The International Agency for the Prevention of Blindness.
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Biomedical subjects
Publications and source records attributed to C Kupfer.
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Public health ophthalmology, often referred to as preventive or community ophthalmology, focuses on three community based activities: preventive, curative, and promotive. The pioneering work of Professor Barrie Jones in this field is recognised. Examples of each activity are provided, with emphasis on the developing world.
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Neural crest cells give rise to all connective tissues anterior to the lens epithelium including corneal stromal cells, corneal and trabecular mesothelial cells, iris stromal cells, and iris melanophores. These cells constitute a continuous layer which extends from the corneal mesothelium to trabecular meshwork mesothelium and onto the anterior surface of the iris. Between the seventh and eighth month of gestation in man, the layer of cells loses its continuity. The present case suggests a defective terminal induction of a particular structural component of the angle derived from neural crest resulting in massive congenital adhesions in the anterior chamber angle. The persistence of a layer of abnormal cells lining the anterior chamber structures further reinforces the presence of defective mesothelial cells. Additional cases having such clinicopathologic correlation may provide further insight into this hypothesis.
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A previous study of 16 patients and 16 controls had indicated that the mean ocular rigidity value was significantly lower in Osteogenesis Imperfecta (OI) patients than in normal controls (p = 0.001). These preliminary results have been confirmed in the present study of 46 patients and 53 controls where the difference in mean ocular rigidity between the patient and control group was statistically significant at the p less than 0.0001 level. Of particular interest was the inverse correlation between blueness of sclera and ocular rigidity in patients with OI. The establishment of such a relationship depended upon the availability of a larger sample size than had previously been examined.
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Tissues of the eye affected by diabetes are the lens, cornea, and retina. The lens becomes cataractous through osmotic swelling of its cortical fibers. Sorbitol, formed in the presence of aldose reductase, accumulates in the lens during hyperglycemia. Dulcitol similarly accumulates in the presence of galactosemia. Cataractogenesis in both cases can be prevented by inhibitors of aldose reductase. The efficacy of synthetic inhibitors differs in various tissues and species, but they react with aldose reductase at a common structural site. The most promising inhibitor is sorbinil . Diabetic retinopathy is similarly related to sorbitol accumulation and may be prevented or reversed by inhibition of aldose reductase. Healing of corneal wounds in diabetes is facilitated by enzyme inhibition. Retinal vasculopathy of diabetes is due to selective loss of the intramural pericytes that normally form structural elements in the retinal capillary walls. The vulnerability of these cells is due to their aldose reductase content. Whether inhibition of aldose reductase will prevent retinopathy is being tested in a randomized trial conducted by the National Eye Institute.
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