Seasonal allergies: tips and remedies

While this time of year usually brings cheerful weather and the growth of beautiful plants, millions of people will be gearing up once again to do battle with a problem that recurs every year. Itchy eyes, repetitive sneezing, a permanently runny nose - the symptoms of seasonal allergies.

In the US, around 7.8% of people aged 18 and above are estimated to have hay fever.

For many people, the emergence of marauding ticks at this time of year is the least of their worries. The real struggle for these people is with seasonal allergies, also referred to as hay fever or allergic rhinitis.

If these common symptoms seem to develop for weeks and months on end at the same time each year, it is likely that you could be affected by seasonal allergies. The condition affects many in the US; in 2010, around 11.1 million visits to physicians' offices led to a primary diagnosis of hay fever.

Thankfully, despite how infuriating and disruptive seasonal allergies can be, there are many steps that can be taken to lessen their impact. In this Spotlight, we take a look at what seasonal allergies are and what the best strategies are for handling them.

What causes such allergies?

People develop allergies when their body's immune system reacts to a substance as though it is a threat like an infection, producing antibodies to fight it. These substances are referred to as allergens.

The next time that the body encounters the allergen, it produces more antibodies in anticipation, releasing histamine and chemical mediators in the body that lead to an allergic reaction. It is these chemicals that typically cause symptoms in the nose, throat, eyes and other areas of the body.

Jan Batten, a British Lung Foundation (BLF) Helpline nurse, explained to Medical News Today that as the summer months approach, certain allergies begin to cause more problems, such as allergies to flower pollen, grass pollen, tree molds and fungi. The drier days around this time of year help the allergens to remain in the atmosphere for longer.

"Summer allergies start to pick up around May and those affected will usually get itchy and runny eyes, a runny nose and inflamed, swollen sinuses. Breathing through your nose can be difficult too, and you might have a cough," she explained.

The American College of Allergy, Asthma & Immunology (ACAAI) report that allergies are the sixth leading cause of chronic illness in the US. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), around 7.8% of people aged 18 and above have hay fever. Worldwide, the condition affects 10-30% of the population.

Most people with hay fever understand that their symptoms are set off by pollen, the fine powder released from flowering plants in order to reproduce. Pollens are spread by the wind and can be inhaled or land in the eyes or on the skin.

The most common trigger of seasonal allergies is pollen, though they can also be triggered by grasses and mold. Dealing with seasonal allergies, however, is not merely a matter of knowing when these airborne allergens are most prevalent and trying to avoid them. There are a few added complications to keep you on your toes.

Avoiding triggers - be aware of what sets you off

"People focus on the highs and lows of pollen counts," says Dr. James Sublett, president of ACAAI. "What they don't realize is that a high total pollen count doesn't always mean you will have allergy symptoms. The pollen from the plant you are allergic to may not be high. The key is to know what you're allergic to, and how to treat your particular symptoms."

Different kinds of pollen are prevalent at different times of the year, as well as varying from location to location. Between January and April, pollen is typically released from trees including pine, ash, birch, elm and poplar. During the summer months, grass pollens dominate, and in the fall, weed pollen is most prevalent.

People can determine whether they have an allergy or not by consulting their primary care physician and undergoing allergy testing. Dr. Andrew S. Kim, an allergist from the Allergy & Asthma Centers in Fairfax and Fredericksburg, VA, told MNT that sometimes people confuse having allergies with the flu or common cold.

Pollen is the cause of most seasonal allergies and is produced by flowers, trees, grasses and weeds alike.

"Allergies may share some similarities with sneezing and sniffling but the length of time is a big difference. Allergy symptoms usually last for weeks and months and patients typically complain of itchy nose, throat and eyes as well," he said.

"Allergy patients usually do not have fever. They do have dry cough and clear nasal drainage versus infectious cough which is characterized by yellow, or greenish nasal drainage. Some people may have asthma symptoms, such as cough, wheeze and chest tightness."

Once an individual knows that they have a seasonal allergy and is aware of what triggers it, they are in a much better position to avoid debilitating allergic reactions. Keeping track of pollen forecasts is a good place to start. It is good to remember that these change by the hour, and can be boosted when it is warm, dry and windy.

To reduce the chances of an allergic reaction, it is recommended that you stay inside when pollen counts are at their highest. These usually peak around the morning hours and maintain high levels during the afternoon.

If you do need to go outside, there are a number of steps that can be taken to reduce the chances of coming into contact with allergens. Wearing wraparound sunglasses offers protection to the eyes, and applying a small amount of petroleum jelly to the insides of the nostrils can prevent some allergens from reaching the sensitive lining of the nose.

Delegating outdoor chores to people that do not have seasonal allergies is a sensible approach. If there is no escaping lawn mowing or weed pulling, however, wear an NIOSH-rated (National Institute for Occupational Safety and Health) 95 filter mask to keep allergens out.

Laundry should not be hung to dry outside, despite the conditions being perfect for it. Pollen can stick to sheets and towels and be brought into the home - normally a haven from pollens. In fact, when tackling seasonal allergies, ensuring that your home is your castle is a great strategy.

Minimizing the risk indoors

It is impossible to remove all allergens from the air inside the home, but there are certainly steps that can help reduce levels of exposure. Keeping the windows shut is a simple strategy that should be one of the first to be adopted.

Shutting the windows might be the last thing on your mind when temperatures start to rise. To stay cool without the threat of pollen looming large, use air conditioning in the house and car. It is preferable that high-efficiency air filters are used and that units follow regular maintenance schedules.

Whenever you venture outside, there is the chance that you will bring pollen back inside with you on your clothes and hair. For this reason, people should wash their hair and clothes more regularly during periods when the pollen count is high.

If you are drying clothes indoors and keeping the windows closed, you may need to use a dehumidifier to keep the indoor air dry. Keeping the air dry indoors helps prevent the growth of other allergens such as molds.

Keeping the home clean with a vacuum cleaner that has a high-efficiency particulate air filter and using a damp duster to stop pollens moving about the home also helps to clean up any allergens that are present, reducing the chances of them getting onto and into the body.

"Simple changes like wearing wraparound sunglasses, washing your clothes and hair more regularly, keeping your home clean, avoiding open, grassy spaces where possible and keeping your windows shut can help lessen the effect of summer allergies," Jan Batten told.

All of these measures are relatively simple to take and can go a long way toward protecting the body from seasonal allergies. However, as stated before, it is nigh-on impossible to completely avoid exposure to allergens. Particularly for people who experience severe reactions to pollen, the best route to ease symptoms is often a medical one.

Medicine and other treatment

People tend to have unique allergic responses, so the treatment that works best for each individual will vary accordingly. While some people will be able to cope with seasonal allergies with over-the-counter medication and being careful about their exposure to allergens, others may require personal treatment plans drawn up by specially trained allergists.

Oral antihistamines are a form of nonprescription medication that alleviate many of the symptoms of seasonal allergies.

There is a wide range of nonprescription medication available for people who have seasonal allergies. Oral antihistamines relieve symptoms such as sneezing, itching and runny noses. Decongestants relieve nasal stuffiness and come in both oral and nasal form. Some medications contain a combination of the two.

Two types of immunotherapy are available to those who require relief from severe symptoms. These are allergy shots and tablets, and they are provided and prescribed by allergists. Allergy testing will need to be carried out first to determine precisely what allergens trigger symptoms.

Allergy shots consist of injecting a patient with diluted extracts of an allergen. Increasing doses are administered until a maintenance dose is established. This process helps the body to build up a form of resistance to the allergen and reduces the severity of symptoms.

Tablets can currently be used to treat allergies to grass and ragweed pollens. Beginning at least 3 months before the relevant pollen season begins, patients take one tablet daily, with the treatment continuing for as long as 3 years.

Dr. Kim told MNT that one of the best ways to reduce the influence of seasonal allergies is to start taking medication - such as topical nasal steroids - about a week before the beginning of the allergy season:

"Don't wait until symptoms kick in and you're already feeling bad before taking allergy medication. Instead, prepare by taking medications just before the season starts to minimize the symptoms of seasonal allergies."

A number of alternative treatments are also available, including natural remedies that feature extracts of butterbur and spirulina. It is recommended that any use of alternative treatments is discussed with a physician first, as some remedies may not be entirely safe for use.

There are many options for alleviating seasonal allergies

Allergies can be worrying, especially for people who are otherwise healthy and unused to experiencing sudden debilitating symptoms. If left unchecked, seasonal allergies can often turn an otherwise enjoyable time of year for many into misery.

Thankfully, there are many routes available for people with seasonal allergies to alleviate their symptoms. As ever, if there are any concerns or worries, it is best to speak with a health care professional who will be able to offer advice, provide treatment or refer on to a specialist.

Although there is no cure at present for seasonal allergies, the multiple options for treatment should hopefully provide some relief until winter rolls around again and we can shiver together, happy in the fact that pollen has gone for another year.

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New Discovery Offers Hope For People Who Can't Smell

A recent study by researchers at the University of Michigan Medical School and their team from other universities and published online in Nature Medicine reports that gene therapy could help people restore their sense of smell. The research, conducted on mice, is a sign of hope for people who were born without the ability to smell or who have lost it due to some unfortunate reason.

The experts believe that fixing congenital anosmia, which is medical language for not being able to smell anything, may eventually lead to curing similar medical issues which also come from the cilia or small hair-like pieces which reside on the outside of cells and are present in diseases involving the kidneys, eyes, and other parts of the body.

According to the report, it may take a while for the evidence to be able to help humans and it will eventually be extremely significant for individuals who have lost the ability to smell because of some type of medical problem, and not so much for people who can't smell because of trauma to the nose, or simply old age. However, the new findings help researchers to understand anosmia on the cellular level, which gives hope to anyone who does not have a sense of smell that someday their ability to smell may be restored.

Jeffery Martens, Ph.D., senior author of the study commented:

"Using gene therapy in a mouse model of cilia dysfunction, we were able to rescue and restore olfactory function, or sense of smell. Essentially, we induces the neurons that transmit the sense of smell to regrow the cilia they'd lost."

The rodents involved in the study possessed some genetic defect that affected a protein named IFT88. This defect made the individuals have less- than-normal amounts of cilia in their bodies. When this problem occurs in mice, it results in early death and poor feeding habits, while for humans it can be fatal.

IFT88 genes were implanted into the cells in the mice when the researchers gave them a common cold virus which had plenty of normal DNA. This made it easy for the virus to infect them, and therefore, the researchers could insert the virus into the cells of the mice.

After this, the experts were able to analyze the feeding habits of the mice, as well as how they were growing, and the neuron signals which assist in the smelling process.

14 days after the mice were treated with 3 day therapy, the researchers found the mice to have increased in body weight by 60%, which meant their feeding habits had improved. When the mice were exposed to amyl acetate, or banana oil, the experts were able to see that their neurons were also working correctly.

Martens said: "At the molecular level, function that had been absent was restored.

First author Jeremy McIntyre, Ph.D., added:

"By restoring the protein back into the olfactory neurons, we could give the cell the ability to regrow and extend cilia off the dendrite knob, which is what the olfactory neuron needs to detect odorants."

People who have ciliopathies, diseases caused by the dysfunction of cilia, may benefit greatly from these findings. Examples of ciliopathies include:

• nephronopthisis
• dyskinesia
• primary ciliary
• Alström syndrome
• Bardet-Biedl syndrome

The scientists say that almost all cells in the body have the ability to grow one or more cilia. For the olfactory system, more than one cilia come from the olfactory sensory neurons. These are sensory cells which are present in the olfactory epithelium, the tissue of the nasal cavity. When loss of smell occurs, receptors the connect odorants are restrained on the cilia, resulting the loss of cilia, and the loss of sense of smell.

Martens concludes:

"We hope this stimulates the olfactory research community to look at asnosmia caused by other factors, such as head trauma and degenerative diseases. We know a lot about how this system works - now have to look at how to fix it when it malfunctions."

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Strategies To Prevent Noise-Induced Hearing Loss, Tinnitus In Soldiers To Be Presented

Antioxidants, dietary supplements and high-tech brain imaging are among some of the novel strategies that may help detect, treat and even prevent noise-induced hearing loss and tinnitus among American troops, according to researchers at Henry Ford Hospital.

A culmination of nearly 25 years of research on noise-induced hearing loss - a growing medical issue that affects more than 12 percent of American troops returning from conflicts around the globe - will be presented Sept. 9 at the American Academy of Otolaryngology-Head & Neck Surgery annual meeting in Washington, D.C.

Led by Michael Seidman, M.D., the research team is the first to identify how acoustic trauma from machinery and explosive devices damages the inner ear cells and breaks down cell growth, much like age-related hearing loss.

"Improvised explosive devices, aircraft and other weaponry being used by the military are frankly deafening our troops," says Dr. Seidman, director of the Division of Otologic/Neurotologic Surgery in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Hospital.

"Noise-induced hearing loss doesn't just impact a person's ability to hear; it can cause balance issues, make it difficult to sleep and communicate, and even raise the risk for heart disease by increasing a person's blood pressure, lipids and blood sugar."

As part of his presentation, Dr. Seidman will explain how noise-induced hearing loss, as well as tinnitus-related traumatic brain injury, occurs based on research from Wayne State University's Jinsheng Zhang, Ph.D.

Dr. Zhang has developed a model of blast-induced tinnitus and hearing loss using a shock tube that generates a 194 decibel shock wave similar to many of the explosive devices being deployed against troops.

Further, Dr. Seidman will discuss the use of nutraceuticals, such as acetyl-l-carnitine, alpha lipoic acid and resveratrol - a substance found in red wine and red grapes - to mitigate hearing-related issues.

Based on initial results, Dr. Seidman says a nutraceutical with a resveratrol-based component may possibly hold the potential to not only prevent, but reverse hearing loss in certain circumstances for soldiers. This research is based on animal models, but will soon be tested with humans, to see if a pill could soon be developed to prevent acoustic trauma in troops.

In addition, Dr. Seidman will highlight new research on tinnitus, a chronic ringing of the head or ears that affects more than 50 million patients.

A study co-authored by Susan Bowyer, Ph.D., senior bioscientific researcher at Henry Ford Hospital, found that an imaging technique called magnetoencephalography (MEG) can determine the site of perception of tinnitus in the brain, which could in turn allow physicians to target the area with electrical or chemical therapies to lessen symptoms.

Although is no cure for tinnitus, several interventions are available, including dietary modification, the use of specific herbs and supplements, sound therapies, centrally acting medications and electrical stimulation of the cochlea and brain using implantable electrodes and an implantable pulse generator.

To date, Dr. Seidman has treated six patients with direct electrical stimulation to the brain, reducing the tinnitus in four of those patients.

In all, the team's work on noise-induced hearing loss and tinnitus has led to more than 50 peer-reviewed publications and several patents.

According to Dr. Seidman, more research and funding are needed in order to generate critical data to facilitate an understanding of the damage caused by acoustic trauma and develop strategies to mitigate that damage.

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Chronic sinus infection thought to be tissue issue, Mayo Clinic scientists show it's snot

Findings call for radical change in treatment for the disease, researchers say -

Mayo Clinic researchers have found that the cause of chronic sinus infections lies in the nasal mucus -- the snot -- not in the nasal and sinus tissue targeted by standard treatment. The findings will be published in the August issue of Journal of Allergy and Clinical Immunology and are available online at elsevierhealth.com/jaci.

"This strikingly teaches against what has been thought worldwide about the origin of chronic sinus infection: that inflammatory cells break down, releasing toxic proteins into the diseased airway tissue," says lead researcher and Mayo Clinic ear, nose and throat specialist Jens Ponikau, M.D. "Instead we found that these toxic proteins are released into the mucus, and not in the tissue. Therefore, scientists might need to take not only the tissue but also the mucus into account when trying to understand what causes chronic sinus infections and probably other airway diseases."

The findings could significantly change the way chronic sinus infection is treated, according to Dr. Ponikau.

"This has far-reaching implications," says Dr. Ponikau. "This suggests a beneficial effect in treatments that target primarily the underlying and presumably damage-inflicting nasal and sinus membrane inflammation, instead of the secondary bacterial infection that has been the primary target of treatments for the disease. Also, some surgeons have already started to change the way they do surgery for patients with chronic sinus infections, focusing now on removing the mucus, which is loaded with toxins from the inflammatory cells, rather than the tissue during surgery. Leaving the mucus behind might predispose patients for early recurrence of the chronic sinus infection."

Dr. Ponikau conducted this research along with Hirohito Kita, M.D., and Gail Kephart, Mayo Clinic allergic diseases researchers. David Sherris, M.D., and Eugene Kern, M.D., both former Mayo Clinic ear, nose and throat specialists who now work at the University at Buffalo, also participated in the project.

The team found that in chronic sinus infection patients, activated white blood cells (eosinophils) cluster in the nasal and sinus mucus and scatter a toxic protein (major basic protein) onto the nasal and sinus membrane. While major basic protein was not distributed in the nasal and sinus tissue, the level of this protein in the mucus of chronic sinus infection patients far exceeded that needed to damage the nasal and sinus membranes and make them more susceptible to infections such as chronic sinus infection.

To conduct this investigation, Dr. Ponikau and fellow researchers collected specimens from 22 consecutive Mayo Clinic chronic sinus infection patients undergoing endoscopic sinus surgery. The surgeons extracted the maximum possible tissue and mucus during the sinus surgery. The surgeons also extracted tissue and mucus from healthy patients undergoing septoplasty, surgery to fix a deviated septum, for comparison with the specimens from the chronic sinus infection patients. Through various forms of laboratory examination of the tissue and attached mucus, the investigators observed an abundance of major basic protein throughout the nasal and sinus mucus in all 22 specimens, but not in the tissue.

Chronic sinus infection is one of the most common chronic diseases in the United States, affecting 32 million adults, according to the National Center of Health Statistics. Chronic sinus infection produces nose and sinus problems characterized by stuffy nose, loss of sense of smell, postnasal drip, nasal discharge, and head and face pain lasting three months or longer. It notably decreases the quality of patients' lives, impairing physical and social functioning, vitality and general health, according to the Mayo Clinic researchers.

To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. MayoClinic.com (http://www.mayoclinic.com) is available as a resource for your health stories.

Mayo Clinic is now using Pathfire's Digital Media Gateway (DMG) for video news release distribution, to streamline our services and provide content that is easily accessible as needed. On the DMG main page, look for the Mayo Clinic branded page in the left navbar, or click on the VNF Master Locator and search for MayoClinic0030. If you have questions or problems in locating the story, contact Pathfire Customer Support at 888-345-0489 or support@pathfire.com.

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Millions Suffer From Addiction to OTC Nasal Sprays

One of the most common complaints by patients suffering from chronic sinus problems is nasal obstruction and over all congestion. Aside from making it uncomfortable to breathe, this condition can also cause headaches, lack of sleep, and a lowered resistance to general sinus infections.

Due to the severity of their symptoms, chronic sinus sufferers eventually turn to chemical nasal sprays in an attempt to combat their chronic congestion. In turn, a growing percentage of these patients are reporting an addiction to Over The Counter (OTC) nasal sprays, and many physicians are concerned about the connection between these OTC products and a worsening of chronic sick sinus symptoms.

The product names are well known and each helps support a Billion dollar company, but these companies have made clear the fact that if their products are mentioned by name in this article, lawsuits will most definitely follow.

The most popular OTC nasal sprays use many of the same chemically active ingredients such as Phenylephrine, Xylometazoline and the most popular Oxymetazoline. Not only are these chemicals bad for your body, but they can also lead to addiction and recurring symptoms that worsen over time. Worse yet, repeated use of these sprays is also known to damage the sensitive membranes inside the nasal passages which can lead to chronic nose bleeds.

"The whole thing becomes a revolving door of addiction," says Wayne Perry, president and founder of SiCap Industries, the company made famous for introducing the world's first commercially available hot pepper nasal spray.

Known as "Sinus Buster," Perry's spicy concoction has been thoroughly embraced by thousands of physicians and nearly 50 thousand dedicated users. Officially launched in 2004, Sinus Buster has become one of the most talked about Nutraceutical products of the past year. Not only does it have a solid reputation as the most effective natural remedy for chronic headaches and sinus conditions, but it's also recommended by hundreds of doctors as an alternative to addictive OTC nasal sprays.

"I've been addicted to various nasal sprays all my life. They start working at first, but then I start needing more and more to keep it working. Finally I started getting nosebleeds and my doctor told me to get off the nasal sprays. He suggested saline spray and that did help stop my nosebleeds, but it didn't do anything to stop my sinus problems. I almost went back to the drug store nasal sprays. Then I read an article about Sinus Buster and how it could help with nasal spray addiction and my congestion. Since the first day I started using that stuff my sinus problems have been under control and I never felt better," says Robin Burgensen, a loyal Sinus Buster user from central Ohio.

"We have hundreds of doctors who say they use Sinus Buster to help get their patients out from under OTC nasal spray addiction. Not only is Sinus Buster safe to use as needed, but within a few days, most nasal spray addicts are completely clean from the chemical sprays. They do continue to use Buster regularly for relieving chronic congestion and related symptoms, but after a few months they end up only using it when they need it. For most people, the more they use intranasal capsaicin, the less they need it. On the other hand, the more you use a chemical nasal spray, the more you end up needing it. Eventually it causes the same problems most users are looking to relieve in the first place. Basically Sinus Buster can wean anyone off of chemical sprays while also relieving their sick sinus symptoms and it's as safe to use as saline. It's completely natural and even pregnant women can use it," adds Perry.

It may sound as though patients are trading one addiction for another, but unlike natural pepper spray, chemical OTC nasal sprays are in a dangerous category all their own. While the natural (Capsaicin) in Sinus Buster fights the root causes of congestion, inflammation and pain, chemical sprays artificially mask symptoms. The active medications in these sprays cause the tiny blood vessels within the mucous membranes to constrict which appears to provide temporary relief at first, but once the chemicals wear off the symptoms return with a vengeance. The more often a person uses chemicals such as phenylephrine, xylometazoline and oxymetazoline, the worse their chronic symptoms become over time. This is the cycle that leads to classic nasal spray addiction.

Unlike "All Natural" nasal sprays, chemical sprays cause a variety of problems when used for more than two or three days at a time. Chemical sprays eventually cause rebound congestion and headaches which is what leads to addiction in the first place. Chemical ingredients also damage the sensitive lining inside the nose. Moreover, long term use of these chemical sprays can also damage the liver and other vital organs.

Although it's a well regarded fact that chemical nasal sprays can be as addictive as Morphine, there have not been any large studies focusing on the number of people actually addicted. Many researchers estimate numbers approaching the 10 million mark in the United States alone -- based on reports from independent physicians.

"We know there are at least 50 million Americans suffering from long term chronic sinus problems, and according to the experiences of ENTs and MDs, as many as one out of four of these people are addicted to popular over the counter nasal sprays," Perry explains.

According to Perry, the companies that produce the most popular nasal sprays are well aware of the complications. In fact, Perry believes these companies rely on the addictive nature of their products to keep sales booming - similar to cigarette manufacturers.

And Perry isn't alone in criticizing the OTC nasal spray industry. Physicians around the world generally recommend against using chemically based over the counter nasal sprays of any kind. In turn, those same physicians recommend using an "All Natural" solution to help wean patients off the chemicals. Now it seems, all natural hot pepper nasal spray is proving to be the most effective tool for breaking the nasal spray addiction cycle.

To find out more about Sinus Buster hot pepper nasal spray, visit the company website at (www.sinusbuster.com). Samples and information kits are also available for verified medical and media personnel upon request.

SICAP INDUSTRIES, LLC

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Noise From Earphones Can Damage Your Ears

Although many people like to turn their headphones up as loud as they can after having a bad day or to get their mind off things bothering them, experts from the University of Leicester have shown evidence for the first time that turning the volume on your headphones up too high can damage the coating of nerve cells, eventually causing temporary deafness.

According to the researchers, the noise levels similar to those of jet levels can be heard on earphones or headphones on personal music players if they are turned up loud enough.

Scientists have known that temporary deafness and tinnitus (a condition that presents itself as a noise such as ringing or buzzing in the ears) can be caused by noises louder than 110 decibels. This study, published in the Proceedings of the National Academy of Sciences, is the first to examine how those noises cause underlying cell damage.

Dr. Martine Hamann, of the Department of Cell Physiologu and Pharmacology, lead author and researcher at the University of Leicester, explained:

"The research allows us to understand the pathway from exposure to loud noises to hearing loss. Dissecting the cellular mechanisms underlying this condition is likely to bring a very significant healthcare benefit to a wide population. The work will help prevention as well as progression into finding appropriate cures for hearing loss."

The myelin sheath is a coating found on nerve cells that carry electrical signals from the ears to the brain, which helps the electrical signals travel along the cell.

The cells become stripped of this coating with exposure to loud noises (noise over 100 decibels), which stops the electrical signals and no longer allows information to be successfully transmitted from the ears to the brain.

Fortunately, full hearing can return when the coating surrounding the nerve cells reform and allows the cells to function normally again. This means that hearing loss is sometimes only temporary.

The study is important, according to Dr. Hamann, because it explains why in certain cases, hearing loss can be reversible. He continued:

"We showed that the sheath around the auditory nerve is lost in about half of the cells we looked at, a bit like stripping the electrical cable linking an amplifier to the loudspeaker. The effect is reversible and after three months, hearing has recovered and so has the sheath around the auditory nerve."

Research is still being conducted on the effects of loud noises on a part of the brain referred to as the dorsal cochlear nucleus, the relay that carries signals from nerve cells in the ear to the parts of the brain that decode and make sense of sounds.

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Simple Eye Exercise which can improve Your Vision

The yoga practitioners attach special importance to eye exercises, for two reasons.

Firstly, a lot of eye problems in later life are due to a loss of tone in the eye muscles. These muscles become rigid, and this loss of elasticity reduces the ability of the lens of the eye to focus at different distances. It also causes the eyesight to become weaker. These exercises tone the eye muscles up and keep them elastic. If you already have eye problems when you begin these exercises, you will find your eyesight improving after a few months.

Secondly, any eye tension present will tend to produce a general feeling of tension, due to the eye's connection to the brain via the optic nerve. What happens is that eye tension produces an increase in the nerve impulses in the eye muscles. This increase in nerve impulses travels along the optic nerve and bombards the brain, causing a general feeling of tension and anxiety. The eye exercises will reduce tension in the eye muscles, as well as reduce general tension.

It is best to do these eye exercises while lying down after you've finished the asanas. This way you're resting after the asanas and doing the eye exercises at the same time, thus reducing the time taken to do your yoga routine.

When doing the eye exercises keep your eyes open and don't move your head.

Sitting (as in the exercises for the neck given above), open your eyes, then check on your posture. Is your spine erect? Hands on the knees? Body relaxed? Head straight? That is how you should always remain while doing eye exercises. The whole body must be motionless; nothing must move except the eyes.

Raise your eyes and find a small point that you can see clearly without straining, without frowning, without becoming tense and, of course, without moving your head. While doing this exercise look at this point each time you raise your eyes.

Next, lower your eyes to find a small point on the floor which you can see clearly when glancing down. Look at it each time you lower your eyes. Breathing should be normal. In other words, you don't have to do deep breathing.

Exercise 1

Move your eyes upwards as far as you can, and then downwards as far as you can. Repeat four more times. Blink quickly a few times 1 to relax the eye muscles.

Exercise 2

Now do the same using points to your right and to your left, at eye level. Keep your raised fingers or two pencils on each side as guides and adjust them so that you can see them clearly when moving the eyes to the right and to the left, but without straining. Keeping the fingers at eye level, and moving only the eyes, look to the right at your chosen point, then to the left. Repeat four times. Blink several times, then close your eyes and rest.

Exercise 3

Choose a point you can see from the right corner of your eyes when you raise them, and another that you can see from the left corner of your eyes when you lower them, half closing the lids. Remember to retain your original posture: spine erect, hands on knees, head straight and motionless.

Look at your chosen point in right corner up, then to the one in left corner down. Repeat four times. Blink several times. Close the eyes and rest.

Now do the same exercise in reverse. That is, first look to the left corner up, then to the right corner down. Repeat four times. Blink several times. Close the eyes and rest.

Exercise 4

This exercise should not be done until three or four days after you have begun eye exercises given here.

Slowly roll your eyes first clockwise, then counterclockwise as follows: Lower your eyes and look at the floor, then slowly move the eyes to the left, higher and higher until you see the ceiling. Now continue circling to the right, lower and lower down, until you see the floor again. Do this slowly, making a full-vision circle. Blink, close your eyes and rest. Then repeat the same action counterclockwise. Do this five times then blink the eyes for at least five seconds.

When rolling the eyes, make as large a circle as possible, so that you feet a little strain as you do the exercise. This stretches the eye muscles to the maximum extent, giving better results.

Exercise 5

Next comes a changing-vision exercise. While doing it you alternately shift your vision from close to distant points several times. Take a pencil, or use your finger, and hold it under the tip of your nose. Then start moving it away, without raising it, until you have fixed it at the closest possible distance where you can see it clearly without any blur. Then raise your eyes a little, look straight into the distance and there find a small point which you can also see very clearly.

Now look at the closer point-the pencil or your finger tip then shift to the farther point in the distance. Repeat several times, blink, close your eyes and squeeze them tight.

Exercise 6

Close your eyes as tightly as you possibly can. Really squeeze the eyes, so the eye muscles contract. Hold this contraction for three seconds, and then let go quickly.

This exercise causes a deep relaxation of the eye muscles, and is especially beneficial after the slight strain caused by the eye exercises. Blink the eyes a few times.

Exercise 7

This exercise is called 'palming' and is very relaxing to the eyes. It is also most important for preserving the eyesight. Palming also has a beneficial, relaxing effect on your nervous system.

It's an ideal way to finish off the eye exercises.

Remain seated on the floor. Draw up your knees, keeping your feet on the floor and slightly apart. Now briskly rub your palms to charge them with electricity and place the cupped palms over your closed eyes. The fingers of the right hand should be crossed over the fingers of the left hand on the forehead. The elbows should rest on your raised knees and the neck should be kept straight. Don't bend your head. Do the deep breathing while palming your eyes.

If you are going to do the palming for longer than a few minutes, better sit down at a table, place some books or pillows in front of you to support your elbows so that you will be able to keep the neck straight, and palm the eyes in this position. If the palming is done for only a short period one can do deep breathing for half a minute or so at first, gradually increasing it every week.

Benefits:

This exercise helps to do away with eye strain, and tension. Your vision will get better and clearer as the ophthalmic, or eye, nerves receive a richer supply of blood. Some people use this to improve their vision

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Top 5 Ways To Protect Your Hearing

To celebrate Better Hearing and Speech Month, the House Ear Institute (HEI) is educating the public on noise-induced hearing loss (NIHL) with the top five ways to protect their hearing.

An estimated 32.5 million people in the United States have a hearing loss. That estimate is up by 2.5 million from just a few years ago. Exposure to excessive noise causes approximately 30 percent of all hearing loss yet this type of hearing loss is preventable.

"Exposure to noise damages the microscopic hair cells found in the inner ear, which play a critical role in our ability to hear," said Dr. Jose Fayad, House Ear Clinic associate. "The damage can be from a brief but intense noise, but is most often caused by regular exposure to excessive sound over the course of several years."

How loud is too loud? Prolonged exposure to sounds above 85 decibels (dB) may cause permanent hearing loss. Normal conversation is measured at a moderate noise level of 50-70 dB. A motorcycle or lawn mower is 85-90 dB. The extreme noise of a typical rock concert is measured at 110 to120 dB and an ambulance siren or jet engine at take-off is 119-140 dB. Regular exposure even wearing headphones or earbuds can be dangerous too if the volume is too loud.

Noise-induced hearing loss is usually painless, progressive and always permanent but can also be 100 percent preventable. Here are the top five ways you to help prevent it:

1. Monitor your exposure time to sounds over 85 dB and take periodic 15-minute "quiet" breaks. Although the maximum time to safely be exposed to 85 dB is 8 hours, the maximum time to safely be exposed to 100 dB is only 15 minutes. See pie-chart for more information.

2. Avoid hazardous sound environments. If you have to raise your voice to be heard, you are in a potentially hazardous environment for your hearing. This includes loud music performances, operating power tools and driving with the windows down at high speeds.

3. Whenever you can't get away from an extreme sound environment, wear hearing protection, such as foam, silicone or pre-molded earplugs, earmuffs or custom earplugs. Look for products with noise-reduction ratings (NRR) of at least 9dB. Most products provide a NRR of 22dB or greater. To hear music and conversation clearly, look for high fidelity hearing protection. They will reduce all sound frequencies equally, and can often make listening to music more enjoyable than without any protection. Shooter's plugs combined with earmuffs should be used for hunting and target practice. All can be found over the counter at your local drugstore or sporting goods shop.

4. Move away from on-stage monitors or amplifiers.

Position yourself so you are not directly in front of the speaker while performing or listening. Musicians should avoid practicing at performance levels when possible.

5. If you suspect hearing loss or notice sudden changes in your hearing or have ear pain, see an otolaryngologist (ENT) or otologist. Also, have your hearing tested by a licensed audiologist. Common hearing tests include the pure tone threshold test, the otoacoustic emissions ("OAE") test, speech audiometry and the Hearing in Noise Test ("HINT"), which was developed by HEI scientists to assess how well you can hear speech in real world situations, where background noise is present.

For consumers who want to learn more, in May the House Ear Institute is launching a virtual hearing conservation workshop. The unique program will be available for worldwide use at http://www.hei.org.

For more information, visit House Ear Institute's Sound Partners® program at www.hei.org or its new site for teens and young adults at http://www.earbud.org, where young visitors can request a free pair of earplugs.

About the House Ear Institute

The House Ear Institute (HEI) is a non-profit 501(c)(3) organization dedicated to advancing hearing science through research and education to improve quality of life. HEI scientists investigate the cellular and molecular causes of hearing loss and related auditory disorders as well as neurological processes pertaining to the human auditory system and the brain. Our researchers also explore technology advancements to improve auditory implants, hearing aids, diagnostic techniques and rehabilitation tools. The Institute shares its knowledge with the scientific and medical communities as well as the general public through its education and outreach programs.

House Ear Institute
2100 West Third Street
Los Angeles, CA 90057
United States
http://www.hei.org

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Eye Infection In 17 States Caused By Lense Solution, FDA Warns

The FDA and the CDC have issued an alert to health care professionals and patients about a lense solution that can cause a rare eye infection caused by a fungus, Fusarium. The infection is rare, but serious - and can cause permanent loss of vision.

The FDA reports that several patients have experienced significant loss of vision. Many have needed corneal transplants.

Investigators have identified the fungus as Fusarium. Since April 9, 109 cases of Fusarium Keratitis are being investigated by the CDC and authorities in 17 US states.

Dr. Daniel Schultz, FDA's Center for Devices and Radiological Health Director, said "This is a serious infection and soft contact lens users should be mindful of the potential to develop this problem. We're advising consumers to practice good basic hygiene and follow manufacturers' instructions for proper use, cleaning and storage of their lenses, and report any signs of infection to their doctors."

Authorities are advising clinicians who diagnose microbial keratitis to refer their patient to an ophthalmologist, if appropriate to obtain a specimen for lab analysis.

The FDA and CDC urgently advise contact lens users to make sure their soft lenses and products used to maintain them are not contaminated.

The following measures should be taken:

-- Wash your hands with soap and water (lint-free method) before touching the lenses

-- Replace your lenses according to the timetable given to you by your doctor

-- Carefully follow the instructions given to you by your doctor and manufacturer regarding cleaning and storage of the lenses

-- Replace your contact lense case every 3-6 months

-- Make sure you keep your contact lense case clean

-- If you experience redness, pain, tearing, increasing light sensitivity, blurry vision, discharge or swelling - remove the lenses immediately and see your doctor.

The FDA and CDC also advise wearers to perform a 'rub and rinse' lens cleaning method, instead of the 'no rub method'. This will minimize the number of germs and reduce the likelihood of infection.

So far, 30 patients have been investigated fully. 28 of them use soft contact lenses, two don't use any contact lens at all. 26 of those 28 soft lens users used Bausch & Lomb ReNu cleaning solution, or a generic brand made by the same company. Five of those 26 used other solutions as well as the ReNu brand. 9 of the patients kept the lenses on overnight (in their sleep).

Sleeping with your lenses on at night increases the risk of microbial keratitis.

Dr. Schultz added "It is important to note that some of the affected patients had used other solutions in addition to the ReNu brand, and that the source of this fungus has not yet been identified. But we're working with CDC and Bausch & Lomb -- and we're investigating other possible causes -- to prevent these infections."

Bausch and Lomb has voluntarily stopped shipping the ReNu Moisture Loc and are investigating the cause of the infections.

The FDA advises any soft contact lens wearer who has existing stocks of Renu Moisture Loc to use the product with caution and report any symptoms of eye infection immediately.

In February of this year Bausch & Lomb voluntarily suspended sales of its ReNu multipurpose solutions in Singapore and Hong Kong after several people reported eye infections.

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Antibiotic Ear Drops Favored Over Popular Oral Antibiotics For Ear Infections

A multicenter study on treating common ear infections in children with ear tubes adds to a growing body of evidence that favors antibiotic ear drops over antibiotics swallowed in pill or liquid form in such cases, a UT Southwestern Medical Center researcher reports.

The latest study, involving 80 children, showed that antibiotic ear drops performed better and faster in treating middle ear infections in children with ear tubes than merely taking oral antibiotics such as swallowing a pill or liquid. The findings are available online in the journal Pediatrics.

"With the use of ear drops, you can put more potent medicine just where you need it," said Dr. Peter Roland, chairman of otolaryngology at UT Southwestern and one of the study's authors.

The latest study looked at children ages 6 months to 12 years who had ear tubes, middle ear infections, and visible drainage in the ear. Both the oral and topical antibiotics cure the infections in more than 70 percent of cases. But the topical drops resolved the ear drainage three to five days faster and resulted in more clinical cures overall - 85 percent for those taking drops, compared to 59 percent for oral administration of medication - according to the study.

That-s in line with previous research and other findings that support increased use of topical antibiotics over oral antibiotics in other cases involving middle ear infections, one of the most common childhood afflictions, said Dr. Roland, who heads the Clinical Center for Auditory, Vestibular and Facial Nerve Disorders at UT Southwestern and who is also chief of pediatric otology at Children-s Medical Center Dallas.

Middle ear infections are the most common diagnosis for which children receive antibiotics, and insertion of ear tubes is the most common surgery performed on children.

Many doctors treat these infections with oral antibiotics like amoxicillin, which is absorbed through the blood stream, said Dr. Roland.

The tubes, researchers reported, provide better access to the middle ear, behind the ear drum, so more of the ear drops medicine reach the infection, avoiding potential intestinal and blood absorption that occurs with oral antibiotics. Researchers discovered that the concentration at the infection can be a thousandfold greater than when oral or IV medication is used.

In addition, because the antibiotic is not distributed throughout the body, there is less chance of developing antibiotic resistance.

Dr. Roland has previously demonstrated that middle ear infections are often caused by micro-organisms that are not susceptible to antibiotics approved for pediatric patients. But the ear infections are sensitive to topical ear drops. That research showed that children with ear tubes have different micro-organisms than those without the tubes, thereby requiring different treatment.

Previous research has shown other advantages to topical antibiotics for middle-ear infections as well:

* They tend to be more tolerable for children, so parents are more likely to comply with the whole regimen.

* They tend to cause fewer gastrointestinal problems, such as diarrhea, gastroenteritis, dermatitis or complications from yeast infections than the oral antibiotics.

* They lead to less antibiotic resistance, a major goal of the Centers for Disease Control and Prevention since 1995.

###

Researchers involved in the Pediatrics study included groups from Texas, Pennsylvania, South Carolina, Utah and Florida.

The research was supported by a grant from Fort Worth-based Alcon Research Ltd. Dr. Roland is a paid medical monitor and consultant on the study.

About UT Southwestern Medical Center

UT Southwestern Medical Center, one of the premier medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. Its more than 1,400 full-time faculty members - including four active Nobel Prize winners, more than any other medical school in the world - are responsible for groundbreaking medical advances and are committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to nearly 89,000 hospitalized patients and oversee 2.1 million outpatient visits a year.

Dr. Peter Roland - http://www.utsouthwestern.edu/findfac/professional/0,2356,16205,00.html

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Retinal Implant 'Enables Blind People To See'

Researchers in Germany have developed a retinal implant that has allowed three blind people to see shapes and objects within days of the implant being installed. Impressively, one blind person was able to identify and find objects placed on a table in front of him, as well as walking around a room independently and approaching people, reading a clock face and differentiating seven shades of grey. The research is published in Proceedings of the Royal Society B.

The device, which has been developed by the company Retinal Implant AG together with the Institute for Ophthalmic Research at the University of Tuebingen, represents an unprecedented advance in electronic visual prostheses and could eventually revolutionise the lives of up 200,000 people worldwide who suffer from blindness as a result of retinitis pigmentosa, a degenerative eye disease.

In this disease light receptors in the eye cease to function. Writing in Proceedings of the Royal Society B, Prof. Dr. Eberhart Zrenner (founding Director of Retinal Implant AG and Director and Chairman of the University of Tuebingen Eye Hospital) states that "The results of this pilot study provide strong evidence that the visual functions of patients blinded by a hereditary retinal dystrophy can, in principle, be restored to a degree sufficient for use in daily life."

The device - known as a subretinal implant - sits underneath the retina, directly replacing light receptors lost in retinal degeneration. As such, it uses the eyes' natural image processing capabilities beyond the light detection stage to produce a visual perception in the patient that is stable and follows their eye movements. Other types of retinal implants - known as epiretinal implants - sit outside the retina and because they bypass the intact light-sensitive structures in the eyes they require the user to wear an external camera and processor unit.

The subretinal implant described in this paper achieves unprecedented clarity because it has a great deal more light receptors than other similar devices. As Prof. Dr. Zrenner states, "The present study...presents proof-of-concept that such devices can restore useful vision in blind human subjects, even though the ultimate goal of broad clinical application will take time to develop."

Source:
Royal Society
Retina Implant AG

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Electronic Retinas Help The Blind See Again

Bionic retinal implants give vision back to the blind…

Two British men have been come the first patients to be successfully implanted with electronic retinal implants. The new pioneering procedure has been shown to give vision back to the blind who have lost their sight due to Retinitis Pigmentosa.

Chris James, 54, who was declared legally blind 22 years ago, became the first to receive the operation to implant an electronic retina in the back of his eye, at the Oxford University Hospitals NHS Trust. The second patient, Robin Miller, 60, who lost his sight 35 years ago, received his implant days later.

The procedure is being pioneered by Robert MacLaren, Professor of Ophthalmology at the University of Oxford, and Mr. Tim Jackson, a consultant ophthalmic surgeon at King’s College Hospital in London. And the electrodes and external battery implants are being performed by Mr. James Ramsden of Oxford University Hospitals and Mr. Markus Groppe, an academic clinical lecturer at the University of Oxford, is performing

Retinal Bionic Implant Restores Vision

The device is design to replace the light-detecting cells in the retina, which deteriorate due to retinitis pigmentosa – an inherited condition that affects approx 1 in every 4,000 people in Europe.
The electronic retinas are just 3mm thick, and contain 1,500 light-sensitive pixels, which mimic the function of the photoreceptor rods and cones. When light reaches the retinal chip, pixels detects the waves and send electronic signals to the optic nerve and brain.

The surgery, which takes around 8 hours, involves implanting the device into the eye, running a thin cable to a control unit which sits behind the ear under the skin, and then attaching an magnetic external battery.
Professor MacLaren explains:

‘What makes this unique is that all functions of the retina are integrated into the chip. It has 1,500 light sensing diodes and small electrodes that stimulate the overlying nerves to create a pixelated image. Apart from a hearing aid-like device behind the ear, you would not know a patient had one implanted.’

The implants are manufactured by a Germany-based company aptly named Retina Implant. After 6 of year of development, the company published the results from its first human trial in Proceedings of the Royal Society B, November 2010. The study showed that using the implant; patients could recognize foreign objects and read words.

The early prototypes were not portable and only worked when linked up in the lab. The new devices in the British patients however, are completely portable.

While the technology appears to be effective in treating Retinitis Pigmentosa it must still undergo more trails to see if the procedure can be tailored to treat age-related macular degeneration, glaucoma or optic nerve disease.

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What Is Exophthalmos? What Causes Exophthalmos?

Exophthalmos, or exophthalmia, is a protruding eyeball anteriorly out of the orbit (eye socket). The Greek word ophthalmos means "eye" and the Greek word ex means "out". Exophthalmos can be either bilateral (both eyes bulge out) or unilateral (just one eye bulges out). Doctors use an exophthalmometer to measure the degree of exophthalmos.

Depending on the severity of the exophthalmos, if it is left untreated the eye lids may fail to close during sleep, resulting in corneal dryness and eventual damage. People with exophthalmos also risk developing superior limbic keratoconjunctivitis, where the area above the cornea becomes inflamed because of the friction that occurs when the patient blinks. Some patients may experience compression of the optic nerve or ophthalmic artery, which can eventually affect the patient's eyesight, leading to blindness.

Exophthalmos is not a condition, but rather a sign of a condition, usually caused by something wrong with the thyroid gland.

According to Medilexicon's medical dictionary, exophthalmos is "Protrusion of one or both eyeballs; can be congenital and familial, or due to pathology, such as a retroorbital tumor (usually unilateral) or thyroid disease (usually bilateral)."

What are the signs and symptoms of exophthalmos?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor notice. For example, pain may be a symptoms while a rash may be a sign.

The most noticeable sign of exophthalmos are bulging or protruding eyeballs (either one or both). If the patient has Graves' disease, a thyroid condition, the bulging develops because the tissues in the eyeballs swell, and the number of cells in the eye increases - resulting in larger eyes which push forward from their orbits (sockets). The human eye sockets are rigid and cannot expand to accommodate the larger eyeball. As the eyeball protrudes the eyelid is forced apart, giving the patient a staring expression with a higher-than normal proportion of the whites of the eyes exposed.

Graves' disease is the most common cause of bulging eyeballs. Signs and symptoms of Graves' disease include:

• Pain in the eyes
• Dry eyes
• Eye irritation
• Sensitivity to light (photophobia)
• Lacrimation - eye secretions and shedding of tears
• Diplopia - double vision caused by the weakening of the eye muscles
• Progressive blindness, if the optic nerve is compressed
• Difficulty in moving eyes - as the eye muscles weaken the patient may find it harder to move the eyes. In some cases the eyes may turn inwards (amblyopia).

The following non-ocular signs and symptoms are also possible with Graves' disease:

• Irregular heartbeats (arrhythmia, palpitations)
• Anxiety
• Raised appetite
• Sleeping problems (insomnia)

What are the causes of exophthalmos?

Graves' disease, an autoimmune disease that causes hyperthyroidism (thyroid gland produces too much thyroid hormone) is the most common cause of exophthalmos. Thyroid problems generally are common causes.

The thyroid gland - the thyroid gland is in the neck, below the Adam's apple. It produces hormones which help to regulate growth and the rate of chemical reactions (metabolism) by which the body uses energy. The thyroid gland produces thyroxine and triiodothyronine.

Thyroid eye disease - also known as TO (thyroid orbitopathy), is a condition in which the soft tissues and muscles surrounding the eyes become swollen and inflamed. This condition is closely linked to hyperthyroidism (overactive thyroid gland), and sometimes hypothyroidism (underactive thyroid gland).

Exophthalmos does not necessarily occur during the onset of hyperthyroidism or hypothyroidism. The eyes may start bulging long after a thyroid problem starts; and even before.

Autoimmune diseases - healthy people's immune systems attack pathogens; organisms and substances that are bad for us, such as some bacteria, viruses, parasites, cancer cells and fungi. If the person's immune system starts attacking good tissue they have an autoimmune disease - the immune system is attacking parts of the person's body that are needed for good health. Graves' disease is an example of an autoimmune disease. Experts are not sure why autoimmune diseases, such as Graves' disease occur.

If the patient's immune system attacks the thyroid gland it often reacts by producing more hormones than normal. The excess thyroid hormone, as well as the autoimmune antibodies may attack the muscles and soft tissue surrounding the eyes, causing:

• Dry eyes (often described as gritty eyes)
• Redness
• Puffy eyes
• Inflammation and swelling
• Problems with eyesight
• Exophthalmos (bulging or protruding eyes)

Inherited diseases - some diseases which may affect the eyes are inherited, the patient has acquired the faulty genes from their parents or grandparents. Graves' disease is an example of a hereditary disease.

Proptosis (eyeball protrusion, one eye) - the presence of something in the eye-socket can cause proptosis, such as:

• A cancerous tumor
• Mucocoele (mucus-filled cyst)
• A blood clot
• Trauma (eye injury)
• Sinus infection

Anybody who notices that one or both eyes are starting to bulge should see their doctor immediately.

How is exophthalmos diagnosed?

In most cases the protrusion or bulging of the eyeballs from the sockets, with much more of the whites of the eyes exposed, is enough for the doctor to diagnose exophthalmos fairly easily. However, as mentioned earlier, exophthalmos is a sign of some disease or condition, and is not a disease in itself. Therefore, if a GP (general practitioner, primary care physician) suspects exophthalmos the patient will probably be referred to an eye specialist - an ophthalmologist. The ophthalmologist will most likely order further tests before confirming a diagnosis.

The following tests may be ordered:

A blood test - this will probably be a thyroid function test to see whether the thyroid gland is healthy.

Exophthalmometer - this instrument measures the degree of eyeball protrusion as well as determining how well the patient can move their eyes. Patients with exophthalmos will be able to look upwards without moving their eyebrows.

Imaging scans - in order to examine the orbit (socket) the doctor may order a CT (computerized tomography) scan or an MRI (magnetic resonance imaging) scan. A scan may also detect a tumor, or any abnormalities in or around the eyes.

What are the treatment options for exophthalmos?

As exophthalmos tends to be a progressive disease - symptoms get worse over time - the ophthalmologist will wish to monitor the patient regularly. Treatment depends on several factors, including the cause, as well as the patient's age and general health.

Thyroid problems - the doctor will treat whatever is causing the thyroid problem so that thyroid hormone levels are brought back to normal. Usually, effective thyroid treatment results in the restoration of normal vision and the appearance of the eyes.

If the patient has Graves' disease thyroid treatment might make no difference to the appearance of the eyes. On occasions the affected vision and appearance of the eyes cannot be improved.

It is important to see your doctor as soon as you notice any bulging of the eyes. Treatment is much more effective if it can begin early.

Surgery - if there is a problem with the connection between the arteries and veins in the eyes the patient may have to undergo surgery. In severe cases the bony floors of the eye sockets may have to be surgically removed (surgical orbital decompression). The procedure allows excess material to move down into the extra space in the antrum (maxillary sinus) by the surgical intervention.

Eye drops - if the patient suffers from dry eyes, eye drops will help keep the eyeballs moist - it is important to keep the cornea lubricated.

Eyeshades - eyeshades may be required if the patient suffers from photophobia (oversensitivity to light).

Corticosteroids - for patients whose eyes are especially painful or swollen (inflamed), the doctor may prescribe corticosteroids. Corticosteroids are effective in reducing swelling and inflammation.

A tumor - most likely the doctor will talk to the patient about removing the tumor surgically, as well as using chemotherapy, radiotherapy (radiation therapy), or a combination.

What are the possible complications of exophthalmos?

In severe cases patients may not be able to close their eyes properly, especially when they are asleep. This can cause the cornea to dry out and become damaged. If the cornea dries out too much there is a much higher risk of infection or ulcers, which can damage vision.

People with exophthalmos or proptosis are more susceptible to developing conjunctivitis.

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What Is Ataxia? What Causes Ataxia?

Ataxia is a lack of muscle coordination which may affect speech, eye movements, the ability to swallow, walking, picking up objects and other voluntary movements. A person with persistent ataxia may have damage in the part of the brain that controls muscle coordination - the cerebellum. Ataxia may have several causes, including multiple sclerosis, a head injury, alcohol abuse, stroke, cerebral palsy, a faulty gene, or a tumor. Ataxia may also be a symptom of incoordination linked to infections.

There are different types of ataxias including Friedreich's ataxia and spinocerebellar ataxia type 6. A less common type is ataxia telangiectasia. According to Ataxia UK, there are over 40 known forms of inherited ataxias - new forms continue to be identified as scientific techniques improve.

The International Ataxia Awareness Day is observed on September 25 each year.

According to Medilexicon's medical dictionary, ataxia is " An inability to coordinate muscle activity during voluntary movement; most often results from disorders of the cerebellum or the posterior columns of the spinal cord; may involve the limbs, head, or trunk."

The term ataxia may also be used more broadly to indicate a lack of coordination in a physiological process, such as optic ataxia (usually part of Balint's syndrome which includes a lack of coordination between visual inputs and hand movements), or ataxic respiration (uncoordinated respiratory movements, usually due to dysfunction of the respiratory centers of the medulla oblongata).

The English word "ataxia" comes from the Ancient Greek word ataksia meaning "disorder". The Ancient Greek word taksia means "order".

Some types of ataxias

Cerebellar ataxia

This is ataxia caused by a dysfunction of the cerebellum - a region in the brain which is involved in the assimilation of sensory perception, coordination and motor control. Cerebellar ataxia causes some basic neurological problems, such as:

• Floppiness (hypotonia).
• Lack of co-ordination between organs, muscles, limbs or joints (asynergy).
• Impaired ability to control distance, power, and speed of an arm, hand, leg or eye movement (dysmetria).
• Difficulty in accurately estimating how much time has passed (dyschronometria).
• An inability to perform rapid, alternating movements (dysdiadochokinesia).

How the patient is affected depends on which parts of the cerebellar are lesioned, and whether lesions occur on one side (unilateral) or both sides (bilateral).

If the vestibulocerebellum is affected the patient's balance and eye movement control will be affected. The patient will typically stand with feet wide apart in order to gain better balance and avoid swaying backwards and forwards (posterior-anterior oscillations). Even when the patient's eyes are open balance is difficult when the feet are together.

If the spinocerebellum is affected the patient will have an unusual gait, with unequal steps, sideways steps, and uncertain starts and stops. The spinocerebellum regulates body and limb movements.

If the cerebrocerebellum is affected the patient will have problems carrying out voluntary, planned movements. The head, eyes, limbs and torso may tremble as voluntary moves are carried out. Speech may be slurred, with variations in rhythm and loudness.

Sensory ataxia

This is ataxia due to loss of proprioception. Proprioception is the sense of the relative position of neighboring parts of the body. It is a sense that indicates whether the body is moving with the required effort, and also where the various parts of the body are located in relation to each other. Even if I am blindfolded I know through proprioception if my arm is above my head or hanging down in front of me, by my side, or behind me.

A patient with sensory ataxia typically has an unsteady stomping gait, with the heel striking hard as it touches the ground with each step. Postural instability becomes worse in poorly lit environments. If a doctor asks the patient to stand with eyes closed and feet together his/her instability will clearly worsen. This is because loss of proprioception makes the patient much more reliant on visual data.

The patient may find it hard to perform smoothly coordinated voluntary movements with the limbs, trunk, pharynx, larynx, and eyes.

Vestibular ataxia

The vestibular system is affected. In acute (sudden) unilateral cases the patient may experience vertigo, nausea, and vomiting. In slow-onset chronic bilateral cases the patient may only experience unsteadiness, giddiness.

What are the symptoms of ataxia?

Symptoms may vary depending on the severity and type of ataxia, of which there are many. If the ataxia is caused by an injury or another health condition, symptoms may emerge at any age, and may well improve and eventually disappear.

Initial ataxia symptoms usually include:

• Poor limb coordination.
• Dysarthria - slurred and slow speech that is difficult to produce. The patient may also have difficulties controlling volume, rhythm, and pitch.

If the ataxia advances other symptoms may also appear:

• Swallowing difficulties, which may sometimes result in choking or coughing.
• Facial expressions become less apparent.
• Tremors - parts of the body may shake or tremble unintentionally.
• Nystagmus - involuntary rapid rhythmic repetitious eye movement. Movements may be vertical, horizontal, or circular.
• Pes cavus - a foot with too high an arch.
• Cold feet - because of a lack of muscle activity.
• Problems with balance.
• Walking difficulties - in severe cases the patient may need a wheelchair.
• Vision problems.
• Hearing problems.
• Depression - as a result of having to live and cope with the symptoms.

Cerebellar ataxias

Cerebellar ataxia early onset usually emerges between the ages of 4 and 26. Late onset ataxia generally appears after the patient is 20 years old. Late-onset ataxias usually present less severe symptoms, compared to early-onset ataxia.

Ataxia telangiectasia symptoms generally include:

• Small veins appear around the corner of the eyes, cheeks and ears.
• Physical and sexual development is usually delayed.

Friedreich's ataxia symptoms generally include:

• The spine curves sideways (scoliosis).
• The heart muscle becomes weaker (cardiomyopathy).
• Diabetes.

For patients whose symptoms are caused by injury or illness, symptoms often improve over time, and eventually go away completely.

What are the causes of ataxia?

Vitamin B₁₂ deficiency - as well as other neurological abnormalities, vitamin B₁₂ deficiency can cause overlapping cerebellar and sensory ataxia.

Ataxia can be a symptom of another health condition, it can also be inherited or non-inherited.

Inherited ataxia

This means the ataxia is caused by a genetic fault inherited either from the mother or father, or both. A faulty gene that is passed down through generations can cause cerebellar ataxia - in some cases its severity worsens from one generation to the next and the age of onset gets younger. This type of worsening inherited ataxia is known as anticipation.

The chances of inheriting ataxia from a parent depends on the type of ataxia that parent has. For a person to develop Friedreich's ataxia the faulty gene would need to be carried by both the mother and the father (recessive inheritance). Spinocerebellar ataxia, on the other hand, only requires one parent to carry the defective gene (dominant inheritance), and each of his/her offspring would have a 50% risk of developing the condition.

Non-inherited ataxia

Even without a family history of ataxia some people may still develop the condition. In some cases, experts never find out what the cause was. The following procedures and circumstances can cause ataxia:

• Brain surgery.
• Head injury.
• Alcohol abuse.
• Drug abuse.
• Infections, such as chicken pox (usually goes away after infection has gone).
• A brain tumor.
• Exposure to toxic chemicals.
• Multiple sclerosis, cerebral palsy, and some other neurological conditions.
• Malformation of the cerebellum while the baby is still in the womb.

How is Ataxia diagnosed?

A doctor who suspects the patient may have ataxia will refer him/her to a neurologist - a doctor specialized in diagnosis, treatment and prevention of conditions and illnesses related to the nervous system.

The specialist will check the patient's medical history for cause factors, such as brain injury, as well as the patient's family history for indications of inheritance. The following tests may also be ordered:

• Magnetic resonance imaging (MRI) or Computerized Tomography (CT) scan - to determine whether there is any brain damage.


• Genetic tests - to determine whether the patient has inherited ataxia.


• Blood tests - some types of ataxia affect the make up of blood.


• Urine tests - urinalysis may suggest specific systemic abnormalities that are linked to some forms of ataxia. If the specialist suspects Wilson's disease the patient may be asked for a 24-hour urine collection to determine how much copper is in the system.

In some cases the specialist never knows what caused the ataxia, this is known as sporadic or idiopathic ataxia.

Reaching a conclusive diagnosis of ataxia can sometimes take a long time because the symptoms could point to several other conditions.

What is the treatment for ataxia?

Although ataxia is not curable, a great deal can be done to ease symptoms and improve the quality of life of the patient. Treatment for coordination and balance problems usually involves the use of adaptive devices which help the patient attain as much independence as possible. These may include the use of a cane (walking stick), crutches, walker or a wheelchair. Symptoms such as tremor, stiffness, spasticity, sleep disorders, muscle weakness, depression (or frustration, sadness and anger) may be addressed with targeted physical therapy, speech therapy, medications and counseling.

• Occupational therapy - the occupational therapist can help the patient manage better around the house and work. This may involve some home adaptations, wheelchair assessments, and making the kitchen more practical for the patient.


• Speech therapy - the speech therapist can help with swallowing, coughing, choking and speech problems. If speech becomes very difficult the speech therapist can help the patient learn how to use speech aids.


• Orthopedic care - this can help patients with curvature of the spine (scoliosis).


• Physical therapy (physiotherapy) - a physical therapist (physiotherapist) can help maintain strength and improve mobility.


• Counseling - patients with ataxia commonly become frustrated and depressed; this usually results from having to cope with some symptoms which affect physical mobility and coordination. Talking to a well qualified counselor, such as a psychotherapist can help.


• Supplements and nutrition - some patients with ataxia have very low levels of vitamin E and require supplements and/or a special diet. As sensitivity to gluten is more common among ataxia patients, a gluten-free diet also helps.


• Medication - some patients with ataxia telangiectasia are prescribed gamma-globulin injections to boost their immune systems. There are also drugs for muscle spasms and uncontrollable eye movements.

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