Think Forward.

Attention à vos yeux devant les écrans de portables ou d’ordinateurs ! 1319

Dr Moussayer khadija, 1 y.
4 min read.
Le travail et les activités de loisirs sur ordinateur (ou également sur portable, tablette…) sollicitent beaucoup les yeux et il est nécessaire de bien veiller à une bonne installation de son poste de travail ainsi qu’au rythme de travail à observer pour éviter la sécheresse oculaire et/ou les maux de tête qui peuvent aller jusqu'à une sécheresse persistante, une pathologie qu'on appelle le syndrome sec. Ce syndrome sec est d’ailleurs une pathologie beaucoup plus fréquente qu’on ne le croît, quand on sait que près de 10 % des adolescents en sont atteints (notamment à cause de la lecture trop intensive de vidéos sur les portables) et qu’elle concerne 20 % des plus de 70 ans. Cette sécheresse peut aussi un révélateur d’affections beaucoup plus graves comme la maladie de Gougerot-Sjögren. LE BON USAGE DES ECRANS L’écran d’un ordinateur doit être perpendiculaire à la fenêtre pour réduire les reflets et les différences de luminosité (et en privilégiant toujours un éclairage modéré dans un espace clos), espacé de 50 à 70 cm des yeux et situé plus bas que la ligne d'horizon de l’œil de sorte à toujours regarder vers le bas. De la sorte, les paupières recouvrent une partie de l’œil, réduisant ainsi l'exposition du globe oculaire à l'air ambiant. Enfin, évitez de lire ou d’écrire sur des fonds sombres et préférez les fonds clairs et une grosse taille de caractère. Le même type de précautions doit être pris si on utilise intensément son smartphone, surtout quand on regarde des vidéos, comme le font notamment beaucoup de jeunes enfants. Il est en effet important de préciser que le taux de clignement des yeux chute fortement lors de la lecture devant un écran : sa cadence tombe assez rapidement, et, sans même s'en rendre compte, de 3 à 4 fois par minute contre 15 en moyenne normalement, ce qui fragilise davantage la qualité du film lacrymal. Chaque clignement permet de redistribuer une nouvelle couche de larme à la surface des yeux et d'éliminer par le fait même la vieille couche. D'où l'importance de prendre le temps de cligner des yeux volontairement et de faire des pauses hors écran régulièrement d’au moins 5 minutes chaque heure ou de 15 minutes au bout de deux heures. LE SYNDROME SEC Ses manifestations, liées à une altération quantitative ou qualitative des larmes, sont très variables : sensation de corps étranger, de brûlures, rougeur oculaire, sensibilité à la lumière vive, trouble visuel intermittent ou même larmoiement excessif paradoxal. Dans certains cas, on constate une difficulté à mouvoir les paupières ou à ouvrir spontanément les yeux le matin au réveil. Ce déficit en larmes expose même à la survenue d’une kérato- conjonctivite lésant la cornée ou pire de la complication cornéenne la plus sévère, des ulcères cornéens susceptibles de se perforer. Quand un syndrome sec persiste ou s'aggrave et se traduit aussi par un assèchement d’autres secrétions (de la bouche, de la peau, des bronches), il faut consulter non seulement un ophtalmologue mais aussi souvent un autre spécialiste, notamment en médecine interne, pour connaître les causes exactes du problème qui peut être dû aussi à une pathologie beaucoup plus grave. Les causes du syndrome sec sont en effet multiples. Outre l’usage trop intensif des écrans, on citera d’abord par ordre d’importance l’atrophie des glandes du fait de l’âge puis les médicaments : plus de 400 spécialités pharmaceutiques sont concernées (dont l’atropine, la morphine, les antihistaminiques, certains antidépresseurs et neuroleptiques, les antiparkinsoniens, les diurétiques,...). Une modification ou un rééquilibrage du traitement du traitement suffit souvent pour réduire de façon supportable ou résoudre cette gêne. Il trouve ensuite son origine dans le tabac, la carence oestrogénique post ménopausique, un diabète décompensé, les états de stress ou de dépression ou encore dans des situations attendues telle la radiothérapie cervico-faciale. Ailleurs, il sera un des symptômes d’une maladie comme la sarcoïdose, l’amylose, une infection par les virus de l’hépatite C ou du SIDA… ou il révélera encore l’hémochromatose et le scorbut. Enfin, le Syndrome sec peut se situer souvent au cœur du Syndrome de Gougerot-Sjögren, de façon tellement emblématique d’ailleurs qu’on fait souvent improprement l’amalgame entre les deux. La maladie de Gougerot-Sjögren fait partie des pathologies auto-immunes (où les cellules chargées normalement de la défense de l’organisme se retournent contre lui). Il concerne essentiellement le sexe féminin dans une proportion de 9 femmes atteintes pour seulement un homme. Souvent, il se complique ou s’associe à de nombreux autres troubles auto-immuns : polyarthrite rhumatoïde, lupus, affections de la thyroïde, du foie, du sang... Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie, Présidente de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS) POUR EN SAVOIR PLUS SUR LE RÔLE DES GLANDES LACRYMALES ET DES LARMES Les larmes sont produites à une cadence moyenne de 0,1 ml par heure, soit un peu moins d'un litre par an. Ce film lacrymal a un rôle essentiel pour la cornée en la protégeant et la nourrissant, la cornée n’étant pas vascularisée. Rappelons que la cornée est la paroi antérieure de l'œil (sur la partie visible de l'œil). Elle est résistante et transparente et entourée du blanc de l’œil. Ce film lacrymal est constitué de 3 couches : 1/ la couche superficielle huileuse (composée de phospholipides et produite par les glandes de Meibomius) : sa principale fonction est de lutter contre l'évaporation des larmes ; 2/ la couche intermédiaire, la plus épaisse, (composée de sécrétions aqueuses des glandes de Krause et Wolfring) : elle contient une série de substances antimicrobiennes (dont le lysozyme, la protéine majeure des larmes, la lactoferrine ainsi que des immunoglobulines) ; 3/ la partie interne, une fine couche muqueuse (qui dérive des cellules en gobelet de la conjonctive) : elle facilite la dispersion des larmes sur la surface oculaire. BIBLIOGRAPHIE - Le travail sur écran Que Choisir Santé décembre 2007-N° 12 – P 16 - Jun Hyung Moon, MD ; Mee Yon Lee, MD ; Nam Ju Moon, MD, PhD -Association Between Video Display Terminal Use and Dry Eye Disease in School Children Journal of Pediatric Ophthalmology and Strabismus March/April 2014 - Volume 51 · Issue 2 : 87-92 DOI : 10.3928/01913913-20140128-01 : https://www.healio.com/ophthalmology/journals/jpos/2014-3-51-2/%7B499cc9fa-879a-4820-ae6b-9e0ecab48efc%7D/association-between-video-display-terminal-use-and-dry-eye-disease-in-school-children ABSTRACT : Dry Eye Syndrome and Sjögren disease A great number of factors can increase the risk of dry eyes. When working at a computer or using a smartphone, we tend to blink our eyes less fully and less frequently, which leads to greater tear evaporation and increased risk of dry eye symptoms. The dryness of the eyes may be also due to an autoimmune disease, Sjogren's.
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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THE ENCHIRIDION - I 1945

Bluwr X Commons: Epictetus, 2 y.
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1 min read.
There are things which are within our power, and there are things which are beyond our power. Within our power are opinion, aim, desire, aversion, and, in one word, whatever affairs are our own. Beyond our power are body, property, reputation, office, and, in one word, whatever are not properly our own affairs. Now the things within our power are by nature free, unrestricted, unhindered; but those beyond our power are weak, dependent, restricted, alien. Remember, then, that if you attribute freedom to things by nature dependent and take what belongs to others for your own, you will be hindered, you will lament, you will be disturbed, you will find fault both with gods and men. But if you take for your own only that which is your own and view what belongs to others just as it really is, then no one will ever compel you, no one will restrict you; you will find fault with no one, you will accuse no one, you will do nothing against your will; no one will hurt you, you will not have an enemy, nor will you suffer any harm. Aiming, therefore, at such great things, remember that you must not allow yourself any inclination, however slight, toward the attainment of the others; but that you must entirely quit some of them, and for the present postpone the rest. But if you would have these, and possess power and wealth likewise, you may miss the latter in seeking the former; and you will certainly fail of that by which alone happiness and freedom are procured. Seek at once, therefore, to be able to say to every unpleasing semblance, “You are but a semblance and by no means the real thing.” And then examine it by those rules which you have; and first and chiefly by this: whether it concerns the things which are within our own power or those which are not; and if it concerns anything beyond our power, be prepared to say that it is nothing to you.

THE ADVENTURES OF TOM SAWYER - PREFACE 2046

Bluwr X Commons: Mark Twain, 2 y.
1 min read.
Most of the adventures recorded in this book really occurred; one or two were experiences of my own, the rest those of boys who were schoolmates of mine. Huck Finn is drawn from life; Tom Sawyer also, but not from an individual—he is a combination of the characteristics of three boys whom I knew, and therefore belongs to the composite order of architecture. The odd superstitions touched upon were all prevalent among children and slaves in the West at the period of this story—that is to say, thirty or forty years ago. Although my book is intended mainly for the entertainment of boys and girls, I hope it will not be shunned by men and women on that account, for part of my plan has been to try to pleasantly remind adults of what they once were themselves, and of how they felt and thought and talked, and what queer enterprises they sometimes engaged in. THE AUTHOR. HARTFORD, 1876.

THE MEDITATIONS - Book I.[1/3] 2090

Bluwr X Commons: Marcus Aurelius, 2 y.
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4 min read.
1. I learned from my grandfather, Verus, to use good manners, and to put restraint on anger. 2. In the famous memory of my father I had a pattern of modesty and manliness. 3. Of my mother I learned to be pious and generous; to keep myself not only from evil deeds, but even from evil thoughts; and to live with a simplicity which is far from customary among the rich. 4. I owe it to my great-grandfather that I did not attend public lectures and discussions, but had good and able teachers at home; and I owe him also the knowledge that for things of this nature a man should count no expense too great. 5. My tutor taught me not to favour either green or blue at the chariot races, nor, in the contests of gladiators, to be a supporter either of light or heavy armed. He taught me also to endure labour; not to need many things; to serve myself without troubling others; not to intermeddle in the affairs of others, and not easily to listen to slanders against them. 6. Of Diognetus I had the lesson not to busy myself about vain things; not to credit the great professions of such as pretend to work wonders, or of sorcerers about their charms, and their expelling of Demons and the like; not to keep quails (for fighting or divination), nor to run after such things; to suffer freedom of speech in others, and to apply myself heartily to philosophy. Him also I must thank for my hearing first Bacchius, then Tandasis and Marcianus; that I wrote dialogues in my youth, and took a liking to the philosopher’s pallet and skins, and to the other things which, by the Grecian discipline, belong to that profession. 7. To Rusticus I owe my first apprehensions that my nature needed reform and cure; and that I did not fall into the ambition of the common Sophists, either by composing speculative writings or by declaiming harangues of exhortation in public; further, that I never strove to be admired by ostentation of great patience in an ascetic life, or by display of activity and application; that I gave over the study of rhetoric, poetry, and the graces of language; and that I did not pace my house in my senatorial robes, or practise any similar affectation. I observed also the simplicity of style in his letters, particularly in that which he wrote to my mother from Sinuessa. I learned from him to be easily appeased, and to be readily reconciled with those who had displeased me or given cause of offence, so soon as they inclined to make their peace; to read with care; not to rest satisfied with a slight and superficial knowledge; nor quickly to assent to great talkers. I have him to thank that I met with the discourses of Epictetus, which he furnished me from his own library. 8. From Apollonius I learned true liberty, and tenacity of purpose; to regard nothing else, even in the smallest degree, but reason always; and always to remain unaltered in the agonies of pain, in the losses of children, or in long diseases. He afforded me a living example of how the same man can, upon occasion, be most yielding and most inflexible. He was patient in exposition; and, as might well be seen, esteemed his fine skill and ability in teaching others the principles of philosophy as the least of his endowments. It was from him that I learned how to receive from friends what are thought favours without seeming humbled by the giver or insensible to the gift. 9. Sextus was my pattern of a benign temper, and his family the model of a household governed by true paternal affection, and a steadfast purpose of living according to nature. Here I could learn to be grave without affectation, to observe sagaciously the several dispositions and inclinations of my friends, to tolerate the ignorant and those who follow current opinions without examination. His conversation showed how a man may accommodate himself to all men and to all companies; for though companionship with him was sweeter and more pleasing than any sort of flattery, yet he was at the same time highly respected and reverenced. No man was ever more happy than he in comprehending, finding out, and arranging in exact order the great maxims necessary for the conduct of life. His example taught me to suppress even the least appearance of anger or any other passion; but still, with all this perfect tranquillity, to possess the tenderest and most affectionate heart; to be apt to approve others yet without noise; to have much learning and little ostentation. 10. I learned from Alexander the Grammarian to avoid censuring others, to refrain from flouting them for a barbarism, solecism, or any false pronunciation. Rather was I dexterously to pronounce the words rightly in my answer, confining approval or objection to the matter itself, and avoiding discussion of the expression, or to use some other form of courteous suggestion. 11. Fronto made me sensible how much of envy, deceit and hypocrisy surrounds princes; and that generally those whom we account nobly born have somehow less natural affection. 12. I learned from Alexander the Platonist not often nor without great necessity to say, or write to any man in a letter, that I am not at leisure; nor thus, under pretext of urgent affairs, to make a practice of excusing myself from the duties which, according to our various ties, we owe to those with whom we live. 13. Of Catulus I learned not to condemn any friend’s expostulation even though it were unjust, but to try to recall him to his former disposition; to stint no praise in speaking of my masters, as is recounted of Domitius and Athenodorus; and to love my children with true affection. 14. Of Severus, my brother, I learned to love my kinsmen, to love truth, to love justice. Through him I came to know Thrasea, Helvidius, Cato, Dion, and Brutus. He gave me my first conception of a Commonwealth founded upon equitable laws and administered with equality of right; and of a Monarchy whose chief concern is the freedom of its subjects. Of him I learned likewise a constant and harmonious devotion to Philosophy; to be ready to do good, to be generous with all my heart. He taught me to be of good hope and trustful of the affection of my friends. I observed in him candour in declaring what he condemned in the conduct of others; and so frank and open was his behaviour, that his friends might easily see without the trouble of conjecture what he liked or disliked.