It has been found that a higher than expected proportion of individuals diagnosed with SLI and dyslexia on the basis of language and reading tests also perform poorly on tests in which auditory processing skills are tested. APD can be assessed using tests that involve identifying, repeating or discriminating speech, and a child may do poorly because of primary language problems. In a study comparing children with a diagnosis of dyslexia and those with a diagnosis of APD, they found the two groups could not be distinguished. Analogous results were observed in studies comparing children diagnosed with SLI or APD, the two groups presenting with similar diagnostic criteria. As such, the diagnosis a child receives may depend on which specialist they consult: the same child who might be diagnosed with APD by an audiologist may instead be diagnosed with SLI by a speech-language therapist or with dyslexia by a psychologist. Causes
Acquired
Acquired APD can be caused by any damage to or dysfunction of the central auditory nervous system and can cause auditory processing problems. For an overview of neurological aspects of APD, see T. D. Griffiths 2002 article "Central Auditory Pathologies". Genetics
Some studies have indicated an increased prevalence of a family history of hearing impairment in these patients. The pattern of results is suggestive that auditory processing disorder may be related to conditions of autosomal dominant inheritance. The ability to listen to and comprehend multiple messages at the same time is a trait that is heavily influenced by our genes, say federal researchers.
Superior limbic keratoconjunctivitis (SLK, Théodores syndrome) is a disease of the eye characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva. It was first described by F. H. Théodore in 1963. Symptoms and signs
Patients present with red eye, burning, tearing, foreign body sensation and mild photophobia. Upon examination, the conjunctiva appears inflamed and thickened, especially at the limbus. Pathophysiology
The development and pathophysiology of SLK is not well understood, but appears to involve microtrauma of keratoconjunctival surfaces. This mechanical hypothesis is supported by the increased lid apposition of exophthalmic thyroid patients, who are known to have an increased incidence of superior limbic keratoconjunctivitis. Diagnosis
Treatment
First-line treatments include topical corticosteroids and artificial tears. For non-responsive cases, potential treatments include topical ciclosporin A, vitamin A, autologous serum and injections of triamcinolone. Surgical treatment options include thermocauterization of the bulbar conjunctiva and conjunctival resection, typically under rose bengal (RB) staining to visualize affected areas. Epidemiology
Superior limbic keratoconjunctivitis tends to occur more often with dry eye syndrome (keratoconjunctivitis sicca), hyperthyroidism and hyperparathyroidism. It is also a rare complication associated with rheumatoid arthritis. Rarely, it may occur as a consequence of upper eyelid blepharoplasty surgery. References


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