Primary care
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Cataract surgery with an intraocular lens implant is one of the most common and thought to be the most effective surgical procedure in any field of medicine. Although aging is the most common cause, other factors are also known to be associated with cataract formation. Although cataracts are the domain of ophthalmology, primary care physicians are frequently the ones to whom patients present with vision complaints. Knowledge of cataract symptoms, how to evaluate them, and a basic understanding of the surgery to correct cataracts make primary care physicians an integral part of treating this leading cause of preventable blindness.
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Glaucoma is a multifactorial degenerative optic neuropathy that can progress at variable rates and afflict all age groups. It is the second leading cause of blindness worldwide. ⋯ Management is aimed at reducing intraocular pressure (IOP). Patients with known risk factors should be referred to an ophthalmologist for complete evaluation.
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Patients who present with mixed clinical neurologic signs and symptoms can be sorted into groups based on the symptom format. Targeted physical examination and evaluation of laboratory results can help quickly segment patients into groups for further workup or admission. The possibility of medication- or toxin-induced neurologic causes must be considered. Medication- and toxin-induced neurologic syndrome is a combination of several symptoms that are induced either by the exposure to or withdrawal of various medications or by toxins, and the symptoms are sometimes difficult to fit into a nice, neat diagnostic package.
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Guillain-Barré syndrome and its clinical variants are a group of rapidly progressing, potentially debilitating neurologic disorders that may have significant morbidity/mortality if left unrecognized or untreated. The most common symptoms include ascending limb weakness and paralysis, which may progress to respiratory failure. ⋯ Several treatment options exist, including plasma exchange and intravenous immunoglobulin administration. Most cases may resolve without sequelae, but those that do not may leave behind significant persistent debility.
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Multiple sclerosis (MS) is a chronic, debilitating disease that can have devastating effects. Presentation varies widely in symptoms, pace, and progression. ⋯ Although the disease is not curable presently, quality of life can be improved by minimizing the frequency and severity of disease burden. Disease modification, symptom management, preservation of function, and treatment of psychosocial issues are paramount to enhance the quality of life for the patient affected with MS.