Additional Information
Book Details
Abstract
A trusted textbook for undergraduate students for more than 100 years, which also caters to the basic needs of postgraduate students and practitioners.
The book was first published in 1907, and on account of its clear and friendly presentation style as well as its authoritative coverage of ocular disorders, it quickly became a fundamental text for students. Since then the book has maintained its popularity with students through regular revisions and updates.
The 19th edition of this book was especially adapted to the context of Indian subcontinent with a special mention about the infections that occur predominantly in this region. The 22nd edition continues this trend by presenting unparalleled guidance on nearly every ophthalmic condition and procedure, including the latest advances in the field, making the book more comprehensive and contemporary.
• Inclusion of Important Points to Remember at the end of the book
• Addition of new clinical photographs, flowcharts, and tables to facilitate quick learning
• Extensively revised and updated edition
• Reader-friendly version with information highlighted in points, flow charts and tables
• Information provided to help prepare for PG entrance and other competitive examinations
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | Cover | ||
| Front matter | iii | ||
| Copyright | iv | ||
| Preface to the twenty-second edition | v | ||
| Preface to the nineteenth edition | vii | ||
| Acknowledgements | ix | ||
| Table of contents | xi | ||
| I Anatomy and Physiology | 1 | ||
| 1 Embryology and anatomy | 3 | ||
| Embryology | 3 | ||
| Anatomy | 3 | ||
| Cornea | 4 | ||
| Transparency of cornea | 4 | ||
| Blood supply and innervation | 4 | ||
| Sclera | 4 | ||
| Anterior chamber | 4 | ||
| Lens | 6 | ||
| Uveal tract | 8 | ||
| Iris | 8 | ||
| Ciliary body | 8 | ||
| Choroid | 9 | ||
| Posterior chamber and vitreous humour | 9 | ||
| Retina | 9 | ||
| Layers of retina (outer to inner) | 9 | ||
| The blood supply of the eye | 11 | ||
| Clinical anatomy of the eye | 13 | ||
| Summary | 14 | ||
| Suggested reading | 15 | ||
| 2 Physiology of the eye | 16 | ||
| Nature and formation of intraocular fluid | 16 | ||
| Circulation of aqueous humour | 17 | ||
| Intraocular pressure | 17 | ||
| Metabolism of ocular tissues | 18 | ||
| Vascularized tissues of the eye | 18 | ||
| Non-vascularized tissues of the eye | 18 | ||
| The cornea | 19 | ||
| The lens | 19 | ||
| Summary | 20 | ||
| Suggested reading | 20 | ||
| 3 The physiology of vision | 21 | ||
| Rhodopsin cycle | 21 | ||
| Magnocellular, parvocellular and koniocellular pathways | 22 | ||
| Visual perceptions | 23 | ||
| Light sense | 23 | ||
| Form sense | 23 | ||
| Sense of contrast | 23 | ||
| Colour sense | 24 | ||
| Theories of colour vision | 24 | ||
| Young–helmholtz or the trichromatic theory | 24 | ||
| The opponent process theory | 24 | ||
| Physiology of vision and the developing brain | 25 | ||
| Binocular vision and stereopsis | 26 | ||
| Summary | 27 | ||
| Suggested reading | 27 | ||
| 4 The neurology of vision | 28 | ||
| The visual pathway | 28 | ||
| Afferent tracts of sensation | 28 | ||
| Anatomy and physiology of the visual pathway | 28 | ||
| Retina, optic nerve and chiasma | 28 | ||
| Optic radiation | 30 | ||
| Occipital cortex | 30 | ||
| Neurology of the brain in relation to vision | 30 | ||
| The pupillary pathways and reactions | 31 | ||
| Nerve supply of the pupillary muscles | 32 | ||
| The pupillary reflexes | 33 | ||
| The light reflex | 33 | ||
| The near reflex | 34 | ||
| The psychosensory reflex | 34 | ||
| Summary | 35 | ||
| Suggested reading | 35 | ||
| II Ophthalmic Optics and Refraction | 37 | ||
| 5 Elementary optics | 39 | ||
| Properties of light | 39 | ||
| Electromagnetic spectrum | 39 | ||
| Wave theory of light | 40 | ||
| Interference, diffraction and polarization | 40 | ||
| Rays of light and images | 41 | ||
| Reflection | 42 | ||
| Laws of reflection | 42 | ||
| Reflection at an irregular surface | 42 | ||
| Reflection at a smooth surface: Plane, concave and convex mirrors | 43 | ||
| Plane mirrors | 43 | ||
| Spherical mirrors | 43 | ||
| Concave mirrors | 43 | ||
| Convex mirrors | 44 | ||
| Refraction | 44 | ||
| Plane lamina | 44 | ||
| Prisms | 45 | ||
| Lenses | 45 | ||
| The effect of a biconvex lens upon rays of light | 45 | ||
| The effect of a biconcave lens upon rays of light | 47 | ||
| Identification of lenses | 47 | ||
| Systems of lenses | 48 | ||
| Summary | 48 | ||
| Suggested reading | 48 | ||
| 6 Elementary physiological optics | 49 | ||
| The optical system of the eye | 49 | ||
| The optical state of the eye | 51 | ||
| Emmetropia | 51 | ||
| Ametropia | 51 | ||
| Types of ametropia | 51 | ||
| Optics of ametropia | 51 | ||
| The correction of ametropia with lenses | 53 | ||
| Optical aberrations | 55 | ||
| Accommodation | 56 | ||
| Presbyopia | 58 | ||
| Summary | 58 | ||
| Suggested reading | 58 | ||
| 7 Refraction | 59 | ||
| Retinoscopy | 59 | ||
| The theory of retinoscopy | 59 | ||
| Principle | 59 | ||
| Equipment | 59 | ||
| Light pathway in retinoscopy | 59 | ||
| The practice of retinoscopy | 62 | ||
| Procedure | 62 | ||
| Mirror retinoscope | 62 | ||
| Streak retinoscope | 62 | ||
| Cycloplegics in refraction | 64 | ||
| Difficulties in retinoscopy | 64 | ||
| Refractometry | 65 | ||
| Keratometry | 65 | ||
| The subjective verification of refraction | 66 | ||
| Summary | 69 | ||
| Suggested reading | 69 | ||
| 8 Refractive errors of the eye | 70 | ||
| Emmetropia | 70 | ||
| Ametropia | 70 | ||
| Myopia | 71 | ||
| Treatment | 73 | ||
| Spectacles | 73 | ||
| Contact lenses | 74 | ||
| Surgical treatment for myopia | 74 | ||
| Hypermetropia (hyperopia) | 75 | ||
| III Ocular Examination Techniques and Ocular Therapeutics | 85 | ||
| 9 Ocular symptomatology | 87 | ||
| History taking | 87 | ||
| Anomalies of ocular motility | 87 | ||
| Asthenopia | 87 | ||
| Binocular diplopia | 87 | ||
| Diminution of vision | 88 | ||
| Amblyopia and amaurosis | 88 | ||
| Amaurosis fugax | 89 | ||
| Visual field defects | 89 | ||
| Night blindness or nyctalopia | 89 | ||
| Hemeralopia | 89 | ||
| Colour blindness or achromatopsia | 90 | ||
| Acquired colour blindness | 90 | ||
| Congenital colour blindness | 90 | ||
| Word blindness | 90 | ||
| Non-organic ‘functional’ visual loss | 90 | ||
| Aetiopathogenesis | 90 | ||
| Clinical features | 90 | ||
| Malingering | 90 | ||
| Differential diagnosis | 91 | ||
| Hysteria | 91 | ||
| Treatment | 91 | ||
| Disorders of the ocular surface | 92 | ||
| Ocular irritation | 92 | ||
| Lacrimation | 92 | ||
| Photophobia | 92 | ||
| Red eye | 92 | ||
| Visual phenomena | 92 | ||
| Glare | 92 | ||
| Floaters | 93 | ||
| Photopsia | 94 | ||
| Metamorphopsia | 94 | ||
| Coloured halos | 94 | ||
| Visual hallucinations | 94 | ||
| Scintillating scotomata | 95 | ||
| Uniocular diplopia | 95 | ||
| Coloured vision (chromatopsia) | 96 | ||
| Summary | 96 | ||
| Suggested reading | 96 | ||
| 10 Assessment of visual function | 97 | ||
| Visual acuity | 97 | ||
| Minimum angle of resolution | 98 | ||
| Visual acuity measurement | 99 | ||
| Visual acuity measurement in special cases | 99 | ||
| The photostress test | 101 | ||
| Field of vision | 101 | ||
| Confrontation test | 101 | ||
| Perimetry | 102 | ||
| Kinetic perimetry | 103 | ||
| Static perimetry | 104 | ||
| Automated perimeters | 104 | ||
| Dark adaptation | 106 | ||
| Contrast sensitivity | 107 | ||
| Colour vision | 107 | ||
| Electrophysiological tests | 109 | ||
| Electroretinography | 109 | ||
| Electro-oculography | 110 | ||
| Visual evoked potential | 110 | ||
| Binocular vision and stereoacuity | 111 | ||
| Summary | 113 | ||
| Suggested reading | 113 | ||
| 11 Examination of the anterior segment | 114 | ||
| The conjunctiva | 114 | ||
| The sclera | 115 | ||
| The cornea | 115 | ||
| The corneal surface | 115 | ||
| Vascularisation | 116 | ||
| Sensations | 117 | ||
| Staining | 118 | ||
| Opacities of the cornea | 118 | ||
| The corneal endothelium | 118 | ||
| Curvature | 119 | ||
| The anterior chamber | 119 | ||
| Depth | 119 | ||
| Contents | 119 | ||
| The iris | 120 | ||
| The pupil | 121 | ||
| Abnormal size of the pupil | 121 | ||
| Pupillary reflexes | 122 | ||
| Abnormal reactions of the pupil | 123 | ||
| The lens | 124 | ||
| The posterior chamber | 124 | ||
| Slit-lamp biomicroscopy | 124 | ||
| Diffuse illumination | 124 | ||
| Focal illumination | 124 | ||
| Retroillumination | 125 | ||
| Specular reflection | 125 | ||
| Scleral scatter | 125 | ||
| Tonometry | 125 | ||
| Indentation tonometer | 127 | ||
| Applanation tonometer | 127 | ||
| Gonioscopy | 128 | ||
| Transillumination | 129 | ||
| Ultrasound biomicroscopy | 130 | ||
| Anterior segment optical coherence tomography | 130 | ||
| Summary | 130 | ||
| Suggested reading | 130 | ||
| 12 Examination of the posterior segment and orbit | 131 | ||
| Ophthalmoscopy | 132 | ||
| Examination by indirect ophthalmoscopy | 136 | ||
| Examination by direct ophthalmoscopy | 137 | ||
| Slit-lamp biomicroscopy | 139 | ||
| Examination of the fundus | 141 | ||
| The normal fundus | 141 | ||
| Ancillary investigations | 142 | ||
| Fluorescein angiography | 142 | ||
| Indocyanine green angiography | 143 | ||
| Ultrasonography | 143 | ||
| A-scan | 143 | ||
| B-scan | 143 | ||
| Colour doppler imaging | 144 | ||
| Optical coherence tomography (oct) | 144 | ||
| Computerized axial tomography (cat) | 144 | ||
| Magnetic resonance imaging (MRI) | 145 | ||
| Summary | 145 | ||
| Suggested reading | 145 | ||
| 13 Ocular therapeutics | 146 | ||
| Routes of administration | 146 | ||
| Topical instillation | 146 | ||
| Subconjunctival injections | 147 | ||
| Peribulbar/sub-tenon injections | 147 | ||
| Intraocular injection | 147 | ||
| Systemic administration | 147 | ||
| Chemotherapy in infective conditions | 147 | ||
| Antibiotics | 147 | ||
| Penicillins | 148 | ||
| Cephalosporins | 148 | ||
| Aminoglycosides | 150 | ||
| Tetracyclines | 151 | ||
| Macrolide and lincomycin groups | 151 | ||
| Glycopeptides | 151 | ||
| Fluoroquinolones | 151 | ||
| Other antibiotics | 151 | ||
| Sulphonamides | 151 | ||
| Antiviral agents | 151 | ||
| Pyrimidine derivatives | 151 | ||
| Purine derivatives | 152 | ||
| Other antiviral agents | 152 | ||
| Antifungal agents | 152 | ||
| Polyene antibiotics | 152 | ||
| Imidazoles | 153 | ||
| Anti-inflammatory therapy | 153 | ||
| Corticosteroids | 153 | ||
| Non-steroidal anti-inflammatory drugs (nsaids) | 154 | ||
| Therapy for ocular allergies | 155 | ||
| Antihistamines | 155 | ||
| Mast cell stabilizers | 155 | ||
| Drugs affecting the pupil and accommodation | 155 | ||
| Cycloplegics and mydriatics | 155 | ||
| Sympathomimetics | 155 | ||
| Medical therapy for glaucoma | 156 | ||
| Parasympathomimetics | 156 | ||
| Sympathomimetics | 156 | ||
| Alpha-agonists | 156 | ||
| Adrenergic antagonists | 157 | ||
| Beta-blockers | 157 | ||
| Prostaglandin analogues and hypotensive lipids | 157 | ||
| Carbonic anhydrase inhibitors | 157 | ||
| Hyperosmotic agents and hypotensive lipids | 158 | ||
| Medical therapy for dry eye | 158 | ||
| Pharmacological agents used in intraocular surgery | 158 | ||
| Irrigating solution | 158 | ||
| Viscoelastics or viscosurgical devices | 158 | ||
| Dyes | 159 | ||
| Antimitotic agents or antimetabolites | 159 | ||
| Anti-vegf agents | 160 | ||
| Riboflavin for corneal collagen cross linking | 160 | ||
| Summary | 160 | ||
| Suggested reading | 160 | ||
| IV Diseases of the Eye | 161 | ||
| 14 Diseases of the conjunctiva | 163 | ||
| Anatomy and physiology | 163 | ||
| Histology | 163 | ||
| Blood supply | 163 | ||
| Lymphatics | 163 | ||
| Nerve supply | 164 | ||
| Functions | 164 | ||
| Microbiology | 164 | ||
| Common clinical features of conjunctival disorders | 165 | ||
| Common symptoms | 165 | ||
| Clinical signs | 165 | ||
| Conjunctivitis | 166 | ||
| Definition, etiology and pathophysiology of different types of conjunctivitis | 166 | ||
| Infectious or infective conjunctivitis | 167 | ||
| Acute conjunctivitis | 167 | ||
| Bacterial conjunctivitis | 167 | ||
| Chlamydial conjunctivitis | 170 | ||
| Viral conjunctivitis | 171 | ||
| Follicular conjunctivitis | 171 | ||
| Epidemic keratoconjunctivitis | 171 | ||
| Pharyngoconjunctival fever | 172 | ||
| Newcastle conjunctivitis | 172 | ||
| Haemorrhagic conjunctivitis | 172 | ||
| Herpetic conjunctivitis | 172 | ||
| Chronic infective conjunctivitis | 172 | ||
| Trachoma | 172 | ||
| Prevalence | 172 | ||
| Aetiology | 173 | ||
| Clinical features | 173 | ||
| Course and prognosis | 173 | ||
| Sequelae | 173 | ||
| Diagnosis | 174 | ||
| Treatment | 174 | ||
| Granulomatous conjunctivitis | 175 | ||
| Parinaud oculoglandular syndrome | 175 | ||
| Cat-scratch disease | 175 | ||
| Lymphogranuloma venereum | 176 | ||
| Tuberculosis of the conjunctiva | 176 | ||
| Syphilis | 176 | ||
| Tularemia | 176 | ||
| Ophthalmia nodosa | 176 | ||
| Leprosy | 176 | ||
| Fungal conjunctivitis | 177 | ||
| Ophthalmia neonatorum | 177 | ||
| Aetiology | 177 | ||
| Causative agents | 177 | ||
| Neisseria gonorrhoeae | 177 | ||
| Chlamydia trachomatis | 177 | ||
| Other bacteria | 177 | ||
| Chemical toxicity | 178 | ||
| Investigations | 178 | ||
| Treatment | 178 | ||
| Prophylaxis | 178 | ||
| Curative treatment | 178 | ||
| Non-infectious conjunctivitis | 179 | ||
| Allergic conjunctivitis | 179 | ||
| Vernal conjunctivitis (vernal keratoconjunctivitis [vkc] or spring catarrh) | 180 | ||
| Atopic keratoconjunctivitis (akc) | 181 | ||
| Giant papillary conjunctivitis (gpc) | 181 | ||
| Endogenous or immune system-mediated conjunctivitis | 181 | ||
| Phlyctenular conjunctivitis | 181 | ||
| Conjunctivitis associated with systemic disorders | 182 | ||
| Sarcoidosis | 182 | ||
| Ocular cicatricial pemphigoid | 182 | ||
| Stevens–johnson syndrome (erythema multiforme major) | 182 | ||
| Ocular rosacea | 183 | ||
| Toxic and chemical conjunctivitis | 183 | ||
| Non-specific chronic conjunctivitis | 183 | ||
| Degenerative changes in the conjunctiva | 184 | ||
| Concretions (lithiasis) | 184 | ||
| Pinguecula | 184 | ||
| Pterygium | 184 | ||
| Conjunctival cysts and tumours | 185 | ||
| Tumorous conditions | 185 | ||
| Congenital tumours | 185 | ||
| Papillomata | 186 | ||
| Simple granulomata | 186 | ||
| Pyogenic granuloma | 186 | ||
| Squamous cell carcinoma (epithelioma) | 186 | ||
| Basal cell carcinoma (rodent ulcer) | 186 | ||
| Lymphomas | 186 | ||
| Kaposi sarcoma | 186 | ||
| Pigmented tumours | 187 | ||
| Dry eye syndromes and disorders of the ocular surface | 187 | ||
| Xerosis (xerophthalmia) | 187 | ||
| Keratoconjunctivitis sicca (sjögren syndrome) | 188 | ||
| Dry eye | 188 | ||
| Symblepharon | 189 | ||
| Conjunctivochalasis | 189 | ||
| Argyrosis | 189 | ||
| Summary | 190 | ||
| Suggested reading | 190 | ||
| 15 Diseases of the cornea | 191 | ||
| Anatomy and physiology | 191 | ||
| Diseases of the cornea | 191 | ||
| Pathophysiology | 191 | ||
| Corneal opacity | 194 | ||
| Corneal oedema | 195 | ||
| Filamentary keratopathy | 195 | ||
| Keratic precipitates | 196 | ||
| Hypopyon | 196 | ||
| Prominent or enlarged corneal nerves | 196 | ||
| Vascularization of the cornea | 196 | ||
| Clinical features: Symptoms, signs and diagnosis | 197 | ||
| Inflammation (keratitis) | 198 | ||
| Infections affecting the cornea | 198 | ||
| Infectious keratitis and corneal ulcers | 199 | ||
| Symptoms, signs and diagnosis | 199 | ||
| Investigations | 199 | ||
| Bacterial corneal ulcers | 199 | ||
| Causative organisms | 199 | ||
| Mode and source of infection | 200 | ||
| Pathology | 200 | ||
| Fungal corneal infections | 201 | ||
| Complications of corneal ulcers | 201 | ||
| Treatment | 203 | ||
| Treatment of bacterial corneal ulcers | 203 | ||
| Treatment of fungal corneal ulcers | 203 | ||
| Treatment of a perforated ulcer | 204 | ||
| Viral infections of the cornea | 205 | ||
| Causative organisms | 205 | ||
| Characteristic features | 205 | ||
| Management | 205 | ||
| Herpes simplex | 205 | ||
| Herpes simplex virus (hsv) | 205 | ||
| Mode of infection | 206 | ||
| Clinical manifestations | 206 | ||
| Treatment | 206 | ||
| Herpes zoster ophthalmicus | 207 | ||
| Mode of infection | 207 | ||
| Symptoms | 207 | ||
| Signs | 207 | ||
| Treatment | 207 | ||
| Systemic therapy | 207 | ||
| Topical agents | 207 | ||
| Parasitic infestations of the cornea | 208 | ||
| Protozoal infections | 208 | ||
| Helminthic infections | 209 | ||
| Immunologically mediated diseases | 209 | ||
| Phlyctenular keratitis | 209 | ||
| Acne rosacea | 209 | ||
| Marginal ulcer (catarrhal ulcer) | 210 | ||
| Chronic serpiginous ulcer (rodent ulcer, mooren ulcer) | 210 | ||
| Interstitial keratitis | 210 | ||
| Disciform keratitis | 212 | ||
| Corneal dystrophies | 212 | ||
| Epithelial and subepithelial dystrophies | 212 | ||
| Bowman layer dystrophies | 212 | ||
| Stromal corneal dystrophies | 213 | ||
| Endothelial corneal dystrophies | 214 | ||
| Degenerative changes | 214 | ||
| Arcus senilis | 214 | ||
| Arcus juvenilis | 214 | ||
| Terrien marginal degeneration | 215 | ||
| Band-shaped keratopathy | 215 | ||
| Climatic droplet keratopathy | 215 | ||
| Salzmann nodular degeneration | 215 | ||
| Other degenerative changes | 216 | ||
| Ectatic conditions | 216 | ||
| Keratoconus (conical cornea) | 216 | ||
| Keratoglobus | 218 | ||
| Pellucid marginal degeneration | 218 | ||
| Miscellaneous conditions | 218 | ||
| Vitamin a deficiency and keratomalacia | 218 | ||
| Exposure keratopathy | 218 | ||
| Neurotrophic keratopathy | 219 | ||
| Neuroparalytic keratopathy | 219 | ||
| Superior limbic keratoconjunctivitis | 219 | ||
| Vernal keratopathy | 219 | ||
| Aphakic and pseudophakic bullous keratopathy | 219 | ||
| Photophthalmia | 220 | ||
| Deposition of materials in the cornea | 220 | ||
| Cornea verticillata | 220 | ||
| Congenital opacities of the cornea | 221 | ||
| Pigmentation of the cornea | 221 | ||
| Tumours of the cornea | 221 | ||
| Surgery for corneal diseases | 221 | ||
| Keratoplasty or corneal grafting | 221 | ||
| Phototherapeutic keratectomy | 223 | ||
| Refractive surgery | 223 | ||
| Keratoprosthesis | 223 | ||
| Summary | 224 | ||
| Suggested reading | 224 | ||
| 16 Diseases of the sclera | 225 | ||
| Anatomy and physiology | 225 | ||
| Inflammation | 225 | ||
| Episcleritis | 225 | ||
| Scleritis | 226 | ||
| Anterior scleritis | 226 | ||
| Posterior scleritis | 228 | ||
| Specific inflammatory diseases associated with scleritis | 228 | ||
| Collagen vascular diseases | 228 | ||
| Infections | 229 | ||
| Gumma | 229 | ||
| Tuberculosis | 229 | ||
| Suppurative bacterial infections | 229 | ||
| Staphyloma | 229 | ||
| Anterior staphyloma | 229 | ||
| Intercalary staphyloma | 229 | ||
| Ciliary staphyloma | 230 | ||
| Equatorial staphyloma | 230 | ||
| Posterior staphyloma | 230 | ||
| Treatment | 230 | ||
| Tumours | 230 | ||
| Choristomas | 230 | ||
| Malignant tumours | 230 | ||
| Congenital abnormalities | 230 | ||
| Blue sclera | 230 | ||
| Summary | 231 | ||
| 17 Diseases of the uveal tract | 232 | ||
| Anatomy and physiology | 232 | ||
| Inflammation (uveitis) | 232 | ||
| Aetiopathogenesis of uveitis | 233 | ||
| Inflammatory | 233 | ||
| Neoplastic | 235 | ||
| Traumatic | 235 | ||
| Clinical features | 235 | ||
| Anterior uveitis | 235 | ||
| Iritis | 235 | ||
| Cyclitis | 237 | ||
| Iridocyclitis | 237 | ||
| Intermediate uveitis | 238 | ||
| Posterior uveitis | 238 | ||
| Investigations | 240 | ||
| Treatment of uveitis | 240 | ||
| General treatment | 240 | ||
| Treatment of sequelae and complications | 241 | ||
| Purulent uveitis, endophthalmitis and panophthalmitis | 241 | ||
| Aetiology | 241 | ||
| Exogenous | 241 | ||
| Endogenous | 242 | ||
| Clinical features | 242 | ||
| Treatment | 243 | ||
| Therapeutic regimen | 243 | ||
| Specific types of uveitis | 244 | ||
| Bacterial uveitis | 244 | ||
| Tuberculosis | 244 | ||
| Tuberculous iritis | 244 | ||
| Tuberculous choroiditis | 244 | ||
| Leprosy | 245 | ||
| Brucellosis | 245 | ||
| Whipple disease | 245 | ||
| Spirochaetal uveitis | 245 | ||
| Syphilis | 245 | ||
| Syphilitic iritis | 245 | ||
| Gummatous iritis | 245 | ||
| Syphilitic choroiditis and chorioretinitis | 245 | ||
| Leptospirosis | 246 | ||
| Viral uveitis | 246 | ||
| Acute retinal necrosis | 247 | ||
| Cytomegalovirus | 247 | ||
| Acquired immune deficiency syndrome | 247 | ||
| Measles | 247 | ||
| Fungal uveitis | 247 | ||
| Parasitic uveitis | 248 | ||
| Toxoplasmosis | 248 | ||
| Onchocerciasis | 249 | ||
| Cysticercosis infestation | 250 | ||
| Immunological uveitis | 250 | ||
| Ankylosing spondylitis and uveitis | 250 | ||
| Reiter disease and uveitis | 250 | ||
| Juvenile chronic arthritis | 250 | ||
| Behçet syndrome | 250 | ||
| Sarcoidosis | 251 | ||
| Uveitis associated with vitiligo, poliosis and deafness (vogt–koyanagi–harada syndrome) | 251 | ||
| Sympathetic ophthalmitis | 251 | ||
| Heterochromic iridocyclitis of fuchs | 251 | ||
| Geographical choroidopathy | 251 | ||
| Acute multifocal placoid pigment epitheliopathy | 252 | ||
| Masquerade syndromes | 252 | ||
| Vascular and circulatory disturbances | 252 | ||
| Central serous choroidopathy | 253 | ||
| Neovascularization of the iris | 253 | ||
| Uveal effusion syndrome | 254 | ||
| Degenerative changes | 254 | ||
| Degenerative changes in the iris | 254 | ||
| Essential (progressive) atrophy of the iris | 254 | ||
| Iridoschisis | 254 | ||
| Pigment dispersion syndrome | 254 | ||
| Degenerative changes in the choroid | 255 | ||
| Secondary degenerations | 255 | ||
| Primary choroidal degenerations | 255 | ||
| Essential (gyrate) atrophy of the choroid | 256 | ||
| Choroideraemia | 256 | ||
| Age related macular degeneration | 256 | ||
| Senile central choroidal atrophy | 257 | ||
| Detachment of the choroid | 258 | ||
| Congenital abnormalities | 258 | ||
| Persistent pupillary membrane | 259 | ||
| Colobomata | 259 | ||
| Albinism | 259 | ||
| Miscellaneous conditions | 259 | ||
| Cysts of the iris | 259 | ||
| Tumours of the uveal tract | 260 | ||
| Summary | 260 | ||
| Suggested reading | 260 | ||
| 18 The lens | 261 | ||
| Anatomy and physiology | 261 | ||
| Structure | 262 | ||
| Function | 262 | ||
| Aetiopathogenesis of cataract | 262 | ||
| Symptoms of cataract | 263 | ||
| Age-related (senile) cataract | 265 | ||
| Cataract associated with ocular disease | 268 | ||
| Complicated cataract | 268 | ||
| Cataract associated with systemic disease | 268 | ||
| Diabetic cataract | 268 | ||
| Parathyroid tetany | 268 | ||
| Myotonic dystrophy | 269 | ||
| Galactosaemia | 269 | ||
| Down syndrome | 269 | ||
| Atopic cataract | 269 | ||
| Cataract due to other causes | 269 | ||
| Heat (infrared) cataract | 269 | ||
| Irradiation cataract | 270 | ||
| Electric cataract | 270 | ||
| Traumatic cataract | 270 | ||
| Developmental cataract | 270 | ||
| Punctate cataract | 270 | ||
| Zonular cataract | 270 | ||
| Fusiform cataract | 271 | ||
| Nuclear cataract | 271 | ||
| Coronary cataract | 272 | ||
| Anterior capsular (polar) cataract | 272 | ||
| Posterior capsular (polar) cataract | 272 | ||
| Treatment of developmental cataract | 272 | ||
| Other congenital and developmental abnormalities of the lens | 273 | ||
| Abnormal shape or size | 273 | ||
| Ectopia lentis | 275 | ||
| Aetiopathogenesis | 275 | ||
| Clinical features | 275 | ||
| Treatment | 275 | ||
| Management of cataract | 276 | ||
| Examination | 276 | ||
| Preoperative management | 277 | ||
| Cataract surgery | 277 | ||
| Optical rehabilitation or correction of aphakia | 282 | ||
| Intraocular lenses | 282 | ||
| Complications of cataract surgery | 284 | ||
| Before surgery or pre-operative complications | 284 | ||
| Perioperative or intra-operative complications | 284 | ||
| After surgery or post-operative complications | 285 | ||
| Posterior capsular opacification (‘after’ or ‘secondary’ cataract) | 285 | ||
| Summary | 285 | ||
| Suggested reading | 286 | ||
| 19 The glaucomas | 287 | ||
| Introduction | 287 | ||
| Pathogenesis | 287 | ||
| Mechanical changes | 287 | ||
| Vascular perfusion | 287 | ||
| Other factors | 287 | ||
| Diagnosis | 288 | ||
| Diagnosis of a glaucomatous field defect | 290 | ||
| Intraocular pressure | 290 | ||
| Types of glaucoma | 290 | ||
| Primary adult glaucomas | 290 | ||
| Primary open-angle glaucoma (poag) | 290 | ||
| Pathogenesis | 292 | ||
| Clinical features | 292 | ||
| Management | 295 | ||
| Treatment | 296 | ||
| Primary angle-closure disease | 296 | ||
| Predisposing factors | 297 | ||
| Clinical features | 297 | ||
| Treatment | 299 | ||
| Combined mechanism glaucoma | 299 | ||
| Secondary glaucomas | 300 | ||
| Aetiopathogenesis | 300 | ||
| Inflammatory glaucomas | 300 | ||
| Neovascular glaucoma | 300 | ||
| Lens-induced glaucoma | 301 | ||
| Aphakic or pseudophakic glaucoma | 301 | ||
| Corticosteroid-induced glaucoma | 302 | ||
| Secondary angle closure glaucoma after perforation of the cornea | 302 | ||
| Pseudoexfoliation syndrome | 302 | ||
| Pigmentary glaucoma | 303 | ||
| Elevated episcleral venous pressure | 303 | ||
| Secondary glaucoma due to an intraocular tumour | 303 | ||
| Malignant glaucoma | 303 | ||
| Paediatric glaucomas | 303 | ||
| Congenital glaucoma | 304 | ||
| Pathogenesis | 304 | ||
| Clinical features | 304 | ||
| Treatment | 305 | ||
| Juvenile primary open-angle glaucoma | 305 | ||
| Aetiopathogenesis | 305 | ||
| Management of the glaucomas | 306 | ||
| Medical management | 306 | ||
| Surgical treatment for glaucoma | 306 | ||
| Glaucoma-filtering operations | 306 | ||
| Trabeculectomy | 306 | ||
| Complications | 307 | ||
| Drainage devices | 308 | ||
| Summary | 308 | ||
| Suggested reading | 308 | ||
| 20 Diseases of the retina | 309 | ||
| Anatomy and physiology | 309 | ||
| The (systemic) vascular retinopathies | 310 | ||
| Hypertensive retinopathy | 311 | ||
| Diabetic retinopathy | 312 | ||
| Diabetic maculopathy | 313 | ||
| Circinate retinopathy | 315 | ||
| Severe non-proliferative or preproliferative diabetic retinopathy | 315 | ||
| Proliferative diabetic retinopathy | 316 | ||
| Retinopathy of prematurity | 317 | ||
| Pathogenesis | 317 | ||
| Management | 318 | ||
| Acquired immune deficiency syndrome | 319 | ||
| Retinopathy in toxaemia of pregnancy | 319 | ||
| Sickle cell retinopathy | 319 | ||
| Lupus erythematosus retinopathy | 320 | ||
| Vascular disorders of the retina | 320 | ||
| Obstruction/occlusion of the retinal arteries | 320 | ||
| Obstruction of the arterial circulation | 320 | ||
| Central retinal artery occlusion (crao) | 320 | ||
| Branch retinal artery occlusion (brao) | 321 | ||
| Obstruction of the venous circulation | 321 | ||
| Venous stasis retinopathy | 321 | ||
| Central retinal vein occlusion (crvo) | 322 | ||
| Branch retinal vein occlusion (brvo) | 322 | ||
| Coats disease | 323 | ||
| Medical therapy in retinal vascular diseases | 324 | ||
| Inflammation of the retina (retinitis) | 324 | ||
| Purulent retinitis | 324 | ||
| Subacute infective retinitis (septic retinitis of roth) | 324 | ||
| Endophthalmitis | 324 | ||
| Acute retinal necrosis (arn) syndrome | 324 | ||
| Cytomegalovirus infection | 324 | ||
| Syphilis | 324 | ||
| Sarcoidosis | 325 | ||
| Toxoplasmosis | 325 | ||
| Toxocariasis | 325 | ||
| Periphlebitis retinae | 325 | ||
| Retinitis from bright light (photoretinitis) | 326 | ||
| Degenerations of the retina | 326 | ||
| Myopic chorioretinal degeneration | 326 | ||
| Age-related macular degeneration | 326 | ||
| Pathogenesis | 326 | ||
| Management | 327 | ||
| Macular holes | 327 | ||
| Pigmentary retinal dystrophy (retinitis pigmentosa) | 327 | ||
| Angioid streaks | 329 | ||
| Benign peripheral retinal degenerations | 329 | ||
| Degenerations associated with retinal breaks | 329 | ||
| Lattice retinal degeneration | 329 | ||
| White without pressure | 329 | ||
| Focal pigment proliferation or clumping | 329 | ||
| Diffuse chorioretinal degeneration | 329 | ||
| Cystoid retinal degeneration of the peripheral retina | 330 | ||
| Retinoschisis | 330 | ||
| Juvenile retinoschisis | 330 | ||
| Detachment of the retina | 330 | ||
| Pathophysiology | 331 | ||
| Predisposing factors | 331 | ||
| Clinical features | 331 | ||
| Diagnosis and management | 331 | ||
| Surgical management | 333 | ||
| Complications of surgery | 335 | ||
| Prognosis | 336 | ||
| Congenital abnormalities of the retina | 336 | ||
| Congenital pigmentation of the retina | 336 | ||
| Medullated nerve fibres | 336 | ||
| Coloboma of the retina and choroid | 336 | ||
| Albinism | 336 | ||
| Phakomatosis | 336 | ||
| Angiomatosis of the retina (von hippel–lindau disease) | 337 | ||
| Tuberous sclerosis (bourneville disease) | 337 | ||
| Neurofibromatosis (von recklinghausen disease) | 337 | ||
| Hereditary dystrophies of the central retina and choroid | 337 | ||
| Sex-linked juvenile retinoschisis | 337 | ||
| Stargardt disease | 337 | ||
| Dominant foveal dystrophy | 338 | ||
| Inverse retinitis pigmentosa | 338 | ||
| Progressive cone dystrophy | 338 | ||
| Vitelliform dystrophy of the fovea | 338 | ||
| Reticular dystrophy of the retinal pigment epithelium | 338 | ||
| Butterfly-shaped pigment dystrophy of the fovea | 338 | ||
| Fundus flavimaculatus | 338 | ||
| Grouped pigmentation of the foveal area | 338 | ||
| The hyaline dystrophies | 339 | ||
| Pseudo-inflammatory foveal dystrophy (sorsby) | 339 | ||
| Central areolar choroidal atrophy | 339 | ||
| Leber congenital amaurosis | 339 | ||
| Lysosomal storage disorders | 339 | ||
| Summary | 340 | ||
| Suggested reading | 340 | ||
| 21 Diseases of the vitreous | 341 | ||
| Changes in the vitreous with age | 341 | ||
| Vitreous detachment | 341 | ||
| Posterior vitreous detachment | 341 | ||
| Anterior and basal vitreous detachments | 342 | ||
| Opacities in the vitreous | 342 | ||
| Vitreous bands and membranes | 342 | ||
| Persistent hyperplastic vitreous | 343 | ||
| Vitreoretinal degeneration | 343 | ||
| Goldmann–favre vitreoretinal degeneration | 343 | ||
| Vitreous haemorrhage | 343 | ||
| Vitreous haemorrhage and retinal tears | 344 | ||
| Vitreous haemorrhage and posterior vitreous detachment | 344 | ||
| Vitreous haemorrhage and retinal vein occlusion | 344 | ||
| Vitreous haemorrhage in eales disease | 344 | ||
| Vitreous haemorrhage due to sickle cell retinopathy | 345 | ||
| Vitreous haemorrhage due to ocular trauma | 345 | ||
| Vitreous surgery | 345 | ||
| Summary | 347 | ||
| Suggested reading | 347 | ||
| 22 Diseases of the optic nerve | 348 | ||
| Overview | 348 | ||
| Anatomy | 348 | ||
| Normal physiology of axoplasmic transport and flow | 348 | ||
| Blood circulation of the optic nerve | 348 | ||
| Aetiopathogenesis of optic nerve diseases | 349 | ||
| Clinical features | 349 | ||
| Systematic approach to differential diagnosis | 349 | ||
| Diseases of the optic nerve | 350 | ||
| Papilloedema | 350 | ||
| Pathogenesis | 350 | ||
| Pathology | 351 | ||
| Aetiology | 351 | ||
| Clinical features | 351 | ||
| Symptoms | 351 | ||
| Signs | 352 | ||
| Differential diagnosis | 353 | ||
| Treatment | 354 | ||
| Disturbances of the circulation | 354 | ||
| Anterior ischaemic optic neuropathy | 354 | ||
| Aetiopathogenesis | 354 | ||
| Clinical features | 356 | ||
| Management | 357 | ||
| Posterior ischaemic optic neuropathy | 358 | ||
| V Disorders of Motility | 401 | ||
| 25 Anatomy and physiology of the motor mechanism | 403 | ||
| The motor apparatus of the eye | 403 | ||
| Position of eyes in orbit and in relation to each other | 403 | ||
| The extraocular muscles | 403 | ||
| Muscle attachments | 403 | ||
| The action of the extraocular muscles | 405 | ||
| Nervous control of ocular movements | 407 | ||
| Laws governing the neural control of ocular movements | 407 | ||
| Nerves and centres | 408 | ||
| Fixation, projection, correspondence and binocular vision | 411 | ||
| Fixation and projection | 411 | ||
| Correspondence | 411 | ||
| Fixation, fusion and reflex movements | 411 | ||
| Binocular vision | 412 | ||
| Convergence and accommodation | 413 | ||
| Summary | 414 | ||
| 26 Comitant strabismus | 415 | ||
| Comitant versus incomitant strabismus | 415 | ||
| Aetiology of comitant strabismus | 415 | ||
| Symptoms of comitant strabismus | 416 | ||
| The investigation of strabismus | 417 | ||
| Forced duction test | 418 | ||
| Force generation test | 419 | ||
| Assessment of binocular vision | 419 | ||
| Measurement of the angle of deviation | 420 | ||
| Hirschberg test | 420 | ||
| Prism bar test | 421 | ||
| Synoptophore | 421 | ||
| General principles of management of strabismus | 421 | ||
| Refraction, prescription of refractive correction, occlusion, surgery | 421 | ||
| Heterophoria or latent strabismus | 422 | ||
| Symptoms | 422 | ||
| Diagnosis | 423 | ||
| Treatment | 424 | ||
| Heterotropia or manifest strabismus | 425 | ||
| Convergent strabismus (esodeviation) | 425 | ||
| Aetiology | 425 | ||
| Classification | 425 | ||
| Treatment | 425 | ||
| Divergent strabismus (exodeviation) | 427 | ||
| Aetiology | 427 | ||
| Classification | 427 | ||
| ‘a’ and ‘v’ phenomena | 427 | ||
| ‘a’ esotropia | 428 | ||
| ‘a’ exotropia | 429 | ||
| ‘v’ esotropia | 429 | ||
| ‘v’ exotropia | 429 | ||
| Microtropia | 429 | ||
| Operations on the extrinsic muscles | 430 | ||
| Recession of a rectus muscle (fig. 26.10a) | 430 | ||
| Resection of a rectus muscle (fig. 26.10b) | 431 | ||
| Surgical methods to weaken the inferior oblique | 431 | ||
| The superior oblique tendon weakening procedure | 431 | ||
| Enhancing the action of the superior oblique | 431 | ||
| Marginal myotomy | 432 | ||
| Muscle transposition procedures | 432 | ||
| Faden operation | 432 | ||
| Conjunctival recession and hang-back sutures | 432 | ||
| Complications | 432 | ||
| Summary | 432 | ||
| Suggested reading | 432 | ||
| 27 Incomitant strabismus | 433 | ||
| Paralytic strabismus | 433 | ||
| Aetiology | 433 | ||
| Pathophysiology | 433 | ||
| Lesions of the nuclei | 433 | ||
| Lesions of the nerves | 433 | ||
| Lesions of the muscles | 434 | ||
| Signs and symptoms | 434 | ||
| Squint | 434 | ||
| Limitation of movement | 434 | ||
| Diplopia | 435 | ||
| False orientation | 436 | ||
| Position of the head | 436 | ||
| Vertigo | 436 | ||
| Changes in long-standing paralysis | 437 | ||
| Clinical work up and investigation of a case of ocular paralysis | 437 | ||
| History taking and preliminary clinical examination | 437 | ||
| Tests to help identify the affected muscle | 439 | ||
| Varieties of ocular paralysis | 440 | ||
| Paralysis of the lateral rectus (6th cranial nerve) (fig. 27.11) | 440 | ||
| Paralysis of the superior oblique (4th cranial nerve) (fig. 27.13) | 441 | ||
| Paralysis of the third nerve (fig. 27.15) | 442 | ||
| Congenital incomitant strabismus | 443 | ||
| Musculofascial anomalies | 443 | ||
| Treatment | 444 | ||
| Kinetic strabismus | 445 | ||
| Restrictive strabismus | 445 | ||
| Synkinesis | 446 | ||
| Summary | 446 | ||
| VI Diseases of the Adnexa | 447 | ||
| 28 Diseases of the lids | 449 | ||
| Anatomy | 449 | ||
| Oedema of the lids | 450 | ||
| Inflammatory oedema | 450 | ||
| Passive oedema | 450 | ||
| Inflammation of the lids | 450 | ||
| Blepharitis | 451 | ||
| Anterior blepharitis | 451 | ||
| Seborrhoeic or squamous blepharitis | 451 | ||
| Staphylococcal or ulcerative blepharitis | 451 | ||
| Posterior blepharitis | 452 | ||
| Molluscum contagiosum | 452 | ||
| Pre-septal cellulitis | 452 | ||
| Allergic dermatitis | 452 | ||
| Inflammation of the glands of the lids | 452 | ||
| Hordeolum externum or stye | 452 | ||
| Hordeolum internum | 453 | ||
| Chalazion | 453 | ||
| Clinical features | 453 | ||
| Treatment | 453 | ||
| Anomalies in the position of the lashes and lids | 454 | ||
| Blepharospasm | 454 | ||
| Trichiasis | 454 | ||
| Entropion | 455 | ||
| Involutional entropion | 455 | ||
| Cicatricial entropion | 456 | ||
| Spastic entropion | 457 | ||
| Congenital entropion | 458 | ||
| Ectropion | 458 | ||
| Senile ectropion | 458 | ||
| Paralytic ectropion | 459 | ||
| Cicatricial ectropion | 459 | ||
| Symblepharon | 459 | ||
| Ankyloblepharon | 459 | ||
| Blepharophimosis | 460 | ||
| Lagophthalmos | 460 | ||
| Ptosis | 460 | ||
| Congenital ptosis | 461 | ||
| Management | 462 | ||
| Acquired ptosis | 464 | ||
| Tumours of the lids and allied conditions | 465 | ||
| Benign growths | 465 | ||
| Xanthelasma or xanthoma | 465 | ||
| Naevus or mole | 465 | ||
| Haemangioma | 466 | ||
| Neurofibromatosis | 466 | ||
| Malignant tumours | 467 | ||
| Squamous cell carcinomata | 467 | ||
| Sebaceous cell carcinomata | 467 | ||
| Kaposi sarcoma | 467 | ||
| Treatment | 468 | ||
| Injuries of the lids | 468 | ||
| Contusions | 468 | ||
| Wounds | 468 | ||
| Burns | 469 | ||
| Congenital abnormalities of the lids | 469 | ||
| Distichiasis | 469 | ||
| Coloboma of the lid | 469 | ||
| Cryptophthalmos | 470 | ||
| Microblepharon | 470 | ||
| Epicanthus | 470 | ||
| Age-related changes of the lids | 470 | ||
| Summary | 471 | ||
| 29 Diseases of the lacrimal apparatus | 472 | ||
| Anatomy and physiology | 472 | ||
| Lacrimal glands | 472 | ||
| Lacrimal passages | 472 | ||
| Lacrimal secretion | 473 | ||
| Nerve supply | 473 | ||
| Diseases of the lacrimal gland | 473 | ||
| Dacryoadenitis | 473 | ||
| Mikulicz syndrome | 474 | ||
| Dacryops | 474 | ||
| Tumours of the lacrimal gland | 474 | ||
| Dry eye disease | 474 | ||
| Tests for dry eye | 475 | ||
| Treatment | 475 | ||
| Diseases of the lacrimal passages | 475 | ||
| Dacryocystitis | 475 | ||
| Chronic dacryocystitis | 476 | ||
| Investigation | 476 | ||
| Treatment | 476 | ||
| Acute dacryocystitis | 477 | ||
| Epiphora | 477 | ||
| Investigations | 477 | ||
| Eversion of the lower punctum | 479 | ||
| Treatment | 479 | ||
| Occlusion of the puncta | 479 | ||
| Occlusion of the canaliculus | 479 | ||
| Congenital anomalies of the puncta and canaliculi | 480 | ||
| Lacrimal obstruction | 480 | ||
| Treatment | 480 | ||
| Summary | 482 | ||
| 30 Diseases of the orbit | 483 | ||
| Anatomy | 483 | ||
| Common signs and symptoms of orbital diseases | 483 | ||
| Proptosis/exophthalmos | 484 | ||
| Enophthalmos | 486 | ||
| Investigation of orbital lesions | 486 | ||
| Plain x-rays | 486 | ||
| Ultrasonography | 486 | ||
| Computerized tomography in orbital lesions | 486 | ||
| Magnetic resonance imaging | 486 | ||
| Orbital inflammation | 486 | ||
| Periostitis | 488 | ||
| Orbital cellulitis | 488 | ||
| Thrombosis of the cavernous sinus | 489 | ||
| Sources of infection | 489 | ||
| Symptoms and signs | 489 | ||
| Management | 490 | ||
| Idiopathic orbital inflammatory disease | 490 | ||
| Tolosa–hunt syndrome | 490 | ||
| Parasitic infestations of the orbit | 490 | ||
| Trichinosis | 490 | ||
| Cysticercosis | 491 | ||
| Hydatid disease | 491 | ||
| Paranasal sinusitis | 491 | ||
| Wegener granulomatosis | 492 | ||
| Tumours of the orbit | 492 | ||
| Benign growths | 492 | ||
| Orbital haemangiomas | 493 | ||
| Orbital varices | 493 | ||
| Haemopoietic tumours | 493 | ||
| Tumours originating from the optic nerve and its sheaths | 494 | ||
| Osteomata | 495 | ||
| Malignant tumours | 495 | ||
| Rhabdomyosarcomata | 495 | ||
| Secondary orbital tumours | 496 | ||
| Malignant nasopharyngeal tumours | 496 | ||
| Lipodystrophies | 496 | ||
| Therapy of orbital tumours | 496 | ||
| Endocrine exophthalmos | 497 | ||
| Injuries of the orbit | 498 | ||
| Pulsatile proptosis | 498 | ||
| Intermittent proptosis | 499 | ||
| Penetrating injuries | 499 | ||
| Non-penetrating injury | 499 | ||
| Summary | 501 | ||
| Suggested reading | 501 | ||
| VII Systemic Ophthalmology | 503 | ||
| 31 Diseases of the nervous system with ocular manifestations | 505 | ||
| Brief overview | 505 | ||
| The visual pathway and neurological disorders | 506 | ||
| Hemianopia | 506 | ||
| Cortical and subcortical lesions | 507 | ||
| Lesions of the optic tract | 508 | ||
| Lesions of the optic chiasma | 508 | ||
| The ocular motor system and neurological disorders | 509 | ||
| Extraocular muscle paresis | 509 | ||
| Nystagmus | 510 | ||
| Aetiopathogenesis and classification | 510 | ||
| Types and clinical features | 511 | ||
| Differential diagnosis | 513 | ||
| Evaluation and treatment | 513 | ||
| Vascular disorders | 514 | ||
| Intracranial aneurysms | 514 | ||
| Pathophysiology | 514 | ||
| Mechanical pressure | 514 | ||
| Production of an arteriovenous fistula | 514 | ||
| Production of subarachnoid haemorrhage | 514 | ||
| Vascular malformations of the nervous system | 514 | ||
| Arteriovenous fistulae | 515 | ||
| Vasculopathies and cerebral occlusive disease | 516 | ||
| Aetiopathogenesis and pathophysiology | 516 | ||
| Clinical syndromes | 516 | ||
| Amaurosis fugax | 516 | ||
| Carotid occlusive disease or ocular ischaemic syndrome | 517 | ||
| Vertebrobasilar insufficiency | 518 | ||
| Cerebral haemorrhage and thrombosis | 518 | ||
| Cortical blindness | 519 | ||
| Infections | 522 | ||
| Meningitis | 522 | ||
| Encephalitis | 523 | ||
| Other infections | 523 | ||
| Syphilitic infections | 523 | ||
| Congenital syphilis | 524 | ||
| Acquired syphilis | 524 | ||
| Neurosyphilis | 524 | ||
| Cerebral syphilis | 524 | ||
| Tabes dorsalis | 524 | ||
| General paralysis of the insane (progressive paralysis, paralytic dementia) | 525 | ||
| Primary optic atrophy | 525 | ||
| Paralyses of the extrinsic ocular muscles | 525 | ||
| Demyelinating diseases | 525 | ||
| Multiple sclerosis | 525 | ||
| Aetiopathogenesis, pathophysiology and clinical overview | 525 | ||
| Ophthalmic manifestations | 526 | ||
| Treatment | 527 | ||
| Neuromyelitis optica (devic disease) | 527 | ||
| Acute multiple sclerosis (marburg variant) | 527 | ||
| Acute disseminated encephalomyelitis | 527 | ||
| Infectious prion diseases | 528 | ||
| Intracranial tumours | 528 | ||
| Clinical features | 528 | ||
| Symptoms | 528 | ||
| Signs | 529 | ||
| Papilloedema | 529 | ||
| Paralyses of the ocular muscles | 529 | ||
| Focal signs | 529 | ||
| Hydrocephalus | 531 | ||
| Head injury | 531 | ||
| Closed head injuries | 531 | ||
| Fractures of the base of the skull | 532 | ||
| Injuries to the optic nerve and optic chiasma | 532 | ||
| Hereditary and degenerative diseases | 532 | ||
| Neurocutaneous syndromes (phakomatoses) | 532 | ||
| Chronic progressive external ophthalmoplegia | 532 | ||
| Hereditary ataxia (friedreich disease) | 533 | ||
| Status dysraphicus | 533 | ||
| Lysosomal storage disorders | 533 | ||
| Wilson disease | 533 | ||
| Alzheimer disease | 533 | ||
| Parkinson disease | 533 | ||
| Progressive supranuclear palsy | 534 | ||
| Ophthalmoplegia caused by deficiencies and toxins | 534 | ||
| Congenital and developmental conditions | 534 | ||
| Encephalocele | 534 | ||
| Craniosynostoses | 534 | ||
| Congenital oculomotor apraxia | 535 | ||
| Congenital spastic diplegia (little disease) | 535 | ||
| Disorders of higher visual functions | 535 | ||
| Visual agnosia | 535 | ||
| Alexia | 535 | ||
| Aphasia | 535 | ||
| Agraphia | 535 | ||
| Visual illusions | 535 | ||
| Hysterical blindness | 535 | ||
| Summary | 535 | ||
| 32 Ocular manifestations of systemic disorders | 536 | ||
| The eye in systemic disease | 536 | ||
| Immunopathological processes and the eye | 536 | ||
| Type I hypersensitivity (acute anaphylactic type) | 536 | ||
| Type II hypersensitivity (complement-dependent type) | 536 | ||
| Type III hypersensitivity (immune-complex type) | 536 | ||
| Type IV hypersensitivity (cell-mediated) | 537 | ||
| Type V hypersensitivity (stimulating) | 537 | ||
| Autoimmune disorders | 537 | ||
| Haematological diseases | 537 | ||
| Infectious diseases | 539 | ||
| Acquired immune deficiency syndrome | 539 | ||
| Endocrine disorders | 539 | ||
| Muscular disorders | 539 | ||
| Inherited disorders | 539 | ||
| Summary | 543 | ||
| VIII Preventive Ophthalmology | 545 | ||
| 33 Genetics in ophthalmology | 547 | ||
| Fundamentals of human molecular genetics | 547 | ||
| DNA, RNA and the basic building blocks | 547 | ||
| DNA, chromosomes and genes | 547 | ||
| Gene expression and protein synthesis | 547 | ||
| Cell division, replication and the cell cycle | 548 | ||
| Genetic disorders, mutations and dna-based diagnosis | 548 | ||
| Transmission of genetic disorders | 551 | ||
| Monogenic or mendelian inheritance | 553 | ||
| Autosomal dominant traits | 554 | ||
| Autosomal recessive traits | 556 | ||
| X-linked recessive trait | 556 | ||
| X-linked dominant trait | 557 | ||
| Multifactorial or polygenic inheritance | 557 | ||
| Chromosomal inheritance | 557 | ||
| Cytoplasmic or mitochondrial inheritance | 557 | ||
| Treatment and prevention of genetic diseases | 557 | ||
| Concept of gene therapy | 558 | ||
| Genetic screening | 559 | ||
| Genetic counselling | 559 | ||
| Prenatal diagnosis | 560 | ||
| Summary | 561 | ||
| 34 The causes and prevention of blindness | 562 | ||
| What is blindness? | 562 | ||
| Causes of blindness | 563 | ||
| Aetiology of blindness: A global perspective | 563 | ||
| What can we do to control blindness? | 564 | ||
| Healthcare delivery systems | 565 | ||
| Primary eye care services | 565 | ||
| The development of eye health services, national programmes for the prevention of blindness and international cooperation | 565 | ||
| Primary eye care | 566 | ||
| Secondary eye care | 566 | ||
| Tertiary eye care | 566 | ||
| Mobile eye services | 566 | ||
| Vision 2020 | 566 | ||
| Specific blinding disorders and the approach to prevention of blindness | 568 | ||
| Cataract | 568 | ||
| Global view | 568 | ||
| IX Surgical Instrumentsin Ophthalmology | 577 | ||
| 35 Surgical instruments in ophthalmology | 579 | ||
| Introduction | 579 | ||
| General microsurgical instruments used for ophthalmic surgery | 579 | ||
| Lid speculums (figs. 35.1–35.3) | 579 | ||
| Forceps (figs. 35.4–35.13) | 580 | ||
| Needle holders (figs. 35.14–35.16) | 580 | ||
| Needles and sutures (fig. 35.17) | 581 | ||
| Cautery (figs. 35.18 and 35.19) | 582 | ||
| Cutting instruments: Blades and scissors | 582 | ||
| Blades (figs. 35.20–35.27) | 582 | ||
| Scissors (figs. 35.28–35.30) | 583 | ||
| Miscellaneous | 584 | ||
| Instruments used for specific types of surgery | 584 | ||
| Instruments for cataract surgery | 584 | ||
| Instruments used for intracapsular cataract extraction (figs. 35.34–35.38) | 584 | ||
| Instruments used for extracapsular cataract extraction (figs. 35.39 and 35.40) | 585 | ||
| Instruments used to make incision for cataract surgery | 585 | ||
| Instruments used for capsulotomy (figs. 35.43–35.46) | 587 | ||
| Instruments used for nucleus delivery or nucleotomy | 587 | ||
| Nucleus delivery | 587 | ||
| Instruments used for aspiration of lens cortex (figs. 35.48–35.50) | 587 | ||
| Irrigation–aspiration cannulas | 587 | ||
| Instruments used for intraocular lens insertion (figs. 35.51–35.59) | 587 | ||
| Instruments for wound closure (figs. 35.60–35.62) | 587 | ||
| Equipment used for phacoemulsification (figs. 35.63–35.67) | 590 | ||
| Probes (fig. 35.68) | 592 | ||
| Instruments used for keratoplasty and corneal surgery (figs. 35.73–35.88) | 596 | ||
| Corneal trephines (figs. 35.78–35.79) | 596 | ||
| Howard punch (fig. 35.80) | 596 | ||
| Glaucoma surgery (fig. 35.89) | 596 | ||
| Vitreoretinal surgery (figs. 35.90 and 35.91) | 596 | ||
| Lids and lacrimal sac surgery (figs. 35.92–35.100) | 596 | ||
| Squint surgery (figs. 35.101–35.105) | 596 | ||
| Instruments for enucleation (figs. 35.106–35.108) | 601 | ||
| Instruments for evisceration (fig. 35.109) | 601 | ||
| Sterilization and maintenance | 602 | ||
| Appendices | 603 | ||
| Appendix I Local anaesthesia in ophthalmology | 605 | ||
| Local anaesthesia in ophthalmology | 606 | ||
| Topical anaesthesia | 606 | ||
| Regional anaesthesia | 606 | ||
| Nerve blocks | 606 | ||
| Appendix II Lasers in ophthalmology | 608 | ||
| Appendix III Iol designs and materials | 609 | ||
| Appendix IV Important points to remember | 612 | ||
| Chapter 1. embryology and anatomy | 612 | ||
| Chapter 2. physiology of the eye | 612 | ||
| Chapter 3. the physiology of vision | 612 | ||
| Chapter 4. the neurology of vision | 612 | ||
| Chapter 5. elementary optics | 613 | ||
| Chapter 6. elementary physiology in optics | 613 | ||
| Chapter 7. refraction | 613 | ||
| Chapter 8. refractive errors of the eye | 613 | ||
| Chapter 9. ocular symptomatology | 613 | ||
| Chapter 10. assessment of visual function | 613 | ||
| Chapter 11. examination of the anterior segment | 614 | ||
| Chapter 12. examination of the posterior segment and orbit | 614 | ||
| Chapter 13. ocular therapeutics | 614 | ||
| Chapter 14. diseases of the conjunctiva | 614 | ||
| Chapter 15. diseases of the cornea | 615 | ||
| Chapter 16. diseases of the sclera | 615 | ||
| Chapter 17. disease of the uveal tract | 615 | ||
| Chapter 18. the lens | 616 | ||
| Chapter 19. the glaucomas | 616 | ||
| Chapter 20. diseases of the retina | 616 | ||
| Chapter 21. diseases of the vitreous | 617 | ||
| Chapter 22. diseases of the optic nerve | 617 | ||
| Chapter 23. intraocular tumours | 618 | ||
| Chapter 24. injuries to the eye | 618 | ||
| Chapter 25. anatomy and physiology of the motor mechanism | 618 | ||
| Chapter 26. comitant strabismus | 618 | ||
| Chapter 27. incomitant strabismus | 618 | ||
| Chapter 28. diseases of the lids | 618 | ||
| Chapter 29. diseases of the lacrimal apparatus | 618 | ||
| Chapter 30. diseases of the orbit | 619 | ||
| Chapter 31. diseases of the nervous system with ocular manifestations | 619 | ||
| Chapter 32. ocular manifestations of systemic disorders | 619 | ||
| Chapter 33. genetics in ophthalmology | 619 | ||
| Chapter 34. the causes and prevention of blindness | 619 | ||
| Index | 621 | ||
| A | 621 | ||
| B | 621 | ||
| C | 621 | ||
| D | 623 | ||
| E | 623 | ||
| F | 623 | ||
| G | 623 | ||
| H | 624 | ||
| I | 624 | ||
| J | 624 | ||
| K | 624 | ||
| L | 624 | ||
| M | 625 | ||
| N | 625 | ||
| O | 625 | ||
| P | 626 | ||
| Q | 626 | ||
| R | 626 | ||
| S | 626 | ||
| T | 627 | ||
| U | 627 | ||
| V | 627 | ||
| W | 628 | ||
| X | 628 | ||
| Y | 628 | ||
| Z | 628 |