Blindness Research Articles

Obesity in patients with craniopharyngioma in the South Asian region – A distinct phenotype

BackgroundCraniopharyngiomas are rare benign tumors located in the sellar and suprasellar region, with an incidence of 0.5–2 cases per million as reported in Western studies. Post-treatment, including surgery and/or radiotherapy, many patients develop significant obesity, primarily due to hypothalamic damage and associated complications such as hypopituitarism. In the South Asian population, genetic predisposition to obesity at lower BMIs, coupled with a carbohydrate-rich diet, may exacerbate obesity in craniopharyngioma patients, presenting a unique challenge. MethodsThis submission is a commentary based on a comprehensive literature review. The authors conducted the review using PubMed to focus on English-language articles covering hypothalamic obesity, craniopharyngioma and obesity in the South Asian population from 1939 to the present. ResultsThe literature review revealed that 50–60 % of patients treated for craniopharyngioma develop obesity, predominantly linked to hypothalamic damage, although these data are mainly derived from Western studies. Hypopituitarism was frequently observed, further contributing to the obesity. Despite a caloric intake appropriate for the age and gender, these patients exhibited reduced physical activity as measured by wrist accelerometers. Patients with hypothalamic obesity due to craniopharyngioma are at risk for metabolic syndrome and cardiovascular morbidity. Additionally, visual impairment was common, leading to a decreased quality of life. The South Asian population, genetically predisposed to visceral obesity and a carbohydrate-rich diet, may display a distinct phenotype. Although multiple treatment modalities have been tried, there is no definite treatment modality available to counteract this condition at present. ConclusionSouth Asian phenotype of craniopharyngioma-related obesity is characterized by significant metabolic and hormonal dysregulation, influenced by both dietary and genetic factors. Nevertheless, there may be a lot to be still understood about this devastating, rapid, relentless hypothalamic obesity syndrome. Also, a higher morbidity rate within this population, underscores the need for further research to develop targeted interventions.

Prevalence of Age-related Macular Degeneration among Elderly Bulgarian Population

Age-related macular degeneration (AMD) is the leading cause of blindness worldwide in an older patient population with the highest risk of disease development in individuals older than 65 years. This study aims to estimate the prevalence of AMD and its stages among the elderly population of Sofia city. An observational study among elderly Sofia citizens, held as prophylactic ophthalmological examinations was performed. The participants underwent full ophthalmic examination including autorefractometry, noncontact tonometry, best-corrected visual acuity measurement, biomicroscopy, and indirect ophthalmoscopy through a dilated pupil. Optical coherent tomography was performed in cases with difficulties to determine the stage of AMD or when the visual acuity did not correspond to the ophthalmoscopy findings. All participants were asked to fill in informed consent and a specifically structured questionnaire based on the modified Wolffson LVQOL questionnaire that was previously used in the study in Eastern Bulgaria (in 2014 by Nencheva). Overall 700 patients, with a median age of 74 years (69 to 96 years) met the inclusion criteria and were enrolled in the study. The prevalence of AMD, early, intermediate and late AMD was estimated as 26.1%, 14%, 6.6%, and 5.6%, respectively. Age was strongly associated with the prevalence of AMD and its stages. The ageing of the population in Bulgaria and worldwide and the large proportion of elderly persons, affected by AMD, emphasize the necessity of regular ophthalmological examinations of that part of the population. The timely diagnosis and treatment are very important for diminishing of blindness and visual impairment.

Postnatal weight loss and neurodevelopmental outcomes at age 3 years in extremely preterm infants: a cohort study

BackgroundPrevious research has suggested a correlation between postnatal maximum weight loss (MWL) and both neonatal mortality and morbidities in extremely preterm infants. However, the relationship between MWL and neurodevelopmental outcomes remains underexplored.MethodsIn a single-center, retrospective cohort study at Okayama Medical Center, we evaluated data from extremely preterm infants admitted to the neonatal intensive care unit from 2010 to 2020. Infants who died within the first 10 days of life were excluded. MWL in the first 10 days was the main exposure, categorized into three groups: >15%, 5–15%, and < 5%. The primary outcome evaluated was the occurrence of death or neurodevelopmental impairment (NDI) at age 3 years, defined as developmental impairments (developmental quotient [DQ] < 85), cerebral palsy, hearing impairments, or visual impairments. Data analysis involved robust Poisson regression, adjusted for perinatal confounders, with a restricted cubic spline function to examine the dose-response relationship. We also conducted a sensitivity analysis using a DQ of < 70 to define developmental impairment.ResultsAmong 135 infants assessed for neurodevelopmental outcomes, 40 were in the > 15% MWL group, 71 in the 5–15% group, and 24 in the < 5% group. Median gestational ages and birth weights were 25.9 weeks and 821 g for > 15% MWL; 26.1 weeks and 818 g for 5–15% MWL; and 26.0 weeks and 734 g for < 5% MWL. Compared with the 5–15% MWL group, the < 5% group exhibited a higher risk of death or NDI at age 3 years (62.8% vs. 80.8%, risk ratio [RR] 1.36, 95% confidence interval [CI] 1.04–1.79) and NDI alone (59.2% vs. 79.2%, RR 1.43, 95% CI 1.06–1.94). Furthermore, higher risks of developmental impairment were also noted in the > 15% (RR 1.32, 95% CI 1.00–1.75) and < 5% (RR 1.46, 95% CI 1.08–1.98) groups. These associations were confirmed by spline analyses. In contrast, the associations between MWL and neurodevelopmental outcomes using a DQ of < 70 were not apparent.ConclusionsMWL within the first 10 days of life may be associated with increased risks of NDI and developmental impairments by age 3 years in extremely preterm infants.

BUILDING DOCUMENT READING ASSISTANT FOR THE VISUALLY IMPAIRED

This study introduces a solution that applies document analysis and recognition technologies to enhance document accessibility for individuals with visual impairments. The objective is to develop an algorithm capable of accurately analyzing the content of document components and converting them into voice format. Leveraging the pre-trained YOLOv8 model for document analysis and optical character recognition technology, the image annotation model uses the AIAnytime API and Pix2Tex technology to extract LaTeX code from images, facilitating the conversion of mathematical formulas into spoken words. The research results demonstrate significant progress in effectively supporting document reading, making a meaningful contribution to the field of assistive technology for the visually impaired.

Identifying SETBP1 haploinsufficiency molecular pathways to improve patient diagnosis using induced pluripotent stem cells and neural disease modelling

BackgroundSETBP1 Haploinsufficiency Disorder (SETBP1-HD) is characterised by mild to moderate intellectual disability, speech and language impairment, mild motor developmental delay, behavioural issues, hypotonia, mild facial dysmorphisms, and vision impairment. Despite a clear link between SETBP1 mutations and neurodevelopmental disorders the precise role of SETBP1 in neural development remains elusive. We investigate the functional effects of three SETBP1 genetic variants including two pathogenic mutations p.Glu545Ter and SETBP1 p.Tyr1066Ter, resulting in removal of SKI and/or SET domains, and a point mutation p.Thr1387Met in the SET domain.MethodsGenetic variants were introduced into induced pluripotent stem cells (iPSCs) and subsequently differentiated into neurons to model the disease. We measured changes in cellular differentiation, SETBP1 protein localisation, and gene expression changes.ResultsThe data indicated a change in the WNT pathway, RNA polymerase II pathway and identified GATA2 as a central transcription factor in disease perturbation. In addition, the genetic variants altered the expression of gene sets related to neural forebrain development matching characteristics typical of the SETBP1-HD phenotype.LimitationsThe study investigates changes in cellular function in differentiation of iPSC to neural progenitor cells as a human model of SETBP1 HD disorder. Future studies may provide additional information relevant to disease on further neural cell specification, to derive mature neurons, neural forebrain cells, or brain organoids.ConclusionsWe developed a human SETBP1-HD model and identified perturbations to the WNT and POL2RA pathway, genes regulated by GATA2. Strikingly neural cells for both the SETBP1 truncation mutations and the single nucleotide variant displayed a SETBP1-HD-like phenotype.

Unveiling the Innate and Adaptive Immunity Interplay: Global Transcriptomic Profiling of the Host Immune Response in Candida albicans Endophthalmitis in a Murine Model.

Intraocular fungal infection poses a significant clinical challenge characterized by chronic inflammation along with vision impairment. Understanding the host defense pathways involved in fungal endophthalmitis will play a pivotal role in identifying adjuvant immunotherapy. Clinical isolates of Candida albicans (15,000 CFU/μL) were intravitreally injected in C57BL/6 mice followed by enucleation at 24 and 72 h postinfection. Histopathological analysis was performed to evaluate the retinal changes and the disease severity. RNA-seq analysis was conducted on homogenized eyeballs to assess the relevant gene profiles and their differentially expressed genes (DEGs). Pathway enrichment analysis was performed to further annotate the functions of the DEGs. Histopathological analysis demonstrated a higher disease severity with increased inflammatory cells at 72 hpi and transcriptome analysis revealed 27,717 DEGs, of which 1493 were significant (adj p value ≤0.05, FC ≥ 1.5). Among these, 924 were upregulated, and 569 were downregulated. Majority of the upregulated genes were associated with the inflammatory/host immune response and signal transduction and enriched in the T-cell signaling pathway, natural killer cell-mediated cytotoxicity, C-type receptor signaling pathway, and NOD-like receptor signaling pathway. Furthermore, inflammation-associated genes such as T-cell surface glycoprotein CD3, cathelicidin antimicrobial peptide, and lymphocyte cell-specific protein tyrosine kinase were enriched, while pathways such as MAPK, cAMP, and metabolic pathways were downregulated. Regulating the T-cell influx could be a potential strategy to modulate excessive inflammation in the retina and could potentially aid in better vision recovery in fungal endophthalmitis.

Optic Atrophy Occurring with Anti‐Tumor Necrosis Factor Alpha Therapy: A Case Report

Ocular involvement related to treatment with tumor necrosis factor alpha inhibitors is a rare adverse effect that may lead to irreversible outcomes. We illustrate through this report a case of optic atrophy under Etanercept in a patient with spondyloarthritis. The diagnosis was suspected due to visual acuity impairment, and was confirmed by ophthalmological examination. Although the TNF-blockers were discontinued and corticosteroids were administered, the follow-up examination did not reveal any improvement in visual acuity. This is a potential serious complication of TNF inhibitors that rheumatologists should recognize when monitoring patients with rheumatic diseases.

Modulation of diabetes-related retinal pathophysiology by PTX3

Diabetic retinopathy (DR) is a common complication of diabetes characterized by vascular pathology and neuroinflammation. Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that functions at the crossroads between innate immunity, inflammation, and tissue remodeling. DR is known to involve inflammatory pathways, although the potential relevance of PTX3 has not been explored. We found that PTX3 protein levels increased in the retina of diabetic mice. Similarly, evaluation of a publicly available transcriptomic human dataset revealed increased PTX3 expression in DR with diabetic macular edema and proliferative retinopathy, when compared to nondiabetic retinas or diabetic retinas without complications. To further understand the role of PTX3 within DR, we employed the streptozotocin-induced diabetes model in PTX3 knockout mice (PTX3KO), which were followed up for 9 mo to evaluate hallmarks of disease progression. In diabetic PTX3KO mice, we observed decreased reactive gliosis, diminished microglia activation, and reduced vasodegeneration, when compared to diabetic PTX3 wild-type littermates. The decrease in DR-associated pathological features in PTX3KO retinas translated into preserved visual function, as evidenced by improved optokinetic response, restored b-wave amplitude in electroretinograms, and attenuated neurodegeneration. We showed that PTX3 induced an inflammatory phenotype in human retinal macroglia, characterized by GFAP upregulation and increased secretion of IL6 and PAI-1. We confirmed that PTX3 was required for TNF-α-induced reactive gliosis, as PTX3KO retinal explants did not up-regulate GFAP in response to TNF-α. This study reveals a unique role for PTX3 as an enhancer of sterile inflammation in DR, which drives pathogenesis and ultimately visual impairment.

Advanced Filtering and Enhancement Techniques for Diabetic Retinopathy Image Analysis

Diabetic retinopathy is a leading cause of visual impairment and blindness in diabetes sufferers. Early detection is crucial to prevent severe outcomes. This study presents an image processing method for retinal images to aid early detection. The method involves four steps: image enlargement, preprocessing, enhancement, and convolution. First, an algorithm enlarges the retinal image to increase resolution and reveal finer details. Preprocessing uses a min-max filtering algorithm to reduce noise and improve image quality. Next, specific pixel range enhancement techniques further refine the image and highlight relevant features. Finally, convolution with customized kernels detects and emphasizes areas indicating diabetic retinopathy, such as aneurysms and hemorrhages. Experimental results show improvement in image clarity and detail, enabling more accurate detection of diabetic retinopathy features. The correlation results are as follows: Filtering (0.35275, 0.20157, 0.4345), Enhancement (0.3214, 0.15823 0.34674), and Convolution (0.33542, 0.15758, 0.36826). The proposed algorithm enhances early detection and diagnosis by improving retinal image quality. Future work can optimize the algorithm and validate results with larger datasets, aiming to refine the determination of areas or pixel values relevant to diabetic retinopathy.

Serum lipid and lipoprotein profiles and their association with intraocular pressure in primary open-angle glaucoma: an observational cross-sectional study in the Chinese population

BackgroundGlaucoma is a leading cause of vision impairment and permanent blindness. Primary open-angle glaucoma (POAG) is a prominent type of primary glaucoma; however, its cause is difficult to determine. This study aimed to analyze the serum lipid profile of Chinese POAG patients and assess its correlation with intraocular pressure (IOP).MethodsThe study included 1,139, 1,248, and 356 Chinese individuals with POAG, primary angle closure glaucoma (PACG), and controls, respectively. Peripheral whole blood samples were collected at the time of diagnosis. Enzymatic colorimetry was used to determine serum levels of different lipids: high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides, cholesterol, and very low-density lipoproteins (VLDL). Additionally, immunoturbidimetry was used to quantify serum levels of apolipoproteins A (APOA), B (APOB), E (APOE), and lipoprotein A [Lp(a)], while intraocular pressure (IOP) was measured in all patients with POAG.ResultsAfter adjusting for age and sex, patients with POAG exhibited elevated serum levels of VLDL, APOA, and APOE but mitigated cholesterol levels compared with the control participants. Significantly lower serum triglyceride, VLDL, and Lp(a) levels were found in patients with PACG than in control participants. Serum cholesterol (P = 0.019; β = -0.75, 95% confidence interval [CI]: -1.38 – -0.12) and HDL levels (P < 0.001; β = -2.91, 95% CI: -4.58 – -1.25) were inversely linked to IOP in patients with POAG, after adjusting for age, sex, and ocular metrics. In addition, serum Lp(a) levels were correlated with the average IOP (P = 0.023; β = -0.0039, 95% CI: -0.0073 – -0.006) and night peak (P = 0.027; β = -0.0061, 95% CI: -0.0113 – -0.0008) in patients with POAG.ConclusionsSignificantly different serum lipid and lipoprotein profiles were observed in POAG and PACG patients. This study highlighted the differences in serum lipid and lipoprotein levels among Chinese POAG patients and their relationship with IOP and IOP fluctuation. Serum lipid and lipoprotein profiles should be considered while evaluating glaucoma risk.

The Effects of a Multi-Sports Program on the Physical Fitness, Quality of Life, and Well-Being of People with Intellectual and Developmental Disabilities—A Study Protocol

We intend to develop an intervention program based on sports for people with Intellectual and Developmental Disability (IDD) to analyze its effects on physical fitness, quality of life (QoL), and well-being. The convenience sample will consist of at least 24 participants aged between 18 and 65, of both sexes, who are institutionalized with a previous diagnosis of IDD and no associated comorbidities (e.g., visual impairment or cerebral palsy). The participants will be divided into two groups: (i) the experimental group and (ii) the control group. The experimental group will have a weekly session, lasting 60 min, for 36 weeks. There will be a baseline assessment, a final assessment, and a follow-up assessment (three months after the end of the program). The results of this study are intended to contribute to the development of more assertive community interventions, based on sports, for the benefit of this population.

Effects of 8 weeks aquatic exercises on balance recovery strategies and center of pressure sways in blind women: A randomized controlled trial

Visual impairment presents significant challenges to mobility and daily activities, often resulting in a sedentary lifestyle and decreased physical fitness. This study aimed to investigate the effects of an 8-week aquatic exercise protocol on balance recovery strategies and center of pressure (COP) sways in blind women. A total of 30 participants were randomly assigned to either an experimental group (EX, n = 15) or a control group (CO, n = 15). Balance recovery parameters, including hip sways, ankle sways, and the ratio of hip sways to ankle sways, were assessed using motion analysis, while COP sways were measured using a force platform. The aquatic exercise protocol focused on enhancing the somatosensory system through a variety of targeted exercises. The results revealed a significant improvement in balance recovery strategies among participants in the EX group, characterized by reduced hip sways, increased ankle sways, and a decreased hip sways/ankle sways ratio in both anterior–posterior and posterior–anterior directions. Moreover, COP sways significantly decreased, as indicated by reductions in ellipse area and traveled distance in both directions. These findings suggest that the aquatic exercise protocol facilitated a shift from a hip-dominant to an ankle-based strategy, indicating improved adaptive balance recovery mechanisms. The reduced COP sways further indicate enhanced postural stability. These positive outcomes underscore the effectiveness of targeted aquatic interventions in enhancing physical capabilities and overall balance in blind women. Including such exercises in rehabilitation programs may contribute to reducing fall risks and improving the quality of life for individuals with visual impairments.

SENSE-Cog Lewy: Investigating the Impact of Sensory Loss on the Diagnosis, Clinical Features and Prognosis of Lewy Body Dementia

Abstract Background Lewy Body Dementia (LBD) accounts for 20% of the nearly 65,000 people with dementia in Ireland, but fewer than 5% of those affected receive a formal diagnosis. LBD includes both Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) and can be characterised by fluctuating and progressive cognitive difficulties, vivid visual hallucinations and REM sleep behaviour disturbances. Sensory function such hearing, vision and olfactory function declines with age—but increasing evidence shows that abnormal patterns of sensory dysfunction can be one of the earliest clinical signs and predictors of progression of neurodegenerative diseases such as Lewy body dementia and Parkinson’s disease dementia. Methods A scoping review was undertaken using Embase, CINAHL, PsychINFO and PubMed. Only reports on people with LBD (DLB and PDD) from any stage, prodromal to late stage were considered. Papers primarily addressing other forms of neurocognitive disorders were excluded. Sensory loss was conceptualised as the loss of smell, vision and hearing. Two reviewers independently assessed each study for inclusion, and disagreements were resolved by a third reviewer. Results Reports on sensory loss in LBD were very few and most often were comparing sensory loss across different dementia types. Strong associations were observed between olfactory loss and particular visual impairment patterns and the severity of both cognitive and non-cognitive DLB symptoms. Olfactory impairment is a potential early biomarker of DLB and PDD and severity of olfactory dysfunction can predict cognitive decline. Visual hallucinations, for example, were found to be closely linked to visual impairment patterns such as pareidolia. Conclusion This study highlights a knowledge gap regarding the patterns of sensory loss in LBD and their relationship with cognitive and non-cognitive LBD symptoms. Sensory assessments represent potentially valuable diagnostic and prognosis tool in LBD, with further research required to understand the aetiological mechanisms underlying sensory impairment in LBD and other dementias.

Global certification of visual impairment registries: A scoping review.

Visual impairment is a global problem which is predicted to rise in the coming years. Some of the biggest causes of visual impairment globally include uncorrected refractive error, cataract and age-related macular degeneration. People with a visual impairment often require support and so many countries hold registers of visual impairment. These registers can sit at a national, regional or local level. This scoping review aims to identify which countries hold visual impairment registries and have published data from them. Medline All, Embase and EBSCOHost were searched using several search terms after consulting an information specialist. All papers after the year 2000 were included in the scoping review. All results are shown using a PRISMA diagram and presented narratively. The total number of articles and papers identified was 1266; after screening and review, 57 articles were included in the review from 2000 to 2024. These articles came from 19 different countries and encompassed national, regional and local visual impairment databases. Many countries cited age-related macular degeneration as the major cause of blindness with diabetic retinopathy and glaucoma following. In less economically developed countries, refractive error was the main cause of sight loss. There were papers which focused on specific eye conditions such as glaucoma and diabetic retinopathy or on specific cohorts including working-age population and children. The leading causes of blindness in children appeared to be inherited retinal diseases, albinism and cerebral visual impairment. Certification of visual impairment is held differently across the world. There is commonality among different countries regarding the major causes of visual impairment in both adults and children. The importance of holding visual impairment registers to support people with a visual impairment and to plan services is essential.

Sibling Relationship of Children with Visual Impairments

Sibling Relationship of Children with Visual Impairments

Magnitude and Direction of Interlimb Asymmetry and the Association of Interlimb Asymmetry with Physical Performance in Judo Athletes with Visual Impairment.

For judo athletes with visual impairments and their coaches, understanding possible muscle adaptations can be challenging. As it is commonplace for these adaptations to include interlimb asymmetry, we analyzed the magnitude and direction of interlimb asymmetry in judo athletes with visual impairments and verified the association of this asymmetry with their unilateral physical performances. Participants were 18 elite judo athletes (10 male, 8 female) with visual impairments. These athletes performed three physical tests: countermovement jump (CMJ), medicine ball throw (MBT), and handgrip strength (HGS), while we conducted unilateral right and left side assessments using the interlimb asymmetry equation for each physical test. Our main results showed that the CMJ and MBT tests presented asymmetry values above 10%; with CMJ significantly higher than HGS (p = 0.050), and with inconsistencies across the three tests in the direction of interlimb asymmetry (k = -0.22-0.26). Unilateral CMJ (left limb) was negatively correlated with asymmetry (r = -0.51; p = 0.031), and unilateral MBT (right limb) was positively correlated with asymmetry (r = 0.52; p = 0.024). Based on these results, coaches should prioritize regular assessments of interlimb asymmetry using these specific tests. This data can guide the construction of training programs aimed at minimizing asymmetry and enhancing overall physical performance. Continuous monitoring and adjustment of training strategies based on asymmetry findings are crucial for optimizing muscle balance in judo athletes with visual impairments.

The incidence of visual impairment due to retinitis pigmentosa has declined in Finland over the last 40 years.

To study the changes in incidence, age at onset and severity of visual impairment (VI) due to retinitis pigmentosa (RP) in the Years 1980-2019, and the incidence and age at diagnosis of hereditary retinal dystrophy (HRD) diagnoses coded by ICD10 H35.5 in the Years 1998-2019 in Finland. A total of 1606 persons with VI due to RP registered by the Finnish Register of Visual Impairment and total of 4291 HRD diagnoses registered by the Care Register of the Finnish Institute for Health and Welfare were included. VI was classified according to the Finnish national definitions derived from the WHO definitions. The significance of the changes in incidence and age at onset were tested with statistical tests (Kruskal-Wallis, Mann-Whitney U and Cochran-Armitage). Two-tailed p-value below 0.05 was considered significant. The incidence of VI due to RP has decreased from 0.96/100 000 in the 1980s to 0.55/100 000 in the 2010s (p 0.004). The age at onset of VI has increased from 41.6 to 50.3 years. The severity of VI has not changed. The incidence of HRD diagnoses has decreased from 3.66/100 000 in the 2000s to 2.86/100 000 in the 2010s (p 0.024). The age at diagnosis has risen in male patients from 42.1 to 44.5 years (p 0.024). The VI caused by RP in Finland has decreased. It develops at an older age than in the past. We hypothesize that this trend may be attributed to informed decisions by visually impaired persons to refrain from having offspring to prevent the transmission of hereditary mutations. The severity of VI due to RP has remained relatively unchanged. The incidence of HRD diagnoses has decreased, and the diagnosis occurs at an older age among men.

Making Mathematics Accessible to Visually Impaired High School Learners in South Africa: Teachers’ Instructional Approaches, Assistive Devices and Challenges

ABSTRACT This case study explored the instructional approaches and assistive devices employed by high school mathematics teachers in teaching visually impaired (VI) learners and the challenges encountered by the teachers in facilitating the learners’ construction of mathematical knowledge. The participants were two high school mathematics teachers from a special school for the visually impaired in South Africa. Data was collected via semi-structured interviews and lesson observation. Inadequate skills in using Braille codes, time constraints, lack of learners’ home support structure, and technology failure are some of the challenges encountered by the teachers in teaching the VI learners. The approaches used by the teachers to teach mathematics to the VI learners in this study are direct instruction, contextual linking, scaffolding, peer tutoring, and problem-solving. The technologies the teachers used included text enlargers, text translators, text embossers, structure embossers, and scientific talking calculators. The study recommends in-service training for teachers teaching mathematics to

Ocular and Periocular Tattoo Adverse Effects: A Review.

Ocular and periocular tattoos, involving ink application to the eyeball or surrounding skin, have gained popularity as forms of self-expression. However, this trend raises significant concerns about potential complications that can adversely affect ocular health and esthetics. Awareness of these risks is crucial for both patients and practitioners. A comprehensive literature review was conducted, focusing on studies discussing complications related to ocular and periocular tattooing. Relevant studies were identified through the MEDLINE, PubMed, and Ovid databases. The reviewed papers were evaluated based on study design, including blinding, sample size, control use, randomization, and objective endpoints, and classified according to the Oxford Center for Evidence-Based Medicine evidence hierarchy. The review identified a wide range of complications, including immediate issues like bleeding, infections (conjunctivitis, endophthalmitis), and allergic reactions. Delayed reactions included granuloma formation, often requiring further treatment. The most serious risk identified was potential visual impairment due to improper technique or ink placement. With the growing trend in ocular and periocular tattooing, there is an urgent need for increased awareness of associated risks. It is crucial to ensure that only qualified professionals perform these procedures, emphasizing the importance of understanding ocular anatomy. Developing strict regulatory guidelines and prioritizing research on the long-term effects of these tattoos are essential for patient safety. A collaborative approach among healthcare providers, regulatory bodies, and educational institutions is needed to mitigate risks and promote best practices in cosmetic tattooing.

ANALISIS KESULITAN MENYIMAK SISWA KELAS III DENGAN PENGGUNAAN MEDIA PEMBELAJARAN AUDIO VISUAL

Difficulty in listening is a difficulty in understanding what they are listening to and this difficulty in listening can be an obstacle during learning in class, because students can miscapture information or perceptions. This study aims to find out the difficulties of listening experienced by students using audio visual learning media. The research method used is qualitative descriptive. The subjects studied were grade III students of SDN Tanah Tinggi 7 Tangerang. The data collection technique uses test sheets, observation sheets, and interview sheets. The results showed that the causes of students' difficulty listening were students feeling bored, having difficulty concentrating, experiencing visual impairment problems, lack of understanding of listening vocabulary, students being noisy and unsettled when approaching the time to go home, lack of interest in fairy tales, dark room conditions and class hours that started too early. This is based on the internal factors of the student, namely from within the student himself and external factors, namely from the physical and social environment around the student.