The poiintt of Democritus' physiology of the eye is that vision occurs because the eye allows the image in, and its sponginess aids the transmission of the image to the reasoning faculty. Thus,, Democritus' ophthalmology plays an important, though neglected, part in his theory of vision.

This short note attempts to shed light on some of the surgical procedures referred to in Martial's epigram 10.56 by consulting pertinent Graeco-Roman medical texts. A fuller understanding of one such intervention supports Martial's text as transmitted.

Se realizó una revisión documental con el objetivo de reseñar los aspectos históricos relacionados con el surgimiento y desarrollo de la Oftalmología en Camagüey. Se utilizaron documentos de la Biblioteca Provincial “Julio Antonio Mella” y la “Casa Finlay”; así como informaciones obtenidas en entrevistas personales. Se señalaron las características fundamentales de las formas, medios y técnicas de la atención médico-quirúrgicas en cada etapa, y se destacaron las personalidades científicas y los aportes realizados a la especialidad en la docencia, asistencia e (...) investigación. A documental revision was carried out with the objective of describing the historical aspects related with the origin and development of Ophthalmology in Camagüey. Documents from the “Julio Antonio Mella” Provincial Library and the “Finlay House” were used, as well as information obtained by personal interviews. The fundamental characteristics of the forms, means and techniques of the medical-surgical care in each period were pointed out, and were remarked the scientific personalities and the contribution made to the specialty in teaching, assistance and research. (shrink)

In 1688 the Irish scientist and politician William Molyneux sent a letter to the philosopher John Locke. In it, he asked him a question: could someone who was born blind, and able to distinguish a globe and a cube by touch, be able to immediately distinguish and name these shapes by sight if given the ability to see? -/- The philosophical puzzle offered in Molyneux’s letter fascinated not only Locke, but major thinkers such as Leibniz, Berkeley, Diderot, Reid, and numerous (...) others including psychologists and cognitive scientists today. Does such a question represent a philosophical puzzle or a problem that can be solved by experimental tests? Can vision be fully restored after blindness? What is the relation between vision and touch? Are the senses linked through learning or bound at birth? -/- Molyneux’s Question and the History of Philosophy is a major collection of essays that explore the long-standing issues Molyneux’s problem presents to philosophy of mind, perception and the senses. In addition, the volume considers the question from an interdisciplinary angle, examines the pre-history of the question, and aspects of it that have been ignored, such as perspectives from religion and disability. -/- As such, Molyneux’s Question and the History of Philosophy presents a set of philosophically rich, empirically informed, and scientifically rigorous original investigations into this famous puzzle. It will be of great interest to students and researchers in philosophy, psychology, and the cognitive sciences including neuroscience, neurobiology and ophthalmology, as well as those studying the mind, perception and the senses. (shrink)

BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

These chapters analyze texts from Isaac Newton’s work to shed new light on scientific understanding at his time. Newton used the concept of “sensorium” in writings intended for a public audience, in relation to both humans and God, but even today there is no consensus about the meaning of his term. The literal definition of the Latin term 'sensorium', or its English equivalent 'sensory', is 'thing that feels’ but this is a theoretical construct. The book takes readers on a process (...) of discovery, through inquiry into both Newton’s concept and its underlying model. It begins with the human sensorium. This part of his concept is situated in the context of the aforesaid writings but also in the context of the writings of two of Newton's contemporaries, the physicians William Briggs and Thomas Willis, both of whom were at the forefront of their respective specialties of ophthalmology and neurology. Only once the human sensorium has been explored is it possible to generalize to the unobservable divine sensorium, because Newton's method of reasoning from experience requires that the second part of his concept is last in the order of knowledge. And the reason for this sequence is that his method, the short-hand term for which is 'analogy of nature', proceeds from that which has been observed to be universally true to that which is beyond the limits of observation. Consequently, generalization passes insensibly into reasoning by analogy. Readers will see how certain widespread assumptions can be called into question, such as that Newton was a theological voluntarist for whom the will is superior to the intellect, or that, for Newton, not only the world or universe but also God occupies the whole extent of infinite space. The insights afforded through this book will appeal to scholars of the philosophy of science, human physiology, philosophy of mind and epistemology, among others. (shrink)

Erwin Panofsky’s essay “Perspective as Symbolic Form” from 1924 is among the most widely commented essays in twentieth-century aesthetics and was discussed with regard to art theory, Renaissance painting, Western codes of depiction, history of optical devices, psychology of perception, or even ophthalmology. Strangely enough, however, almost nothing has been written about the philosophical claim implicit in the title, i.e. that perspective is a symbolic form among others. The article situates the essay within the intellectual constellation at Aby Warburg’s (...) Kulturwissenschaftliche Bibliothek in Hamburg, and analyzes the role of Ernst Cassirer’s philosophy of symbolic forms for the members of the Warburg circle. Does perspective meet the requirements for becoming a further “symbolic form,” beyond those outlined by Cassirer? The article argues that, ultimately, perspective cannot possibly be a symbolic form; not because it does not meet Cassirer’s philosophical requirements, but rather, because that would uproot Cassirer’s overall project. While revisiting Panofsky with Cassirer unearths the wide-raging philosophical implication of the essay, revisiting Cassirer with Panofsky means to highlight the fundamentally perspectival nature of all symbolic forms. (shrink)

This paper presents an analysis of learning effectiveness for the courses “Selected issues in visual rehabilitation” and “Ophthalmology and ophthalmic nursing” taught in the years 2009-2011 at the Medical University of Bialystok, Poland. We compared the effectiveness of traditional and distance learning methods; an e-learning platform was implemented experimentally for the purpose of this study. We assessed the usefulness of online learning in terms of organization, knowledge gained and students’ satisfaction with the course. The study was conducted among 75 (...) second year master degree students in the nursing field in the academic years 2009/2010 and 2010/2011. The students were divided into two groups. For the study group of 39 persons, lectures and seminars took place on an e-learning platform, while 36 persons in the control group attended traditional classes. 80% of students in the e-learning group and 89% of students in the traditional group assessed the organization of both forms of courses positively. The fact that the majority of students in both the e-learning and traditional classes gave positive feedback indicates that for both forms there was a high level of content and technical preparedness. The mean scores of the final exam for both courses were 82% in the e-learning group and 79% in the traditional group in the years 2009- 2011. The above results show that both forms of learning are equally effective. (shrink)

The topic of colour vision is one that integrates research from psychology, neuroscience, biology, ophthalmology, physics, and genetics. How do we make sense of colour in the world, and how has such an ability evolved in humans? How does the brain interpret colour images? Do men discriminate colours differently from women? Why do some people have problems perceiving colours? Mollon, Pokorny, and Knoblauch are leading authorities on this topic, and together they have brought together a stellar list of contributors, (...) encompassing all these fields. (shrink)

La Segunda Guerra Mundial y las atrocidades cometidas en investigaciones con los prisioneros en los campos de concentración nazis y japoneses, despertaron la conciencia por el desarrollo de los derechos humanos que se habían conquistado paulatinamente a lo largo de la historia. Por ello se conforman una serie de leyes, normas y declaraciones donde se tratan los aspectos bioéticos en los ensayos clínicos. Se debe prestar vital atención a la relación médico-paciente en el curso de las investigaciones y considerar la (...) relación beneficio/riesgo cuando se va a experimentar en seres humanos. La retinopatía diabética proliferativa es una de las afecciones oftalmológicas que más ensayos ha suscitado. El objetivo de este trabajo consiste en analizar algunos aspectos éticos en la experimentación en pacientes con esta afección. The Second World War and the atrocities committed in research with prisoners in Japanese and Nazi concentration camps, awakened consciousness for the development of human rights that had gradually been conquered throughout history. That´s why a series of laws, rules and statements that deal with bioethical aspects in clinical trials, were passed. Special attention must be given to the doctor-patient relationship during the research and consider the benefit/risk ratio when conducting experiments on human beings. Proliferative Diabetic Retinopathy is one of the ophthalmological disorders that has given rise to more trials. The research goal is to analyze some ethical aspects when experimenting on patients with this condition. (shrink)

IntroductionCerebral visual impairment is an important cause of visual impairment in western countries. Perinatal hypoxic-ischemic damage is the most frequent cause of CVI but CVI can also be the result of a genetic disorder. The majority of children with CVI have cerebral palsy and/or developmental delay. Early diagnosis is crucial; however, there is a need for consensus on evidence based diagnostic tools and referral criteria. The aim of this study is to develop guidelines for diagnosis and referral in CVI according (...) to the grade method.Patients and MethodsWe developed the guidelines according to the GRADE method 5 searches on CVI were performed in the databases Medline, Embase, and Psychinfo, each with a distinct topic.ResultsBased on evidence articles were selected on five topics: 1. Medical history and CVI-questionnaires 23. 2. Ophthalmological and orthoptic assessment 37. 3. Neuropsychological assessment 5. 4. Neuroradiological evaluation and magnetic resonance imaging 9. 5. Genetic assessment 5.ConclusionIn medical history taking, prematurity low birth weight and APGAR Scores are important. Different questionnaires are advised for children under the age of 3 years, older children and for specific risk groups. In ophthalmological examination, eye movements, specially saccades, accommodation, crowding, contrast sensitivity and visual fields should be evaluated. OCT can show objective signs of trans-synaptic degeneration and abnormalities in fixation and saccades can be measured with eye tracking. Screening of visual perceptive functioning is recommended and can be directive for further assessment. MRI findings in CVI in Cerebral Palsy can be structured in five groups: Brain maldevelopment, white and gray matter lesions, postnatal lesions and a normal MRI. In children with CVI and periventricular leukomalacia, brain lesion severity correlates with visual function impairment. A differentiation can be made between cortical and subcortical damage and related visual function impairment. Additional assessments can be necessary to complete the diagnosis of CVI and/or to reveal the etiology. (shrink)

During the coronavirus disease 2019 (COVID‐19) pandemic, bioethical analyses often emphasized population health and societal benefit. Hospital policies frequently focused on reducing risk of transmitting SARS‐CoV‐2 by restricting visitors; requiring protective equipment; and screening staff, patients and visitors. While restrictions can be burdensome, they are often justified as essential measures to protect the whole population against a virus with high rates of transmission, morbidity and mortality. Yet communities are not monolithic, and the impacts of these restrictions affect different groups differently. (...) An ophthalmological unit outreach program in Ethiopia serves to illustrate. Pre‐operative screening policies were designed to protect as many patients as possible but had adverse impacts on underserved communities. As this case study demonstrates, creating hospital policies that truly serve the good of the society may require a more holistic review of impacts on inequitably positioned communities. (shrink)

BackgroundParkinson's disease is a chronic neurodegenerative disease, which can be alleviated in drug treatment, but with evident side effects. At the same time, increasing evidence shows that exercise can significantly improve the symptoms of patients with Parkinson's disease, with an effect that cannot be achieved by drug treatment. The related research on exercise on Parkinson's disease increases rapidly with the passage of time. However, the research analysis on Parkinson's disease by means of bibliometrics is rare. The purpose of this study (...) is to perform a bibliometric analysis of the research hotspots and development trends of the global movement on Parkinson's disease from 2012 to 2021.MethodsThe literature was derived from the Web of Science core collection database, and the social science citation index was set as SCI-EXPANDED. The language was set to English, and the literature category was set as article and review and published from 2012 to 2021. CiteSpace and other software were used to analyze the relationship among published documents, countries, institutions, journals, authors, references, disciplines, and keywords.ResultsA total of 2,222 articles were included in the analysis. The analysis showed that the publication volume increased with the increase in years, with a total of 76 countries and 546 academic journals published; the largest number was that of the United States. The journals are mainly concentrated in the fields of neurology, sports, and ophthalmology. Rush University and Movement Disorders journals are the main institutions and journals. The cited keywords show that trial, cognition, and interference are the research hotspots and development trends in recent years.ConclusionThe number of published articles on Parkinson's disease by exercise has increased rapidly in the past 10 years, and the bibliometric analysis can provide useful information for future research teams and researchers. (shrink)

This article contains an analysis of Warren Neidich’s early photographic work of 1997 until 2002. These works are linked to the extensive theoretical production of the artists who connect them to the concepts of the dispositif and apparatus respectively. The article provides a close description of the parameters of four pivotal work groups of Neidich’s early practice, Brain Wash, Double Vision, Shot Reverse Shot and Law of Loci. These works were realized with the aid of low-tech devices stemming from neuro- (...) class='Hi'>ophthalmology, marking the interface between current neuro-philosophical discourses such as the plasticity of the brain, the apparati of visual, i.e. analog and digital, culture and the philosophy of memory. It is suggested that Neidich, even though he intervenes and contributes importantly to these intermingling discourses in a broad manner, is particularly interested in the degraded and infirm implementations of human vision in order to explore new sensations and habits of perception. (shrink)

PurposeTo evaluate the relationship between intraocular straylight perception and: (i) contrast sensitivity (CS), (ii) halo size, and (iii) hazard recognition distance, in the presence and absence of glare.Subjects and methodsParticipants were 15 (5 female) ophthalmologically healthy adults, aged 54.6–80.6 (median: 67.2) years. Intraocular straylight (log s) was measured using a straylight meter (C-Quant; Oculus GmbH, Wetzlar, Germany). CS with glare was measured clinically using the Optovist I device (Vistec Inc., Olching, Germany) and also within a driving simulator using Landolt Cs. (...) These were presented under both static or dynamic viewing conditions, and either with or without glare. Hazard detection distance was measured for simulated obstacles of varying contrast. For this, the participant was required to maintain a speed of 60 km/h within a custom-built nighttime driving simulator. Glare was simulated by LED arrays, moved by cable robots to mimic an oncoming car’s headlights. Halo size (“halometry”) was measured by moving Landolt Cs outward originating from the center of a static glare source. The outcome measure from “halometry” was the radius of the halo (angular extent, in degrees visual angle).ResultsThe correlation between intraocular straylight perception, log s, and hazard recognition distance under glare was poor for the low contrast obstacles (leading/subdominant eye: r = 0.27/r = 0.34). Conversely, log CS measured with glare strongly predicted hazard recognition distances under glare. This was true both when log CS was measured using a clinical device (Optovist I: r = 0.93) and within the driving simulator, under static (r = 0.69) and dynamic (r = 0.61) conditions, and also with “halometry” (r = 0.70). Glare reduced log CS and hazard recognition distance for almost all visual function parameters.ConclusionIntraocular straylight was a poor predictor of visual function and driving performance within this experiment. Conversely, CS was a strong predictor of both hazard recognition and halo extent. The presence of glare and motion lead to a degradation of CS in a driving simulator. Future studies are necessary to evaluate the effectiveness of all above-mentioned vision-related parameters for predicting fitness to drive under real-life conditions. (shrink)

Considerable controversy has recently arisen regarding the patenting of medical and surgical processes in the United States. One such patent, viz. for a "chevron" incision used in ophthalmologic surgery, has especially occasioned heated response including a major, condemnatory ethics policy statement from the American Medical Association as well as federal legislation denying patent protection for most uses of a patented medical or surgical procedure. This article identifies and discusses the major legal, ethical and public policy considerations offered by proponents and (...) opponents of such patents. The existing literature divides up into those who favor such patents essentially without qualification, and those who condemn and wish to outlaw them. We advance a compromise position where administrative and legislative action is called for to provide more specific guidelines regarding the patentability of such processes by the Patent and Trademark Office. Our position, in sum, will be that too much is at stake in this complicated area for either the blanket prohibition, or wholesale, uncritical acceptance, of the patenting of medical and surgical processes or techniques. (shrink)

More and more studies showed that strabismus is not simply an ocular disease, but a neuro-ophthalmology disease. To analyze potential changes in brain activity and their relationship to behavioral performance in comitant strabismus patients and healthy controls. Our study recruited 28 patients with comitant strabismus and 28 people with matched weight, age range, and sex ratio as healthy controls. Using resting-state functional magnetic resonance imaging, we evaluated fALFF to compare spontaneous brain activity between comitant strabismus and healthy controls. We (...) did hospital anxiety and depression scale questionnaires for these patients. We found significantly lower fALFF value in comitant strabismus patients compared with controls in the left frontal superior medial gyrus and the right middle cingulum. In the latter region, fALFF was significantly negatively correlated with the hospital anxiety and depression scale, as well as the duration of disease. Receiver operating characteristic curve analysis indicated that the fALFF method has clear potential for the diagnosis of comitant strabismus patients. These results revealed abnormal spontaneous activity in two brain regions of comitant strabismus patients, which may indicate underlying pathologic mechanisms and may help to advance clinical treatment. (shrink)

Dual task is known to affect postural stabilty in children. We explored the effect of visual tasks on postural control in dyslexic and in age-matched non-dyslexic children. Thirty dyslexic children (mean age: 9.80 ± 0.28 years) were compared with thirty non-dyslexic children (mean age: 9.92 ± 0.35 years). All children underwent ophthalmologic and optometric evaluation. Eye movements were recorded by a video-oculography system (EyeBrain ® T2) and postural sway was recorded simultaneously by a force platform (TechnoConept®). Both groups of children (...) performed fixations, pursuits, pro- and anti-saccades tasks. Dyslexic children showed significantly poor near fusional vergence ranges (convergence and divergence) with respect to the non-dyslexic children. During the postural task, quality of fixation and anti-saccade performance in dyslexic children were significantly worse compared to non-dyslexic children. In contrast, the number of catch-up saccades during pursuits and the latency of pro-and anti-saccades were similar in both groups of children examined. Concerning postural quality, dyslexic children were more unstable than age-matched non-dyslexic children. For both groups of children tested we also observed that executing saccades (pro- and anti-saccades) reduced postural values significantly in comparison with fixation and pursuit tasks. The impairment in convergence and divergence fusional capabilities could be due to an immaturity in cortical structures controlling the vergence system. The poor oculomotor performance reported in dyslexic children suggested a deficit in allocating visual attention and their postural instability observed is in line with the cerebellar impairment previously reported in dyslexic children. Finally, pro- or anti-saccades reduce postural values compared to fixation and pursuit tasks in both groups of children tested, suggesting a different influence of visual tasks on postural control according to their attentional demand. (shrink)

Proteoglycan 4 (PRG4), first identified in synovial fluid, is an extracellular matrix structural protein in the joint implicated in reducing shear at the cartilage surface as well as controlling adhesion‐dependent synovial growth and regulating bulk protein deposition onto the cartilage. However, recent evidence suggests that it can bind to and effect downstream signaling of a number of cell surface receptors implicated in regulating the inflammatory response. Therefore, we pose the hypothesis: Does PRG4 regulate the inflammatory response and maintain tissue homeostasis? (...) Based on these novel findings implicating PRG4 as an inflammatory signaling molecule, we will present and discuss several hypotheses regarding potential mechanisms by which PRG4 may be able to regulate inflammation. If future studies can demonstrate that PRG4 is a potent inflammatory mediator, this will change current paradigms in the musculoskeletal and ophthalmological fields regarding the how the inflammatory microenvironment is regulated in these tissues and potentially others. (shrink)

This paper traces the history in print of a treatise on ophthalmology by Benvenutus Grassus, De probatissima arte oculorum, originally written in Latin in the late thirteenth century and translated into English in the fifteenth century. It presents evidence of the appearance in print of the English translation as a section of Philip Barrough's The Method of Phisicke in 1583, a book that went through ten subsequent reprintings, the last appearing in 1652. Other evidence is presented on the influence (...) of Benvenutus' treatise in ophthalmological works published in the earlier half of the seventeenth century, and both greater and lesser traces are shown to exist. The last appearance of the treatise is in an auctioneer's catalogue of 1713, where apparently the book failed to find a buyer. (shrink)

Aim: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.Method: Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union the leaflets were assessed (...) for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed.Results: All the units’ leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50–75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high.Conclusion: Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Of Literary Universals:Ninety-Five ThesesPatrick Colm Hogan1. There is no such thing as human culture or human cultural difference without human universality.1 (A parallel point about understanding human cultural difference was made by Donald Davidson.2) Alternatively, cultural difference is variation on human universality.2. It follows that every area of a culture manifests human universality. (Otherwise, those cultural areas would not exist.) It does not follow that all areas of culture (...) are found in all cultures. The empirical study of literature, an area of some cultures, would not exist if it did not manifest human universality. It does not follow that the empirical study of literature exists in all cultures.3. The presence of verbal art in any given culture—thus the determination of whether verbal art is found in all cultures—is dependent on the investigator's definition of the term "verbal art," not on the presence or absence of a parallel term in the culture being investigated. "Verbal art" is no different from any other term or phrase in this respect. We would not conclude that there is no color orange in a place that does not have a word parallel to "orange" or that there is no astigmatism in societies without ophthalmology—or that the English do not experience ennui or Schadenfreude.On Communicative Speech4. To understand or even isolate verbal art, we must first understand the general purposes and properties of communicative speech.5. Communicative speech aims at producing some mental alteration in an addressee. That change commonly has some direct or indirect action as its desired outcome. For example, suppose I am building [End Page 145] a house with Wittgenstein and I say "Plank!" My aim is to produce a mental change in Wittgenstein that will result in him retrieving a plank and bringing it to me.6. Action commonly involves a set of generative principles for bodily motion or mental deliberation, a set of regulative principles for adjusting the motion or deliberation, and a set of motives for initiating the motion or deliberation.7. Communicative speech, then, commonly aims at fostering emotions and ideas or representations that, in combination, activate and specify generative principles for action in an addressee. (The emotion may be very weak—for example, a mild aversion to being uncooperative.) It may involve regulative principles as well.8. Verbal art—as I am using the phrase—also aims at producing a mental alteration in an addressee. However, that mental alteration is not, in the first place, governed by the overarching goal of effecting a particular actional outcome. Thus it is not designed to engage generative rules for action or to trigger emotions that motivate such action.9. Rather, verbal art is commonly designed to communicate regulative principles for action and to inspire emotions that do not have direct actional outcomes in the case at hand.10. There are two sorts of regulative principles that figure prominently in both ordinary life and verbal art—ethical and prudential. They constitute the thematic or didactic aspect of verbal art, an aspect noted in every major tradition of literary theory—European, South Asian, East Asian, and Middle Eastern/North African.311. Here and in other cases, individual works of verbal art need not share all universal properties or share them all in the same degree.Rather, all cultural traditions have a body of works of verbal art that, as a whole, have these properties.On Emotion12. Any sort of emotion may occur in verbal art. Indeed, verbal art involves all varieties of emotion.13. However, verbal art is not about the addressee himself or herself. Therefore a literary work does not inspire narrowly egocentric emotions in its audience. It inspires empathic emotions.14. Empathic emotion may be a function of situational particularity or of group identity. In situational empathy, we share a person's or character's emotion insofar as we have been in a parallel situation. [End Page 146] The shared feeling is based on emotional memories. In group-identity empathy, we share a person's or character's feelings because we tacitly understand him or her as sharing our identity. This shared feeling is, then... (shrink)

IntroductionCerebral visual impairment results from damage to cerebral visual processing structures. It is the most common cause of pediatric visual impairment in developed countries and rising in prevalence in developing nations. There is currently limited understanding on how neurologic, developmental, and ophthalmic factors predict outcome for pediatric CVI.MethodA retrospective manual chart review of pediatric CVI patients seen at the tertiary pediatric hospital neurology and neuro-ophthalmology service between 2010 and 2019 was conducted. Patients were stratified into severity groups, and followed (...) over time to identify outcome predictors. Collected baseline characteristics included perinatal, genetic, developmental, and neurologic history, along with neuroimaging and fundoscopic findings on examination. Longitudinal data collected included age, seizure control, and type of therapy received. Linear mixed-effect models were used for longitudinal CVI grade outcome analysis.ResultsA total of 249 individuals spanning 779 patient visits were identified. Mean age at diagnosis was 18.8 ± 16.8 months. About 64.3% were born at term age. Perinatal history revealed hypoxic ischemic encephalopathy in 16.5%, intraventricular hemorrhage in 11.6%, and seizures in 21.7%. At presentation, 60.3% had a diagnosis of cerebral palsy and 84.7% had developmental delay. Among all subjects, 78.6% had epilepsy; 33.8% had an epileptic encephalopathy, with spasms/hypsarrhythmia being most common. Abnormal neuroimaging was present in 93.8%. Genetic anomalies were present in 26.9%. Baseline visual examination revealed no blink-to-light in 24.5%; only BTL in 34.5%, fixation/tracking in 26.5%, and optokinetic drum follow in 14.4%. Longitudinal data analysis showed that perinatal history of HIE, a positive epilepsy history, using multiple epilepsy medications, cerebral palsy, and abnormal fundoscopic findings were all negatively associated with CVI grade change over time. After controlling for significant confounders, receiving any type of therapy [early childhood intervention, physical and occupational therapy, refractive error correction or glasses] was significantly associated with longitudinal improvement in CVI grade compared to patients who did not receive any therapy, with glasses yielding the largest benefit.ConclusionThis study offers extensive insights into neurologic, developmental and ophthalmologic features in patients with moderate to severe CVI. In concordance with previous findings, aspects of perinatal history and epilepsy/seizure control may help inform severity and prognosis in the general neurology or ophthalmology clinic. Conversely, these aspects, as well as genetic and specific epilepsy traits may alert vision health care providers in the clinic to pursue visual evaluation in at-risk individuals. Longitudinal follow-up of CVI patients showed that interventional therapies demonstrated vision function improvement greater than no therapy and maturational development. (shrink)

The issue of recurrent attenders to eye casualties has received little discussion in the ethics and health policy literature. As many ophthalmology departments offer a walk-in emergency service, protocols need to be in place to ensure appropriate use of this resource and also to identify potential psychiatric comorbidity in such attenders. We illustrate the problem with a recent case.A 42-year-old woman self-presented 14 times over a 4-month period to the same ophthalmic accident and emergency unit. ….

ZusammenfassungNach zwölf Jahren intensiver Forschung etablierte der Ophthalmologe Theodor Leber (1840–1917) am Ende des 19. Jahrhunderts in der Entzündungsforschung die Chemotaxis der Leukozyten. Obwohl sich seine Theorie damals reibungslos in die immunologische Forschung einschrieb, wird sein Name jedoch bis heute nur in der englischsprachigen Fachliteratur mit der Chemotaxis verknüpft. In seinem Experimentalsystem hatte Leber zwar schon Anfang der 1880er Jahre eine Theorie der chemischen Attraktion der Leukozyten beim Entzündungsprozess entwickeln können. Aber seine unkonventionelle Methodik—die Einführung von chemisch indifferentem Fremdmaterial zur (...) Auslösung einer Entzündung am Kaninchenauge—widersprach schon vom Ansatz her dem zu diesem Zeitpunkt dominant bakteriologischen Denkstil der Entzündungsforschung. In diesem Forschungsfeld hielt Leber an einer Forschungspraxis fest, die aus einer engen Verzahnung von experimenteller und theoretischer Arbeit bestand. Erst als eine Öffnung des bakteriologischen Denkstils eingetreten war, gelang es Leber seine auf losen Protokollseiten festgehaltenen Versuchsbeobachtungen in überzeugende Belege seiner Entzündungstheorie zu transformieren. Die mikrohistorische Rekonstruktion von Lebers experimenteller und schriftlicher Arbeit anhand seiner Laborprotokolle erschließt die Forschungspraxis eines Wissenschaftlers, der in der damals etablierten mikrobiologischen Entzündungsforschung kaum Anerkennung fand. Durch Verbindung der mikrohistorischen Rekonstruktion mit einer makrohistorischen Analyse lassen sich außerdem Beharrungsfaktoren im Prozess der Wissensentstehung offenlegen. Leber entwickelte eine spezifische Papiertechnik, durch die er seine experimentellen Erkenntnisse zwar mobilisierte und stabilisierte, aber nicht mit dem Fortschreiten der Wissenschaft mithalten konnte. (shrink)

ZusammenfassungNach zwölf Jahren intensiver Forschung etablierte der Ophthalmologe Theodor Leber (1840–1917) am Ende des 19. Jahrhunderts in der Entzündungsforschung die Chemotaxis der Leukozyten. Obwohl sich seine Theorie damals reibungslos in die immunologische Forschung einschrieb, wird sein Name jedoch bis heute nur in der englischsprachigen Fachliteratur mit der Chemotaxis verknüpft. In seinem Experimentalsystem hatte Leber zwar schon Anfang der 1880er Jahre eine Theorie der chemischen Attraktion der Leukozyten beim Entzündungsprozess entwickeln können. Aber seine unkonventionelle Methodik—die Einführung von chemisch indifferentem Fremdmaterial zur (...) Auslösung einer Entzündung am Kaninchenauge—widersprach schon vom Ansatz her dem zu diesem Zeitpunkt dominant bakteriologischen Denkstil der Entzündungsforschung. In diesem Forschungsfeld hielt Leber an einer Forschungspraxis fest, die aus einer engen Verzahnung von experimenteller und theoretischer Arbeit bestand. Erst als eine Öffnung des bakteriologischen Denkstils eingetreten war, gelang es Leber seine auf losen Protokollseiten festgehaltenen Versuchsbeobachtungen in überzeugende Belege seiner Entzündungstheorie zu transformieren. Die mikrohistorische Rekonstruktion von Lebers experimenteller und schriftlicher Arbeit anhand seiner Laborprotokolle erschließt die Forschungspraxis eines Wissenschaftlers, der in der damals etablierten mikrobiologischen Entzündungsforschung kaum Anerkennung fand. Durch Verbindung der mikrohistorischen Rekonstruktion mit einer makrohistorischen Analyse lassen sich außerdem Beharrungsfaktoren im Prozess der Wissensentstehung offenlegen. Leber entwickelte eine spezifische Papiertechnik, durch die er seine experimentellen Erkenntnisse zwar mobilisierte und stabilisierte, aber nicht mit dem Fortschreiten der Wissenschaft mithalten konnte. (shrink)

Se realizó una investigación cualitativa, durante noviembre de 2013 a noviembre de 2015 con el objetivo de mostrar un protocolo de salud como tecnología social para la promoción y prevención de las manifestaciones oftalmológicas en pacientes con VIH/sida. Se utilizaron métodos teóricos y empíricos los cuales permitieron conocer antecedentes del problema a investigar, realizar acciones y caracterizar el fenómeno en estudio. El protocolo constituye una tecnología social, debido a que está compuesto por normas y procedimientos para la conducción de un (...) proceso social no relacionado con la esfera productiva. El diseño de esta tecnología social propicia un adecuado diagnóstico, tratamiento y seguimiento de las enfermedades oculares en pacientes con VIH/sida, sustentado en la teoría del conocimiento. A qualitative investigation was carried out during November 2013 to November 2015 with the objective of developing a protocol as social technology for the promotion and prevention of ophthalmologic manifestations in patients with HIV/AIDS. Theoretical and empirical methods that allowed knowing the antecedents of the problem under investigation, to carry out actions and to characterize the studied phenomenon, were used. The protocol constitutes a social technology, because it is composed by norms and procedures for the conduction of a social process that is not related with the productive area. The design of this social technology favors an adequate diagnosis, treatment and follow-up of eye conditions in patients with HIV/ AIDS, based on the theory of knowledge. (shrink)

Chinese Hui medicine is a unique Chinese traditional medicine system formed by the integration of traditional Islamic Arabia medicine and China traditional Chinese medicine. It is also the cream of ancient Eastern and Western traditional medicine. Hui medicine is based on its unique concepts of Hui medical philosophy, such as the theory of Zhenyi Vitality and the theory of seven elements. It is the only traditional national medicine developed by inheriting Islamic Arab medical philosophy and integrating Chinese traditional Chinese medical (...) philosophy theory. Hui medicine likes to use the application method characterized by aromatic Hui medicine (also known as ship medicine). It has high traditional treatment effect in Hui orthopedics and traumatology, Hui medicine of brain, Hui medicine of gynecology, Hui medicine of ophthalmology, Hui medicine of dermatology, Hui medicine of anorectal, etc. There is a relatively complete traditional medical system of Hui medicine. The Sinicized Islamic philosophical system guides the philosophical concept of Hui medicine. Hui medicine absorbs and combines the essence of traditional Chinese medicine, which forms the theoretical system of “Zhenyi (True one)”, “Vitality”, “Yin and Yang”, “Qixing”, “Four natures”, “Four body fluids” “Viscera Qi activity” and “Four parts and seven diseases” systems, which have been formed in the diagnosis and treatment of diseases. The characteristics of Hui medicine application are based on the formulation of aromatic drugs, and the nature of cold, hot, dryness, and humidity is conducted for each drug, as well as the drug strength (toxicity) of each drug is graded in grades 1 - 4. Therefore, Hui medicine is a traditional ethnic medicine combined with Chinese and Western medicine. (shrink)

BackgroundCerebral Visual Impairment is a very common finding in children affected by Cerebral Palsy. In this paper we studied the characteristics of CVI of a large group of children with CP and CVI, describing their neurovisual profiles according to three different age subgroups.MethodsWe enrolled 180 subjects with CP and CVI for the study. We carried out a demographic and clinical data collection, neurological examination, developmental or cognitive assessment, and a video-recorded visual function assessment including an evaluation of ophthalmological characteristics, oculomotor (...) functions, and basic visual functions. In school-aged children, we also performed an evaluation of their cognitive-visual profiles.ResultsThere were signs of CVI in all the three subgroups. Subgroup 1 and subgroup 2 were different for fixation, visual acuity and contrast sensitivity, being more frequently impaired in younger children. Comparing subgroup 2 with subgroup 3, the older children presented more frequently myopia while the younger ones esotropia and alteration in smooth pursuit and saccades. Furthermore, fixation, smooth pursuit, visual acuity, contrast sensitivity and visual filed were more frequently impaired in younger children compared to the older ones. Multiple correspondence analysis confirmed the different neurovisual profiles according to age: younger children with CP showed more signs of CVI compared to the older ones. 34 out of 68 children belonging to subgroup 3 underwent the cognitive visual evaluation; an impairment of cognitive visual skills was detected in 21 subjects.ConclusionYounger children with CP showed more signs of CVI compared to the older ones, likely for the physiological maturation of visual system and mechanisms of neuroplasticity. In this direction, we suggest an early neurovisual evaluation to detect any weak visual functions. (shrink)

ObjectiveWe aim to investigate the feasibility of using diffusion tensor imaging to evaluate changes in extraocular muscles and lacrimal gland in patients with thyroid-associated ophthalmopathy and to evaluate disease severity.Materials and MethodsA total of 74 participants, including 17 healthy controls, 22 patients with mild TAO, and 35 patients with moderate-severe TAO, underwent 3-Tesla DTI to measure fractional anisotropy and mean diffusivity of the EOMs and LG. Ophthalmological examinations, including visual acuity, exophthalmos, intraocular pressure, and fundoscopy, were performed. FA and MD (...) values were compared among patients with different disease severity. Multiple linear regression was adopted to predict the impact of clinical variables on DTI parameters of orbital soft tissue.ResultsTAO patients’ EOMs and LG showed significantly lower FA values and higher MD compared to HCs’. Moderate-severe TAO patients’ EOMs and LG had dramatically lower FA and higher MD compared with HCs. In addition, only the DTI parameters of the medial rectus were considerably different between mild and moderate-severe TAO patients. Multiple linear regression showed that disease severity had a significant impact on the DTI parameters of orbital soft tissue.ConclusionDTI is a useful tool for detecting microstructural changes in TAO patients’ orbital soft tissue. DTI findings, especially medial rectus DTI parameters, can help to indicate the disease severity in TAO patients. (shrink)

Background: There is limited research on brain lesions in children with cerebral visual impairment of heterogeneous etiologies and according to associated subtyping and vision dysfunctions. This study was part of a larger project establishing data-driven subtypes of childhood CVI according to visual dysfunctions. Currently there is no consensus in relation to assessment, diagnosis and classification of CVI and more information about brain lesions may be of potential diagnostic value.Aim: This study aimed to investigate overall patterns of brain lesions and associations (...) with level of visual dysfunction and to compare the patterns between the classification subgroups in children with CVI.Methods: School-aged children with CVI received ophthalmological and neuro-psychological/developmental assessments to establish CVI-related subtyping. Other pediatric information was collected from medical records. MRI scans were coded according to a semi-quantitative template including brain regions and summed for total scores. Non-parametric analyses were conducted.Results: 28 children had clinical brain MRI scans available [44% of total sample, Group A n = 16, Group B n = 12]. Total brain scores ranged between 0 and 18 and were widespread across regions. 71 per cent had post-geniculate visual pathway damage. The median total brain and hemisphere scores of Group B were higher than subgroup A but differences did not reach statistical significance. No statistically significant associations were found between brain scores and vision variables.Conclusion: This study found a spread of lesions across all regions on the brain scans in children with congenital CVI. The majority had damage in the postgeniculate visual pathways and visual cortex region suggesting this is an area of interest and potentially informative for diagnosis. However the subtyping classification did not show differences in number or region of lesions though the trend was higher toward Group B. This study confirms the complex diffuse and variable nature of brain lesions in children with congenital CVI, many of whom have other neurological impairments. (shrink)

ObjectiveTo elucidate the clinical, radiologic characteristics of Leber’s hereditary optic neuropathy (LHON) associated with the other diseases.Materials and methodsClinical data were retrospectively collected from hospitalized patients with LHON associated with the other diseases at the Neuro-Ophthalmology Department at the Chinese People’s Liberation Army General Hospital (PLAGH) from December 2014 to October 2018.ResultsA total of 13 patients, 24 eyes (10 men and 3 women; mean age, 30.69 ± 12.76 years) with LHON mitochondrial DNA (mtDNA) mutations, were included in the cohort. (...) 14502(5)11778(4)11778 &11696(1)12811(1)11696(1)3460(1). One patient was positive for aquaporin-4 antibody (AQP4-Ab), and two were positive for myelin oligodendrocyte glycoprotein antibody (MOG-Ab). Three patients were associated with idiopathic optic neuritis (ON). Two patients were with compression optic neuropathy. Three patients were with the central nervous system (CNS) diseases. One patient was with proliferative diabetic retinopathy (PDR) and one with idiopathic orbital inflammatory syndrome (IOIS). At the onset, visual acuity (VA) in eighteen eyes was below 0.1, one eye was 0.5, five eyes were above 0.5, while VA in sixteen eyes was below a 0.1 outcome, three eyes experienced moderate vision loss. MRI images showed T2 lesions and enhancement in nine patients who received corticosteroids treatment; additional immune modulators treatment was performed on two patients. None of the patients had relapse during the follow-up time.ConclusionLeber’s hereditary optic neuropathy can be accompanied with multiple-related diseases, especially different subtypes of ON, which were also exhibited with IOIS and compression optic neuropathy for the first time in this cohort. This condition may be a distinct entity with an unusual clinical and therapeutic profile. (shrink)

Recently a prospective, observational clinical study was carried out in the department of ophthalmology, at a district general hospital. The main purpose of the study was to evaluate the medicolegal and ethical implication of consent and confidentiality in ophthalmic practice, in accordance with the guidelines provided by medical law. One hundred patients, who had been referred by optometrists to ophthalmologists, were included in the study. The general ophthalmic services (GOS) 18 form, a referral form used by optometrists for referring (...) patients to ophthalmologists, which allows optometrists to share a patient's medical information with ophthalmologists, was used as a …. (shrink)

This book explores the interrelationships between optics, vision and perspective before the Classical Age, examining binocularity in particular. The author shows how binocular vision was one of the key juncture points between the three concepts and readers will see how important it is to understand the approach that scholars once took. In the Middle Ages and the Renaissance, the concept of Perspectiva – the Latin word for optics – encompassed many areas of enquiry that had been viewed since antiquity as (...) interconnected, but which a erwards were separated: optics was incorporated into the field of physics (i.e., physical and geometrical optics), vision came to be regarded as the sum of various psycho-physiological mechanisms involved in the way the eye operates (i.e., physiological optics and psychology of vision) and the word ‘perspective’ was reserved for the mathematical representation of the external world (i.e., linear perspective). The author shows how this division, which emerged as a result of the spread of the sciences in classical Europe, turns out to be an anachronism if we confront certain facts from the immediately preceding periods. It is essential to take into account the way medieval scholars posed the problem – which included all facets of the Latin word perspectiva – when exploring the events of this period. (shrink)

Four poems by three poets with commentary and introduction explore metaphor, connection, and relationship in the broad realm of medical care, including the application to medical school.

PURPOSE:To report the localization of a gene causing drusen and macular degeneration in a previously undescribed North American family. METHODS:Genetic mapping studies were performed using linkage analysis in a single family with drusen and atrophic macular degeneration. RESULTS:The clinical manifestations in this family ranged from fine macular drusen in asymptomatic middle-aged individuals to atrophic macular lesions in two children and two elderly patients. We mapped the gene to chromosome 6q14 between markers D6S2258 and D6S1644. CONCLUSIONS:In a family with autosomal dominant (...) drusen and atrophic macular degeneration, the gene maps to a 3.2-cM region on chromosome 6q14. This locus appears to be distinct from, but adjacent to, the loci for cone-rod dystrophy 7 (CORD7) and North Carolina macular dystrophy (MCDR1). Future identification of the gene responsible for the disease in this family will provide a better understanding of macular degeneration. (shrink)

Purpose. To determine whether highlights are rapidly identified at early levels of vision. -/- Methods. Visual search experiments were carried out using simple black and white figures corresponding to shiny objects lit from various directions. These included, for example, depictions of cylinders with highlights positioned at various heights (see figure). Targets and distractors differed only in the arrangement of their constituent regions, allowing them to be distinguished by the position of the highlights on the corresponding objects. -/- Results. Three observers (...) were tested. Search is rapid when the target corresponds to a shiny black object with a bottom highlight among objects with top highlights (view figure from rightside up). However, search slows down when the target corresponds to an object with a top highlight among objects with bottom highlights (view figure from upside down). This asymmetry in search speeds is destroyed when the contrast of the figures is reversed. -/- Conclusions. These results indicate that regions in the image can be rapidly identified as highlights at early levels of vision. They also suggest--as for several other rapid recovery processes--that an assumption of lighting from above is used as a simplifying constraint. (shrink)

PurposeTo use the power of knowledge acquisition and machine learning in the development of a collaborative computer classification system based on the features of age-related macular degeneration (AMD).MethodsA vocabulary was acquired from four AMD experts who examined 100 ophthalmoscopic images. The vocabulary was analyzed, hierarchically structured, and incorporated into a collaborative computer classification system called IDOCS. Using this system, three of the experts examined images from a second set of digital images compiled from more than 1000 patients with AMD. Images (...) were annotated, and features were identified and defined. Decision trees, a machine learning method, were trained on the data collected and used to extract patterns. Interrelationships between the data from the different clinicians were investigated.ResultsSix drusen classes in the structured vocabulary were largely sufficient to describe all the identified features. The decision trees classified the data with 76.86% to 88.5% accuracy and distilled patterns in the form of hierarchical trees composed of 5 to 15 nodes. Experts were largely consistent in their characterization of soft, and to a lesser extent, hard drusen, but diverge in definition of other drusen. Size and crystalline morphology were the main determinants of drusen type across all experts.ConclusionsMachine learning is a powerful tool for the characterization of disease phenotypes. The creation of a defined feature set for AMD will facilitate the development of an IDOCS-based classification system. (shrink)