Menu Expand
Review of Ophthalmology E-Book

Review of Ophthalmology E-Book

William B. Trattler | Peter K. Kaiser | Neil J. Friedman

(2012)

Additional Information

Book Details

Abstract

Don’t take chances with your exam prep! Trust Review of Ophthalmology to help you study all the current information you need to know to ace your exams!

  • Efficiently review a wide spectrum of topics with an organization by common ophthalmologic subspecialties.

  • Maximize retention with a popular outline approach that distills key information on each topic alongside sample review questions.

  • Review the findings of many important clinical studies with which you are expected to be familiar.
  • Test your understanding of essential information with questions at the end of each chapter and answers at the end of the book.
  • Study on the go, search the complete text online, and download images at www.expertconsult.com.
  • Be fully prepared for current exam topics with information on the latest techniques in corneal surgery, macular degeneration treatment and trials, and expanded treatment options for many sections.

  • View anatomic details, common ophthalmic test findings, and examples of classic histopathology specimens through brand-new illustrations and photographs.

Table of Contents

Section Title Page Action Price
Front cover cover
Review of Ophthalmology i
Copyright page iv
Table of Contents v
Preface vi
Acknowledgements vii
1 Optics 1
Properties of Light 1
Index of refraction (n): 1
Interference: 1
Coherence: 1
Polarization: 1
Diffraction: 1
Scattering: 1
Reflection: 2
Transmission: 2
Absorption: 2
Illumination: 2
Luminance: 2
Laser: 2
Refraction 2
Snell’s law: 2
Critical angle: 2
Total internal reflection: 2
Prisms 3
Prism diopter (PD, Δ): 3
Angle of minimum deviation: 3
Risley prism: 3
Fresnel prisms: 3
Prismatic effect of lenses (Figure 1-4): 3
Prentice’s rule: 3
Prismatic effect of bifocal glasses: 4
Chromatic effects: 4
Duochrome test: 4
Vector addition of prisms: 4
Vergence 4
Convergence (converging rays): 4
Divergence (diverging rays): 4
Parallel rays: 4
Diopter: 4
Lens: 4
Basic lens formula: 4
Objects and images: 4
Lenses: 5
Lens effectivity: 5
Vertex distance conversion: 5
Pure cylindrical lens: 6
Spherocylindrical lens: 6
Cylinder transposition: 6
Power cross diagram: 6
Combining cylinders at oblique axis: 6
Power of cylinder at oblique axis: 6
Aberrations 6
Spherical: 6
Coma: 6
Curvature of field: 7
Astigmatism of oblique incidence: 7
Distortion: 7
Chromatic: 7
Magnification 7
Transverse (linear or lateral): 7
Axial: 7
Angular: 7
Size of image seen through glasses: 7
Anisometropia: 7
Aniseikonia: 7
Knapp’s rule: 7
Telescopes: 7
Accommodation through telescope: 8
Mirrors 8
Law of reflection: 8
Objects and images: 8
Focal length: 8
Reflecting power: 8
Convex: 8
Concave: 8
Plano: 8
Central ray: 8
Eye as Optical System 8
Model Eye 8
Vision Measurements 8
Minimum visible: 8
Minimum discriminable: 8
Minimum separable: 8
Vernier acuity: 9
Snellen acuity: 9
ETDRS Chart: 9
Near acuity: 9
Acuity testing in children: 9
Factors other than disease that reduce measured visual acuity: 9
Legal blindness (in US): 9
Visual acuity is influenced by pupil size: 9
Laser inferometer: 9
Contrast sensitivity: 9
Refractive Error 9
Axial vs refractive: 9
Far point: 10
Astigmatism: 10
Correction of ametropia: 10
Acquired hyperopia: 10
Acquired myopia: 10
Night myopia: 10
Acquired astigmatism: 10
Accommodation 10
Amplitude of accommodation: 10
Range of accommodation: 10
Presbyopia: 10
Theories of accommodation: 11
Donder’s table: 11
Conditions that cause asthenopia (eye fatigue with sustained near effort): 11
Premature presbyopia (subnormal accommodation): 11
Color Vision 11
3 components of color: 11
Hue: 11
Saturation: 11
Brightness: 11
Bezold-Brucke phenomenon: 11
Abney effect: 11
Luminosity curve: 11
Afterimages: 11
Color perception: 11
Prescribing Glasses 11
Children (Table 1-3): 11
Adults: 12
Minus cylinder grinding: 12
Match base curves: 12
Binocular balance: 12
Bifocal add: 12
Kestenbaum’s rule: 12
Aphakic spectacles: 12
Contact Lenses (Cl) 12
Toric lens: 12
Ballasted lens: 12
Sagittal depth/apical height: 12
Radius of curvature (base curve): 12
Overall diameter: 12
Oxygen transmission: 12
Accommodative demand: 12
Fitting rigid CL: 13
Power calculation: 13
Evaluating fit: 13
Low-Vision Aids 13
Kestenbaum’s rule: 13
Near devices: 13
Distance devices: 13
Intraocular Lenses (IOL) 13
Ophthalmic Instruments 14
Direct ophthalmoscope (Figure 1-19): 14
Indirect ophthalmoscope (Figure 1-20): 14
Retinoscope: 14
Slit-lamp biomicroscope (Figure 1-21): 14
Lensometer: 15
Keratometer: 15
Applanation tonometry: 15
A- and B-scan ultrasonography: 15
Ocular coherence tomography (OCT): 15
Equations 15
Vergence formula: 15
Lens power (diopters): 15
Snell’s law: 15
Prismatic power: 15
Prentice’s rule: 15
Reduced schematic eye (calculations of retinal image size): 16
Spherical equivalent: 16
Refracting power of a spherical surface: 16
Reflecting power of a spherical mirror: 16
Power of a thin lens immersed in fluid: 16
Power of lens at new vertex distance: 16
Linear magnification: 16
Axial magnification: 16
Angular magnification: 16
Simple magnifier: 16
Telescope (Galilean and astronomical): 16
Total accommodation through telescope: 16
IOL power (SRK): 16
AC/A ratio (accommodative converge/accommodation): 16
Review Questions (Answers start on page 355) 16
Suggested Readings 19
2 Pharmacology 21
Ocular Pharmacology 21
Pharmacodynamics: 21
Pharmacokinetics: 21
Bioavailability: 21
Therapeutic index: 21
Inhibitory quotient (IQ): 21
Routes of Administration 21
Topical: 21
Subconjunctival / sub-Tenon’s: 22
Retrobulbar / peribulbar: 22
Intraocular: 22
Systemic: 22
Concentration 22
Anesthetics 22
Mechanism: 22
Structure: 22
Topical: 22
Parenteral: 22
General: 22
Autonomic System 23
Sympathetic 23
Adrenergic receptors: 23
3 Embryology / Pathology 35
Embryology 35
Formation of eye: 35
Embryonic plate (Figure 3.1): 35
Optic pit: 35
Optic vesicle: 35
Optic cup (Figure 3.2): 35
Embryonic fissure: 35
Hyaloid artery (Figure 3-3): 35
Primitive epithelial papillae: 36
Vitreous: 36
Retina: 37
Choroid: 37
Sclera: 37
Cornea: 37
Angle: 37
Lens: 37
Summary 37
Iris: 37
Ciliary body (CB): 38
Nasolacrimal system: 38
Eyelids: 38
Embryologic tissues and their components: 38
Pathology 39
Microbial studies 39
Stains 39
Gram: 39
Giemsa: 39
Acid fast (Ziehl-Neelsen): 39
Periodic acid-Schiff (PAS): 39
Gomori’s methenamine silver: 39
Calcofluor white: 39
KOH: 39
Culture Media 40
Blood agar: 40
Blood agar in 5–10% carbon dioxide: 40
Chocolate (contains hemin and nicotinamide adenine dinucleotide [NAD]): 40
Thioglycolate: 40
Sabouraud’s: 40
Löwenstein-Jensen: 40
Loeffler’s: 40
Non-nutrient agar with E. coli overgrowth: 40
Cytology 40
Intracytoplasmic basophilic inclusions (Giemsa stain): 40
Intranuclear eosinophilic inclusions (Papanicolaou stain): 40
Tissue stains 40
Hematoxylin and eosin (H&E): 40
Periodic acid-Schiff (PAS): 40
Masson trichrome: 40
Congo red: 40
Crystal violet: 40
Alcian blue: 40
Colloidal iron: 40
Oil red O: 40
Sudan black: 40
Luxol fast blue: 40
Bodian: 40
Mucicarmine: 40
Verhoeff Van Gieson: 40
Movat’s pentachrome: 40
Wilder: 40
Alizarin red: 40
von Kossa: 40
Prussian blue: 40
Fontana-Masson: 40
S-100 protein: 40
Polarizing filters: 40
Tissue fixation 40
Orientation of globe: 40
Paraffin: 40
Glutaraldehyde: 40
Formalin and Bouin’s fixative: 40
Ethyl alcohol: 41
Fixation artifacts: 41
Hypersensitivity reactions (coombs and gell classification) 41
Type I: 41
Type II: 41
Type III: 41
Type IV: 41
Type V: 41
Immunoglobulins 41
IgG: 41
IgA: 41
IgM: 41
IgD: 41
IgE: 41
Hla (human leukocyte antigen) system 41
Inflammation 42
Types of Inflammatory Cells 42
Neutrophils: 42
Eosinophils: 42
Mast cells: 42
Lymphocytes: 42
Plasma cells: 42
Macrophages: 42
Epithelioid histiocyte: 42
Giant cells: 42
Types of Inflammation 42
Acute: 42
Chronic: 43
Sequelae of Inflammation 43
Cornea: 43
Anterior chamber: 43
Lens: 43
Ciliary body: 43
Retina: 43
Phthisis: 43
Eyelid epithelial changes 43
Hyperkeratosis: 43
Parakeratosis: 43
Dyskeratosis: 43
Acanthosis: 43
Acantholysis: 43
Dysplasia: 43
Carcinoma in situ (CIN): 43
Squamous cell carcinoma: 43
Anaplasia: 43
Papillomatosis: 43
Pseudoepitheliomatous hyperplasia: 43
Elastosis: 43
Aging changes 44
4 Neuro-ophthalmology 49
Anatomy of the Visual Pathway 49
Optic nerve: 49
Chiasm: 49
Optic tract: 50
Lateral geniculate body: 51
Optic radiation: 52
Primary visual cortex (striate cortex, V1, Brodmann’s area 17): 52
Visual association areas: 52
Other areas: 52
Physiology 52
Testing 52
Color vision tests: 52
Photostress recovery test: 54
Contrast sensitivity: 54
Visually evoked cortical potentials / responses (VEP, VER): 54
Amsler grid: 54
Optokinetic nystagmus (OKN): 54
Red glass test: 54
Potential acuity meter (PAM): 54
Purkinje vascular phenomena and blue field entopic test: 54
Visual Field (VF) Defects (Figure 4-9) 54
Types: 54
Localizing VF defects: 55
Neurologic VF defects: 55
Eye Movements under Supranuclear Control 56
Horizontal gaze center (Figures 4-10,4-11): 56
Saccadic system: 56
Smooth pursuit system: 56
Vergence system: 56
Position maintenance system (vestibulo-ocular reflex [VOR]): 56
Nonoptic reflex systems: 57
Diplopia 58
Types: 58
Etiology: 58
Differential diagnosis (DDx): 58
Restrictive syndromes: 58
Eye Movement Disorders 58
Central Disorders (Supranuclear) (Figure 4-13) 58
Horizontal Gaze Palsies 58
Congenital 58
Möbius’ Syndrome 58
Ocular Motor Apraxia 58
Associations: 58
Findings: 58
Acquired 59
Frontoparietal lesion (stroke, trauma, or infection): 59
Doll’s head testing and calorics: 59
Parieto-occipital lesion: 59
Tegmental lesion: 59
Pontine lesion (PPRF): 59
Parkinson’s disease: 59
Huntington’s chorea 59
Drug-induced: 59
Pseudogaze palsies: 59
Internuclear ophthalmoplegia (INO) (Figure 4-14): 59
One-and-a-half syndrome (Fisher syndrome) (Figure 4-15): 59
Vertical Gaze Abnormalities 60
Parinaud’s Syndrome (Dorsal Midbrain Syndrome) 60
5 Pediatrics / Strabismus 91
Pediatrics 91
Anatomy 91
Physiology 91
History: 91
Orbital Disorders 92
Congenital Anomalies 92
Anophthalmos 92
6 Orbit / Lids / Adnexa 157
Anatomy 157
Dimensions 157
Orbit: 157
Optic nerve: 157
Proptosis: 157
Apertures 157
Superior orbital fissure: 157
Optic canal (orbital foramen): 157
Inferior orbital fissure: 157
Nasolacrimal canal: 157
Zygomaticofacial and zygomaticotemporal canals: 157
Ethmoidal foramina: 157
Frontosphenoidal foramina: 157
Foramen ovale: 157
Foramen rotundum: 157
Foramen lacerum: 157
Vascular Supply to Eye 157
Ophthalmic artery: 157
Venous system: 160
Innervation of Eye 160
Ophthalmic division (V1): 160
Maxillary nerve (V2): 160
Parasympathetic innervation: 160
Sympathetic innervation: 160
Sinuses 161
Frontal: 161
Ethmoid: 161
Sphenoid: 161
Maxillary: 161
Soft Tissues 161
Periorbita: 161
Annulus of Zinn: 161
Adipose tissue: 161
Lacrimal gland: 161
Eyelid 162
Lamellae of upper eyelid: (Figure 6-10) 162
Skin: 162
Orbicularis oculi: (Figure 6-11) 162
Other muscles of forehead and eyebrow: 163
Orbital septum: 163
Upper eyelid retractors: 164
Lower eyelid retractors: 164
Tarsus: 165
Medial canthal tendon: 165
Lateral canthal tendon: 165
Eyelid margin: 165
Vascular supply: 165
Innervation: 165
Lymphatic drainage: 165
Glands of the eyelids: 166
Nasolacrimal System 166
Puncta: 166
Canaliculi: 166
Nasolacrimal sac: 166
Nasolacrimal duct: 166
Lacrimal pump: 166
Imaging 167
Ultrasound 167
MRI 167
Relaxation times: 167
7 Cornea / External Disease 191
Anatomy / Physiology 191
Conjunctiva 191
Palpebral conjunctiva: 191
Bulbar conjunctiva: 191
Plica semilunaris: 191
Caruncle: 191
Precorneal Tear Film 191
Layers: 191
Cornea (Figure 7-1) 191
Average measurements: 191
Epithelium: 191
Basal lamina: 192
Bowman’s membrane: 192
Stroma: 192
Descemet’s membrane: 192
Endothelium: 192
Innervation: 193
Stains: 193
Special techniques: 193
Limbus 193
Sclera 193
Thickness: 193
3 layers (ill defined): 193
Conjunctival Disorders 193
Inflammation 193
Follicles 193
Papillae 194
Chemosis 194
Phlyctenule 194
Etiology: 194
8 Uveitis 229
Pathophysiology 229
Inflammatory reaction: 229
Retinal S-antigen: 229
Classification 229
Pathology: 229
9 Glaucoma 251
Anatomy/physiology 251
Ciliary body (CB) 251
Functions 251
Outflow Pathways 252
Trabecular meshwork (traditional pathway): 252
Uveoscleral outflow (15–20% of total outflow): 252
Angle Structures 252
Schwalbe’s line: 252
Trabecular meshwork (TM): 252
Schlemm’s canal: 253
DDx of blood in Schlemm’s canal: 253
Scleral spur (SS): 253
Ciliary body (CB): 253
Angle Abnormalities 253
Peripheral anterior synechia (PAS): 253
Normal vessels: 253
Abnormal vessels: 253
Angle recession: 253
Cyclodialysis cleft: 253
Iridodialysis: 253
Optic Nerve (Figure 9-2) 253
Testing 253
Intraocular Pressure 253
Goldmann equation: 253
Tonometry 254
Indentation 254
Applanation: 254
Noncontact 254
Gonioscopy 254
Classification systems 254
Types of lenses 255
Grading system of shallow/flat anterior chamber 255
Visual Fields 255
Types: 255
Goldmann (kinetic and static): 255
Humphrey (static): 255
Tangent screen (usually kinetic): 255
VF defect: 255
Optic Nerve Head (ONH) Analyzers 256
Confocal scanning laser ophthalmoscopy (CSLO; Heidelberg retinal tomograph [HRT]; TopSS): 256
Optical coherence tomography (OCT): 256
Scanning laser polarimetry (SLP; Nerve Fiber Analyzer, GDx): 256
Optic nerve blood flow measurement: 256
Pathology 257
Glaucoma 257
Schnabel’s Cavernous Optic Atrophy 257
Pathology: 257
Gliosis of the Optic Nerve 257
Disorders 257
Childhood Glaucoma 257
Primary Open-Angle Glaucoma (POAG) 257
Epidemiology: 257
Genetics: 257
Risk factors: 258
Pathogenesis: 258
Findings: 258
Visual fields: 258
Secondary Open-Angle Glaucoma 260
Mechanism/Etiology: 260
Hyphema 260
Sickle cell 260
Ghost cells 260
Lytic glaucomas 260
Hemolytic: 260
Phacolytic: 260
Melanomalytic: 260
Melanocytomalytic: 260
Tumor cells 260
Pigmentary glaucoma (PG) (AD) 260
Mechanism: 261
10 Anterior Segment 273
Iris, ciliary body, and anterior chamber (AC) angle 273
Anatomy 273
Limbus 273
Definitions: 273
Ciliary Body and Angle Structures 273
Disorders 273
Trauma 273
Hyphema 273
Etiology: 273
Findings: 273
Diagnosis: 273
Treatment: 273
Complications: 273
Sickle cell and hyphema: 273
Iris and Angle Trauma (Figure 10-2) 274
Iris sphincter tear: 274
Traumatic mydriasis: 274
Iridodialysis: 274
Angle recession: 274
Cyclodialysis: 274
Open Globe/Intraocular Foreign Body 274
Penetration: 274
Perforation: 274
Findings: 274
Types of foreign bodies: 275
Treatment: 275
Prognosis: 275
Congenital Abnormalities 276
Mesodermal Dysgenesis Syndromes 276
Other Disorders 276
Corectopia 276
Iris Heterochromia 276
11 Posterior segment 289
Anatomy 289
Vitreous 289
Vitreous base: 289
Vitreoretinal junctions: 289
Retina (Figure 11-3) 289
Neurosensory Retina (9 Layers): 289
Peripheral Retina: 290
Macula: 290
Fovea (Figures 11-6, 11.7): 291
Foveola: 291
Intercellular Junctions 292
Clinical Correlation 292
Hemorrhages 292
RPE: 292
Functions: 292
Bruch’s Membrane: 292
Layers: 292
Neuroglial Cells 292
Astrocytes: 292
Müller’s cells: 292
Microglia: 292
Arachnoidal cells: 292
Oligodendrocytes: 292
Schwann cells: 292
Choroid 292
Layers: 293
Physiology 293
Visual pigments: 293
Rod photoreceptor membranes: 293
Luminosity curves: 293
Electrophysiology 293
Electroretinogram (ERG) 293
Components (Figure 11-10): 293
Photopic (light adapted): 294
Scotopic (dark adapted): 294
Indications: 295
Disease states (Figure 11-14, Table 11-2): 295
Pattern ERG (PERG): 296
Electro-oculogram (EOG) 296
Arden ratio: 297
Procedure: 297
Retinal Imaging 297
Optical Coherence Tomography (OCT) 297
Heidelberg Retinal Tomograph (HRT) 297
Retinal Thickness Analyzer (RTA) 297
Scanning Laser Ophthalmoscope (SLO) 298
Ultrasound 298
A-scan: 298
B-scan: 298
Reflectivity: 298
Internal structure: 298
Sound attenuation: 298
After movement: 299
Vascularity: 299
Specific lesions: 299
Fluorescein Angiogram (FA) 300
Phases: 300
Characteristics: 301
Indocyanine Green (ICG) 301
Disorders 302
Vitreous Abnormalities 302
Asteroid Hyalosis 302
Pathology: 302
Synchisis Scintillans (Cholesterol Bulbi) 302
Primary Amyloidosis 302
Posterior Vitreous Detachment (PVD) 302
Mechanism: 302
Symptoms: 302
Findings: 302
Vitreous Hemorrhage (VH) 302
Etiology: 302
Ochre membrane: 302
Persistent Hyperplastic Primary Vitreous (PHPV) 302
Retinal Abnormalities 302
Congenital 302
Trauma 302
Commotio Retinae (Berlin’s Edema) 302
Contusion of RPE 303
Choroidal Rupture 303
Mechanism: 303
Direct: 303
Indirect: 303
Answers to Questions 355
Chapter 1 Optics 355
Chapter 2 Pharmacology 357
Chapter 3 Embryology/Pathology 358
Chapter 4 Neuro-Ophthalmology 359
Chapter 5 Pediatrics/Strabismus 361
Chapter 6 Orbit/Lids/Adnexa 363
Chapter 7 Cornea/External Disease 365
Chapter 8 Uveitis 366
Chapter 9 Glaucoma 368
Chapter 10 Anterior Segment 369
Chapter 11 Posterior Segment 370
Index 373
A 373
B 374
C 375
D 377
E 377
F 378
G 379
H 379
I 380
J 380
K 381
L 381
M 382
N 383
O 383
P 384
Q 386
R 386
S 386
T 387
U 388
V 388
W 389
X 389
Y 389
Z 389