lead into complete blindness. The symptoms of Patalgat Timir can be correlated with refractive error. Globally it is estimated that approximately 1.3 billion people live with some form of vision impairment. There is no medicinal treatment available for refractive error in modern science and available therapies have some complications like dry eye, corneal ulceration etc. While in Ayurvedic text Timir is said to be ‘Ayushdhisadhya’ if treated in early stages. So, Ayurvedic science can be explored to find a better alternative to manage this condition. In Ayurveda there are number of preventive and curative modalities explained to treat Timir in the form of Pathykaraahar-vihar, Rasayana yoga, Chakshusya drugs, Netrakarma, Kriyakalpa, Panchkarma etc. Use of these therapies helps us to prevent vision loss and to maintain vision.

Microaneurysm classification system in color fundus images using auto‐weight dilated convolutional network

AbstractMicroaneurysms (MAs) are the early indications of diabetic retinopathy (DR), which may result in total visual loss. MAs detection is an exciting work due to its small, darkish color and subtle nature. The automatic detection and categorization of MAs in retinal fundus images using a multi‐scale approach based on Deep Neural Networks and Neighborhood Analysis is proposed in this research article. MAs segmentation, classification, and preprocessing comprise the three steps of the proposed technique. To extract the multi‐scale MA features, the auto‐weight dilated convolutional unit (AD) is specifically used for convolutional feature maps. To fuse convolutional feature maps in encoding layers, the AD unit used a learnable set of parameters. An efficient architecture for feature extraction during the encoding step is incorporated into the AD unit. We integrated the AD unit with the benefits of the U‐Net network for deep and shallow features. Additionally, in order to improve the suggested model and produce the final derivation, we developed a novel optimization approach. After that, neighborhood analysis is performed to name the Micro‐aneurysm because the lesion is actually a collection of independent little images rather than the entire image. The classification accuracy of the proposed method for the three different data sets such as MESSIDOR, online retinal fundus image database for glaucoma analysis (ORIGA), and RIM‐ONE‐R1, is 99.28%, 98.95%, and 98.76% respectively. The results show a good performance of the proposed model against the other analyzed procedure.

LIFI Based Smart shoes Indoor Navigation for Visually Impaired Using Visible Light Communication

Abstract— Blindness is a qualitative term that describes the clinical condition whereby individuals have no light perceptions a result of total vision loss. The daily life of a blind person is affected largely by navigation and mobility issues. The oldest and traditional mobility aids for persons with visual impairments are the walking cane and guide dogs. The short comes of these aides are range of motion and very little Information conveyed. With the rapid advancement in modern technology, this Project proposes a smart shoe that helps the visually impaired in navigation through voice commands which are conveyed through light source in their path. The shoe also detects any obstacles in their path. The main aim of this project is to provide reliable navigation and mobility to visually- impaired Keywords— Li-Fi, Obstacle Detection, Ultrasonic Sensor, Water Sensor, Voice Command, Navigation System.

Optic nerve diseases and regeneration: How far are we from the promised land?

The retinal ganglion cells (RGCs) are the sole output neurons that connect information from the retina to the brain. Optic neuropathies such as glaucoma, trauma, inflammation, ischemia and hereditary optic neuropathy can cause RGC loss and axon damage, and lead to partial or total loss of vision, which is an irreversible process in mammals. The accurate diagnoses of optic neuropathies are crucial for timely treatments to prevent irrevocable RGCs loss. After severe ON damage in optic neuropathies, promoting RGC axon regeneration is vital for restoring vision. Clearance of neuronal debris, decreased intrinsic growth capacity, and the presence of inhibitory factors have been shown to contribute to the failure of post-traumatic CNS regeneration. Here, we review the current understanding of manifestations and treatments of various common optic neuropathies. We also summarise the current known mechanisms of RGC survival and axon regeneration in mammals, including specific intrinsic signalling pathways, key transcription factors, reprogramming genes, inflammation-related regeneration factors, stem cell therapy, and combination therapies. Significant differences in RGC subtypes in survival and regenerative capacity after injury have also been found. Finally, we highlight the developmental states and non-mammalian species that are capable of regenerating RGC axons after injury, and cellular state reprogramming for neural repair.

Pathophysiology of Neurodegeneration in Retinal Diseases as Glaucoma and Diabetic Retinopathy and Potential Mechanisms of Retinal Neuroprotection

Retinal cell neurodegeneration relates to glaucoma, diabetic retinopathy, age-related macular degeneration, and retinitis pigmentosa. Early stages of such disease are preceded by retinal neurodegeneration or angiogenesis in retinal vessels. It is a well established fact that total or partial vision loss is caused by abnormal retinal degeneration of the photo receptors or the inner retinal neurons, as well as unusual growth of cells forming extra retinal venules and arterioles. However the reasons and mechanisms behind the abnormal retinal cell deaths or unusual cell growths remains unknown and is considered an area of active research. This paper reviews contemporary research on retinal disease citing reasons for a typical retinal vessel cell growth, unusual death of retinal cells, and ways to repair the retinal damaged cells under various degrees of impairment. Knowledge about the mechanism behind the sudden change in cell pattern behavior will help to track and better understand the reasons behind early start and rate of progression for such retinal diseases, and how to harness an quick control over disease progression, with help to prognosis and complete recovery. Neurodegeneration of RGC (retinal ganglion cell) is due to Glutamate excitoxicity and a few other factors. Neovascularization occurs from increased VEGF presence in vitreous of eye. Precise cellular repair is done on retina using derived information.

An ayurvedic approach to a case of ulcerative keratitis (Savrana Shukra)

Ulcerative keratitis (UK) is one of the most prevalent ocular diseases characterized by partial or total loss of vision. While contact lens wear is the primary risk factor of the UK in the young, compromised ocular immunity is responsible for it in the old age group. Early diagnosis and treatment help to bring about better results. Antimicrobial therapy remains the mainstay of treatment in ulcerative keratitis, whereas adjunctive topical corticosteroid therapy remains a matter of debate. The UK signs and symptoms match that of Savrana Shukra mentioned in the Ayurvedic texts. We present the case of a 72-year-old male admitted for redness and blurred vision in the right eye, associated with ocular pain, tearing, and photophobia. We diagnosed the case as Savrana Shukra. He underwent Ayurvedic therapy in the form of internal medicines such as Amritotaram Kashaya, Manjistadi kashaya, Kaisora Guggulu and Pratimarsha Nasya with Anu tailam. He also underwent treatments such as Jalokavacharana, Netra Seka, Vidalaka and Anjana karma. After a month of treatment, the corneal ulcer healed completely and thinned down the scar on the cornea. His visual acuity improved from 6/60B to 6/6 in the affected eye. Ayurvedic treatment was effective in completely healing the corneal ulcer and controlling the active inflammation, thereby improving vision. However, more extensive studies with larger samples will yield more data to prove the potential of Ayurveda in such cases.

Towards interactive customization of multimodal embedded navigation systems for visually impaired people

Working technologically with the limitations imposed by the lack of vision is a challenge when the objective is to guarantee an improvement in the lives of people with visual impairment. Trivial tasks for people with vision become challenges for those who cannot see obstacles, resulting in accidents. Thanks to technology, these tasks may be alleviated for people with visual impairment by detecting safe paths and obstacles. However, there may be different needs and preferences among people with visual impairment, and this issue lacks exploration in the literature, since most of the existing approaches offer little or no flexibility in their functioning, not allowing visually impaired users to self-customize them. Thus, this article presents a research effort towards the autonomous, interactive, and multimodal customization of navigation systems for visually impaired people with total vision loss or severe low vision by introducing an abstract model for interactively customizable multimodal navigation systems to serve as a basis for developing this type of system as well as the development of a vision-based multimodal, embedded, and interactively customizable navigation system with input from 14 members of a local Non-Governmental Organization (NGO) for visually impaired people. The developed system was embedded in a wearable prototype based on a System on Chip, validated, and then submitted to evaluations in two experiments carried out with the NGO members, who also co-designed the wearable aspects of the prototype. The evaluation results show that by allowing a navigation system to be fully customized, different needs and preferences can be satisfied, making it easier to be adopted in the daily lives of visually impaired people and contributing to the state of the art of this type of system’s customizability.