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Stroke affecting the eye requires immediate treatment, can signal future vascular events

Central retinal artery occlusion is a cardiovascular problem disguised as an eye problem. It is less common than stroke affecting the brain but is a critical sign of ill health and requires immediate medical attention.

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Photo by Andriyko Podilnyk from Unsplash.com

While most people think of strokes affecting the brain, they can also affect the eye. Central retinal artery occlusion (CRAO) is a rare form of acute ischemic stroke that occurs when blood flow is blocked to the main artery of the eye. It typically causes painless, immediate vision loss in the impacted eye, with fewer than 20% of people regaining functional vision in that eye.

Today, the American Heart Association published a new scientific statement, “Management of Central Retinal Artery Occlusion,” in Stroke, an American Heart Association journal. The American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section affirms the educational benefit of the scientific statement, and it has been endorsed by the North American Neuro-Ophthalmology Society, the American Academy of Ophthalmology Quality of Care Secretariat and the American Academy of Optometry.

“Central retinal artery occlusion is a cardiovascular problem disguised as an eye problem. It is less common than stroke affecting the brain but is a critical sign of ill health and requires immediate medical attention,” said Chair of the statement writing committee Brian C. Mac Grory, M.B.B.Ch., B.A.O., M.R.C.P., an assistant professor of neurology and staff neurologist at the Duke Comprehensive Stroke Center at Duke University School of Medicine in Durham, North Carolina. “Unfortunately, a CRAO is a warning sign of other vascular issues, so ongoing follow-up is critical to prevent a future stroke or heart attack.”

In a comprehensive review of the world literature, committee members from the specialties of neurology, ophthalmology, cardiology, interventional neuroradiology, neurosurgery and vitreoretinal surgery summarized the state of the science in this condition. They found indications that this type of stroke can be caused by problems with carotid arteries, the blood vessels in the neck. However, there is also evidence CRAOs could be caused by problems with the heart, such as atrial fibrillation, which is the most common irregular heart rhythm. The risk of having a CRAO increases with age and in the presence of cardiovascular risk factors such as hypertension, hyperlipidemia, Type 2 diabetes, smoking and obesity.

The new scientific statement notes the lack of large clinical trials on CRAOs leads to uncertainty within the medical community of exactly what causes them or the best way to treat them. As a result, there is wide variability in diagnosis and treatment methods. Most concerning, according to Mac Grory, is that many practitioners may not recognize CRAO as a form of stroke resulting in patients receiving delayed testing and treatment, often in the outpatient clinic instead of the emergency department.

“We know acute CRAO is a medical emergency requiring early recognition and triage to emergency medical treatment,” Mac Grory said. “There is a narrow time window for effective treatment of CRAO and a high rate of serious related illness. So, if a person is diagnosed in a doctor’s office or other outpatient clinic, they should be immediately sent to a hospital emergency department for further evaluation and treatment.”

Current literature suggests that treatment with intravenous tissue plasminogen activator (tPA), a “clot buster” that is also used to treat brain strokes, may be effective. But tPA must be administered within 4.5 hours of the first sign of symptoms to be most effective and safe.

The writing committee also noted that emerging treatments, such as hyperbaric oxygen and intra-arterial alteplase, show promise but require further study. Other potential treatments that require further research and evaluation include novel thrombolytics to break up clots and novel neuroprotectants (substances capable of preserving brain function and structure) for use in tandem with other therapies to restore blood flow in the blocked artery.

Because of the potential for future strokes or even heart attacks, patients should undergo urgent screening and treatment of vascular risk factors. The writing committee notes that the complexities of diagnosing and treating CRAOs require a team of specialists working together. Secondary prevention (including monitoring for complications) must be a collaborative effort between neurologists, ophthalmologists, cardiologists and primary care clinicians. Risk factor modification includes lifestyle and pharmacological interventions.

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DKT Philippines Foundation unveils PH’s first family planning mobile clinic

The SODEX Mobile Clinic is an innovation to improve DKT Philippines Foundation’s SODEX Program and its contribution to achieving the DOH 8-Point Action Agenda and National Objectives for Health.

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DKT Philippines Foundation, a charitable non-profit organization promoting family planning and HIV prevention, officially launched the SODEX (Service Outreach and Distribution Extension Program) Mobile Clinic – the country’s first-ever family planning ambulatory clinic. This pioneering effort aims to provide safe and accessible modern family planning methods for Filipinos in far-flung areas to bridge the gap between Filipinos wanting to space and limit pregnancy and the disparities in Family Planning service provision.

The SODEX Mobile Clinic is an innovation to improve DKT Philippines Foundation’s SODEX Program and its contribution to achieving the DOH 8-Point Action Agenda and National Objectives for Health.

“DKT Philippines Foundation’s mission is to provide couples with affordable, and safe options for family planning, and HIV/AIDS prevention through dynamic social marketing,” said Loida Almendares, the Foundation’s Director of Programs. “The SODEX mobile clinic will provide a wide array of free family planning services especially in areas with lesser access to services like the geographically isolated or socially disadvantaged areas. The mobile clinic will bring the services closer to the people and meet them where they are,” she added.

The mobile clinic will provide free Family Planning commodities such as pills, condoms, injectables and intrauterine devices (IUD). It will also offer free bilateral tubal ligation (BTL) using local anesthesia and non-scalpel vasectomy (NSV). Onboarding the clinic are Physician/Surgeon trained on the provision of BTL, NSV, IUD, and subdermal implant services; FP-trained nurse; FP- trained midwife; a circulating staff, and a driver. To ensure that all clients are well-informed and fit to take the services, they will undergo counseling and final screening prior to getting the method.

In partnership with 30 LGUs from Luzon, DKT Philippines Foundation aims to foster sustainable and long-term partnerships with these LGUs to cultivate Filipinos’ desire to meaningfully participate and contribute to government efforts to achieve universal health coverage for all.

“DKT Philippines Foundation and its Family Planning Mobile Clinic reinforce DKT’s commitment to ensuring nobody is left behind and provides free and quality reproductive health options including permanent methods, to those most remote and vulnerable communities. Made possible by the sales of family planning products under the TRUST Reproductive Health Choices brand, the mobile clinic ensures that people who still cannot afford the highly affordable TRUST products, or cannot access the reproductive health services they need in the public sector, are not left behind and still have free access to these services. It is a part of a total market approach, complementing the important work the local LGUs do on a daily basis.” said Denise van Dijk, Chair of the Board of DKT Philippines Foundation.

The mobile clinic will travel for 119 days to offer free services in the provinces of Central Luzon, North Luzon, Cordillera, MIMAROPA and CALABARZON with the first stop being at Binangonan, Rizal where the launch took place. The clinic will stay in one area for a day or two from 8 AM to 6 PM. By next year, the mobile clinic will cover communities in the Visayas and Mindanao areas. 

The launch and blessing event was officially attended by fellow reproductive health advocates in public and private sectors, development partners, and family planning clients.  Guest of honor and speaker was Department of Health Undersecretary Dr. Glenn Mathew Baggao with special participation of the Mayor of Binangonan, Rizal – Hon. Cesar M. Ynares.

The programs and free services of DKT Philippines Foundation are made possible by the country’s leading brand of contraceptives TRUST Reproductive Health Choices, which is carried by the social enterprise DKT Health, Inc.

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Pru Life UK ramps up recruitment efforts

Through a series of Build Your Business (BYB) sessions—held online and in person in key cities across the country—seasoned PRU business builders share their success stories and tips to encourage attendees to pursue their own business goals.

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Pru Life UK ramps up its recruitment efforts to empower ambitious individuals from all walks of life to build a long-lasting business with the leading life insurer.

Through a series of Build Your Business (BYB) sessions—held online and in person in key cities across the country—seasoned PRU business builders share their success stories and tips to encourage attendees to pursue their own business goals.

“By choosing Pru Life UK, aspiring financial advisors can be confident that they are backed by the #1 life insurer in the country with strong market presence and solid financial results,” said Marylin Detalla-Averia, Chief Agency Officer of Pru Life UK.

The company ranks number one in the life insurance industry in the Philippines, garnering the highest New Business Annual Premium Equivalent based on the Insurance Commission’s report as of 31 December 2023.

“Our financial advisors are provided with all the support they need to help build their business. They have access to digital tools, development programs, hip offices, and attractive rewards and incentives with unlimited earning potential. This allows them to be their own boss and live their ideal lifestyle while helping clients achieve theirs.”

Celebration of success with #BuildYourPRUBusiness

While BYB sessions are held year-round, the company leads an energetic approach to recruitment this May.

Themed Paint the Town Red: It’s PRUFiesta time, Recruitment Never Stops!, BYB sessions will be held in  Metro Manila (Makati, Ortigas, QC), Pampanga (Clark, Sta. Rosa), South (Alabang, Lipa), North (Baguio), and VisMin (Cebu, Davao, CDO).

Attendees will receive mentorship on becoming a business builder with Pru Life UK’s 40,000-agency force, the largest in the industry.

A virtual BYB session will happen on May 22 featuring “Pambansang Wealth Coach” Chinkee Tan, who will talk about financial management and business development, further highlighting the importance of financial planning and empowering entrepreneurial mindset.

Pru Life UK also holds its weekly Facebook live Q&A sessions for budding and experienced business builders. Held every Thursday at 7:00 p.m., these online sessions offer a glimpse into the world of financial advisors. 

Seeking a meaningful and rewarding business opportunity? Visit bit.ly/JoinPRU2024 to join Pru Life UK’s BYB sessions.

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BAFI, USAID deliver biodiversity projects, MIND S-COOL TV and Biodiversity Crisis Escape Room

Both projects serve to innovatively highlight the critical concepts of “roles” and “collaboration” in addressing the biodiversity crisis as well as the “measures” of the values, not only monetary, that we should all consider living with nature.

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Bonifacio Art Foundation, Inc. (BAFI) and the United States Agency for International Development have joined forces to bring you a two-part biodiversity special of MIND S-COOL TV as well as a traveling Biodiversity Crisis Escape Room (BCER). Both projects serve to innovatively highlight the critical concepts of “roles” and “collaboration” in addressing the biodiversity crisis as well as the “measures” of the values, not only monetary, that we should all consider living with nature.

BCER is the first, traveling, experiential, immersive space, made up of 3 main rooms that will stand for the biodiversity crisis. The goal is for the participants to escape the crisis TOGETHER by helping one another realize and fulfill their roles. BCER will be hosted by BAFI’s The Mind Museum right after its opening at the museum on May 22 and will travel to host venues in Subic (Harbor Point, June15), Puerto Princesa (Robinson’s Mall, June 29) and Davao (Abreeza Mall, July 27) to enjoin participants who include – legislators, enforcers, regulators as well as community leaders – including cultural leaders AND local flora and fauna as well in the form of life-sized moving puppets, manned by professional puppeteers. It will also welcome the general public to experience this very unique and meaningful escape room on the dates mentioned.

Inside BCER, participants will take on roles that they would randomly pick. They will enter 3 connected rooms that they could only escape from if they understand what needs to be done and that they work together. The challenges they will face in each room are closely tied to realizing the “Mga Sukat ng Kalikasan” (measures/values of nature) in order to escape the biodiversity crisis. The experience will be facilitated so it will mimic the real human conversations and actions that need to happen in decision-making involving our natural heritage in which we all share in terms of not just benefits but also responsibilities. 

The 2-part biodiversity special of MIND S-COOL TV, the #1 science show across all channels[1] is a TV version of BCER fleshing out a narrative that will involve our main questers as well as non-human “players” who will be called to help out since MIND S-COOL has been held hostage by the biodiversity crisis. They will experience being trapped in the rooms together with other characters, including life-sized puppets that represent non-humans such as flora, fauna, habitats, abiotic elements giving nature a “voice”. The story of this special 2-part can be summarized as “all life is embedded in nature and we need to realize its many values because if we don’t, the quality of our interconnected lives will be degraded.”  Part 1 of this special will air on May 26, 11 am and replayed at 4:30 PM on OnePh Channel on Cignal while part 2 will air the week after. These will be followed by replays for 6 weeks.

Kathy Wachala, Chief of Party for USAID’s Sustainable Interventions for Biodiversity, Oceans and Landscapes (SIBOL) project, says: “This partnership with BAFI to do BCER and MIND S-COOL TV enabled us to roll-out a very powerful way for stakeholders to internalize their actual roles and work together to come up with solutions to the biodiversity crisis.” Maria Isabel Garcia, Managing Director/Curator of BAFI, also comments on the project, saying, “We are so inspired by the kind of partnership we have with USAID SIBOL since it allowed us to recruit very imaginative ways of engagement for science to serve life, biodiversity.”

We can all escape the biodiversity crisis if we understand that all lives are interconnected and that we all work together, now.

To know more about the USAID SIBOL project and its interventions, you may send an email to info@ph-sibol.org.

Mind S-Cool TV and Biodiversity Crisis Escape Room were conceived and created by the Bonifacio Art Foundation, Inc., the creator and operator of The Mind Museum and the BGC Arts Center.

To know more, or if you wish to know how you can support mind s-cool and the other projects of the Bonifacio Art Foundation, send an inquiry to: mindscool@bafi.org.ph, inquiry@themindmuseum.org or info@bgcartscenter.org.


[1] According to the latest Nielsen Ratings Survey

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