Rheumatoid Arthritis

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Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic disease in which various joints in the body are inflamed, leading to swelling, pain, stiffness, and the possible loss of function.

Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks joints and other tissues. The pattern of joints affected is usually symmetrical, involves the hands and other joints, and is worse in the morning. Rheumatoid arthritis is a systemic (body-wide) disease, involving other body organs, whereas osteoarthritis is limited to the joints. Both forms of arthritis can be crippling.
The process may develop in the following way:

The disease process leading to rheumatoid arthritis begins in the synovium, the membrane that surrounds a joint and creates a protective sac.
This sac is filled with lubricating liquid called the synovial fluid. In addition to cushioning joints, this fluid supplies nutrients and oxygen to cartilage, a slippery tissue that coats the ends of bones.
Cartilage is composed primarily of collagen, the structural protein in the body, which forms a mesh to give support and flexibility to joints.
In rheumatoid arthritis, an abnormal immune system response produces destructive molecules that cause continuous inflammation of the synovium. Collagen is gradually destroyed, narrowing the joint space and eventually damaging bone.
If the disease develops into a form called progressive rheumatoid arthritis, destruction to the cartilage accelerates. Fluid and immune system cells accumulate in the synovium to produce a pannus, a growth composed of thickened synovial tissue.
The pannus produces more enzymes that destroy nearby cartilage, aggravating the area and attracting more inflammatory white cells, thereby perpetuating the process.
This inflammatory process not only affects cartilage and bones but can also harm organs in other parts of the body.

Don't be blind to the sun's effects on eyes - USA Today

Don't be blind to the sun's effects on eyes
Michelle Healy, USA TODAY

If you've heeded the health messages to protect your skin by covering up and slathering on the sunblock, you're taking important steps to playing it safe in the sun. But you'll come up short if you don't also wear sunglasses and a hat to protect your eyes from harmful ultraviolet rays, health experts say.

"Most people are not aware that long-term exposure to sunlight, with its ultraviolet wavelengths, can be very damaging to the eyes," says Lee Duffner, an ophthalmologist in Hollywood, Fla., and spokesman for the American Academy of Ophthalmology.

Although there's considerable public awareness about UV light's ability to burn and age the skin, awareness of its effect on the eyes has "fallen in the shadows," says optometry professor Jan Bergmanson of the University of Houston College of Optometry, founding director of the Texas Eye Research and Technology Center.

A 2009 survey by the American Optometric Association found that one in three adults are unaware of the eye health risks of spending too much time in the sun without proper protection. Just 29% of parents say they make sure their children wear sunglasses while outdoors.

A report in March by Prevent Blindness America, a leading eye health and safety organization, says the cumulative exposure to UV light over time can contribute to "significant and lasting damage to the eye and vision," including:

Cataracts, a clouding of the eye's lens that can blur vision. It afflicts one in every six Americans over 40 and more than half over 80, about 20 million people. An estimated 20% of cases are caused by extended UV exposure.

Macular degeneration, resulting from damage to the retina that destroys sharp, central vision. It is the leading cause of blindness in the USA.

Pterygium, a tissue growth over the white part of the surface of the eye that can alter the curve of the eyeball, causing astigmatism. If the pterygium starts to grow over the cornea, it can blur or obstruct vision and may need to be removed.

But even a few hours of intense, unprotected exposure can have consequences, says optometrist Sarah Hinkley of the American Optometric Association.

Among the most common conditions is photokeratitis or sunburn to the eyes, also known as "snowblindness," a temporary but painful burn to the cornea resulting in blurred vision and even temporary blindness, Hinkley says.

It's unclear how much UV exposure is required before vision is affected, but there is concern that environmental conditions are increasing the number of UV-related health issues, including sunburn, skin cancer and eye diseases.

"Much of what we are experiencing in terms of skin and eye damage is caused by the deterioration of the ozone layer," which is designed to "filter out the most toxic of the ultraviolet waves," says Bergmanson, who studies the effects of UV radiation on the eye. "When the ozone layer is depleted, more UV light makes its way to the Earth's surface."

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