{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:24:40Z","timestamp":1786944280272,"version":"build-2736575974"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      In Thailand, many eye diseases are described under the umbrella term\n                      <jats:italic>tor<\/jats:italic>\n                      , originating from Thai Traditional Medicine (TTM), including pinguecula, pterygium, cataract, and glaucoma (torlom, tornuea, torkrajok, and torhin). Ophthalmologists often use these terms as labels for biomedical diagnoses, whereas TTM practitioners use them within a traditional framework that includes characteristic back skin lesions. Apparent disagreement between diagnoses may therefore reflect nosologic mismatch rather than simple error. This study aimed to compare TTM tor diagnoses with ophthalmic diagnoses and to examine the association between tor categories and back skin lesion types.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a double-blind study in adults attending a university ophthalmology clinic and an affiliated TTM clinic. All participants underwent ophthalmic examination and independent assessment by an ophthalmologist and a TTM practitioner. Back skin lesions identified as\n                      <jats:italic>tor<\/jats:italic>\n                      -related were photographed with dermoscopy and classified by a dermatologist. Agreement between TTM and ophthalmic diagnoses was evaluated using Cohen\u2019s kappa, and the association between TTM diagnosis and lesion type was tested with Fisher\u2019s exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 140 enrolled participants, 128 were included in the ophthalmic analysis. Tornuea showed moderate agreement with pterygium (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u202f=\u202f0.598) and torhin with glaucoma (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u202f=\u202f0.407), whereas torlom and torkrajok showed no agreement with pinguecula or cataract. Among 186 skin lesions, there was no significant association between TTM diagnosis and dermatologic lesion type.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      TTM tor diagnoses therefore only partly overlap with biomedical eye disease categories, and\n                      <jats:italic>tor<\/jats:italic>\n                      -related back lesions appear to be benign rather than disease-specific markers.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1859102","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:34:50Z","timestamp":1786941290000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared names, different diseases: concordance of Thai traditional Tor diagnoses with biomedical eye conditions and back skin lesions"],"prefix":"10.3389","volume":"13","author":[{"given":"Piriya","family":"Chonsut","sequence":"first","affiliation":[{"name":"Department of Applied Thai Traditional Medicine, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Center of Excellence in Tropical Pathobiology, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paratthakorn","family":"Sangkaew","sequence":"additional","affiliation":[{"name":"Department of Applied Thai Traditional Medicine, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Center of Excellence in Tropical Pathobiology, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weeratian","family":"Tawanwongsri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Walailak University Hospital, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wararee","family":"Sriyuttagrai","sequence":"additional","affiliation":[{"name":"Walailak University Hospital, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Department of Ophthalmology, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirada","family":"Yincharoen","sequence":"additional","affiliation":[{"name":"Walailak University Hospital, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Department of Surgery, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rini","family":"Sulastiwaty","sequence":"additional","affiliation":[{"name":"Mayapada Eye Center","place":["Jakarta, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auemphon","family":"Mordmuang","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lunla","family":"Udomwech","sequence":"additional","affiliation":[{"name":"Walailak University Hospital, Walailak University","place":["Nakhon Si Thammarat, Thailand"]},{"name":"Department of Ophthalmology, School of Medicine, Walailak University","place":["Nakhon Si Thammarat, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e114245","DOI":"10.1371\/journal.pone.0114245","article-title":"The first rapid assessment of avoidable blindness (RAAB) in Thailand","volume":"9","author":"Isipradit","year":"2014","journal-title":"PLoS One"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1136\/bjophthalmol-2011-300539","article-title":"Global estimates of visual impairment: 2010","volume":"96","author":"Pascolini","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"ref3","volume-title":"World Report on Vision","year":"2019"},{"key":"ref4","volume-title":"Thai traditional and alternative health report: Thai traditional medicine, indigenous medicine, and alternative medicine","year":"2018"},{"key":"ref5","volume-title":"Thai Traditional Medicine at a 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