From: Subject: The National Marfan Foundation Date: Thu, 20 Nov 2008 12:57:57 +0100 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0000_01C94B0F.9C2B0EF0" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.5579 This is a multi-part message in MIME format. ------=_NextPart_000_0000_01C94B0F.9C2B0EF0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.marfan.org/nmf/GetSubContentRequestHandler.do?sub_menu_item_content_id=10&menu_item_id=42 The National Marfan Foundation

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<= IMG=20 = src=3D"http://www.marfan.org/nmf/images/printer_button.gif"=20 border=3D0> P= rinter=20 Version

Ocular Concerns

Prepared by the = Professional Advisory=20 Board of the National Marfan = Foundation

What is=20 the Marfan syndrome?

The Marfan syndrome is = a=20 genetic disorder that affects the body=92s connective = tissue. It=20 may affect the eyes, skeleton, blood vessels and = heart. More=20 than 200,000 Americans have the Marfan syndrome or a = related=20 connective tissue disorder.

What is the = cause of=20 the Marfan syndrome?

People with the Marfan = syndrome have a mutation on one of their two copies of = a gene=20 that specifies the connective tissue protein = fibrillin-1.=20

How is the Marfan syndrome=20 diagnosed?

The diagnostic evaluation for = the Marfan=20 syndrome should be performed by physicians experienced = with=20 the condition. The evaluation should include, at a = minimum:=20

  • Detailed medical and family history.

  • Complete physical examination.

  • Eye examination by an ophthalmologist who uses a = slit=20 lamp to look for lens dislocation after fully = dilating the=20 pupil.

  • Echocardiogram looking for involvement of the=20 cardiovascular system that is often not evident from = the=20 physical examination.
This series of steps = is=20 important, not only in determining the diagnosis, but = also in=20 detecting problems that require immediate attention or = long-term management. The Marfan syndrome is often a=20 progressive condition and the signs may be subtle at = first.=20 Only in a small fraction of people is a test of the=20 fibrillin-1 gene necessary or useful for diagnosis.=20

Why does the finding of a dislocated lens = need to=20 be investigated?

A dislocated lens is often = the=20 first sign identified in a person with the Marfan = syndrome.=20 While dislocated lenses may severely interfere with = visual=20 development and function, it is the accompanying=20 cardiovascular manifestations of the Marfan syndrome = that may=20 lead to severe morbidity. As a result, all people with = lens=20 dislocation should be evaluated further.

Eye = care=20 professionals should play a significant role in = detecting the=20 Marfan syndrome. An eye care professional who suspects = the=20 Marfan syndrome should urge the patient to see a = medical=20 geneticist and a cardiologist for a complete = evaluation and a=20 definitive diagnosis. The National Marfan Foundation = (800-8-=20 MARFAN) can provide assistance and additional = information.=20

What are the ophthalmologic problems caused = by the=20 Marfan syndrome?

One or more of the = following=20 conditions are common among persons with the Marfan = syndrome:=20 high refractive error, flattened corneal curvature, = dislocated=20 lenses, early onset cataracts, glaucoma, retinal = detachment=20 and strabismus.

Right eye of a person with = moderate=20 dislocation of the lens; the lens is shifted up and = slightly=20 to the lateral side.




Most people = with the=20 Marfan syndrome are myopic (near-sighted) and have = astigmatism=20 (visual distortion). Approximately 65 percent of = people with=20 the disorder have dislocated lenses (ectopia lentis). = The lens=20 may be markedly off center or so subtly dislocated = that an=20 ophthalmologist might miss the dislocation without = fully=20 dilating the pupils.

Dislocated lenses occur = in=20 several other conditions, most commonly after trauma, = but=20 their presence is a strong indication of the Marfan = syndrome=20 and warrants further evaluation. A slit lamp = examination is=20 necessary to identify the lens dislocation. Cataracts = often=20 form in middle age of people with the disorder. = Retinal=20 detachment is more common in people who have the = Marfan=20 syndrome. Glaucoma will also develop in about 35 = percent of=20 people with the Marfan syndrome during their life = time, often=20 at an earlier age than in the general population.=20

What is the standard ophthalmic=20 treatment?

Many of the ocular problems = associated=20 with the Marfan syndrome are induced by the lenticular = and=20 axial myopia. They can be corrected with glasses or = contact=20 lenses (special flat contacts may be required for = proper=20 correction). Meticulous retinoscopy is essential for = adequate=20 optical correction, and full correction is desirable. = Corneal=20 refractive surgery (laser keratotomy) is = contraindicated in=20 most people with the Marfan syndrome if the corneas = are=20 markedly flattened already.

Cataracts are much = more=20 common in patients with the Marfan syndrome than in = people who=20 do not have the disorder, and often occur by the age = of 40 or=20 50. Implant surgery is quite routinely performed and = new=20 techniques for lens removal and implant have produced = very=20 high success rates. It is essential that the surgery = be=20 performed at one of the ophthalmology centers that = recognizes=20 the surgical complications likely to occur in people = with the=20 Marfan syndrome; that is, vitreous loss, rupture of = the=20 residual zonules and extension of the capsulotomy.=20

Good results in patients with dislocated = lenses can be=20 obtained with the use of aphakic (refracting around = the lens)=20 glasses in combination with Atropine sulfate 1% = ophthalmic=20 drops to enlarge the pupil as an alternative to = surgery.=20

Lens dislocation is rarely, if ever, present = at birth,=20 and may be first noted at all ages, most commonly = prior to 10=20 years of age.

Special attention must be paid = to=20 identifying children with amblyopia, or lazy eye. It = is=20 essential that treatment be started prior to the age = of 6 or 7=20 years in order for sight to be recovered in the weaker = eye.=20

People with the Marfan syndrome should be = taught to=20 recognize the signs of retinal detachment and seek = immediate=20 consultation by an ophthalmologist.

Because = glaucoma=20 is more prevalent among people with the Marfan = syndrome than=20 people who do not have the disorder, intraocular = pressure=20 measurement should be part of a routine annual = examination.=20 Low tension glaucoma is also seen in people with the = Marfan=20 syndrome. If medical management is not successful, = results=20 from surgery have been excellent.

Annual = ophthalmic=20 examinations are encouraged, including refraction, = intraocular=20 pressure measurement and evaluation of the peripheral = retina.=20 Assessment of the optic nerve head is also=20 mandatory.


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LIST-STYLE-IMAGE: = url(/nmf/images/bullet_listitem.gif); PADDING-BOTTOM: 0px; MARGIN: 0px; = FONT: bold 10px/1.1em verdana,arial,helvetica,sans-serif; COLOR: #666; = PADDING-TOP: 0px } #contentBlock UL LI { PADDING-BOTTOM: 3px } #contentBlock UL UL { PADDING-RIGHT: 0px; PADDING-LEFT: 16px; PADDING-BOTTOM: 0px; MARGIN: = 0px; PADDING-TOP: 3px } #rightCol { PADDING-RIGHT: 0px; PADDING-LEFT: 4px; PADDING-BOTTOM: 5px; = PADDING-TOP: 0px } IMG#sectionImage { MARGIN: 4px 0px } .subnav { PADDING-RIGHT: 8px; PADDING-LEFT: 8px; MARGIN-BOTTOM: 5px; = PADDING-BOTTOM: 8px; PADDING-TOP: 8px; BACKGROUND-COLOR: #b2afaf } .subnav UL { FONT: bold 10px/1.1em verdana,arial,helvetica,sans-serif; MARGIN-LEFT: = -27px; COLOR: #000 } .subnav UL A:link { COLOR: #333; TEXT-DECORATION: none } .subnav UL A:visited { COLOR: #333; TEXT-DECORATION: none } .subnav UL A:hover { COLOR: #fff; TEXT-DECORATION: none } .subnav LI { FONT-WEIGHT: bold; PADDING-BOTTOM: 2px } .subnav UL UL { =09 } .subnav H1 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav H2 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav H3 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav H4 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav H5 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav H6 { FONT: bold 10px verdana,arial,helvetica,sans-serif; COLOR: #fff; = BACKGROUND-COLOR: #b2afaf } .subnav UL { PADDING-LEFT: 13px; LIST-STYLE-IMAGE: = url(/nmf/images/arrow_subnav.gif); MARGIN: 0px; FONT: bold 10px/1.1em = verdana,arial,helvetica,sans-serif; COLOR: #333 } .subnav H1 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } .subnav H2 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } .subnav H3 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } .subnav H4 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } .subnav H5 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } .subnav H6 { PADDING-LEFT: 13px; BACKGROUND: = url(/nmf/images/arrow_subnav_header.gif) #b2afaf no-repeat; FONT: bold = 10px verdana,arial,helvetica,sans-serif; COLOR: #fff } #rightCol BLOCKQUOTE { BORDER-RIGHT: #cfd2c9 1px solid; PADDING-RIGHT: 10px; BORDER-TOP: = #cfd2c9 1px solid; PADDING-LEFT: 8px; BACKGROUND: = url(/nmf/images/back_boxdots.gif) #fff; PADDING-BOTTOM: 14px; MARGIN: = 0px 0px 5px; FONT: bold 10px verdana,arial,helvetica,sans-serif; = BORDER-LEFT: #cfd2c9 1px solid; COLOR: #fe8112; PADDING-TOP: 23px; = BORDER-BOTTOM: #cfd2c9 1px solid; TEXT-ALIGN: center } #rightCol BLOCKQUOTE P { MARGIN-TOP: 0px; MARGIN-BOTTOM: 1.8em; FONT: bold 10px = verdana,arial,helvetica,sans-serif; COLOR: #fe8112 } #rightCol BLOCKQUOTE .quoteSource { MARGIN: 0px; TEXT-ALIGN: right } #rightCol BLOCKQUOTE .serviceUL { PADDING-LEFT: 6px; LIST-STYLE-IMAGE: = url(/nmf/images/bullet_listitem.gif); MARGIN: 10px; FONT: 10px = verdana,arial,helvetica,sans-serif; COLOR: #0293e4; TEXT-ALIGN: left } #contact { PADDING-RIGHT: 10px; LINE-HEIGHT: 1.4em; TEXT-ALIGN: right } #copyright { PADDING-RIGHT: 10px; LINE-HEIGHT: 1.4em; TEXT-ALIGN: right } #contact { PADDING-RIGHT: 10px; MARGIN-TOP: 5px; FONT: 10px/2em = verdana,arial,helvetica,sans-serif; COLOR: #5d5d5d; BACKGROUND-COLOR: = #ebeced; TEXT-ALIGN: right } #copyright { PADDING-RIGHT: 10px; BORDER-TOP: #c60 1px solid; BACKGROUND: = url(/nmf/images/back_copyright.gif) #b2b2b4; FONT: 10px/2em = verdana,arial,helvetica,sans-serif; COLOR: #fff; TEXT-ALIGN: right } @media Print =20 { #navSkip { DISPLAY: none } #utilityNav { DISPLAY: none } #navigation { DISPLAY: none } #headerRight { DISPLAY: none } #navMenu { DISPLAY: none } #rightCol { DISPLAY: none } .noprint { DISPLAY: none } } ------=_NextPart_000_0000_01C94B0F.9C2B0EF0 Content-Type: application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://www.marfan.org/nmf/javascript/sample3_data.js // QuickMenu Pro, Copyright (c) 1998 - 2003, OpenCube Inc. - = http://www.opencube.com /*------------------------------------------- Colors, Borders, Dividers, and more... --------------------------------------------*/ dqm__sub_menu_width =3D 130 //default sub menu widths dqm__sub_xy =3D "0,0" //default sub x,y coordinates - = defined relative //to the top-left corner of parent image or sub menu =20 dqm__urltarget =3D "_self" //default URL target: _self, _parent, _new, = or "my frame name" dqm__border_width =3D 1 dqm__divider_height =3D 1 dqm__border_color =3D "#FFFFFF" //Hex color or 'transparent' dqm__menu_bgcolor =3D "#F5F3E6" //Hex color or 'transparent' dqm__hl_bgcolor =3D "#6F8DB9" =09 dqm__mouse_off_delay =3D 150 //defined in milliseconds (activated = after mouse stops) dqm__nn4_mouse_off_delay =3D 500 //defined in milliseconds (activated = after leaving sub) /*------------------------------------------- Font settings and margins --------------------------------------------*/ =20 //Font settings dqm__textcolor =3D "#818181" dqm__fontfamily =3D "arial" //Any available system font =20 dqm__fontsize =3D 11 //Defined with pixel sizing =09 dqm__fontsize_ie4 =3D 9 //Defined with point sizing dqm__textdecoration =3D "normal" //set to: 'normal', or 'underline' dqm__fontweight =3D "normal" //set to: 'normal', or 'bold' dqm__fontstyle =3D "normal" //set to: 'normal', or 'italic' =09 //Rollover font settings dqm__hl_textcolor =3D "#FFFFFF" dqm__hl_textdecoration =3D "normal" //set to: 'normal', or 'underline' //Margins and text alignment dqm__text_alignment =3D "left" //set to: 'left', 'center' or 'right' dqm__margin_top =3D 1 dqm__margin_bottom =3D 2 dqm__margin_left =3D 5 dqm__margin_right =3D 4 =20 /*------------------------------------------- Bullet and Icon image library - Unlimited bullet or icon images may be defined below and then associated with any sub menu items within the 'Sub Menu Structure=20 and Text' section of this data file. --------------------------------------------*/ //Relative positioned icon images (flow with sub item text) =09 /*--------------------------------------------- Optional Status Bar Text -----------------------------------------------*/ dqm__show_urls_statusbar =3D false =20 //dqm__status_text0 =3D "Sample text - Main Menu Item 0" //dqm__status_text1 =3D "Sample text - Main Menu Item 1" //dqm__status_text1_0 =3D "Sample text - Main Menu Item 1, Sub Item 0"=09 //dqm__status_text1_0 =3D "Sample text - Main Menu Item 1, Sub Item 1"=09 /*------------------------------------------- Internet Explorer Transition Effects --------------------------------------------*/ //Options include - none | fade | pixelate |iris | slide | = gradientwipe | checkerboard | radialwipe | randombars | randomdissolve = |stretch dqm__sub_menu_effect =3D "none" dqm__sub_item_effect =3D "none" //Define the effect duration in seconds below. =20 dqm__sub_menu_effect_duration =3D .50 dqm__sub_item_effect_duration =3D .5 //Specific settings for various transitions. dqm__effect_pixelate_maxsqare =3D 10 dqm__effect_iris_irisstyle =3D "CIRCLE" //CROSS, CIRCLE, PLUS, SQUARE, = or STAR dqm__effect_checkerboard_squaresx =3D 14 dqm__effect_checkerboard_squaresY =3D 14 dqm__effect_checkerboard_direction =3D "LEFT" //UP, DOWN, LEFT, RIGHT //Opacity and drop shadows. dqm__sub_menu_opacity =3D 100 //1 to 100 dqm__dropshadow_color =3D "none" //Hex color value or 'none' dqm__dropshadow_offx =3D 5 //drop shadow width dqm__dropshadow_offy =3D 5 //drop shadow height /*------------------------------------------- Browser Bug fixes and Workarounds --------------------------------------------*/ //Mac offset fixes, adjust until sub menus position correctly. =20 dqm__os9_ie5mac_offset_X =3D 10 dqm__os9_ie5mac_offset_Y =3D 15 dqm__osx_ie5mac_offset_X =3D 0 dqm__osx_ie5mac_offset_Y =3D 0 dqm__ie4mac_offset_X =3D -8 dqm__ie4mac_offset_Y =3D -50 //Netscape 4 resize bug workaround. dqm__nn4_reaload_after_resize =3D true dqm__nn4_resize_prompt_user =3D false dqm__nn4_resize_prompt_message =3D "To reinitialize the navigation menu = please click the 'Reload' button." =20 //Set to true if the menu is the only item on the HTML page. dqm__use_opera_div_detect_fix =3D false //Pre-defined sub menu item heights for the Espial Escape browser. dqm__escape_item_height =3D 20 /*--------------------------------------------- Exposed menu events ----------------------------------------------*/ //Reference additional onload statements here. //dqm__onload_code =3D "alert('custom function - onload')" //The 'X' indicates the index number of the sub menu group or item. dqm__showmenu_codeX =3D "status =3D 'custom show menu function call - = menu0'" dqm__hidemenu_codeX =3D "status =3D 'custom hide menu function call - = menu0'" dqm__clickitem_codeX_X =3D "alert('custom Function - Menu Item 0_0')" /*--------------------------------------------- Specific Sub Menu Settings ----------------------------------------------*/ //The following settings may be defined for specific sub menu = groups. //The 'X' represents the index number of the sub menu group. dqm__border_widthX =3D 10; dqm__divider_heightX =3D 5; =09 dqm__border_colorX =3D "#0000ff"; =20 dqm__menu_bgcolorX =3D "#ff0000" dqm__hl_bgcolorX =3D "#00ff00" dqm__hl_textcolorX =3D "#ff0000" dqm__text_alignmentX =3D "left" //The following settings may be defined for specific sub menu items. //The 'X' represents the index number of the sub menu item. dqm__hl_subdescX =3D "custom highlight text" dqm__urltargetX =3D "_new" /************************************************************************= ********************** *************************************************************************= ********************* Main Menu Rollover Images and Links =20 *************************************************************************= ********************* *************************************************************************= *********************/ //Main Menu Item 0 dqm__rollover_image0 =3D "/nmf/images/nav_about_on.gif" dqm__rollover_wh0 =3D "202,19" dqm__url0 =3D "#"; =20 //Main Menu Item 1 dqm__rollover_image1 =3D "/nmf/images/nav_living_with_on.gif" dqm__rollover_wh1 =3D "202,19" dqm__url1 =3D "#"; =20 //Main Menu Item 2 dqm__rollover_image2 =3D "/nmf/images/nav_support_on.gif" dqm__rollover_wh2 =3D "202,19" dqm__url2 =3D "#"; =20 //Main Menu Item 3 dqm__rollover_image3 =3D "/nmf/images/nav_research_on.gif" dqm__rollover_wh3 =3D "202,19" dqm__url3 =3D "#"; =20 //Main Menu Item 4 dqm__rollover_image4 =3D "/nmf/images/nav_education_on.gif" dqm__rollover_wh4 =3D "202,19" dqm__url4 =3D "#"; =20 //Main Menu Item 5 =09 dqm__rollover_image5 =3D "/nmf/images/nav_medical_on.gif" dqm__rollover_wh5 =3D "202,19" dqm__url5 =3D "#"; =20 dqm__rollover_image6 =3D "/nmf/images/nav_related_on.gif" dqm__rollover_wh6 =3D "202,19" dqm__url6 =3D "#"; =20 dqm__rollover_image7 =3D "/nmf/images/nav_marketplace_on.gif" dqm__rollover_wh7 =3D "202,19" dqm__url7 =3D "/nmf/jsp/ecommerce.jsp"; /************************************************************************= ********************** *************************************************************************= ********************* Sub Menu Structure and Text =20 *************************************************************************= ********************* *************************************************************************= *********************/ =20 //Sub Menu 0 dqm__sub_xy0 =3D "0,0" dqm__sub_menu_width0 =3D 144 dqm__subdesc0_0 =3D "What Is Marfan Syndrome" dqm__subdesc0_1 =3D "Diagnosis" dqm__subdesc0_2 =3D "Characteristics" dqm__subdesc0_3 =3D "Causes" dqm__subdesc0_4 =3D "Related Disorders" dqm__subdesc0_5 =3D "Treatment Options" dqm__subdesc0_6 =3D "Emotional Effects" dqm__subdesc0_7 =3D "Overall Outlook" dqm__subdesc0_8 =3D "Marfan Myths" =09 dqm__icon_index0_0 =3D 0 dqm__icon_index0_1 =3D 0 dqm__icon_index0_2 =3D 0 dqm__icon_index0_3 =3D 0 dqm__icon_index0_4 =3D 0 dqm__icon_index0_5 =3D 0 dqm__icon_index0_6 =3D 0 dqm__icon_index0_7 =3D 0 dqm__icon_index0_8 =3D 0 dqm__url0_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D2" dqm__url0_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D3" dqm__url0_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D4" dqm__url0_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D5" dqm__url0_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D6" dqm__url0_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D7" dqm__url0_6 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D8" dqm__url0_7 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D9" dqm__url0_8 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D11" //Sub Menu 1 dqm__sub_xy1 =3D "0,2" dqm__sub_menu_width1 =3D 144 =09 dqm__subdesc1_0 =3D "Management And Overview" dqm__subdesc1_1 =3D "Heart And Blood Vessels" dqm__subdesc1_2 =3D "Skeleton And Joints" dqm__subdesc1_3 =3D "Dural Ectasia" dqm__subdesc1_4 =3D "Dental" dqm__subdesc1_5 =3D "Eyes" dqm__subdesc1_6 =3D "Lungs" dqm__subdesc1_7 =3D "Emergency Situations" dqm__subdesc1_8 =3D "Children" dqm__subdesc1_9 =3D "Pregnancy And Reproduction" dqm__icon_index1_0 =3D 0 dqm__icon_index1_1 =3D 0 dqm__icon_index1_2 =3D 0 dqm__icon_index1_3 =3D 0 dqm__icon_index1_4 =3D 0 dqm__icon_index1_5 =3D 0 dqm__icon_index1_6 =3D 0 dqm__icon_index1_7 =3D 0 dqm__icon_index1_8 =3D 0 dqm__icon_index1_9 =3D 0 dqm__2nd_icon_index1_0 =3D 0 dqm__2nd_icon_index1_1 =3D 0 dqm__2nd_icon_index1_2 =3D 0 dqm__2nd_icon_index1_3 =3D 0 dqm__2nd_icon_index1_4 =3D 0 dqm__2nd_icon_index1_5 =3D 0 dqm__2nd_icon_index1_6 =3D 0 dqm__2nd_icon_index1_7 =3D 0 dqm__2nd_icon_index1_8 =3D 0 dqm__2nd_icon_index1_9 =3D 0 dqm__url1_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D21" dqm__url1_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D22" dqm__url1_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D23" dqm__url1_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D25" dqm__url1_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D26" dqm__url1_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D24" dqm__url1_6 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D94" dqm__url1_7 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D27" dqm__url1_8 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D28" dqm__url1_9 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D29" =09 //Sub Menu 2 dqm__sub_xy2 =3D "0,2" dqm__sub_menu_width2 =3D 144 dqm__subdesc2_0 =3D "Introduction"=20 dqm__subdesc2_1 =3D "Finding The Right Doctor" dqm__subdesc2_2 =3D "Ask A Question" dqm__subdesc2_3 =3D "International Services" dqm__subdesc2_4 =3D "Local Contacts" dqm__subdesc2_5 =3D "Peer Connections" dqm__icon_index2_0 =3D 0 dqm__icon_index2_1 =3D 0 dqm__icon_index2_2 =3D 0 dqm__icon_index2_3 =3D 0 dqm__icon_index2_4 =3D 0 dqm__icon_index2_5 =3D 0 dqm__url2_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D31" dqm__url2_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D32" dqm__url2_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D33" dqm__url2_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D34" dqm__url2_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D35" dqm__url2_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D36" //Sub Menu 3 dqm__sub_xy3 =3D "0,2" dqm__sub_menu_width3 =3D 190 dqm__subdesc3_0 =3D "Introduction" dqm__subdesc3_1 =3D "Grants and Research=A0Resources" dqm__subdesc3_2 =3D "Research News And Events" dqm__subdesc3_3 =3D "Clinical Research Studies" dqm__subdesc3_4 =3D "Advocacy" dqm__icon_index3_0 =3D 0 dqm__icon_index3_1 =3D 0 dqm__icon_index3_2 =3D 0 dqm__icon_index3_3 =3D 0 dqm__icon_index3_4 =3D 0 dqm__url3_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D46" dqm__url3_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D47" dqm__url3_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D48" dqm__url3_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D49" dqm__url3_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D50" //Sub Menu 4 dqm__sub_xy4 =3D "0,2" dqm__sub_menu_width4 =3D 144 dqm__subdesc4_0 =3D "Introduction" dqm__subdesc4_1 =3D "Emergency Medicine Campaign" dqm__subdesc4_2 =3D "Pediatric Awareness" dqm__subdesc4_3 =3D "Sports And Physical Activity" dqm__subdesc4_4 =3D "Medical Specialty Brochures" dqm__subdesc4_5 =3D "Touring Medical Exhibit" dqm__subdesc4_6 =3D "Media Outreach" dqm__icon_index4_0 =3D 0 dqm__icon_index4_1 =3D 0 dqm__icon_index4_2 =3D 0 dqm__icon_index4_3 =3D 0 dqm__icon_index4_4 =3D 0 dqm__icon_index4_5 =3D 0 dqm__icon_index4_6 =3D 0 dqm__url4_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D38" dqm__url4_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D39" dqm__url4_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D40" dqm__url4_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D41" dqm__url4_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D42" dqm__url4_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D43" dqm__url4_6 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D44" //Sub Menu 5 dqm__sub_xy5 =3D "0,2" dqm__sub_menu_width5 =3D 144 dqm__subdesc5_0 =3D "Causes And Diagnosis" dqm__subdesc5_1 =3D "Cardiac Management" dqm__subdesc5_2 =3D "Orthopedic Management" dqm__subdesc5_3 =3D "Ocular Management" dqm__subdesc5_4 =3D "General Management" dqm__subdesc5_5 =3D "Continuing Education" dqm__icon_index5_0 =3D 0 dqm__icon_index5_1 =3D 0 dqm__icon_index5_2 =3D 0 dqm__icon_index5_3 =3D 0 dqm__icon_index5_4 =3D 0 dqm__icon_index5_5 =3D 0 dqm__url5_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D52" dqm__url5_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D53" dqm__url5_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D54" dqm__url5_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D55" dqm__url5_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D56" dqm__url5_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D57" dqm__sub_xy6 =3D "0,2" dqm__sub_menu_width6 =3D 190 //Related Disorders Menu***** dqm__subdesc6_0 =3D "Introduction" dqm__subdesc6_1 =3D "Aneurysms & Dissections" dqm__subdesc6_2 =3D "Mitral Valve Prolapse" dqm__subdesc6_3 =3D "Skeletal Features/MASS Phenotype" dqm__subdesc6_4 =3D "Loeys-Dietz" dqm__subdesc6_5 =3D "Lens Dislocation" dqm__subdesc6_6 =3D "Beals Syndrome" dqm__subdesc6_7 =3D "Other" =09 dqm__icon_index6_0 =3D 0 dqm__icon_index6_1 =3D 0 dqm__icon_index6_2 =3D 0 dqm__icon_index6_3 =3D 0 dqm__icon_index6_4 =3D 0 dqm__icon_index6_5 =3D 0 dqm__icon_index6_6 =3D 0 dqm__icon_index6_7 =3D 0 =09 dqm__url6_0 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D78" dqm__url6_1 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D79" dqm__url6_2 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D80" dqm__url6_3 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D81" dqm__url6_4 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D84" dqm__url6_5 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D85" dqm__url6_6 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D86" dqm__url6_7 =3D "/nmf/GetContentRequestHandler.do?menu_item_id=3D87" =09 //Marketplace Menu =09 //dqm__subdesc7_0 =3D "Publications" //dqm__subdesc7_1 =3D "Videos" //dqm__subdesc7_2 =3D "Promotional Items" //dqm__subdesc7_3 =3D 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