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Diabetes mellitus (DM) is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. The major forms of diabetes are classified according to those caused by deficiency of insulin secretion due to pancreatic β-cell damage (type 1 DM, or T1DM) and those that are a consequence of insulin resistance occurring at the level of skeletal muscle, liver, and adipose tissue, with various degrees of β-cell impairment (type 2 DM, or T2DM). T1DM is the most common endocrine-metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development. Individuals with T1DM confront serious lifestyle alterations that include an absolute daily requirement for exogenous insulin, the need to monitor their own glucose level, and the need to pay attention to dietary intake. Morbidity and mortality stem from acute metabolic derangements and from long-term complications (usually in adulthood) that affect small and large vessels resulting in retinopathy, nephropathy, neuropathy, ischemic heart disease, and arterial obstruction with gangrene of the extremities. The acute clinical manifestations are due to hypoinsulinemic hyperglycemic ketoacidosis. Autoimmune mechanisms are factors in the genesis of T1DM; the long-term complications are related to metabolic disturbances (hyperglycemia). Type 1 Diabetes Mellitus Formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes, T1DM is characterized by low or absent levels of endogenously produced insulin and dependence on exogenous insulin to prevent development of ketoacidosis, an acute life-threatening complication of T1DM. The natural history includes 4 distinct stages: (1) preclinical β-cell autoimmunity with progressive defect of insulin secretion, (2) onset of clinical diabetes, (3) transient remission “honeymoon period,” and (4) established diabetes associated with acute and chronic complications and decreased life expectancy. The onset occurs predominantly in childhood, with median age of 7-15 yr, but it may present at any age. The incidence of T1DM has steadily increased in many parts of the world, including Europe and the USA. T1DM is characterized by autoimmune destruction of pancreatic islet β cells. Both genetic susceptibility and environmental factors contribute to the pathogenesis. Susceptibility to T1DM is genetically controlled by alleles of the major histocompatibility complex (MHC) class II genes expressing human leukocyte antigens (HLAs). It is also associated with autoantibodies to islet cell cytoplasm (ICA), insulin (IAA), antibodies to glutamic acid decarboxylase (GADA or GAD65), and ICA512 (IA2). T1DM is associated with other autoimmune diseases such as thyroiditis, celiac disease, multiple sclerosis, and Addison disease. There is some suggestion that high dietary intake of omega-3 polyunsaturated fatty acids and vitamin D supplementation in early childhood decreases the incidence of autoi
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Marketing an optometric practice
Mba monograph13 0412_marketinganoptometricpractice
Mba monograph13 0412_marketinganoptometricpractice
Presbyopia
Presbyopia
Goldman applanation tonometry
Goldman applanation tonometry
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Myopia
keratometry
keratometry
Funduscopy
Funduscopy
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Optometry, a focus on vision
Astigmatism 2
Astigmatism 2
Spectacle prescription fulfillment in medical optometry cope approved
Spectacle prescription fulfillment in medical optometry cope approved
Non surgical management of strabismus .ppt
Non surgical management of strabismus .ppt
Biometry
Biometry
Contact Lens-Induced Acute Red Eye(CLARE)
Contact Lens-Induced Acute Red Eye(CLARE)
Primetry
Primetry
Blepharitis
Blepharitis
Amblyopia treatment dr mirzajani
Amblyopia treatment dr mirzajani
optometric prescription
optometric prescription
Peripheral refraction in myopia
Peripheral refraction in myopia
Intermittent exotropia
Intermittent exotropia
Auto perimetry
Auto perimetry
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Dr Ho Sze Yuen FHKAM (Ophthalmology)
2.
3.
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5.
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Circinate ring
8.
Circinate ring laser
9.
10.
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Proliferative diabetic retinopathy
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Preliferatibe diabetic retinopathy
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Proliferative diabetic retinopathy
14.
Proliferative diabetic retinopathy
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Pre-retinal haemorrhage
16.
17.
18.
Fluorescein angiography procedure
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Fluorescein angiogram
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Pan-retinal phtocoagulation(PRP)
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Laser application
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Proliferative diabetic retinopathy
after PRP
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Advanced tractional retinal
detachment
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27.
Circinate ring
28.
Circinate ring laser
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30.
31.
Pan-retinal phtocoagulation(PRP)
32.
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