Cambrils - Tarragona

Un alemán, un francés y un gallego se encontraban comentando acerca de sus esposas.
El alemán dice:
-Mi esposa sí que es tonta; resulta que se compró un Mercedes... ¡y ni siquiera ella sabe manejar!
Replica el francés:
-Eso no es nada; la mía acaba de comprar un Renoir y un libro de arte... ¡y ni siquiera ella sabe leer!
El gallego dice:
-La más bruta de todas es la mía; acaba de irse de vacaciones por dos semanas y se compró dos cajas de condones... ¡y ni siquiera ella tiene pene!

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Un gallego fue a hacer el servicio militar a Escocia y entonces
llega el momento en que tienen que apuntarse;
se pone en la fila y tiene dos escoceses por delante.
Dice el cabo:
-¿Nombre?
-Wilson Mac Wilson.
-Siguiente...
-Namara Mac Namara.
-Siguiente...
Y dice el gallego:
-Nolo Mac Nolo.

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¿Por qué dejaron de poner películas en los aviones de Galicia?
Porque al terminarse la película, todos salían por la puerta de atrás.

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¿Por qué los gallegos ven los partidos de fútbol codificados con caca de perro en la cabeza?
Porque es sólo para abonados.

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En una escuelita gallega es el primer día de clases y el profesor les dice a las alumnas:
-Niñas, búsquense en las listas.
Se acerca una de las chicas y le dice:
-Profesor, no estoy en las listas.
-Entonces búsquese en las tontas.

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Tres gallegos están jugando al póker y uno de ellos empieza a hablar sobre su mujer cuando estaba encinta:
-Antes de dar a luz estaba leyendo "Blancanieves y los Siete Enanitos" y tuvo siete niños y una niña.
-La mía, dice Jorge, estaba leyendo "Peter Pan" y tuvo un niño.
-¡Caray!, dice José, me voy al hospital corriendo; mi esposa está leyendo los "101 Dálmatas".

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Un gallego llama a una aerolínea y pregunta:
-Señorita... ¿podría decirme cuánto se demora el vuelo Madrid-New York?
-Un momentito.
El gallego le da las gracias y cuelga.

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Se encuentran dos gallegos y uno le dice al otro muy feliz:
-Manolo, me compré la videocasetera que tanto deseaba con el dinero que me dieron cuando vendí el televisor.

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Un par de gallegos dispuestos a poner una zapatería, oyen decir que los mejores zapatos son los de cocodrilo, agarran una barca y se van a cazar cocodrilos. Después de haber matado más de 50 cocodrilos, le dice uno al otro:
-Mira... si cazamos otro más sin zapatos... me largo.

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Están Felipiño y Marusiña en la cama:
-¡Ay Marusiña... si llego a saber que eras vírgen hubiese ido más despacio!
-¡Ay Felipiño... si llego a saber que eras tan bestia me hubiese quitado los leotardos!


Un Saludo desde Murcia La Seca y Sedienta

El huracán, la pérdida, la ruina,
el caos, la penuria, el maleficio,
el terremoto, el crack, el estropicio,
la peste y el tsunami de Indochina.

El pánico, el horror, la escabechina,
la quiebra, la epidemia, el precipicio,
el propio apocalipsis, el suplicio
y la irrupción atrás sin vaselina.

La plaga, la catástrofe, el quebranto,
el rayo, la hecatombe, el camposanto,
la hambruna, el estertor, la zona cero.

La adversidad, el mal, la desventura,
el vértigo, el naufragio, la negrura...
y José Luis Rodríguez Zapatero.

is the anterior part of the outermost layer of the eye. It is the clear, dome-shaped surface that covers the front of the eye. The cornea helps to protect the rest of the eye from germs, dust, and other harmful matter. It also acts as a lens to help focus light on the retina, the layer of light-sensitive cells at the back of the eye.

Contents [hide]
1 Description
2 Role of the Cornea in the Body
3 Diseases of the the Cornea
4 Corneal Transplant
5 Related Professions
6 Research
7 References
8 Links to Clinical Images
9 External Links
Description
The cornea is a thin layer of clear tissue that is the frontmost part of the eye. It is made up of highly organized cells and proteins. Because the cornea must be clear to allow light into the eye, it does not contain any blood vessels to deliver nourishment and protection (in the form of immune cells and proteins). Instead, the cornea receives its nourishment from tears and from aqueous humor, the fluid that fills the chamber behind it.
The cornea is arranged into five basic layers that each have an important function.
Epithelium. The epithelium is the outermost layer of the cornea and accounts for about 10% of the cornea's thickness. The epithelium keeps foreign material, such as dust, water, and bacteria, out of the eye and other layers of the cornea, and it provides a smooth surface that absorbs oxygen and cell nutrients from tears. The epithelium is filled with many tiny nerve endings that make the cornea very sensitive to pain. The part of the epithelium that serves as the foundation on which the epithelial cells are anchored is called the basement membrane.
Bowman layer. The Bowman layer lies directly below the epithelium and is composed of strong, layered protein fibers called collagen. If the cornea is injured, cells and protein of the Bowman layer can form a scar as the cornea heals. If these scars are large and centrally located, they can interfere with vision.
Stroma. Beneath the Bowman layer is the stroma, which makes up about 90% of the thickness of the cornea. It is composed mainly of water (78%) and collagen (16%). Collagen gives the cornea its strength, elasticity, and shape. The specific arrangement of the collagen fibers in the stroma allows for the uninterrupted passage of light into the eye.
Descemet membrane. The Descemet membrane is a thin, strong sheet of tissue just under the stroma. It serves as a protective barrier against infection and injuries. This membrane is made up of collagen fibers that are different from those of the stroma, and it is produced by the endothelial cells that lie below it.
Endothelium. The endothelium, the innermost layer of the cornea, is extremely thin. Its purpose is to remove excess fluid from the stroma which leaks in from the inside of the eye. Without this action, the stroma would swell with fluids and become hazy and opaque. In a healthy eye, there is a balance between the amount of fluid that leaks into the stroma and the amount that is pumped out by the endothelium. If endothelial cells are destroyed by disease or trauma, they cannot be replaced, and if too many are lost then the cornea can swell, which could lead to blindness. In such a situation, a corneal transplant may be needed to restore sight.
Role of the Cornea in the Body
The cornea has two main functions in the eye.
It helps to shield the other parts of the eye from germs, dust, and other harmful material. The cornea shares this protective task with the eyelids, the bones around the eye, tears, and the sclera (the white part of the eye).
It acts as the outermost lens for the eye. The cornea can change shape, and by doing so, it helps focus incoming light onto the retina at the back of the eye. The cornea contributes between 65% and 75% of the total focusing power of the eye. It works in concert with the eye's lens to provide this focusing power.
In order to see clearly, the cornea and lens must focus incoming light rays exactly on the retina, the layer at the back of the eye which converts light into electrical impulses sent to the brain. If the cornea is damaged and light is not focused on the retina, vision can be blurred. Furthermore, if the cornea has hazy or opaque areas, the result can be blind spots.
The cornea also serves to filter out the most damaging ultraviolet wavelengths in sunlight. Without this protection, the lens and the retina would be highly susceptible to injury from ultraviolet radiation.
Diseases of the the Cornea


Clouding of the cornea from keratitis caused by congenital syphilis. Source: CDC/Susan Lindsley, VD.
The cornea heals fast after minor injuries or abrasions. If the cornea is scratched, healthy cells move quickly over the area to patch the injury before infection occurs and vision is affected. If a scratch penetrates more deeply, however, the healing process may take longer and may be accompanied by greater pain, blurred vision, increased production of tears, redness of the eye, and extreme sensitivity to light. Deeper injuries of the cornea can also cause scarring which can lead to hazy vision or blind spots.
The following are some diseases and conditions that can affect the cornea.
Allergies. Allergies affecting the eye are fairly common and are typically related to pollen exposure. Symptoms can include redness, itching, increased tear production, burning, stinging, and watery discharge.
Dry eyes. The continuous production and drainage of tears is important for maintaining the health of the eye. Tears help wounds heal and protect the eye against infection. In people with dry eye, tear production and the quality of the tears is decreased. This can lead to inadequate lubrication of the cornea. The symptoms include a scratchy or sandy feeling in the eye or a foreign body sensation. Women tend to have dry eyes more frequently than men. The condition can occur in people with disorders of connective tissue, such as rheumatoid arthritis and Sjogren syndrome.
Fuch dystrophy. Fuch dystrophy is a slowly progressive disease that usually affects both eyes and occurs when endothelial cells in the cornea gradually deteriorate for no apparent reason. As more endothelial cells are lost, the endothelium becomes less efficient at removing fluids from the cornea, leading to swelling and distorted or blurred vision.
Iridocorneal endothelial syndrome (ICE syndrome). ICE syndrome has three main features: changes in the iris, the part of the eye that regulates the amount of light entering; swelling of the cornea; and the development of glaucoma. It results from the movement of endothelial cells from the cornea to the iris, and is more common in women, usually occurring between the ages of 30 and 50. The cause of the disease is unknown.
Keratoconus. Keratoconus is a progressive thinning of the cornea and is the most common form of corneal dystrophy in the United States. It tends to affect teenagers and young adults and arises when the middle of the cornea thins and gradually bulges outward forming a rounded cone shape. This produces moderate to severe distortion and blurriness in vision. It may result from an inherited corneal abnormality, an eye injury, certain eye diseases, or some systemic diseases such as Leber congenital amaurosis, Ehlers-Danlos syndrome, or Down syndrome.
Lattice dystrophy. This dystrophy is named for an accumulation of amyloid deposits (abnormal protein fibers) throughout the middle of the corneal stroma. The appearance on eye exam looks like a lattice in the cornea. Over time, the lattice lines grow opaque and spread to involve more of the stroma leading to cloudiness of the cornea and loss of vision. The cause is unknown and the disease tends to affect children between the ages of two and seven, although it can occur at any age.
Map-dot-fingerprint dystrophy. This disorder occurs when the basement membrane of the epithelium (the outermost layer of the cornea) develops abnormally. When this happens, the epithelial cells cannot attach to the basement membrane normally, leading to recurrent loss of epithelial cells and erosions. The erosions can be a recurrent, chronic problem that sometimes results in blurred or decreased vision. The condition usually affects adults between 40 and 70 years of age. The name comes from the appearance of the cornea on eye exam: large, slightly gray outlines appear in the cornea and look like a continent on a map. There may be clusters of opaque dots close to the map-like patches. The condition often resolves on its own, and most people don't realize they have it since they do not have pain or vision loss.
Pterygium. A pterygium is a pink, triangular-shaped growth of tissue on the cornea. Some pterygia grow slowly throughout a person's life, while others stop growing after a certain point. They rarely grow so large that they cover the pupil of the eye. Pterygia are more common in sunny climates and in young adults. Its cause is unknown but exposure to ultraviolet light is thought to play a role. Surgery is usually not recommended unless there is significant blockage of vision.
Stevens-Johnson syndrome. Stevens-Johnson syndrome (SJS) is a skin disorder that can also affect the cornea and other eye structures. It can lead to corneal blisters, erosions, and holes, resulting in significant loss of vision in some cases. The exact cause of SJS is unknown, but it is typically related to a medication reaction.
Other corneal dystrophies. Corneal dystrophy is a condition where one or more parts of the cornea lose their normal clarity due to a buildup of cloudy material. There are over 20 dystrophies that can affect all layers of the cornea. These conditions are usually inherited, affect both eyes equally, are not caused by outside factors such as injury or diet, progress gradually, and most can occur in otherwise healthy men or women.
Conjunctivitis. Conjunctivitis (pink eye) refers to inflammation of the conjunctiva, the protective membrane that lines the inside of the eyelids and covers the sclera (the whites of the eyes). Conjunctivitis is usually caused by a virus or by bacteria and can cause redness, pain, and itching in the affected eye with a purulent discharge. Most cases will resolve without specific therapy, but some cases will need antimicrobial eye drops to clear the infection.


Clouding of the cornea (keratitis) caused by Acanthamoeba. Source: CDC.
Keratitis. Several bacterial, fungal, and viral organisms can infect the cornea, either directly or from being spread from other eye structures. Many of these infections can be treated with antimicrobial agents, either given in eye drops, by mouth, or by vein.
Herpes zoster ophthalmicus (shingles of the eye). The virus that causes herpes zoster can affect the cornea in about 40% of cases that involve the head and neck. A clue that the eye is in danger is if the shingles are on the tip of the nose (Hutchinson's sign), as the same infected nerve goes to both areas.[1] The disease is seen more commonly in the elderly and in those with a weakened immune system. It can be treated with eye drops containing antiviral medication or with antiviral drugs taken by mouth or given intravenously. If untreated, the condition can lead to corneal scarring and blindness.
Ocular herpes simplex. Herpes simplex infection of the eye is a recurrent viral infection caused by the herpes simplex virus. It is the most common infectious cause of corneal blindness in the United States. The disease can result in painful swelling of the cornea, a condition called stromal keratitis. This can cause the body's immune system to attack and destroy cells in the corneal stroma, leading to scarring and loss of vision.
Trauma. Trauma can lead to corneal abrasions, a puncture, or tearing of the cornea. Trauma can arise from physical injury to the eye, foreign body injury, or from the use of improperly cleaned or unsterilized contact lenses. Trauma can lead to introduction of bacteria, fungi, and viruses into the eye and cornea resulting in keratitis. Puncture or tearing of the cornea can lead to loss of eye fluid and corneal tissue, and damage to other eye structures.
Corneal Transplant
A corneal transplant replaces a diseased or scarred cornea with a new one. When the cornea becomes cloudy, light cannot penetrate the eye to reach the light-sensitive retina. Poor vision or blindness may result.
In corneal transplant surgery, the surgeon removes the central portion of the cloudy cornea and replaces it with a clear cornea, usually donated through an eye bank. A trephine, an instrument like a cookie cutter, is used to remove the cloudy cornea. The surgeon places the new cornea in the opening and sews it with a very fine thread. The thread stays in for months or even years until the eye heals properly (removing the thread is quite simple and can be done in an eye doctor's office). Following surgery, eye drops to help promote healing are needed for several months.
Corneal transplants are very common in the United States; about 40,000 are performed each year. The chances of success of this operation have risen dramatically because of technological advances, such as less irritating sutures (threads which are often finer than a human hair) and the surgical microscope. Corneal transplantation has restored sight to many, who a generation ago would have been blinded permanently by corneal injury, infection, or inherited corneal disease or degeneration.
Even with a fairly high success rate, some problems can develop, such as rejection of the new cornea. Warning signs for rejection are decreased vision, increased redness of the eye, increased pain, and increased sensitivity to light. If any of these last for more than six hours, an eye doctor should be called. Rejection can be successfully treated if medication is administered at the first sign of symptoms.
A study supported by the National Eye Institute (NEI) suggests that matching the blood type, but not tissue type, of the recipient with that of the cornea donor may improve the success rate of corneal transplants in people at high risk for graft failure. Approximately 20% of corneal transplant patients*mdash;between 6000–8000 a year—reject their donor corneas. The NEI-supported study, called the Collaborative Corneal Transplantation Study, found that high-risk patients may reduce the likelihood of corneal rejection if their blood types match those of the cornea donors. The study also concluded that intensive steroid treatment after transplant surgery improves the chances for a successful transplant.
Related Professions
Ophthalmologists are medical doctors (MDs) who have received special training in the care and management of the eyes and eye disorders. They can examine, diagnosis, and treat diseases of the eye and surrounding structures.
Optometrists are health care providers who specialize in the eye and visual system. They can examine, diagnose, and medically treat eye diseases and, in some areas, they may perform laser procedures on the eye. They generally cannot perform eye surgery, however.
Research
Vision research is leading to progress in understanding and treating corneal diseases. For example, scientists are learning how transplanting corneal cells from a patient's healthy eye to the diseased eye can treat certain conditions that previously caused blindness. Vision researchers continue to investigate ways to enhance corneal healing and eliminate the corneal scarring that can threaten sight. Also, understanding how genes produce and maintain a healthy cornea will help in treating corneal disease.
Genetic studies in families afflicted with corneal dystrophies have yielded new insight into thirteen different corneal dystrophies, including keratoconus. To identify factors that influence the severity and progression of keratoconus, the NEI is conducting a natural history study—the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study—that is following more than 1200 patients with the disease. Scientists are looking for answers to how rapidly their keratoconus will progress, how bad their vision will become, and whether they will need corneal surgery to treat it. Results from the CLEK Study will enable eye care practitioners to better manage this complex disease.
The Herpetic Eye Disease Study (HEDS) is a group of clinical trials that studied various treatments for severe ocular herpes. HEDS researchers reported that oral acyclovir reduced the chance that ocular herpes, a recurrent disease, would return.[2] The study showed that acyclovir therapy can benefit people with all forms of ocular herpes. Current HEDS research is examining the role of psychological stress and other factors as triggers of ocular herpes recurrences.