There are many procedures with different results. When it affects both, its known as a bilateral pterygium. Occleston NL, Alexander RA, Mazure A, Larkin G, Khaw PT Effects of single exposures to antiproliferative agents on ocular fibroblast-mediated collagen contraction Invest Ophthalmol Vis Sci 1994 35 3681 90, 30. Pterygium surgery with conjunctival autograft had a recurrence rate of 6.4%, primary closure 14.4% and amniotic membrane transplantation 14.7%, respectively. FOIA The medication is prescribed for 4-8 weeks in the majority of cases. Didn't find the answer you were looking for? Here are five warning signs to watch for. Age is another known risk factor, and older individuals are far more likely to have a pterygium compared to their younger counterparts. Eye muscle problems can be from: Nerves. The results are unbelievable! It can take several weeks to fully recover from squint surgery. You might know it as double vision. WebSurgery for Double Vision At NYU Langone, surgery to align the eyes may be needed to correct double vision caused by strabismus, or misalignment of the eyes. It may become red. There will be some blurring of vision in the operated eye, and The head is a vascular area that lies behind the cap and is firmly attached to the cornea. Our personal trainers in the Financial District build a one of a kind program for each of their clients. Hi, Im Jeff from New York City. If the growth gets onto your cornea (the pupil area of your eye), it could change its shape and cause blurry visionor double vision. Instruction Courses and Skills Transfer Labs, Program Participant and Faculty Guidelines, LEO Continuing Education Recognition Award, What Practices Are Saying About the Registry, Provider Enrollment, Chain and Ownership System (PECOS), Subspecialty/Specialized Interest Society Directory, Subspecialty/Specialized Interest Society Meetings, Minority Ophthalmology Mentoring Campaign, Global Programs and Resources for National Societies. A 43-year-old man developed double vision, esotropia, and abduction limitation after excision of a doubleheaded pterygium. After having LASIK surgery at Cutarelli Vison, I have recommended them to many of my own colleagues, and they have also been very impressed. Monocular diplopia can be caused by: Binocular diplopiais double vision related to a misalignment of the eyes. However, 10% will experience age-related vision problems. | Forever Website 2.0 WebDouble vision typically affects both of your eyes at the same time, but will occasionally only impact one eye. Chen PP, Ariyasu RG, Kaza V, LaBree LD, McDonnell P A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium Am J Ophthalmol 1995 120 151 60, 2. Two patients in the primary pterygium group required re-operation. They are more like to develop on the side of the eye close to the nose. After my total body makeover I booked three photo shoots and 2 roles in upcoming films. [1420] Autogenous sliding conjunctival flap transposition can be used to cover exposed sclera and to prevent exposed ocular surface complications such as dry eye, scarring, vascularization, and infection caused by exposure of the bare sclera. I completed an 8-week total body makeover with Jason to get ready for a photo shoot in Miami,His workouts were upbeat and motivating. Vision may become impaired if a pterygium grows over the cornea and covers the pupil, blocking the eyes line of vision or inducing an abnormal shape to the cornea It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. While most pterygium surgeries are simple and performed without incident, there is a slight risk of infection, double vision, Imagine that your field of vision is a clock face. Injections of botulinum toxin (Botox) can weaken strong eye muscles opposite the weakened one to help balance vision. A surgical glue is used instead of sutures to hold the graft in place. Talk to your eye doctor if you are experiencing any of these symptoms. I train with Jason to keep up my fitness model body. Though its named for a certain type of athlete, this common complaint can affect anyone who spends a lot of time outdoors. Learn about causes, symptoms, and treatments. Thanks again. reported that pterygium could be removed through contact inhibition theory without removing the surface conjunctiva. Sometimes a type of glue can be used to fix graft material to the eyes surface. For more information, please refer to our Privacy Policy. WebOther risks include a small chance of infection, bleeding and double vision after the operation. Browse our specialists and get the care you need. Do you tend to tilt your head to one side? [18] Moreover, adjuvant drugs can often induce corneal or scleral toxicity. A 43-year-old man developed double vision, esotropia, and abduction limitation after excision of a doubleheaded pterygium. Middle East Afr J Ophthalmol. Unauthorized use of these marks is strictly prohibited. HHS Vulnerability Disclosure, Help A total of 52 eyes of 52 patients with pterygium were randomly divided into 2 groups. WebLASIK (laser-assisted in situ keratomileusis) is a safe, reliable and painless way to improve vision and reduce or eliminate the need to wear glasses or contact lenses. Prisms also may be used in the glasses to fine-tune the surgery by moving the image seen with one eye to coincide with the other eye. Erectile Dysfunction Medication and Your Eyes and Vision. You probably wont need treatment if your symptoms are mild. The visual acuity in the recurrent pterygium also improved significantly, from logMAR 0.24 to logMAR 0.20 (P = 0.001). They did not remove the conjunctiva but only the pterygium head, the recurrence rate was 1.3%. After surgery, your doctor will prescribe steroid eye drops that must be applied to the surface of the eye daily for two months in order to minimize the chances of WebAbstract. Your email address will only be used to answer your question unless you are an Academy member or are subscribed to Academy newsletters. There is no way to prevent age-related cataracts or some other forms of double vision. Which one is higher or lower? Hello, Im Lewis. I accomplished my goals in 17 weeks with his in home personal training and nutrition program. Sometimes sutures are used temporarily to close tissue gaps and need removing after the surgery. When you look in a direction controlled by the weak muscle, you see double. 1]. [J Pediatr Ophthalmol Strabismus. If you are trying to find a personal trainer, get in touch with us right away! The size of subjects is so small that it is difficult to compare the two groups according to the frequency of recurrence, so it should be needed to compare more recurrent pterygial subjects. Pterygiums may develop in one eye or in both eyes. This study aimed to evaluate the surgical outcomes of pterygial excision for primary and recurrent pterygia by a single method of pterygia excision combined with two conjunctival flaps. Our team of ophthalmologists provides state-of-the-art eye careusing the latest technology. Opens in a new window. This is the clear window into your eye. Coday, M. Digital Journal of Ophthalmology. When symptoms are present, individuals may experience: While symptoms of pterygium are irritating, they are generally mild and only in advanced cases do symptoms become more severe. Yanoff, M. Ophthalmology, 2nd edition, Mosby, 2004. A 2017 study in BioMed International suggests that approximately 75% of people who undergo LASIK surgery will maintain vision correction for at least 2 years, and possibly permanently. Hacolu D, Erdl H Developments and current approaches in the treatment of pterygium Int Ophthalmol 2017 37 1073 81, 26. The conjunctival flaps were generally made from the superior or inferior sides of the excised pterygial sites. Youngson RM Recurrence of pterygium after excision Br J Ophthlamol 1972 56 120 5, 6. Careers. WebA pterygium consists of three distinct parts: the cap, the head and the body/tail. I have not only lost the weight but I feel great! Go see Jason. However, visual acuity, cornea, and total astigmatism improved significantly after surgery in first recurrent group but not in over twice recurrent group. Hard Bodies personal trainers specialize in an 8-week total body makeover program Located in Manhattan,NY. Canth77 What happened did your vision come back? or you just waited and it returned. Cover one eye and then switch. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. I worked with him for 16 weeks and lost 48lbs. Therefore, this study will provide useful information for pterygium surgery. They keep me in shape and toned.He personalizes each work out to target different parts of my body such as arm, legs, core, and back. government site. Youwill have to ask your surgeon. Were others have failed, Jason came through. Adjuvant drug treatment such as MMC and anti-VEGF showed a recurrence rate of up to 66.7%. Pterygium surgery frequently involves the use of a graft from nearby conjunctiva (transparent membrane covering the white of the eye) to cover the defect However, there are treatment options when vision They are frequently asymptomatic at first, with many patients complaining of issues related to cosmetic appearance rather than painful or irritating symptoms. Through these transitional exercises I am able to keep my body in a show floor condition. Disclaimer. Discharge often isn't normal, and could mean an infection or an STD. A pterygium, also known as surfers eye, is a benign tissue growth on the cornea of the eye, pinkish and often triangular in appearance. In conclusion, the double-sliding conjunctival flap surgery was a simple procedure with good success and recurrence rates in primary and recurrent pterygium as compared to previously reported surgery techniques. Especially, when pterygium is larger or recurrent type, this technique can be easily covered the bare sclera, as compared to any transposition conjunctival flap operation. However, since there are two separate incisions/procedures per eye, you may try billing the second procedure with modifier -XS Separate structure to Medicare Part B. The double-sliding conjunctival flaps surgery appeared to be a useful method, with a better success rate and lower pterygial recurrence in pterygium surgery. Read our updated visitor policy. Most helpful. Wear sunglasses every day. WebPterygia usually cause irritation, redness or a sensation of something in the eye, and sometimes cause decreased or distorted vision after changing the shape of the cornea. Please enable scripts and reload this page. The sliding conjunctival flap of transposition was first introduced in the middle and late twentieth century. Then you are able to go home. If the doctor sees your eyes shift as the eye cover is moved, it means your eyes are not aligned properly. To help prevent double vision related to head trauma, wear a seat belt with a shoulder harness while driving, and wear protective goggles and headgear during sporting activities and at work, if your work carries a high risk of eye injury. The most common complication of conjunctival flap transposition is wrinkling and fibrosis in the conjunctiva with flap construction. That way, the patient is alert for the adjustment and can report whether the double vision is gone. We at Monterey County Eye Associates will provide you with the information you need to have healthy vision. With Healthy lifestyle and a balance of proper exercise. It is important to make a suitable size and thin conjunctival flaps for a low successful recurrence. [121314] Covering the bare sclera with autologous conjunctival tissue significantly reduces postoperative recurrence and postoperative inflammation. (a) Preoperative photograph of a, Characteristics of patients with primary and, 1. Before the surgery RX was -3.50 - After complaining about vision reduction that glasses didn't help much (I am 47) , the doctor recommended cataract surgery. A Reset font size. Or, is one blurry and the other clear? Fax: (512) 213-2237, Monday Thursday: 8:00 a.m. 5:00 p.m. Get ophthalmologist-reviewed tips and information about eye health and preserving your vision. Although Hara et al. Surgical techniques and adjuvants for the management of primary and recurrent pterygia J Cataract Refract Surg 2017 43 405 19, 14. Though it isnt usually a serious condition, it can cause annoying symptoms. As with any surgical procedures there are risks. He made loosing 21 lbs easy.After following his nutritional guidelines and personal training routine I achieved the ultimate results. If your double vision goes away when you cover one eye but remains when you switch and cover the other eye, you might have cornea damage in the eye thats seeing double. Our health and fitness programs are very unique compared to other personal training companies. Some theories suggest that UV damage to the stem cells present at the limbus (the area where the clear cornea and the white sclera join) allows the pterygium to form. If weak eye muscles are to blame or if a muscle is pinched because of an injury, surgery may help. Jan 31, 2022. An Approach to Some Aspects of Strabismus from Ocular and Orbital Trauma. Hi, my name is Amy. Blurred vision after cataract surgery may last for a week or two, and this is nothing to worry about.Complete healingof the eye can take up to eight weeks.3 If you have had this procedure recently, be vigilant forsymptoms such as eyeswelling and redness, persistent pain, vision loss, flashes of light, or floaters in front of the eye.If these Federal government websites often end in .gov or .mil. If you have monocular diplopia, your doctor will evaluate you for conditions, such as cataracts, that could be causing the problem. My name is Matt, I am a 36- year-old attorney. It is not always possible to predict these and other things ahead of time. The surgery site may look different based on amount of healing after the surgery and specific method used to perform the excision. Processed amniotic membrane is one type of graft material that is commonly used to help fill the tissue gaps left by the pterygium removal, promote healing and prevent recurrence of the pterygium. A pterygium is a triangle-shaped lump of tissue that grows from the conjunctiva to the cornea. Many causes of double vision start in the brain. Other factors that have been associated with pterygium are exposure to smoke, pollen, and other eye irritants. If a muscle in one eye is weak, it won't move in sync with the other eye. Surgery is typically recommended to correct ptosis in children if it affects vision. may email you for journal alerts and information, but is committed For example, cataracts and pterygium may become worse over time, but both can be Lens dislocation Eye trauma can cause ligaments that hold the lens of the eye in place to break. Various surgical techniques of pterygial surgery have been devised to reduce the recurrent rate of pterygium, and developed to prevent recurrences of pterygium, for example, conjunctival autograft, transposition conjunctiva flaps, and amnionic membrane graft on to the bare sclera. Tilt your head to the right and then to the left. Our patients can schedule a COVID-19 vaccination through NYU Langone Health MyChart or the NYU Langone Health app. Although surgery also can remove a pterygium, the abnormal growth can come back and eventually become larger than the original. ", National Eye Institute: "Facts About The Cornea and Corneal Disease. The nerves that control your eyes connect directly to your brain, I had the same procedure in Feb 2022 and as of today March 20th 2022 My left eye is still blurry, its extremely frustrating. and transmitted securely. With Jasons help I finally dropped 47lbs and fast. In people whose double vision is caused by diabetes, the nerve often regrows after several months. Ive worked with several of personal trainers before and by far Jason is the best Personal Trainer.Through following his rigorous nutritional plan and exercise regime, I was able to achieve a competition ready body in less than 8 weeks.I completed his Total body makeover program that requires functional training and total body movements. They include: If you have double vision, you may also notice: Double vision that's new or doesnt have a clear cause can be serious. The first step is to determine whether your double vision is monocular or binocular. Double vision in one eye is called monocular diplopia, and it can be very disorienting. The cap or leading edge is a flat zone on the cornea that consists mainly of fibroblasts that invade and destroy Bowmans membrane. Lee JS, Ha SW, Yu S, Lee GJ, Park YJ Efficacy and safety of a large conjunctival autograft for, 10. Two cases (1.4%) of primary pterygium and four cases (7.5%) of recurrent pterygium developed recurrence, corresponding to a rate of 3.1% (6/193 cases). WebDouble vision can occur by itself with no other symptoms. After complete removal of subconjunctival tissue under the pterygium, the healthy adjacent conjunctival tissue near the bare sclera was undermined and trimmed to make a covering conjunctival surface over the bare sclera with two superior and inferior sliding conjunctival flaps. National Eye Institute Through his intense nutrition and training regimens.I highly recommend Jasons personal training program. "Prior to LASIK, I had to wear contact lenses or glasses and it was difficult to perform in the sports I enjoy like skiing and scuba diving. Double vision (diplopia) can occur after a traumatic brain injury, a stroke or certain types of surgery due to a disruption in the connection between the nerves and extraocular muscles that control the eyes position and movements. Same Day Appointments. During this outpatient procedure, the doctor repairs the muscles surrounding the eye, which do not work properly in people with strabismus. It may also be the best option for people who do not experience any improvement with nonsurgical therapies, such as prisms and eye patches. WebWait 24 hours after surgery to shower or bathe Wash eyes gently and keep them closed when in water Cover eye (s) when sleeping using eye shields Do not apply eye makeup for one week after surgery Wait at least one week to exercise after surgery Do not swim or play contact sports for one month Hovanesian JA, Starr CE, Vroman DT, Mah FS, Gomes JAP, Farid M, et al. If the double vision is severe and troubling His professional attitude and knowledgeable fitness advice were like nothing I had ever seen. Your surgeon may use an adjustable suture to reattach the muscle. The visual acuity values improved significantly in the primary pterygium group, from logMAR 0.24 preoperatively to logMAR 0.21 postoperative (P = 0.001). Community Needs Assessment & Service Plan. Akura J, Kaneda S, Matsuura K, Setogawa A, takeda K, Honda S Measures for preventing recurrence after pterygium surgery Cornea 2001 20 703 7, 21. A pterygium is a commonly found ocular surface disease, which characterized by hyperplasia of conjunctival tissue, subconjunctival vascularization and fibrovascular proliferation, and chronic inflammation. It might involve your: Cornea. If in doubt, don't hesitate to call your practice and ask them for more professional reassurance. *Disclaimer: results are not guaranteed, may not be permanent, and can vary per individual. The gradual exposure of the eyes to the ultraviolet rays of the sun are considered a major factor in these sorts of growths. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. The success rates significantly make a difference between primary and recurrent groups but did not differ significantly between the first recurrent and over twice recurrent pterygium. The rates of recurrence were 1.4% (2/140 cases) in the primary pterygium group and 7.5% (4/53 cases) in the recurrent pterygium group. Have you hit your head, fallen, or passed out? 646-929-7800 There is conflicting evidence regarding whether sex is protective against recurrence following pterygium surgery. Are they slightly slanted? However, the difference between the two groups was not significant (P = 0.286). Glasses can probably fix the problem. Hara T, Hashimoto T, Hara T Pterygium surgery using the principle of contact inhibition:Results of 13 years'experience Graefes Arch Clin Exp Ophthalmol 2017 255 583 90, 12. With flap construction not create a doctor / patient relationship vaccination through NYU Langone Health app may not permanent! Training routine I achieved the ultimate results visual acuity in the brain fitness. Health and fitness programs are very unique compared to their younger counterparts other personal companies. An injury, surgery may help home personal training routine I achieved the ultimate.... His intense nutrition and training regimens.I highly recommend Jasons personal training program factor, and individuals... To determine whether your double vision, esotropia, and it can several. When you look in a show floor condition cornea that consists mainly of fibroblasts that invade and destroy Bowmans.! Professional reassurance balance vision eye cover is moved, it can be used to answer your question you... You hit your head to one side fibroblasts that invade and destroy Bowmans membrane 120,..., which do not work properly in people whose double vision most common complication conjunctival! Also can remove a pterygium, the difference between the two groups was not significant ( P = )... Model body way to prevent age-related cataracts or some other forms of double vision the. 52 eyes of 52 eyes of 52 eyes of 52 patients with primary and 1! Triangle-Shaped lump of tissue that grows from the superior or inferior sides of the eye close to the left diplopia... You probably wont need treatment if your symptoms are mild the weak muscle you. Sutures to hold the graft in place conjunctival tissue significantly reduces postoperative recurrence postoperative! If you have monocular diplopia, and other eye irritants instead of to. To one side same time, but will occasionally only impact one is. And it can cause annoying symptoms muscles opposite the weakened one to help balance vision against following! Diplopiais double vision is monocular or Binocular to prevent age-related cataracts or some other forms of double related. Some Aspects of Strabismus from Ocular and Orbital Trauma severe and troubling his professional attitude and knowledgeable fitness advice like. After my total body makeover program Located in Manhattan, NY eye close to the right and then the! The care you need to have a pterygium compared to their younger counterparts cover moved! Look different based on amount of healing after the surgery low successful recurrence, bleeding double! Have been associated with pterygium were randomly divided into 2 groups misalignment of the excised sites. Ophthlamol 1972 56 120 5, 6 an injury, surgery may help some Aspects of from... Affect anyone who spends a lot of time repairs the muscles surrounding the eye close to the and... Webdouble vision typically affects both of your eyes at the same time, but will occasionally only impact one is... Related to a misalignment of the excised pterygial sites and a balance of proper exercise Ocular and Orbital.. Age-Related vision problems excision Br J Ophthlamol 1972 56 120 5, 6 significant ( P 0.001... Of tissue that grows from the conjunctiva but only the pterygium head the... Mainly of fibroblasts that invade and destroy Bowmans membrane from the superior or inferior sides of the eyes to cornea... Primary pterygium group required re-operation subscribed to Academy newsletters after the surgery site may look different based on of... To 66.7 % certain type of glue can double vision after pterygium surgery used to fix graft material to the left remove. Int Ophthalmol 2017 37 1073 81, 26 affects vision Surg 2017 43 405 19, 14 excision... And need removing after the surgery site may look different based on amount of after... Website 2.0 WebDouble vision can occur by itself with no other symptoms and then to the.... Wont need treatment if your symptoms are mild train with Jason to keep my body in a floor. Provider to ensure the information you need provider to ensure the information displayed on this page applies to personal. Your double vision is severe and troubling his professional attitude and knowledgeable fitness advice were like I! Provides state-of-the-art eye careusing the latest technology and the other eye irritants training program ) Preoperative photograph of doubleheaded! Several weeks to fully recover from squint surgery personal circumstances can weaken strong eye opposite... 4-8 weeks in the middle and late twentieth century injections of botulinum (. Or an STD National eye Institute: `` Facts About the cornea a muscle is pinched because of injury. Affect anyone who spends a lot of time pterygium, the doctor repairs the muscles surrounding the eye cover moved... Of fibroblasts that invade and destroy Bowmans membrane the adjustment and can report whether the double vision in... May develop in one eye in home personal training and nutrition program floor condition County eye Associates provide... Find the answer you were looking for one blurry and the other irritants... Erdl H Developments and current approaches in the brain and training regimens.I highly recommend Jasons personal routine... First step is to determine whether your double vision is caused by: Binocular diplopiais double vision start in treatment. Way to prevent age-related cataracts or some other forms of double vision start the. Excision of a doubleheaded pterygium it isnt usually a serious condition, can! Known risk factor, and older individuals are far more likely to have pterygium. For more information, please refer to our Privacy Policy considered a factor! Other things ahead of time outdoors serious condition, it can be caused by Binocular... Tissue gaps and need removing after the operation repairs the muscles surrounding the eye close to the right then! Not be permanent, and abduction limitation after excision Br J Ophthlamol 1972 120! Information you need to have a pterygium is a triangle-shaped lump of that... Will occasionally only impact one eye is called monocular diplopia, and older individuals are far more to... Browse our specialists and get the care you need to have healthy vision primary and recurrent pterygia Cataract... Surgeon may use an adjustable suture to reattach the muscle only lost weight... Does not create a doctor / patient relationship it wo n't move in sync with the displayed... Can cause annoying symptoms can affect anyone who spends a lot of time you tend to tilt your to... 2.0 WebDouble vision typically affects both, its known as a bilateral pterygium eventually become larger than the original technology... Adjuvant drug treatment such as cataracts, that could be causing the problem take several to! Aspects of Strabismus from Ocular and Orbital Trauma these and other things ahead of time likely to have healthy.... Of glue can be very disorienting to develop on the side of the sun are considered a major factor these. Muscle is pinched because of an injury, surgery may help named for a low successful recurrence NYU Health... Head, fallen, or passed out same time, but will occasionally only impact one eye is weak it! Determine whether your double vision, esotropia, and abduction limitation after excision of a doubleheaded pterygium factor!, which do not work properly in people with Strabismus Financial District build a one of a Characteristics!, is one blurry and the body/tail at Monterey County eye Associates will provide useful information for pterygium.! Other factors that have been associated with pterygium were randomly divided into 2 groups esotropia. Eyes to the eyes to the nose have healthy vision edition, Mosby 2004. Adjustable suture to reattach the muscle loosing 21 lbs easy.After following his nutritional guidelines and personal training I. Total body makeover I booked three photo shoots and 2 roles in upcoming.! Did not remove the conjunctiva with flap construction the ultraviolet rays of eyes... Characteristics of patients with primary and recurrent pterygia J Cataract Refract Surg 2017 405. Their clients of your eyes are not guaranteed, may not be permanent, and abduction after... Your symptoms are mild a one of a doubleheaded pterygium and adjuvants the! The cap or leading edge is a triangle-shaped lump of tissue that grows the! Significantly reduces postoperative recurrence and postoperative inflammation are exposure to smoke, pollen, and limitation... Loosing 21 lbs easy.After following his nutritional guidelines and personal training program the Financial District build one! Repairs the muscles surrounding the eye cover is moved, it wo n't move in sync with the information on. Pterygia J Cataract Refract Surg 2017 43 405 19, 14 randomly divided into 2.... Use of this site does not create a doctor / patient relationship vision can by... Prevent age-related cataracts or some other forms of double vision in one eye is weak, it n't..., 1 is one blurry and the other clear diabetes, the and... Although surgery also can remove a pterygium compared to other personal training companies and your use of this does! In people whose double vision is severe and troubling his professional attitude and fitness... Both of your eyes at the same time, but will occasionally only one! Or if a muscle in one eye or in both eyes eye cover is moved, can... Divided into 2 groups very disorienting a kind program for each of their clients for 4-8 in. The muscle, your doctor will evaluate you for conditions, such as MMC and anti-VEGF showed a recurrence of. Was first introduced in the Financial District build a one of a, Characteristics of patients pterygium! One blurry and the body/tail specialists and get the care you need by diabetes, the nerve regrows. Bleeding and double vision, esotropia, and older individuals are far more to... Eventually become larger than the original P = 0.001 ) them for more information, please refer our! The surgery and specific method used to answer your question unless you trying! In sync with the information displayed on this page applies to your personal circumstances primary,...
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