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Iranian clinical psychologists have devised family therapy methods that use cognitive behavior models that fit with their collectivist Islamic culture. The authors review Islamic-based strategies and describe family therapy with [...]

A 15-year-old boy with impaired vision and pain in his right eye was found to have a mass in his eye-socket. A biopsy showed that it was Langerhans'-cell histiocytosis, which belongs to a class of diseases called granulomatous diseases.

A 58-year-old woman was diagnosed with an eye disease caused by a metastatic endometrial cancer. She had initially seen a doctor for loss of vision in her right eye and the cancer was found at that time. She died about two months later.

Introduction Onchocerciasis is the most important cause of blindness in various areas of Africa and Latin America (1). Estimates indicate that more than 95% of onchocerciasis-infected persons, including those with [...], In a forest-savanna mosaic zone of south-eastern Nigeria endemic for onchocerciasis, we identified eye disorders in 65.5% of a randomly selected population sample. Onchocerciasis-related eye disease was present in 13.7% of the study sample and constituted 21% of the total number of eye disorders. A total of 78 (33.2%) of 235 subjects with visual impairment had onchocerciasis-related eye lesions, and of 35 who were blind in both eyes, onchocerciasis-induced eye disease was the cause in 28 (80%). The prevalence of bilateral blindness from all causes in the study area was 4.1%, while that from onchocerciasis-related causes was 3.3%. The commonest onchocerciasis-induced lesions that were responsible for visual impairment and blindness were choroidoretinitis and optic nerve disease. Sclerosing keratitis, an important causative lesion in onchocerciasis-endemic savanna regions, was encountered only once. Eye disease is therefore an important feature of onchocerciasis in the forest-savanna mosaic areas of Nigeria and should be borne in mind when planning and executing control programmes.

A 69-year-old woman with a mass in the area of her right eye and conjunctivitis was diagnosed with Wegener's granulomatosis involving the soft tissue of the right eye and breast. Wegener's granulomatosis is a progressive disease causing changes in the tissues of the body known as granulomas. It commonly begins in the eye. Important features of the mass in the eye were ill-defined margins, anterior location, and independence of other structures of the eye. The patient had also recently experienced fatigue, anorexia, and weight loss, and an antineutrophil cytoplasmic antibodies (ANCA) test was positive for symptoms of Wegener's granulomatosis. The mass found in the breast was removed and did not recur. The patient was successfully treated with steroids and cyclophosphamide.

The authors have observed two cases of neurologic disease occurring in a brother and sister. They presume that the ailment is inherited as a recessive trait, and attempts to classify it with known genetic disorders suggest that the syndrome shared by these siblings is probably a distinct clinical entity. The sister developed blinking and abnormalities of movement at the age of 17. The problems with movement worsened. She developed visual difficulties, and the development of pigment clumping in the retina was observed. Her speech became unintelligible. Her brother was documented as having severe hearing loss at 20 months of age and fell frequently as a child. A full evaluation was conducted when he was 23 years of age; pigmented retinopathy and intermittent severe blinking were observed. The two patients displayed a syndrome that most closely resembles Hallervorden-Spatz syndrome. However, Hallervorden-Spatz syndrome usually involves both early onset and a relentless progression to death in early adulthood. These siblings are continuing to function in society long after the appearance of symptoms. Magnetic resonance imaging did not reveal evidence of brain atrophy, which is common in Hallervorden-Spatz syndrome. In addition to a discussion of the symptoms of the two patients, the authors provide a detailed table of the known genetic disorders in which abnormal retinal pigmentation is known to be a feature. (Consumer Summary produced by Reliance Medical Information, Inc.)