In Puerto Rico, Mal de Ojo or "Evil Eye" is believed to be caused when someone gives a wicked glare of jealousy to someone, usually when the person receiving the glare is unaware. The jealousy can be disguised into a positive aspect such as compliments or admiration. Mal de Ojo is considered a curse and illness. It is believed that without proper protection, bad luck, injury, and illness are expected to follow. Mal de Ojo impact is believed to affect speech, relationships, work, family and most notably, health. Since Mal de Ojo centers around envy and compliments, it creates fear of interacting with people that are outside of their culture. Indirect harm could be brought to them or their family. When it comes to children, they are considered to be more susceptible to Mal de Ojo and it is believed that it can weaken them, leading to illness. As a child grows every effort is taken to protect them. When diagnosing Mal de Ojo, it is important to notice the symptoms. Physical symptoms can include: loss of appetite, body weakness, stomach ache, insomnia, fever, nausea, eye infections, lack of energy, and temperament.