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Tests

What Is A Pediatric Ophthalmologist? | Ophthalmology

Pediatric ophthalmologist

Pediatric ophthalmology is a subspecialty related to visual improvement, eye diseases, and vision care in children. If your child has an eye problem, has difficulty reading, or needs surgery or medical treatment for a disease that affects the eyes, a pediatric ophthalmologist will have the experience and qualifications to treat your child.

Reasons to visit a pediatric ophthalmologist

Early detection of eye problems can protect your child’s vision. There are warning signs your child may have an eye problem:

  • Persistent watery eyes
  • Frequent eye rubbing
  • Sensitivity to light
  • A white or yellow substance in the pupil (lack of red reflex)
  • Redness that does not go away
  • Pus or crust in the eyes
  • Crossed or wandering eyes
  • Squinting
  • Frequent head tilting or face turning
  • Drooping eyelids or bulging eyes
  • Eyes moving back and forth involuntarily

Conditions pediatric ophthalmologists treat

Pediatric ophthalmologists treat children who have eye diseases such as:

  • Amblyopia (lazy eye)
  • Anisometropia: Unbalanced focus in a person’s eyes.
  • Congenital cataracts: Cataracts that happen in newborns
  • Dissociated vertical deviation: One eye that drifts gently upward
  • Drooping eyelid (ptosis)
  • Esotropia: One or both eyes that change inside, sometimes called crossed eyes
  • Exotropia: One or both eyes that turn outward
  • Ocular infections: Bacterial, viral, or fungal infections in the eye, eyelid, or enclosing areas
  • Ocular trauma: Injury to the eye, eyelid, or enclosing areas
  • Retinopathy of prematurity: Eye disorder of the retina (back layer of the eye) that essentially affects premature babies.
  • Strabismus: Misalignment of the eyes, either higher, downwards, outside, or inside, which can sometimes occur in adults or not be diagnosed until adulthood.
  • Superior oblique palsy: Disorder of the fourth cranial nerve that causes instability in the eye muscle (superior oblique), occurring in misaligned eyes.
  • Uveitis: Group of inflammatory conditions that effects swelling in the middle layer of the eye and can begin vision loss.
  • Refraction (vision) errors such as nearsightedness, farsightedness, and astigmatism

What kind of tests do pediatric ophthalmologists perform?

Vision Assessment: Special skills are required to assess a child’s vision, especially in preschool-age children. Different methods are used for different ages.

Refractive error diagnosis (need and resistance of glasses): This test is performed after an eruption in most pediatric patients to confirm objective measurement.

Mobility tests: Quantitative measurements of ocular misalignment are required to plan the medical and surgical treatment of strabismus.

Biomicroscopy and dilated fundus tests: These are required to investigate the behaviour of eye diseases related to diabetes, juvenile idiopathic arthritis, genetic abnormalities, neurological pathology (increased intracranial pressure), as well as systemic conditions such as cataracts and specific eye conditions and glaucoma.

Testing under anaesthesia (AUS): This may be necessary to diagnose and/or treat conditions in patients who are not allowed to perform proper tests/treatments in the workplace.

Monitor diseases over time and determines if treatment is working properly and make any necessary changes.

What kind of treatments do pediatric ophthalmologists provide?

Pediatric ophthalmologists can diagnose, treat, and control all children’s eye problems. Pediatric ophthalmologists generally provide the following services:

  • Eye exams
  • Perform surgery, microsurgery, and laser surgery (for obstacles like weak eye muscles, crossed eyes, wandering eyes, blocked tear ducts, retinal problems, and diseases)
  • Diagnose problems of the eye affected by diseases of the body such as diabetes or juvenile rheumatoid arthritis (JRA) and other medical and neurological diseases.
  • Diagnose visible processing disorders
  • Care for eye injuries

What kind of procedures done by pediatric ophthalmologists?

Surgical procedures conducted by pediatric ophthalmologists, which include:

  • Strabismus surgery: eye muscle surgery to repair misaligned eyes, crossed eyes, or walleyes.
  • Blocked tear duct surgery: an outpatient procedure performed to address blocked tear ducts in children.
  • Pediatric cataracts (cataract is either congenital/infantile and acquired/juvenile).
  • Glaucoma cataract extraction: pediatric cataract extraction and replacement with intraocular lenses (IOL’s) in patients with glaucoma.
  • Chalazion (eyelid cysts) excision: excision of a chalazion (eyelid cyst) and stye (eyelid margin cyst).
  • Congenital ptosis (drooping eyelids) surgery.
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About Eye Problems In Children | Ophthalmology

Eye problems in children

There are many types of eye problems and diseases that can affect a child’s vision. If an eye condition is suspected or if the child fails a vision test, he should be referred to a pediatric ophthalmologist for further evaluation and diagnosis. Early detection and treatment are important to prevent lifelong vision defects.

There are some types of eye problems in children:

1. Astigmatism

Astigmatism, a common eye problem in children is a refractive disorder that affects the shape of the cornea or lens. For near and far objects, vision can be blurred because the affected eye does not focus. Astigmatism coexists with both myopia and hyperopia and should be corrected as soon as it is diagnosed.

Diagnosing astigmatism in children is difficult because children with astigmatism sometimes do not recognize the ambiguity they need to see as a notification condition. Comprehensive eye exams are needed to make a proper diagnosis and rule out other eye problems.

Treatment for astigmatism

The goal of astigmatism treatment is to improve visual acuity and eye comfort. Treatments are corrective lenses or refractive surgery.

Eyeglasses: Glasses are made with lenses that help replace the asymmetrical shape of your eye. Lenses allow light to tilt your eye correctly. Glasses can also correct other refractive errors such as myopia or hyperopia.

Contact lenses: Some people have better vision with contact lenses instead of glasses. Contact lenses can provide clear vision and panoramic vision. However, since contact lenses are worn directly on the eyes, regular cleaning and care are required to maintain eye health. Regular soft lenses may not be effective in improving astigmatism.

Special toric soft contact lenses can be adjusted for a wide variety of astigmatism. Because rigid gas permeable contact lenses maintain their regular shape while on the cornea, they can replace the irregular shape of the cornea and improve vision for people with astigmatism.

Orthokeratology: Orthokeratology (ortho-K) involves fitting a series of rigid contact lenses to redesign the cornea. The patient uses contact lenses for a short time, such as at night, and then separates them.

People with moderate astigmatism may temporarily have clear vision without glasses for their daily activities. Orthokeratology does not permanently improve vision. If patients stop wearing retinal lenses, their vision can return to its original state.

Laser and other refractive surgeries: Performed with LASIK laser technology (photorefractive keratectomy) or manual incisions (radial keratotomy), which rescue the cornea by removing small pieces of tissue from the cornea.

2. Cataract

Cataracts are one of the common eye problems in children caused by cloudy spots that develop on the lens of the eye. Children experience cataracts as blurred vision, which affects their development and leads to permanent vision loss. The lens is inside the eye, back the iris. Pediatric cataracts can occur in one or both eyes.

Treatment for cataract

Treatment depends on your child’s symptoms, age, and general health. It also depends on the hardness of the situation. Treatment will be determined by your child’s healthcare provider based on your child’s cataracts.

In some cases, your child may require glasses or contact lenses. This will help your child look better. Most children older than 1 year will need surgery to remove the cataract and a new lens will be inserted.

3. Ptosis

Ptosis, one of the common eye problems in children is a narrowing of the upper eyelid. The eyelid is only slightly lowered or it may completely cover the pupil or eye. Ptosis affects one or both eyelids. In some cases, ptosis can limit and prevent normal vision. Sometimes there is congenital ptosis; In other cases, it occurs later in life due to injury or illness.

Treatment for ptosis

Eyelid lift surgery repairs the upper eyelids.

  • If vision is not affected, surgery can wait for 3 to 4 years for the child to grow a little.
  • In severe cases, immediate surgery is needed to prevent “lazy eye” (amblyopia).

The provider also treats any eye problems caused by ptosis. Your children may need:

  • Wear an eye patch to strengthen vision in the weak eye.
  • Wear special glasses to correct the irregular curve of the cornea that causes blurred vision (astigmatism).

Children with mild ptosis should have regular eye exams to prevent the development of amblyopia.

Surgery works well to improve the appearance and function of the eye. Some children require more than one surgery.

4. Hyperopia

Farsightedness, one of the common eye problems in children appears to be a refractive error, so the image is centered behind the retina, and vision is blurred. The cause may be in the eyeball or the optical power of the cornea and lens may be less than necessary. There is also a specific genealogical component.

Treatment for hyperopia

Hyperopia can be treated with corrective contact lenses or protective glasses. Alternatively, eye surgery can be very effective for the right candidates.

  • Conventional correction: Glasses or contact lenses in the form of positive lenses.
  • Surgical correction: The two surgical procedures available are laser eye surgery and clear lens removal. The latter is similar to cataract surgery but involves the removal of a clear lens (without cataracts).

If your hyperopia treatment is a surgical correction, it is important to speak with your eye surgeon about your choice. Your age, the severity of your hyperopia, the thickness of your corneas, and whether you have other eye conditions are many factors to consider.

5. Glaucoma

Glaucoma, one of the common eye problems in children is a disease that affects the optic nerves of the eye. This usually happens when fluid forms in front of your eye. That excess fluid increases the pressure in the eye and damages the optic nerve.

Symptoms start very slowly, you may not notice them. The only way to know if you have glaucoma is a comprehensive dilated eye exam.

Treatment for glaucoma

Doctors use a variety of glaucoma treatments, including medications (usually eye drops), laser treatment, and surgery.

  • Low pressure by reducing the amount of fluid produced in the eye, in the form of medications, eye drops, or tablets, and increasing drainage. One or more drugs can be used simultaneously.
  • Laser therapy to reduce pressure in the eye is done on a patient basis. A method called laser trabeculoplasty increases fluid drainage in patients with open-angle glaucoma. people with angle-closure glaucoma must be treated with a procedure commonly called laser iridotomy, which creates a small opening (part of the color of the eyes) in the iris that allows the drainage angle to open.
  • Surgery may be necessary to create a second drainage path in the eye to support the natural ones. Glaucoma surgery is usually performed on a patient-by-patient basis under local anesthesia and can allow the patient to reduce or eliminate glaucoma medication.

For more advanced cases, an artificial glaucoma drainage implant can help reduce stress. The implant helps drain excess fluid that builds up in the body.

6. Strabismus

Strabismus, one of the common eye problems in children also known as hypertrophy and crossed eyes, is a misalignment of the eyes, causing one eye to point toward the nose (esotropia) or outward (exotropia), while the other eye is centered.

Misalignment occurs once in newborns, especially if they are tired, they should get over it by the age of three months. In children, uncorrected strabismus can lead to amblyopia, in which case the brain begins to ignore the weak and misaligned signals sent by the eyes, which can lead to vision problems.

Treatment for strabismus

A complete vision evaluation is important to accurately diagnose strabismus (and/or amblyopia). Some types of strabismus are visually recognizable, but the test should include a thorough assessment of the visual system, including a binocular vision assessment to see how the eyes focus and move. Assessing visual acuity alone is not enough. You can expect your ophthalmologists to take a complete history.

It is common to test near and far acuity when evaluating the general health and structure of the eye. The doctor will make a cover to specifically test and diagnose strabismus. Test (also known as the coverage test), as well as the Hirschberg test (also known as Hirschberg corneal reflex test).

7. Amblyopia

Amblyopia, one of the common eye problems in children is when the vision in one or both eyes does not develop properly in childhood. This is sometimes called laziness. Amblyopia is a common problem in infants and young children.

A child’s vision develops during the first years of life. It is necessary to diagnose and treat amblyopia as soon as practicable. Otherwise, a child with amblyopia will not develop a normal, healthy vision.

Treatment for amblyopia

The earlier amblyopia is detected and treated, the better the outcome for the child. Treatment depends on the type of amblyopia the child has and how severe it is.

Glasses / Contact lenses: Corrective glasses or contact lenses are indicated if you have amblyopia because you are nearsighted or farsighted, or astigmatism in one eye.

Eye patch: Wearing a patch over your dominant eye can help strengthen your weak eye. Your doctor may recommend that you wear a patch for 1 to 2 hours a day, depending on the severity of your amblyopia. The patch helps develop the area of the brain that controls vision.

Eye drops: You can use eye drops once or twice a day to cloud your vision in your good eye. Like an eye patch, it encourages your weaker eye to wear more. It is an alternative to the patch.

Surgery: If you cross your eyes or your eyes point in opposite directions, your eye muscles may need surgery.

8. Pink eye

Pinkeye, one of the common eye problems in children is the common name for conjunctivitis, which causes inflammation and redness of the lining of the eye. The pinkeye can be caused by viruses, bacterial infections, allergies, or chemical factors. Sometimes it is the result of a chronic illness. Most commonly, the viral or bacterial infection causes pinkeye.

Treatment for pink eye

Treatment may include antibiotic eye drops or ointments and depending on the type of pinkeye.

Purulent pinkeye with a pink or red eyeball, white or yellow discharge, red or sticky eyelids, and eye discomfort usually caused by bacteria. It can be treated with antibiotics (eye drops or ointments) to prevent the disease from spreading to other people.

Non-purulent pinkeye, where the eyeball is pink or red, but the discharge is clear or watery, with only slight or uncomfortable. It usually causes a virus or other irritation (such as an allergy or exposure to a chemical such as chlorine in a swimming pool). The antibiotic drop does not work for this type of pinkeye.

9. Uveitis

Uveitis, one of the common eye problems in children is an inflammation of the uvea (or uveal membrane), the three middle layers that make up the eye. It can be contagious or contagious. It is a treatable condition; However, without proper treatment, it can lead to other problems such as glaucoma, cataracts, optic nerve damage, retinal detachment, and severe vision loss.

Treatment for uveitis

Steroids are the main treatment for uveitis. This will help reduce the inflammation inside your eye.

Different types of steroid medications are recommended depending on the type of uveitis. For example:

  • Eyedrops are often used for uveitis that hits the front of the eye.
  • Injections, tablets, and capsules are usually used to treat uveitis that affects the middle and back of the eye.

Additional treatment may also be necessary. They can be eye drops to reduce pain or, in some cases, surgery.

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Overview of Endocrine-Disrupting Chemicals | Endocrinology

What are endocrine-disrupting chemicals?

Endocrine-disrupting chemicals disrupt the body’s endocrine system, causing adverse effects on development, reproduction, the immune and neurological systems in humans and wildlife. Natural and man-made substances are believed to cause endocrine disruption, including plasticizers such as EC drugs, compounds such as dioxins and dioxins, polychlorinated biphenyls, DDT and other pesticides, and bisphenol.

Endocrine-disrupting chemicals can be found in everyday products. Including flame retardants, foods, toys, cosmetics, and pesticides. Endocrine-disrupting chemicals (EDCs) are a global problem for the environment and human health. They are defined as “a chemical or chemical compound that interferes with any aspect of the action of hormones.” It is estimated that there are around 1000 chemicals with endocrine auction properties.

Endocrine-disrupting chemicals include pesticides, fungicides, industrial chemicals, plasticizers, nonylphenols, metals, pharmaceuticals, and phytoestrogens. Human exposure to endocrine-disrupting chemicals occurs primarily through ingestion and, to some extent, through inhalation and dermal ingestion. Most endocrine-disrupting chemicals are lipophilic and bioaccumulate in adipose tissue, thus having a long half-life in the body.

The full effect of human exposure to endocrine-disrupting chemicals is difficult to predict, as adverse effects develop late and manifest later in life and may not be seen in some. Importance of exposure time. The developing fetus and newborns are the most vulnerable to endocrine disruption. Endocrine-disrupting chemicals can interfere with the synthesis, action, and metabolism of sex steroid hormones, leading to developmental and reproductive problems, infertility, and hormone-sensitive cancers in both women and men.

Types of endocrine-disrupting chemicals

Natural hormones released by an animal into the environment and chemicals produced by one species that perform hormonal actions on other species. For example, human hormones that are accidentally reactivated during the processing of human waste circulating in sewage can cause changes in fish.

Natural chemicals, including plant components (so-called phytoestrogens such as genistein or control) and toxins produced by certain fungi.

Artificially produced drugs are intended to be highly hormonally active. The contraceptive pill and hormone-responsive cancer treatments are examples. They can also be found in sewage sludge.

Chemicals and man-made by-products are released into the environment. Laboratory experiments have suggested that some man-made chemicals can cause endocrine changes. These include some pesticides (including DDT and other chlorinated compounds), chemicals in some medical and consumer products (such as some plastic additives), and many industrial chemicals, including polychlorinated biphenyls (PCBs) and dioxins.

Endocrine-disrupting chemicals mechanisms

  • Research on endocrine disruptors comes primarily from animal studies, where researchers can explore how endocrine disruptors disrupt the endocrine system and hormonal changes. Some chemicals act on the endocrine system to alter the body’s homeostatic mechanisms or to initiate processes at unusual times in the life cycle. Chemicals show their effects in many different ways:
  • Certain chemicals act on the endocrine system to alter the body’s homeostatic mechanisms or to initiate processes at unusual times in the life cycle. Chemicals show their effects in many different ways:
  • They can mimic the biological activity of the hormone by binding to the cell receptor, leading to an unwanted response by initiating the cell’s normal response to the natural hormone at the wrong time or at high levels (agonist effect).
  • They can bind to the receiver but do not activate it. In contrast, the presence of the chemical at the receptor prevents the natural hormone from binding (antagonistic effect).
  • They bind to transport proteins in the blood, thus altering the number of natural hormones in circulation.
  • These disrupt the body’s metabolic processes and affect the rate of synthesis or breakdown of natural hormones.
  • Endocrine disorders in the human body can cause breast cancer, testicular cancer, thyroid and ovarian dysfunction, Alzheimer’s disease, schizophrenia, nerve damage, and esophagitis. In addition to the decrease in fertility, the incidence of endometriosis, and other types of cancer. Exposure to endocrine disruptors during pregnancy and immediately after birth represents a great long-term health risk.

Some endocrine-disrupting chemicals and specific health outcomes

Research by the National Toxicology Program (NTP), a division of the Department of Health and Human Services, as well as other researchers and the NIEHS has reported significant effects of endocrine disruptors.

Diethylstilbestrol (DES) is a synthetic estrogen created in 1938; From 1940 to 1970 it was included in cattle feed to increase muscle growth and was prescribed for the prevention of miscarriages. An article in the New England Journal of Medicine in 1971 reported that the medical community discontinued its use after reporting an association between fetal exposure in the first trimester of pregnancy and rare cancer (vaginal adenocarcinoma), which manifested in adolescence, and in young women exposed decades later.

These DES daughters experience many of the diseases and disorders highlighted in the list to the right. 8 DES sons had an increased risk of noncancerous epididymal cysts (growth in the testes).

Other endocrine-disrupting chemicals examples

  • This Toxipedia content will be discussed in more detail on the relevant web pages of this site.
  • Organochlorines such as dioxins and perchlorate can affect thyroid function.
  • Dioxin TCDD is known cancer, and the European Union’s priority list classifies TCDD as an endocrine chemical inhibitor.
  • IARC and the US EPA list specific PCBs such as Arochlor as “potential cancers.”
  • Phthalates, BPA, and other packaging chemicals can cause reproductive diseases. D (2-Ethylhexyl) Phthalate (DHP) is a high-volume production chemical. NTP has found that DEHP poses a risk to human development, especially in sick baby boys. Current human exposures Bisphenol-A.
  • Polybrominated diphenyl ethers (PBDEs) can cause a number of problems, including cancer, thyroid problems, and neurodevelopmental effects. Many brominated flame retardants are banned in the EU and US.
  • Pesticides like tamoxifen and DDT have carcinogenic properties.
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Specialists

Overview of Neuro-ophthalmologist | Ophthalmology

What is a neuro-ophthalmologist?

Neuro-ophthalmologist is a super specialty that integrates the fields of neurology and ophthalmology. Neuro-ophthalmologists are qualified for the diagnosis and control of several systemic diseases of the nervous system that affect vision, eye movements, and alignment, as well as pupillary reflexes.

Neuro-ophthalmologists receive specialized training and experience in eye, brain, nerve, and muscle problems. These physicians complete at least five years of clinical training after medical school and normally receive a board certificate in neurology, ophthalmology, or both.

Neuro-ophthalmologist has unique abilities to diagnose and treat a wide variety of problems in patients from a neurological, ophthalmological, and medical point of view. Expensive medical exams are often avoided by consulting a neuro-ophthalmologist.

What are the conditions treated by neuro-ophthalmologists?

Conditions that are treated by a neuro-ophthalmologist, which include:

  • Blepharospasm: Unlimited blinking, squeezing, or closing of the eyes
  • Brain tumors or strokes that affect vision
  • Defects in the visual field
  • Double vision
  • Droopy eyelids
  • Eyelid or facial spasms
  • Headache and migraines
  • Idiopathic intracranial hypertension
  • Involuntary eye movement, including nystagmus (also known as “dancing eyes”):  Unusual condition in which the eyes move rapidly in a reversible pattern – sideways, up or down, or in a rotating pattern. This can significantly reduce vision, either temporarily or permanently. It can be inherited or caused by metabolic or neurological problems, including multiple sclerosis, and sometimes in people with an inner ear problem.
  • Microcranial nerve palsy
  • Myasthenia gravis
  • Optic neuritis or neuropathy
  • Pseudotumor cerebri
  • Unequal pupils
  • Unexplained vision loss

Neuro-ophthalmologist tests

Neuro-ophthalmology testing starts with a careful review of the patient’s difficulties and related problems, followed by an evaluation of vision and eye movements, usually with visual acuity, color vision, and visual field tests. The eyes are examined under a microscope (slit lamp) with special attention to the optic nerve and the retina. In most cases, dilating drops are given to enhance the testing of these important structures. Eye movements are also evaluated, which may include the use of prismatic lenses and special graphics.

Also, the pressure and size of each eye can be examined. For unequal students, points can be assigned to identify the cause of the problem. Visual field testing is done using a machine that displays lights in different areas, but the patient presses a button to detect each light and assesses patterns of visual field damage leading to diagnosis. Lastly, neuro-ophthalmologists sit down with their patients to discuss their disease and possible treatments or management strategies.

Whats are the treatments done by neuro-ophthalmologists?

Treatment depends on the specific type of disorder being diagnosed but includes vision restoration therapy (VRT). VRT is a non-invasive treatment that helps repair vision loss as an outcome of a traumatic brain injury such as a stroke. Using a specially designed computer device, VRT promotes visual stimulation to increase visual activity in the brain. This has helped some patients to lose their vision.

After making an appointment, you should be ready to see a neuro-ophthalmologist. The test begins with a complete review of your problems. Your vision is then checked, which often includes visual acuity, visual field tests, and color vision. Eye movement is also assessed using prismatic lenses and graphics.

You can also go through a CT scan or MRI to check if the brain is damaged. Some common diseases and their treatments:

Optic neuritis: This is a condition of a sudden loss of vision, which can be due to information from the optic nerve. It is usually caused by an infection and is associated with multiple sclerosis. If you have optic neuritis, your neuro-ophthalmologist will use antibiotics and corticosteroids appropriately, which can help clear the infection and prevent further damage.

Papilloma: Characterized by inflammation of the optic nerve and can be easily detected by a doctor during an evaluation of the retina. It is usually due to increased pressure in the brain and may be due to a tumor or infection.

If it is due to stress, then medications are used to shrink the joint within the skull, but due to this ridiculous enlargement, you may need surgery.

Nutritional optic neuropathy: In this case, the toxins found in tobacco alcohol can damage the optic nerve. It is also caused by a lack of various nutrients and a deficiency of the vitamin B complex. Your neuro-ophthalmologist will prescribe vitamins and lifestyle changes.

Diabetic retinopathy: The cause of this disease is usually diabetes, and if diabetes is not diagnosed, it is advisable to control and treat diabetes before further damage to the blood vessels occurs.

What are the services given by neuro-ophthalmologists?

Your care begins with a detailed evaluation. Our neuro-ophthalmologist takes a close look at the interactions between the eyes and the brain, getting to the root of the problem. We recommend personalized treatments to restore vision. If other treatments are unsuccessful, we will not stop until you have the relief you need.

Your care may include:

  • Special Exam – You have access to the latest imaging technologies, including ocular coherence tomography (OCT). This test uses light waves to examine the layer of tissue in the eye through layers. We are also one of the few multifocal electrocardiogram (ERG) programs offered locally to detect retinal problems.
  • Medications: If you have symptoms due to an infection, you may feel better after taking antibiotics. If you experience inflammation, you may need a stronger dose of steroids.
  • Surgery: If surgery is required, you have access to all available surgical treatments. Our neuro-ophthalmologist will perform some procedures. You may also receive care from other members of the Storm Eyes team, including specialists in reconstructive eye surgery.
  • Low vision therapy: If other treatments don’t relieve symptoms, you have no choice. Our team includes optometrists and therapists who improve the rest of their sight for those with partial but permanent loss of vision (low vision).
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Control of Obesity and Appetite | Endocrinology

Control of obesity and appetite

Obesity and appetite are one of the main challenges for human health worldwide. However, there are currently no effective pharmacological interventions for obesity. New studies have improved our understanding of energy homeostasis by classifying sophisticated neurohumoral networks that transmit signals between the brain and the gut to control food intake.

The hypothalamus is a key region that has reciprocal connections between higher cortical centers, such as the reward-related limbic pathways, and the brain stem. In addition, the hypothalamus integrates a series of peripheral signals that modulate food intake and energy expenditure. Gut hormones such as peptide YY, pancreatic polypeptide, glucagon-like peptide, oxyntomodulin, and ghrelin, are moderated by acute food ingestion.

In contrast, adiposity signals such as leptin and insulin are involved in energy homeostasis both in the short and long term. In this article, we focus on the role of gut hormones and their related neural networks (the gut-brain axis) in appetite control and their potential as new therapies for obesity.

Regulation of obesity and appetite

The global obesity and appetite epidemic is on the rise, and endocrinologists are at the forefront in diagnosing its underlying causes and prescribing treatment plans. Our latest scientific statements, Obesity Pathogenesis and the Science of Obesity Management provide a comprehensive overview of the state of the science in the field of obesity and identify areas for future research.

Central mechanisms in the regulation of obesity and appetite

In the CNS, the hypothalamus is the key region complicated in the regulation of appetite. It has before been hypothesized that satiety was controlled by the ventromedial hypothalamic nucleus and that eating was controlled by the lateral region. However, this early hypothesis has evolved into a much more complete and complex understanding of the integrated neural network responsible for appetite regulation, involving discrete pathways within specific nuclei of the hypothalamus, and various regulatory modulators.

The regulation of eating, energy intake and expenditure, and Bodyweight is a homeostatic process. General health info is connected predominantly through long-term humoral signals, whereas the initiation and termination of meals are believed to be regulated through short-term signals, such as neural signals from the brain and humoral signals from the brain. intestine.

Intestinal hormones and obesity

The GI tract is the largest endocrine organ in the body and is believed to play an important role in the regulation of appetite as a source of several regulatory peptide hormones. Postprandial satiety is believed to be regulated by a sensory system that communicates between the intestine and the appetite-regulating centers in the brain, the hypothalamus is responsible for the detection of nutrients and energy and the corresponding adjustments in food intake.

In the intestine, there is a set of endocrine cells, which synthesize and release various hormones in response to nutrient and energy intake, and these hormones have been shown to influence appetite in humans and rodents when administered at physiological levels. Distinguishing between genuine satiating effects and reductions in appetite due to nausea or feelings of poor health can potentially confuse experimental results.

Food intake is influenced not only by nutritional status but also by various palatability cues, including taste and smell. Dose administration via oral gavage can be used to mitigate potential taste aversion and/or smell and effectively allow further critical analysis of the results of such studies. Together, unlike leptin and insulin, which have been proposed to signal long-term energy status, gut hormones are believed to play a critical role in the initiation and completion of meals.

Can gut hormones control obesity and appetite?

The current obesity epidemic is driven by the availability of very tasty and high-calorie foods and the low requirement of physical activity in our modern environment. If energy consumption exceeds energy use, the extra calories are stored as body fat. Although the body has mechanisms that work to maintain body weight over time, they mainly defend against starvation and are less robust in preventing the development of obesity.

Information of this homeostatic system that controls body weight has augmented exponentially over the last decade and has revealed new possibilities for the treatment of obesity and its associated comorbidities. A therapeutic target in the development of agents based on gastrointestinal hormones that control appetite.

The serious personal, social, and economic consequences that the continued global increase in the prevalence of obesity heralds are well documented. Currently, licensed non-surgical interventions have limited efficacy. This relative failure of available therapies has prompted work aimed at harnessing the physiological mechanisms of appetite control.

The search for the body’s own satiety signals as therapeutic targets promises effective reductions in body weight with minimal disruption to other systems, avoiding the side effects that occur as an unwanted consequence of therapies targeting ubiquitous receptor and neurotransmitter complexes.