“Prevent Blindness has declared April as Women’s Eye Health and Safety Month in an effort to educate the public on the increased risk for women and vision health issues, as well as steps that can be taken to prevent vision loss.

Two out of every three people living with blindness or vision problems are women according to the National Eye Institute. Women are at greater risk of developing a number of eye conditions, including age-related macular degeneration (AMD), cataracts and glaucoma.

At Texas Retina, we know that women often manage their family’s health and take care of everyone else first. However, it is important that women make their own eye health a priority as early detection and consistent treatment can significantly reduce the risk of vision loss. Here are a few tips:

• Women 40 and older should have an annual dilated eye exam.
• They should also see their optometrist or ophthalmologist any time they experience a change in vision.
• Eat a healthy diet rich in vitamin C, vitamin E, beta carotene, lutein, zeaxanthin, zinc and omega-3 fatty acids. This should include foods such as salmon, broccoli and dark leafy greens.
• Stay active as regular exercise is known to reduce the risk of eye disease.
• Protect your eyes from the sun by wearing proper sunglasses that block ultraviolet radiation.
• Avoid smoking.“

Texas Retina (https://www.texasretina.com/2024/04/02/april-is-womens-eye-health-and-safety-month)

Two out of every three people living with blindness or vision problems are women, according to the National Eye Institute. And, data from The Future of Vision: Forecasting the Prevalence and Costs of Vision Problems study shows that women are at higher risk for certain eye diseases and conditions. Prevent Blindness has declared April as Women’s Eye Health and Safety Month in an effort to educate the public on the increased risk for women and vision health issues, as well as steps that can be taken to prevent vision loss.

Women have a higher prevalence of major vision problems, including:

• Age-related Macular Degeneration
• Autoimmune Diseases (such as Lupus or Sjögren’s Syndrome)
• Cataract
• Dry Eye
• Glaucoma
• Low Vision
• Thyroid Eye Disease
• Refractive Error

According to the World Health Organization’s World Report on Vision, women, on average, live longer than men, and are thus at greater risk of developing eye conditions associated with ageing. However, even after controlling for age, global estimates suggest that women with moderate and severe presenting distance vision impairment outnumber men by approximately 7 percent.

Gender and financial disparities can also create barriers to eyecare access for women.  A recent study published in JAMA Ophthalmology found that although women were more likely to use eye care, they are also more likely to report difficulty affording eyeglasses than men.

In addition to eye disease and conditions, women have unique health issues related to pregnancy and menopause due to fluctuating hormone levels. Women may notice changes in their ability to see clearly during pregnancy. Women with pre-existing conditions, like glaucoma, high blood pressure or diabetes, need to alert their eye doctor that they are pregnant (or planning to become pregnant). Additionally, dry eye leading to a clinical diagnosis or severe symptoms affects more than 3.2 million American women middle-aged and older.

As ophthalmologists and optometrists re-open their practices temporary closing of the office due to the COVID-19 pandemic, it is important that women make their vision health a priority to help detect vision issues early. Early and consistent treatment for most eye diseases can significantly reduce the risk of vision loss.

“Head and neck cancers usually begin in the squamous cells that line the mucosal surfaces inside the mouth, nose, throat, and salivary glands. They are often referred to as squamous cell carcinomas of the head and neck.

Head and neck cancers account for nearly 4 percent of all cancers in the United States, according to the National Cancer Institute (NCI).

Counting cancers of the oral cavity, pharynx, and larynx, the NCI estimates that about 66,920 cases occurred in the U.S. in 2023. About 15,400 people died from these diseases, according to the NCI’s Surveillance, Epidemiology and End Results (SEER) program.

Head and neck cancer is more common among men than women. These cancers are also diagnosed more often among people over age 50 than among younger people.

Symptoms of head and neck cancers may include a lump or a sore that doesn’t heal. In addition, symptoms can include sore throat that doesn’t go away, difficulty in swallowing, and a hoarse voice.

Alcohol and tobacco use are major risk factors for head and neck cancers. Also, infection with cancer-causing types of human papillomavirus (HPV) increases a person’s risk of certain head and neck cancers.”

American Association for Cancer Research – AACR (https://www.aacr.org/patients-caregivers/awareness-months/head-and-neck-cancer-awareness-month/)

  ORAL CANCER RECONCONSTRUCTION SURVIVORS

KNOW THE SYMPTOMS

Most oral, head, and neck cancers begin in the cells that make up the moist tissues (mucosal surfaces) of the head and neck, including in the mouth, nose, and throat. Like other cancers, oral, head, and neck cancers occur when abnormal cells begin to grow and divide uncontrollably and form a mass, called a malignant tumor.

The National Cancer Institute estimates that 85 percent of oral, head, and neck cancers are linked to tobacco use. Men (age 50 or older) who use both tobacco and alcohol are at the highest risk.

Cancers of the brain, eye, thyroid, as well as the skin, bones, muscles and nerves of the head and neck are not included under the heading of “oral, head and neck” cancer.

Doctors identify oral, head, and neck cancers by the area in which the cancer begins:

Lip and oral cavity cancer occurs on the lips, the front two-thirds of the tongue, the gums, the lining of the cheeks and lips, the floor of the mouth under the tongue, the palate, and the area behind the wisdom teeth.

Where does oral cancer affect:

Oral cancer (mouth cancer) is the broad term for cancer that affects the inside of your mouth. Oral cancer can look like a common problem with your lips or in your mouth, like white patches or sores that bleed. Oral cancer (mouth cancer) is the most common form of head and neck cancer. It typically affects people age 60 and older. Oral cancer affects your lips and the first parts of your tongue, mouth roof and floor. It also affects your oropharynx — the last part of your tongue and roof of your mouth, your tonsils, the sides and back of your throat that can include your sinuses, and pharynx (throat). The difference between a common problem and potential cancer is these changes don’t go away. Left untreated, oral cancer can spread throughout your mouth and throat to other areas of your head and neck. Approximately 63% of people with oral cavity cancer are alive five years after diagnosis.

 It can be life-threatening if not diagnosed and treated early.

When it is caught early, like other cancers is much easier for doctors to treat when caught early. Yet most people get a diagnosis when their condition is too advanced to treat effectively. If you see your dentist or doctor regularly and learn how to spot suspicious changes, you’ll have a much better shot at an early diagnosis.

Overall, about 11 people in 100,000 will develop oral cancer during their lifetime. Men are more likely than women to develop oral cancer. People who are white are more likely to develop oral cancer than people who are Black.

The overall 5-year survival rate for patients with an early diagnosis of oral cavity and pharynx cancers is 84%. If the cancer has spread to nearby tissues, organs, or lymph nodes, the 5-year survival rate drops to 65%.

How it is diagnosed?

As part of your routine dental exam, your dentist will conduct an oral cancer screening exam.  Your dentist knows what a healthy mouth should look like and probably has the best chance of spotting any cancer. Experts recommend getting checked every year starting at age 18, and sooner if you start smoking or having sex.

More specifically, your dentist will feel for any lumps or irregular tissue changes in your neck, head, face, and oral cavity. When examining your mouth, your dentist will look for any sores or discolored tissue as well as check for any signs and symptoms mentioned above.

A biopsy may be needed to determine the makeup of a suspicious-looking area. There are different types of biopsies and your doctor can determine which one is best.

Treatments:

It varies from person to person depending on the stage of oral cancer the person has and how advanced the cancer is.

Whether a patient has surgery, radiation, and surgery, or radiation, surgery, and chemotherapy, you need to remember it depends on the stage of cancer development. Each case is individual.

Patients with cancers treated in their early stages may have little in the way of post-treatment disfigurement. For those whose cancer is caught at a later stage, the results of surgical removal of the disease may require reconstruction of portions of their oral cavity or facial features. There may be needed adjunctive therapy to assist in speech, chewing of foods, the problems associated with the lack of salivary function, and the fabrication of dental or facial prostheses.

“In 1986, President Reagan recognized March as “National Hemophilia Month” which has since been changed to #BleedingDisordersAwarenessMonth to be inclusive of all #bleedingdisorders. We’ll be posting facts throughout the month to honor our history and raise awareness about all #bleedingdisorders. Hemophilia is usually an inherited bleeding disorder in which the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery.”

World Federation of Hemophilia – WFH (https://www.hemophiliafed.org/resource/bleeding-disorders-awareness-month/)

What is this condition?

Hemophilia is a bleeding disorder characterized by low levels of clotting factor proteins. Correct diagnosis of Hemophilia is essential to providing effective treatment. Blood Center of Wisconsin offers one of the largest diagnostic menus to accurately and confidently diagnose Hemophilia.

The X and Y chromosomes are called sex chromosomes. The gene for hemophilia is carried on the X chromosome. Hemophilia is inherited in an X-linked recessive manner.  Females inherit two X chromosomes, one from their mother and one from their father (XX). Males inherit an X chromosome from their mother and a Y chromosome from their father (XY). That means if a son inherits an X chromosome carrying hemophilia from his mother, he will have hemophilia. It also means that fathers cannot pass hemophilia on to their sons.

But because daughters have two X chromosomes, even if they inherit the hemophilia gene from their mother, most likely they will inherit a healthy X chromosome from their father and not have hemophilia. A daughter who inherits an X chromosome that contains the gene for hemophilia is called a carrier. She can pass the gene on to her children. Hemophilia can occur in daughters, but is rare.

For a female carrier, there are four possible outcomes for each pregnancy:

1. A girl who is not a carrier
2. A girl who is a carrier
3. A boy without hemophilia
4. A boy with hemophilia

Hemophilia is an X-linked inherited bleeding disorder caused by mutation of the F8 gene that encodes for coagulation factor VIII or the F9 gene that encodes for coagulation factor IX. The degree of plasma factor deficiency correlates with both the clinical severity of disease and genetic findings. Severe hemophilia is characterized by plasma factor VIII or factor IX levels of under 1 IU/dl. Moderate and mild hemophilia are characterized by factor VIII or factor IX levels of 1-5 IU/dL or 6 – 40 IU/dL, respectively. Genetic analysis is useful for identification of the underlying genetic defect in males with severe, moderate or mild hemophilia and for determination of carrier status in the female individuals within their families. Additionally, data is emerging regarding the correlation between a patients mutation status and the risk of that patient developing an inhibitor.

People with hemophilia A often, bleed longer than other people. Bleeds can occur internally, into joints and muscles, or externally, from minor cuts, dental procedures or trauma. How frequently a person bleeds and the severity of those bleeds depends on how much FVIII is in the plasma, the straw-colored fluid portion of blood.

Normal plasma levels of FVIII range from 50% to 150%. Levels below 50%, or half of what is needed to form a clot, determine a person’s symptoms.

• Mild hemophilia A-  6% up to 49% of FVIII in the blood. People with mild hemophilia Agenerally experience bleeding only after serious injury, trauma or surgery. In many cases, mild hemophilia is not diagnosed until an injury, surgery or tooth extraction results in prolonged bleeding. The first episode may not occur until adulthood. Women with mild hemophilia often experience menorrhagia, heavy menstrual periods, and can hemorrhage after childbirth.
• Moderate hemophilia A. 1% up to 5% of FVIII in the blood. People with moderate hemophilia A  tend to have bleeding episodes after injuries. Bleeds that occur without obvious cause are called spontaneous bleeding episodes.
• Severe hemophilia A.  <1% of FVIII in the blood. People with severe hemophilia A experience bleeding following an injury and may have frequent spontaneous bleeding episodes, often into their joints and musclesHemophilia A and B are diagnosed by measuring factor clotting activity. Individuals who have hemophilia A have low factor VIII clotting activity. Individuals who have hemophilia B have low factor IX clotting activity.Genetic testing is usually used to identify women who are carriers of a FVIII or FIX gene mutation, and to diagnose hemophilia in a fetus during a pregnancy (prenatal diagnosis). It is sometimes used to diagnose individuals who have mild symptoms of hemophilia A or B.There is currently no cure for hemophilia. Treatment depends on the severity of hemophilia.People who have moderate to severe hemophilia A or B may need to have an infusion of clotting factor taken from donated human blood or from genetically engineered products called recombinant clotting factors to stop the bleeding. If the potential for bleeding is serious, a doctor may give infusions of clotting factor to avoid bleeding (preventive infusions) before the bleeding begins. Repeated infusions may be necessary if the internal bleeding is serious. When a person who has hemophilia has a small cut or scrape, using pressure and a bandage will take care of the wound. An ice pack can be used when there are small areas of bleeding under the skin.
• When bleeding has damaged joints, physical therapy is used to help them function better. Physical therapy helps to keep the joints moving and prevents the joints from becoming frozen or badly deformed. Sometimes the bleeding into joints damages them or destroys them. In this situation, the individual may be given an artificial joint.
• Treatment may involve slow injection of a medicine called desmopressin (DDAVP) by the doctor into one of the veins. DDAVP helps to release more clotting factor to stop the bleeding. Sometimes, DDAVP is given as a medication that can be breathed in through the nose (nasal spray).
• Diagnosing this condition:
• Hemophilia is diagnosed with blood tests to determine if clotting factors are missing or at low levels, and which ones are causing the problem. If you have a family history of hemophilia, it is important that your doctors know the clotting factor your relatives are missing.
• Treatment of the condition:
• Genetic testing is also available for the factor VIII gene and the factor IX gene. Genetic testing of the FVIII gene finds a disease-causing mutation in up to 98 percent of individuals who have hemophilia A. Genetic testing of the FIX gene finds disease-causing mutations in more than 99 percent of individuals who have hemophilia B.
• Researchers have been working to develop a gene replacement treatment (gene therapy) for Hemophilia A. Research of gene therapy for hemophilia A is now taking place. The results are encouraging. Researchers continue to evaluate the long-term safety of gene therapies. The hope is that there will be a genetic cure for hemophilia in the future.

How Sarcoidosis can be diagnosed:

• biopsy of the lungs, liver, skin, or other affected organs to check for granulomas
• Blood tests, including complete blood counts, to check hormone levels and to test for other conditions that may cause sarcoidosis
• Bronchoscopy, which may include rinsing an area of the lung to get cells or using a needle to take cells from the lymph nodes in the chest
• Chest X-ray to look for granulomas in the lungs and heart and determine the stage of the disease. Often, sarcoidosis is found because a chest X-ray is performed for another reason.
• Neurological tests, such as electromyography, evoked potentials, spinal taps, or nerve conduction tests, to detect problems with the nervous system caused by sarcoidosis
• Eye exam to look for eye damage, which can occur without symptoms in a person with sarcoidosis
• Gallium scan external link , which uses a radioactive material called gallium to look for inflammation, usually in the eyes or lymph nodes.
• High-resolution computed tomography (CT) scan to look for granulomas
• Magnetic resonance imaging (MRI) to help find granulomas. Learn more in our Chest MRI Health Topic.
• Positron electron tomography (PET) scan, a type of imaging that can help find granulomas
• Pulmonary function tests to check whether you have breathing problems
• Ultrasound to look for granulomas

There is a staging to Sarcoidosis:

“Sarcoidosis is considered a rare disease. There are usually fewer than 200,000 cases of sarcoidosis at any given time in the U.S.

Research suggests that a combination of genetics and environmental factors cause sarcoidosis, but its exact cause is unknown. We think certain people are more likely to have their immune system overreact to certain triggers (antigens), like bacteria and viruses. Despite the immune system’s involvement, sarcoidosis isn’t considered an autoimmune disorder.

Since we don’t know for sure which combination of genes and triggers causes sarcoidosis, it’s impossible to predict who will get it.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/11863-sarcoidosis#:~:text=Sarcoidosis%20is%20a%20condition%20that%20causes%20your%20immune%20system%20to,fibrosis%2C%20causing%20permanent%20lung%20scarring.)

Lung lesions – 95% Thoracic lymph nodes – 50% Skin lesions – 30%  Eyes – 30%

Inflammatory Disease- Sarcoidosis or Sarcoid is a inflammatory disease that consists of granuloma.

Wide Spread Disease- Disease is wide spread in multiple organs.

• The Sarcoidosis disease tends to come and go all of a sudden.
• Disease may progressively develop as a serious illness.
• Patient may experience several relapse throughout the life.

• Sarcoidosis or Sarcoid is a gradual progressive disease.
• Microscopic lumps called granulomas start to appear in the affected organs.¹
• In most of the cases, these granulomas tend to clear with or without treatments.
• There are few instances where granuloma grows in size and continues to be a part of the organ.
• Granuloma eventually ends up as fibrotic lump but may cause several complications.

Causes

Doctors don’t know the exact cause of sarcoidosis. Some people appear to have a genetic predisposition to develop the disease, which may be triggered by bacteria, viruses, dust or chemicals.

This triggers an overreaction of your immune system and immune cells begin to collect in a pattern of inflammation called granulomas. As granulomas build up in an organ, the function of that organ can be affected.

Risk factors

While anyone can develop sarcoidosis, factors that may increase your risk include:

• Age and sex. Sarcoidosis often occurs between the ages of 20 and 40. Women are slightly more likely to develop the disease.
• Race. African-Americans have a higher incidence of sarcoidosis than do white Americans. Also, sarcoidosis may be more severe and may be more likely to recur and cause lung problems in African-Americans.
• Family history. If someone in your family has had sarcoidosis, you’re more likely to develop the disease.

Complications

For most people, sarcoidosis resolves on its own with no lasting consequences. But sometimes it causes long-term problems.

• Lungs. Untreated pulmonary sarcoidosis can lead to permanent scarring in your lungs, making it difficult to breathe.
• Eyes. Inflammation can affect almost any part of your eye and can eventually cause blindness. Rarely, sarcoidosis also can cause cataracts and glaucoma.
• Kidneys. Sarcoidosis can affect how your body handles calcium, which can lead to kidney failure.
• Heart. Granulomas in your heart can cause abnormal heart rhythms and other heart problems. In rare instances, this may lead to death.
• Nervous system. A small number of people with sarcoidosis develop problems related to the central nervous system when granulomas form in the brain and spinal cord. Inflammation in the facial nerves, for example, can cause facial paralysis.