Additional Information
Book Details
Abstract
Freeman, is your go-to resource for practical, up-to-date guidance on ocular diseases, surgical procedures, medications, and equipment, as well as paramedical procedures and office management in the ophthalmology, optometry, opticianry or eye care settings. Thoroughly updated content and more than 1,000 full-color illustrations cover all the knowledge and skills you need for your day-to-day duties as well as success on certification and recertification exams. This comprehensive text provides essential learning and practical guidance for ophthalmic assistants, technicians, medical technologists, physician assistants, and all others involved in ocular care, helping each become a valuable asset to the eye care team.
- Full-color visual guidance for identification of ophthalmic disorders, explanations of difficult concepts, and depictions of the newest equipment used in ophthalmology and optometry.
- Quick-reference appendices provide hospital/practice forms for more efficient patient record keeping, conversion tables, and numerous language translations, plus information on ocular emergencies, pharmaceuticals, and more.
- Updated throughout with the latest information on basic science, new testing procedures, new equipment, the role of the assistant in the practice, and an expanded chapter on OCT imaging.
- A new bonus color image atlas tests your clinical recognition of disease and disorders of the eye.
- Four brand-new chapters cover the latest industry advances regarding dry eye, vision function and impairment, uveitis, and surgical correction of presbyopia.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Foreword: An all purpose resource | viii | ||
| Foreword: How paraoptometric assistants and optometry students can benefit from this textbook | ix | ||
| Foreword: challenges for opticianry | xi | ||
| Foreword: How this textbook can be a valuable tool for physician assistants | xiii | ||
| Preface | xiv | ||
| Acknowledgements | xv | ||
| List of Contributors | xvi | ||
| List of Reviewers | xix | ||
| Dedication | xx | ||
| Chapter 1: Anatomy of the eye | 1 | ||
| Surface anatomy | 1 | ||
| Tear film | 4 | ||
| Cornea | 4 | ||
| Sclera | 6 | ||
| Uvea | 6 | ||
| Iris | 6 | ||
| Ciliary body | 6 | ||
| Choroid | 6 | ||
| Angle structures | 7 | ||
| Lens | 7 | ||
| Vitreous | 7 | ||
| Retina | 8 | ||
| Optic nerve | 8 | ||
| Visual pathway | 10 | ||
| Ocular muscles | 10 | ||
| Summary | 10 | ||
| Chapter 2: Physiology of the eye | 13 | ||
| Alignment of the eyes | 13 | ||
| Looking straight ahead (fixation) | 14 | ||
| Locking images (fusion) | 14 | ||
| Eye movements | 15 | ||
| Control centers for eye movements | 16 | ||
| Looking toward a close object | 16 | ||
| Seeing in depth | 17 | ||
| Focusing at near (accommodation) | 18 | ||
| Transparent pathway for light | 19 | ||
| Retinal images | 22 | ||
| Intraocular pressure | 22 | ||
| Tears | 23 | ||
| Color vision | 23 | ||
| Chapter 3: Optics | 27 | ||
| Physical optics | 27 | ||
| What is light? | 27 | ||
| How does light travel? | 27 | ||
| Nature of the world visible to humans | 27 | ||
| Speed of light | 28 | ||
| How do we measure intensity of a light source? | 28 | ||
| Color | 29 | ||
| Rays of light and the spectrum | 29 | ||
| Bending of light | 30 | ||
| How light can alter its direction | 30 | ||
| Geometric optics | 31 | ||
| Terminology | 31 | ||
| Dispersion | 32 | ||
| Color | 32 | ||
| Mirrors and reflection | 32 | ||
| Lenses | 34 | ||
| How do lenses bend rays of light? | 35 | ||
| What is a prism? | 35 | ||
| How are prisms measured? | 35 | ||
| The use of prisms | 35 | ||
| Convex lenses | 36 | ||
| Concave lenses | 36 | ||
| Focal length | 37 | ||
| Spherical aberration | 38 | ||
| Chromatic aberration | 38 | ||
| Cylinders | 40 | ||
| Transposition | 40 | ||
| Practical aspects of optics | 40 | ||
| Fiberoptics | 40 | ||
| Gonioscopy | 41 | ||
| Telescopes | 41 | ||
| Astronomical telescope | 41 | ||
| Galilean telescope | 41 | ||
| Optical illusions | 42 | ||
| Chapter 4: Pharmacology | 46 | ||
| General principles | 46 | ||
| Locally applied medication | 46 | ||
| Tolerance | 46 | ||
| Tonicity | 46 | ||
| Sterility | 47 | ||
| Stability | 47 | ||
| Penetration | 47 | ||
| Alternative routes of medication | 48 | ||
| Subconjunctival injections | 48 | ||
| Continuous-release delivery | 48 | ||
| Retrobulbar injections | 48 | ||
| Intracameral injection | 48 | ||
| Systemic medication | 48 | ||
| Complications of locally administered drugs | 48 | ||
| Allergic reactions | 48 | ||
| Toxic reactions | 48 | ||
| Discoloration of the eye | 49 | ||
| Undesirable side effects | 49 | ||
| Idiosyncrasy | 49 | ||
| Loss of effect by inactivation | 49 | ||
| Spread of infection | 49 | ||
| Prescription writing | 49 | ||
| Autonomic drugs | 50 | ||
| Mydriatic and cycloplegic agents | 51 | ||
| Mydriatic agents | 51 | ||
| Cycloplegic agents | 51 | ||
| Miotics | 52 | ||
| Direct-acting miotics | 53 | ||
| Cholinesterase inhibitors | 53 | ||
| Side effects | 53 | ||
| Drugs that lower intraocular pressure | 53 | ||
| Anesthetics | 54 | ||
| Topical anesthetics | 54 | ||
| Chapter 5: Microbiology | 64 | ||
| Bacteria | 65 | ||
| Viruses | 66 | ||
| Fungi | 67 | ||
| Other microbes | 67 | ||
| Clinical indications for smears and cultures | 68 | ||
| Taking smears | 69 | ||
| Making a stain | 70 | ||
| Gram stain for bacterial identification | 70 | ||
| Diff-Quik stain for cytologic identification | 70 | ||
| Specimen collection for culture | 70 | ||
| Other aids to identify organisms | 71 | ||
| Summary | 71 | ||
| Chapter 6: Office efficiency and public relations | 74 | ||
| How to make patients happy | 74 | ||
| New patients and returning patients | 76 | ||
| The telephone | 77 | ||
| Memory joggers | 77 | ||
| Risk management | 77 | ||
| Returning telephone calls | 78 | ||
| Telephone manners | 78 | ||
| Scheduling appointments | 80 | ||
| Booking the arriving patient | 81 | ||
| The reception room | 81 | ||
| Running late | 82 | ||
| Scribes | 82 | ||
| Making future appointments | 82 | ||
| Financing | 82 | ||
| Recall cards | 82 | ||
| Automated voice machines | 83 | ||
| Filing | 83 | ||
| Electronic medical and health records | 83 | ||
| Prescription pads | 84 | ||
| Office equipment | 84 | ||
| Personal qualities for improved office efficiency | 84 | ||
| Avoiding interruptions | 84 | ||
| Improving the patient experience through service recovery | 85 | ||
| Secretarial duties | 86 | ||
| Handling the ophthalmologists schedule | 86 | ||
| Handling sales representatives | 86 | ||
| Handling mail | 87 | ||
| Medical ethics | 87 | ||
| In the physicians absence | 88 | ||
| Aids in public relations | 88 | ||
| Patient surveys | 90 | ||
| Publicity | 90 | ||
| Cost | 91 | ||
| Size of the audience | 91 | ||
| Credibility | 91 | ||
| Effect | 91 | ||
| Versatility | 91 | ||
| Longevity | 91 | ||
| Advertising | 91 | ||
| Summary | 91 | ||
| Chapter 7: History taking | 94 | ||
| Organization of a history | 94 | ||
| History procedure | 95 | ||
| General information | 95 | ||
| Chief complaint | 95 | ||
| History of present illness | 96 | ||
| Loss of vision | 96 | ||
| Blurred vision secondary to an error of refraction | 96 | ||
| Blurred vision for close work | 96 | ||
| Blurred vision for distance work | 96 | ||
| Blurred vision secondary to organic disease | 98 | ||
| Loss of central vision | 98 | ||
| Distorted vision | 98 | ||
| Night blindness | 98 | ||
| Transient gray-outs or blur-outs of vision lasting several seconds in one or both eyes | 98 | ||
| Inability to see to the right or to the left | 98 | ||
| Ascending veil | 99 | ||
| Headaches | 99 | ||
| Asthenopia | 99 | ||
| Red eye | 100 | ||
| Discharge | 100 | ||
| Pain | 100 | ||
| Blurred vision | 100 | ||
| Other causes | 100 | ||
| Double vision or diplopia | 100 | ||
| Floating spots and light flashes | 100 | ||
| Tearing | 101 | ||
| Past health, medications, and allergies | 102 | ||
| Family history | 102 | ||
| Common familial disorders | 102 | ||
| Tips in history taking | 102 | ||
| Scribes | 103 | ||
| Summary | 104 | ||
| Chapter 8: Preliminary examination | 107 | ||
| Vision assessment | 107 | ||
| Early treatment diabetic retinopathy study chart | 112 | ||
| Use of pinhole | 112 | ||
| Dynamic visual acuity | 112 | ||
| Contrast sensitivity | 112 | ||
| Glare testing | 114 | ||
| Macular photostress test | 114 | ||
| Potential acuity | 114 | ||
| Potential acuity meter | 114 | ||
| Interferometer | 115 | ||
| Retinometer | 115 | ||
| Near vision testing | 115 | ||
| Measurement of glasses | 116 | ||
| Universal method of using any lensmeter | 119 | ||
| Addition | 119 | ||
| Automatic lensmeters | 119 | ||
| Accommodation | 121 | ||
| Measurement of amplitude of accommodation | 121 | ||
| Proximity method | 121 | ||
| Triple line test | 121 | ||
| Effect of age | 121 | ||
| Convergence | 121 | ||
| Color vision | 122 | ||
| Ishihara test plates | 122 | ||
| Hardy-Rand-Rittler plates | 122 | ||
| Colormaster | 122 | ||
| Depth perception | 123 | ||
| Fly test | 123 | ||
| Wirt stereo test | 123 | ||
| Worth four-dot test | 123 | ||
| Biopter test | 124 | ||
| External examination | 124 | ||
| Symmetry of orbits | 125 | ||
| Eyelashes | 125 | ||
| Lid margins | 125 | ||
| Conjunctiva | 125 | ||
| Lacrimal apparatus | 126 | ||
| Sclera | 127 | ||
| Cornea | 127 | ||
| Use of fluorescein, rose bengal, and lissamine green stains | 127 | ||
| Iris | 128 | ||
| Anterior chamber | 128 | ||
| Penlight examination for estimating the depth of the anterior chamber | 128 | ||
| Pupil | 129 | ||
| Pupillary reflexes | 129 | ||
| Relative afferent pupillary defect test | 130 | ||
| Size | 131 | ||
| Shape | 131 | ||
| Equality of size | 131 | ||
| Differential diagnosis of a dilated pupil | 132 | ||
| Third nerve palsy | 132 | ||
| Trauma | 132 | ||
| Adies pupil | 132 | ||
| Acute glaucoma | 132 | ||
| Drug-induced dilation | 132 | ||
| Differential diagnosis of a constricted pupil | 132 | ||
| Horners syndrome | 132 | ||
| Iritis | 132 | ||
| Drug-induced constriction | 132 | ||
| Lens | 132 | ||
| Blinking | 132 | ||
| Examination of the ocular muscles | 132 | ||
| Instillation of eyedrops and ointment | 134 | ||
| When not to dilate before asking the eye doctor | 134 | ||
| Ophthalmoscopy | 135 | ||
| Visual fields | 137 | ||
| Summary | 137 | ||
| Chapter 9: Visual function and impairment | 140 | ||
| Introduction | 140 | ||
| Aspects of vision loss | 140 | ||
| Types of vision | 140 | ||
| Photopic, mesopic, and scotopic vision | 141 | ||
| Photopic vision | 141 | ||
| Mesopic vision | 141 | ||
| Scotopic vision | 141 | ||
| Absent color vision | 141 | ||
| Luminance versus illumination | 141 | ||
| Measurement and assessment of visual loss | 141 | ||
| Aspects of visual impairment | 142 | ||
| Visual functions | 142 | ||
| Measurement and assessment of functional aspects | 142 | ||
| Parameters of ocular function | 142 | ||
| Analysis | 142 | ||
| Ocular (visual screening) | 142 | ||
| Peripheral | 143 | ||
| Preventive medicine guidelines, CPT codebooks evaluation/management guidelines, requirements | 143 | ||
| Why perform visual screening | 143 | ||
| Aspects of vision loss and function | 143 | ||
| Functional vision | 143 | ||
| Binocular vision | 143 | ||
| Contrast sensitivity | 144 | ||
| Testing | 144 | ||
| Everyday visual experience | 145 | ||
| Stereo depth perception: far | 145 | ||
| Scoring with stereo test | 145 | ||
| Color perception | 145 | ||
| Phorias | 146 | ||
| Heterophoria | 146 | ||
| Lateral phoria | 147 | ||
| Vertical phoria | 147 | ||
| Interventions for rehabilitation | 147 | ||
| Chapter 10: Understanding ophthalmic equipment | 148 | ||
| Equipment used for refraction | 148 | ||
| Projector and projector slides | 148 | ||
| Trial case and lenses | 149 | ||
| Use of trial lenses | 149 | ||
| Refractor or phoropter | 150 | ||
| Body | 151 | ||
| Lenses | 151 | ||
| Aperture control handle | 151 | ||
| Auxiliary lenses | 151 | ||
| Accessory equipment | 151 | ||
| Aids in care of refractor/phoropter | 151 | ||
| Retinoscope | 152 | ||
| Spot retinoscope | 152 | ||
| Streak retinoscope (see Figure10.7) | 153 | ||
| Accessories used in refraction | 153 | ||
| Cross cylinder | 153 | ||
| Pinhole disc | 153 | ||
| Distometer | 153 | ||
| Halberg and Janelli clips | 154 | ||
| Equipment used to detect muscle imbalance | 155 | ||
| Maddox rod | 155 | ||
| Prisms | 156 | ||
| Instruments used to determine power of lenses | 157 | ||
| Lensmeter | 157 | ||
| Geneva lens measure | 157 | ||
| Instruments used to examine the interior of the eye | 158 | ||
| Direct ophthalmoscope | 158 | ||
| Special devices on the ophthalmoscope | 160 | ||
| Red-free light | 160 | ||
| Red light | 160 | ||
| Polarized light | 160 | ||
| Slit illumination | 160 | ||
| Aperture discs | 160 | ||
| Cobalt-blue filters | 160 | ||
| Indirect ophthalmoscope | 160 | ||
| Relative merits of direct and indirect ophthalmoscopes | 160 | ||
| Transilluminator | 161 | ||
| Instruments used to study the anterior segment of the eye | 161 | ||
| Slit-lamp microscope | 161 | ||
| Use of slit lamp | 161 | ||
| Design of slit lamp | 161 | ||
| Types of slit lamps | 162 | ||
| Technique of slit-lamp examination (Figure 10.29) | 162 | ||
| Slit-lamp attachments | 164 | ||
| Hruby lens (Figure 10.30) | 164 | ||
| Fundus contact lens | 164 | ||
| Pachymeter | 164 | ||
| Instruments used to examine the angle structures of the eye | 165 | ||
| Goniolens | 165 | ||
| Posner diagnostic and surgical gonioprism | 165 | ||
| Gonioscope | 165 | ||
| Instruments used to assess the cornea | 166 | ||
| Keratometer | 166 | ||
| Specular microscope | 166 | ||
| Instruments used to determine tear flow | 166 | ||
| Dacryocystography/lacrimal scan | 166 | ||
| Instruments used to measure intraocular pressure (tonometer) | 167 | ||
| Special instruments | 167 | ||
| Exophthalmometer | 167 | ||
| Luedde exophthalmometer | 167 | ||
| Hertel exophthalmometer | 167 | ||
| Placidos disc | 167 | ||
| Optokinetic drum | 168 | ||
| Ophthalmodynamometer | 168 | ||
| Doppler test | 169 | ||
| Automatic refractors | 169 | ||
| Computerized corneal topographic analysis | 169 | ||
| Visual field equipment, tangent screens, and perimeters | 170 | ||
| Diagnostic ultrasound: A-scan and B-scan | 170 | ||
| Radioactive phosphorus | 171 | ||
| Electroretinography and electrooculography | 171 | ||
| Lasers | 171 | ||
| Summary | 172 | ||
| Chapter 11: Refractive errors and how to correct them | 175 | ||
| Emmetropia | 175 | ||
| Ametropia | 175 | ||
| Hyperopia | 175 | ||
| Cause | 176 | ||
| Types | 176 | ||
| Role of cycloplegia | 177 | ||
| Symptoms | 177 | ||
| Treatment | 177 | ||
| Myopia | 177 | ||
| Types | 177 | ||
| Cause | 178 | ||
| Progress | 179 | ||
| Symptoms | 179 | ||
| Progressive myopia | 179 | ||
| Treatment | 179 | ||
| Astigmatism | 180 | ||
| Types | 180 | ||
| Regular astigmatism | 180 | ||
| Irregular astigmatism | 180 | ||
| Cause | 181 | ||
| Problems of astigmatic individuals | 181 | ||
| Refractometry and refraction | 181 | ||
| Methods of refractometry | 181 | ||
| Steps for refractometry | 182 | ||
| Cycloplegic drops | 182 | ||
| Lensmeter | 182 | ||
| Retinoscopy | 183 | ||
| Streak retinoscope | 183 | ||
| Autorefractors | 184 | ||
| Historical development | 185 | ||
| Objective refractors | 185 | ||
| Manual objective refractors | 185 | ||
| Automatic objective refractors | 186 | ||
| Combination objective/subjective refractors (Figures 11.15 and 11.16) | 186 | ||
| Automated subjective refractors | 186 | ||
| Remote-controlled refractors | 187 | ||
| Accuracy of measurement | 187 | ||
| Errors with automated refractors | 187 | ||
| Where are we going with automated refraction? | 187 | ||
| Subjective refining of refraction | 188 | ||
| Astigmatism tests | 188 | ||
| Astigmatic clock | 188 | ||
| Cross cylinder | 188 | ||
| Irregular astigmatism | 189 | ||
| Spherical equivalent | 189 | ||
| Duochrome tests | 189 | ||
| Anisometropia | 190 | ||
| Aniseikonia | 190 | ||
| Treatment | 190 | ||
| Aphakia | 190 | ||
| When to refract after cataract surgery | 191 | ||
| Refractive points specific to the aphakic and pseudophakic person | 191 | ||
| Procedure after cataract surgery | 191 | ||
| Cataract lens | 192 | ||
| Presbyopia | 192 | ||
| Symptoms | 192 | ||
| Treatment | 192 | ||
| Tests for the correct power | 193 | ||
| Prescription | 193 | ||
| Dos and donts | 193 | ||
| Myths to be dispelled | 194 | ||
| Complaints: how to anticipate them | 194 | ||
| Glasses checks and how to handle them: 12 key points | 195 | ||
| Summary | 196 | ||
| Chapter 12: History of spectacles | 199 | ||
| Antiquity | 199 | ||
| The beginning | 200 | ||
| Early eyeglasses | 200 | ||
| Rivet spectacles | 200 | ||
| Manufacture | 201 | ||
| The frame | 202 | ||
| Scissor spectacles and fork glasses | 202 | ||
| Single lenses and monocles | 203 | ||
| Spring spectacle frames | 203 | ||
| Temple pieces and curved earpieces | 204 | ||
| Lorgnettes | 204 | ||
| Goggles and sunglasses | 205 | ||
| Glasses in the Far East | 205 | ||
| Summary | 206 | ||
| Further Reading | 206 | ||
| Chapter 13: Facts about glasses | 207 | ||
| History | 207 | ||
| Frames | 207 | ||
| A frame for every face | 207 | ||
| Metal frames | 209 | ||
| Plastic and composite frames | 210 | ||
| Advantages | 212 | ||
| Bridges | 212 | ||
| Combination frames | 212 | ||
| Semirimless frames | 212 | ||
| Frame measurements | 213 | ||
| Temples | 213 | ||
| Specialty frames | 213 | ||
| Frames for individuals with low, flat bridges | 214 | ||
| Side shields | 214 | ||
| Ptosis crutch | 214 | ||
| Dispensing spectacle frames | 214 | ||
| Measuring pupillary distance with a ruler and the reflex method | 216 | ||
| Lenses | 217 | ||
| Aphakic lenses | 218 | ||
| Lenticular lenses | 218 | ||
| Aspheric lenses | 218 | ||
| Plastic lenses | 218 | ||
| Plastic hard-resin lenses (CR-39) | 219 | ||
| Polycarbonate lenses | 219 | ||
| Trivex lenses | 219 | ||
| Safety lenses | 219 | ||
| Heat-treated impact-resistant glass lenses | 220 | ||
| Role of protective lenses in sports | 221 | ||
| Role of protective lenses in shooting, hockey, and racquet sports | 221 | ||
| Antireflection (no-glare) coating | 222 | ||
| Sunglasses and tinted lenses | 222 | ||
| Densities | 223 | ||
| Photochromic (indoor-outdoor) glasses | 224 | ||
| Ultraviolet and blue-blocking lenses | 224 | ||
| Mirrored sunglasses | 225 | ||
| Multifocal lenses | 225 | ||
| Special flat-top bifocals and trifocals | 227 | ||
| Invisible bifocals (progressive-add lenses [PALs]) | 227 | ||
| Multivision lenses from a patients point of view (vocational lenses) | 228 | ||
| Computer glasses | 228 | ||
| Most popular types of multifocal lenses | 229 | ||
| Flat-top segment | 229 | ||
| Round-top fused segments (Kryptok, Achromat) | 229 | ||
| Progressive lenses | 230 | ||
| Centering of lenses | 231 | ||
| Pantoscopic angle | 231 | ||
| Use of prisms in glasses | 232 | ||
| Fresnel lenses and prisms | 232 | ||
| Press-on adds | 232 | ||
| Production of prescription lenses | 232 | ||
| Care of glasses | 233 | ||
| Chapter 14: Rigid contact lenses: basics | 236 | ||
| Development | 236 | ||
| Optics | 237 | ||
| How the corneal contact lens works | 237 | ||
| Terminology | 238 | ||
| Designs | 242 | ||
| Patient examination | 243 | ||
| Fitting corneal contact lenses | 244 | ||
| Measurements | 244 | ||
| Trial lenses | 247 | ||
| Materials and manufacture | 247 | ||
| Fitting gas-permeable lenses | 248 | ||
| Systems for fitting | 248 | ||
| Inventory fitting | 248 | ||
| Nomogram fitting | 249 | ||
| Special problem solving with gas-permeable silicone acrylate and fluorosilicone acrylate lenses | 249 | ||
| Three oclock and nine oclock position staining | 251 | ||
| Lid gap | 251 | ||
| Poor blinking | 251 | ||
| Poor tear film | 251 | ||
| Comment | 252 | ||
| Lens-flexure problems | 252 | ||
| Evaluating contact lenses | 252 | ||
| Measuring diameter | 252 | ||
| Contacto Gauge and Radiuscope | 252 | ||
| Shadowgraph and Contactoscope | 253 | ||
| Measuring power | 254 | ||
| Measuring thickness | 254 | ||
| Insertion and removal techniques | 254 | ||
| Insertion | 254 | ||
| Removal | 255 | ||
| Centering | 255 | ||
| Dos and donts with contact lenses | 255 | ||
| Care | 260 | ||
| Care of gas-permeable lenses | 260 | ||
| Wetting solutions | 260 | ||
| Soaking solutions | 260 | ||
| Cleaning solutions | 260 | ||
| Eyedrops with contacts | 261 | ||
| Evaluating the fit | 261 | ||
| Subjective criteria | 261 | ||
| Adaptation symptoms | 261 | ||
| Abnormal symptoms | 261 | ||
| Objective criteria | 262 | ||
| Fluorescein patterns (Figures 14.30 and 14.31) | 262 | ||
| Alteration of the blink rate | 262 | ||
| Scratches, chips, and roughened edges of the contact lens | 262 | ||
| Changes in the cornea | 265 | ||
| Adjustments | 266 | ||
| Problems associated with overwearing contact lenses | 266 | ||
| Uses | 267 | ||
| Summary | 268 | ||
| Chapter 15: Soft contact lenses | 271 | ||
| History of hydrophilic lenses | 271 | ||
| Advantages | 273 | ||
| Comfort | 273 | ||
| Rapid adaptation | 274 | ||
| Lack of spectacle blur | 274 | ||
| Disposability | 274 | ||
| Minimal lens loss | 274 | ||
| Minimal overwear reaction | 275 | ||
| Lack of glare and photophobia | 275 | ||
| Difficulty in dislodging | 275 | ||
| Protection of entire cornea | 275 | ||
| Attractive alternative for rigid lens drop-outs | 275 | ||
| No serious corneal abrasion on insertion | 275 | ||
| Cosmetic lenses | 275 | ||
| Disadvantages | 275 | ||
| Lack of ability to correct severe astigmatism | 276 | ||
| Variable vision | 276 | ||
| Lack of durability | 276 | ||
| Faulty duplication | 276 | ||
| Deposit formation | 276 | ||
| Modifications impossible | 277 | ||
| Disinfection problems | 277 | ||
| Patient evaluation | 277 | ||
| Patient selection | 277 | ||
| Manufacture | 278 | ||
| Spin-cast lenses | 278 | ||
| Lathe-cut lenses | 278 | ||
| Molded lenses | 278 | ||
| Inventory versus diagnostic lenses | 279 | ||
| Lens inspection | 280 | ||
| Edge and surface inspection | 280 | ||
| Diameter | 280 | ||
| Base curve | 280 | ||
| Power | 281 | ||
| Tight lens | 281 | ||
| Loose lens | 283 | ||
| Disinfection | 283 | ||
| Cleaning | 284 | ||
| Insertion and removal techniques | 285 | ||
| Insertion by the fitter | 285 | ||
| Removal by the fitter | 286 | ||
| Insertion by the patient | 286 | ||
| Removal by the patient | 286 | ||
| Taco test | 287 | ||
| Precautions for wear | 287 | ||
| Wearing schedules | 287 | ||
| Thin and ultrathin lenses | 288 | ||
| Correction of astigmatism | 288 | ||
| Toric lens design | 288 | ||
| Prism ballast | 288 | ||
| Truncation | 289 | ||
| Truncation and prism ballast | 289 | ||
| Double slab-off | 289 | ||
| Medical uses | 289 | ||
| Blisters of cornea (bullous keratopathy) | 289 | ||
| Corneal ulcers | 290 | ||
| Recurrent corneal erosion | 290 | ||
| Dry eyes | 290 | ||
| Conclusion | 292 | ||
| Extended-wear lenses | 292 | ||
| Myopic versus aphakic extended wear | 292 | ||
| Problems with conventional extended-wear lenses | 292 | ||
| New silicone hydrogel lenses (continuous wear) | 293 | ||
| Conclusion | 294 | ||
| Disposable lenses | 294 | ||
| Innovations in design | 295 | ||
| Contact lenses in industry | 296 | ||
| Special occupations | 296 | ||
| Downtime | 297 | ||
| Discontinuance of wear | 297 | ||
| Loss or removal of the lenses | 297 | ||
| Problems with contact lenses | 297 | ||
| Common questions and answers | 297 | ||
| Role of the ophthalmic assistant | 298 | ||
| Chapter 16: Advanced techniques in soft and rigid contact lens fitting | 301 | ||
| Abnormal symptoms and signs | 301 | ||
| Follow-up keratometry | 303 | ||
| Special lenses | 303 | ||
| Contact lenses for high myopia | 304 | ||
| Aphakic lenses | 304 | ||
| Contact lenses for astigmatism | 304 | ||
| Nonrotating lenses | 304 | ||
| Noncircular shapes | 305 | ||
| Toric curve lens | 305 | ||
| Prism ballast lenses | 305 | ||
| Correction of high astigmatism | 305 | ||
| Toric soft contact lenses | 305 | ||
| Contact lenses for keratoconus | 306 | ||
| Scleral lenses | 307 | ||
| Corneal lenses | 309 | ||
| Trial lens fitting | 310 | ||
| Role of corneal topography | 310 | ||
| Piggyback and hybrid lenses | 310 | ||
| Thick-set lenses | 311 | ||
| Bifocal contact lenses | 311 | ||
| Magnification with contact lenses | 313 | ||
| Orthokeratology | 315 | ||
| Corneal refractive therapy | 315 | ||
| Bandage lenses | 315 | ||
| Manufacturing and modification | 316 | ||
| Modifications of finished lenses | 316 | ||
| Diameter reduction | 316 | ||
| Blending (Figure 16.23) | 316 | ||
| Edge shaping | 316 | ||
| Power change | 316 | ||
| Peripheral curve | 317 | ||
| Fenestration of rigid lenses | 317 | ||
| Removing scratches | 317 | ||
| Gas-permeable lenses | 317 | ||
| Extended-wear rigid lenses | 319 | ||
| Silicone-PMMA material | 319 | ||
| Cellulose acetate butyrate | 320 | ||
| Fluorosilicone-acrylate lenses | 320 | ||
| Pure fluorocarbon lenses | 320 | ||
| Hydrogel tinted contact lenses | 320 | ||
| Recommendations for selection of rigid or soft contact lenses | 321 | ||
| Chapter 17: Dry eyes | 323 | ||
| The tear film | 323 | ||
| The tear film lipid layer | 323 | ||
| The aqueous layer | 324 | ||
| The mucin layer | 324 | ||
| Function of the tears | 324 | ||
| Tear film assessment | 324 | ||
| Role of blinking | 325 | ||
| Tests for dry eyes | 326 | ||
| i-Pen osmolarity system | 327 | ||
| i-Pen osmolarity test sensor | 327 | ||
| How to perform the test | 327 | ||
| Instructions on taking samples | 329 | ||
| Test for meibomian gland dysfunction | 330 | ||
| Tear physiology | 330 | ||
| Grading of dry eyes | 330 | ||
| Symptoms | 330 | ||
| Physiology | 330 | ||
| Sjögrens syndrome | 332 | ||
| Management of the dry eye patient: treatment | 332 | ||
| Summary | 333 | ||
| Further reading | 333 | ||
| Chapter 18: Managing a contact lens practice | 334 | ||
| Patient management | 334 | ||
| How to make patients happy | 334 | ||
| Minimize patient wait time | 334 | ||
| Make patients feel important | 335 | ||
| Create space for comfort | 335 | ||
| Respect a patients right to privacy | 335 | ||
| Look the part | 335 | ||
| Pay attention to detail | 335 | ||
| Master communication skills | 335 | ||
| Be fair in all matters of finance | 336 | ||
| Patient information | 336 | ||
| Patient follow-up | 336 | ||
| A successful practice | 336 | ||
| Planning | 337 | ||
| Understanding your organization | 337 | ||
| Finances | 337 | ||
| Pricing policy in the contact lens practice | 337 | ||
| Cost control | 338 | ||
| Performance bonuses | 338 | ||
| Tracking finances | 338 | ||
| Marketing | 338 | ||
| Advertising | 339 | ||
| Staff development | 339 | ||
| The contact lens practice staff | 339 | ||
| Office equipment and space | 340 | ||
| Trial lens-fitting sets | 340 | ||
| Contact lens inventory and ordering | 340 | ||
| Ongoing care | 340 | ||
| Lid care | 340 | ||
| Chapter 19: Visual fields | 341 | ||
| Preliminary procedures | 341 | ||
| Facilities for field testing | 342 | ||
| Confrontation test | 342 | ||
| Perimeters | 343 | ||
| Measuring a field on the perimeter | 344 | ||
| Charts | 344 | ||
| Special perimetric techniques | 344 | ||
| Visual field screening | 344 | ||
| Automated visual fields | 345 | ||
| Amsler grid | 345 | ||
| Normal visual field | 346 | ||
| Pathologic defects in the visual field | 346 | ||
| Scotoma | 347 | ||
| Contraction of the visual field | 348 | ||
| Hysterical visual field | 349 | ||
| Summary | 352 | ||
| Chapter 20: Automated visual field testing | 355 | ||
| Differences between manual and automated perimeters | 355 | ||
| Understanding threshold | 358 | ||
| Threshold testing | 359 | ||
| Swedish Interactive Thresholding Algorithm | 360 | ||
| Frequency doubling Technology | 360 | ||
| Units of measure | 360 | ||
| Automated perimetry: basic rules of testing | 361 | ||
| Before the test | 361 | ||
| Preparing the patient | 361 | ||
| Using best-corrected vision | 361 | ||
| Determining the proper trial lens to use | 361 | ||
| Preparing the perimeter | 362 | ||
| During the test | 362 | ||
| Monitoring fixation | 362 | ||
| Choosing the best strategy | 362 | ||
| Monitoring the test | 363 | ||
| Fixation | 363 | ||
| False positives | 364 | ||
| False negatives | 364 | ||
| Analysis software and printouts | 364 | ||
| Single-field analysis | 364 | ||
| Visual field progression analysis | 364 | ||
| Summary | 365 | ||
| Chapter 21: Ocular injuries | 367 | ||
| Diagnosis of ocular injury | 367 | ||
| Conjunctival and corneal foreign bodies | 368 | ||
| Corneal abrasions | 370 | ||
| Aftercare of patients with superficial injuries | 371 | ||
| Intraocular foreign bodies | 371 | ||
| Contusion of the eyelids: black eye | 372 | ||
| Contusions of the globe | 373 | ||
| Early complications | 373 | ||
| Late complications | 373 | ||
| Penetrating eye injuries | 374 | ||
| Lacerations of the lids | 374 | ||
| Fractures of the orbit | 375 | ||
| Chemical injuries | 376 | ||
| Acids | 376 | ||
| Alkalis | 377 | ||
| First-aid care | 377 | ||
| Second-stage emergency care | 377 | ||
| Personal protection against chemical eye hazards | 378 | ||
| Injuries caused by sports | 378 | ||
| Injuries caused by radiant energy | 379 | ||
| Ultraviolet radiation | 379 | ||
| Infrared rays | 380 | ||
| X-rays | 380 | ||
| Prevention of traumatic injuries to the eye | 380 | ||
| Prevention in industry | 380 | ||
| Prevention at home | 380 | ||
| First-aid care by the ophthalmic assistant | 380 | ||
| Computed tomography scans (also see Chapter 40) | 381 | ||
| Magnetic resonance imaging | 381 | ||
| Chapter 22: The urgent case | 385 | ||
| Ocular emergencies | 385 | ||
| True emergencies (therapy should be instituted within minutes) | 385 | ||
| Urgent situations (patients should be seen the same day) | 385 | ||
| Semiurgent situations (patients should be seen within days) | 386 | ||
| Urgent case: to be seen within the hour | 386 | ||
| Sudden loss of vision in one eye without pain | 386 | ||
| Vein occlusion | 388 | ||
| Urgent case: to be seen the same day | 389 | ||
| Painful red eye | 389 | ||
| Swollen eyelid | 390 | ||
| Flashes of light | 390 | ||
| Double vision or lid droop | 391 | ||
| Temporal arteritis | 391 | ||
| Priority case: to be seen within days | 392 | ||
| Halos around lights | 392 | ||
| Headaches | 393 | ||
| Lost or broken spectacles | 394 | ||
| Gradual loss of sight in quiet eyes | 395 | ||
| Summary | 395 | ||
| Chapter 23: Common eye disorders | 398 | ||
| Conjunctiva | 398 | ||
| Hyperemia | 398 | ||
| Subconjunctival hemorrhage | 398 | ||
| Conjunctivitis | 399 | ||
| Episcleritis | 400 | ||
| Pinguecula/pterygium | 401 | ||
| Conjunctival nevus | 402 | ||
| Cornea | 402 | ||
| Keratoconus | 402 | ||
| Herpes simplex keratitis | 402 | ||
| Recurrent herpes simplex | 403 | ||
| Superficial punctate keratitis | 403 | ||
| Herpes zoster ophthalmicus | 403 | ||
| Marginal corneal ulcers | 404 | ||
| Recurrent corneal erosion | 404 | ||
| Eyelids | 405 | ||
| Epicanthus | 405 | ||
| Entropion | 405 | ||
| Ectropion | 406 | ||
| Ptosis | 406 | ||
| Exaggerated blink activity | 406 | ||
| Blepharochalasis and dermatochalasis | 407 | ||
| Trichiasis | 407 | ||
| Blepharitis | 407 | ||
| Essential blepharospasm | 408 | ||
| External hordeolum (stye) and internal hordeolum | 408 | ||
| Chalazion | 408 | ||
| Tumors of the lid | 408 | ||
| Milia | 408 | ||
| Xanthelasma | 408 | ||
| Carcinoma | 409 | ||
| Seborrheic keratosis (senile verruca) | 409 | ||
| Keratoacanthoma | 409 | ||
| Molluscum contagiosum | 409 | ||
| Lacrimal apparatus | 409 | ||
| Acute dacryoadenitis | 409 | ||
| Lacrimal gland enlargement | 409 | ||
| Tearing (Box 23.1) | 409 | ||
| Dacryocystitis | 410 | ||
| Chapter 24: Common retinal disorders | 413 | ||
| Retinal artery occlusion | 413 | ||
| Retinal vein occlusion | 414 | ||
| Diabetic retinopathy | 415 | ||
| Retinitis pigmentosa | 416 | ||
| Retinopathy of prematurity | 416 | ||
| Retinoschisis | 417 | ||
| Retinal breaks | 417 | ||
| Vitreous hemorrhage | 417 | ||
| Workup for vitreous hemorrhage | 417 | ||
| Management of vitreous hemorrhage | 417 | ||
| Retinal detachment | 417 | ||
| Central serous chorioretinopathy | 418 | ||
| Changes in the retina from concussion | 418 | ||
| Commotio retinae (Berlins ``edema´´) | 418 | ||
| Retinal hemorrhages | 419 | ||
| Retinal detachment | 419 | ||
| Foreign body in the eye | 419 | ||
| Solar maculopathy (eclipse burns of the retina) | 419 | ||
| Age-related macular degeneration | 419 | ||
| Classification | 420 | ||
| Atrophic AMD | 420 | ||
| Exudative AMD | 420 | ||
| Clinical presentation | 421 | ||
| The ocular examination | 421 | ||
| Natural history | 421 | ||
| Diagnostic evaluation | 421 | ||
| Amsler grid | 421 | ||
| Fluorescein angiography | 422 | ||
| Indocyanine green | 422 | ||
| Optical Coherence Tomography | 422 | ||
| Clinical Treatment | 422 | ||
| Atrophic AMD | 422 | ||
| Exudative AMD | 423 | ||
| Ocular manifestations of common systemic diseases | 423 | ||
| Hypertension | 423 | ||
| Sickle cell disease | 425 | ||
| Thyroid disorders | 425 | ||
| Infectious diseases of the retina and choroids | 426 | ||
| Toxoplasmosis | 426 | ||
| Histoplasmosis | 426 | ||
| Malignant melanoma | 427 | ||
| Retinal imaging modalities: fluorescein angiography | 428 | ||
| Further Reading | 433 | ||
| Chapter 25: Glaucoma | 436 | ||
| Classification | 436 | ||
| Primary open-angle or chronic glaucoma | 437 | ||
| Ocular hypertension | 437 | ||
| Secondary glaucoma | 438 | ||
| Pseudoexfoliative (or exfoliative) glaucoma | 438 | ||
| Pigmentary glaucoma | 438 | ||
| Neovascular glaucoma | 440 | ||
| Traumatic glaucoma | 440 | ||
| Glaucomatocyclitic crisis | 440 | ||
| Primary angle-closure glaucoma | 440 | ||
| Congenital glaucoma | 442 | ||
| Diagnosis | 442 | ||
| Screening and aids in diagnosis | 442 | ||
| Screening for glaucoma | 442 | ||
| Open-angle glaucoma | 442 | ||
| Angle-closure glaucoma | 443 | ||
| Tonometry | 443 | ||
| Applanation tonometry | 443 | ||
| Goldmann applanation tonometer | 444 | ||
| Checking the calibration of the Goldmann applanation tonometer | 445 | ||
| Errors in Goldmann tonometry | 446 | ||
| Evaluating the pressures | 446 | ||
| Hints for tonometry use | 447 | ||
| Perkins handheld applanation tonometer | 447 | ||
| Electronic applanation tonometer | 448 | ||
| Other applanation tonometers | 448 | ||
| Icare tonometer | 448 | ||
| Dynamic contour tonometer | 448 | ||
| Indentation tonometry (Schiøtz tonometry) | 448 | ||
| Patient preparation | 451 | ||
| Comparison of the Schiøtz tonometer and the applanation tonometer | 451 | ||
| Noncontact tonometers | 451 | ||
| Ocular response analyzer | 452 | ||
| Tonography | 452 | ||
| Water-drinking test | 452 | ||
| Gonioscopy | 452 | ||
| Corneal thickness | 455 | ||
| Structural: optic nerve | 455 | ||
| Examination of the optic disc | 455 | ||
| The nerve fiber layer | 456 | ||
| Stereo photography | 457 | ||
| Optical coherence tomography (for additional information see Chapter 39) | 457 | ||
| The printout of the RNFL and optic nerve head disc cube 200x200 | 458 | ||
| Anterior segment OCT | 459 | ||
| Heidelberg retina tomograph | 459 | ||
| Pictor | 459 | ||
| Ultrasound biomicroscopy | 459 | ||
| Functional: visual fields | 460 | ||
| Techniques of perimetry | 461 | ||
| Approaches to glaucoma field testing | 462 | ||
| Treatment | 463 | ||
| Medical therapy | 463 | ||
| Pharmaceutical agents commonly used by class | 464 | ||
| Prostaglandins | 464 | ||
| Beta-adrenergic blocking agents | 464 | ||
| Alpha-2 selective agonists | 464 | ||
| Carbonic anhydrase inhibitors | 464 | ||
| Combination drops | 464 | ||
| Miotics | 464 | ||
| Sympathomimetics | 465 | ||
| Hyperosmotic agents | 465 | ||
| Adherence with medication | 465 | ||
| Office-based laser treatments | 465 | ||
| Argon laser trabeculoplasty | 465 | ||
| Selective laser trabeculoplasty (Figure 25.36) | 465 | ||
| When to treat | 466 | ||
| Surgery for glaucoma | 466 | ||
| MIGS | 467 | ||
| Excimer laser trabeculostomy (Figure 25.37) | 467 | ||
| Trabectome | 468 | ||
| iStent (Figure 25.38) | 468 | ||
| Canaloplasty | 468 | ||
| Invasive glaucoma surgical procedures | 468 | ||
| Trabeculectomy (Figure 25.39) | 468 | ||
| Tube shunts (Figure 25.41) | 469 | ||
| Cyclophotocoagulation and cyclocryopexy | 470 | ||
| Treatment of angle-closure glaucoma | 470 | ||
| Management of the patient by the ophthalmic assistant | 471 | ||
| Summary | 472 | ||
| References | 474 | ||
| Chapter 26: Uveitis | 475 | ||
| Introduction | 475 | ||
| Classification of uveitis | 476 | ||
| Causes of uveitis | 476 | ||
| Approach to the patient with uveitis | 478 | ||
| History | 479 | ||
| Eye symptoms | 479 | ||
| Medical history | 479 | ||
| Review of systems | 480 | ||
| Physical examination | 480 | ||
| Ancillary clinic tests and laboratory workup | 480 | ||
| Treatment of uveitis | 481 | ||
| References | 487 | ||
| Chapter 27: Examination of the newborn, infant, and small child | 488 | ||
| Approach to parent and child | 488 | ||
| Vision assessment | 489 | ||
| External examination | 493 | ||
| Pupils | 494 | ||
| Instillation of eyedrops | 494 | ||
| Refraction | 495 | ||
| Retina and optic nerve examination | 495 | ||
| Common pediatric disorders | 496 | ||
| Amblyopia | 496 | ||
| Strabismus | 496 | ||
| Nasolacrimal duct obstruction | 496 | ||
| Retinopathy of prematurity | 496 | ||
| Cataracts and glaucoma | 497 | ||
| Chapter 28: Maintenance of ophthalmic equipment and instruments | 499 | ||
| Applanation tonometer | 499 | ||
| Noncontact tonometer | 500 | ||
| Bulb replacement | 500 | ||
| Target illuminator bulb | 500 | ||
| Source light indicator | 501 | ||
| Fixation lamp | 501 | ||
| Chin rest | 501 | ||
| Headrest cushions | 501 | ||
| Eyepiece and objective | 501 | ||
| Lensmeter | 501 | ||
| Keratometer | 501 | ||
| Slit-lamp biomicroscope | 501 | ||
| Phoropter (Figure 28.4) | 502 | ||
| Greens refractor | 502 | ||
| Projector | 503 | ||
| Projection slide | 503 | ||
| Cleaning the projector screen | 503 | ||
| Replacing the lamp | 503 | ||
| Projection front-surface mirrors | 503 | ||
| Patient viewing mirror | 503 | ||
| Chapter 29: Aseptic technique and minor office surgery | 504 | ||
| Aseptic technique | 504 | ||
| Disinfection of eyelid skin | 504 | ||
| Scrubbing (degerming of hands) | 504 | ||
| Instillation of eye medication | 504 | ||
| Sterility of ophthalmic solutions | 506 | ||
| Disinfection of tonometer prism | 506 | ||
| Minor office surgery | 506 | ||
| Safety considerations | 507 | ||
| Instruments and surgical materials for ophthalmic procedures | 507 | ||
| Forceps | 507 | ||
| Scissors | 507 | ||
| Needle holders | 508 | ||
| Clamps | 508 | ||
| Curets | 508 | ||
| Scalpels, keratomes, and blades | 508 | ||
| Lacrimal instruments | 508 | ||
| Corrosion of stainless steel instruments | 508 | ||
| Procedures | 509 | ||
| Chalazion surgery | 509 | ||
| Eyepatch application | 509 | ||
| Tear duct irrigation | 510 | ||
| Fluorescein test to determine lacrimal function | 510 | ||
| Tear duct probing | 510 | ||
| Ziegler cautery | 511 | ||
| Electrolysis | 511 | ||
| Electrosurgery | 512 | ||
| Eyelid growth removal | 512 | ||
| Pterygium removal | 513 | ||
| Xanthelasma lesion removal | 513 | ||
| Complications during and after office surgery | 514 | ||
| Fainting | 514 | ||
| Central nervous system stimulation | 514 | ||
| Respiratory emergencies | 514 | ||
| Allergic reaction | 515 | ||
| Drug reaction | 515 | ||
| Summary | 515 | ||
| Chapter 30: The operative patient | 518 | ||
| Arrangements for the operation | 518 | ||
| Emergency admission | 518 | ||
| Urgent admission | 519 | ||
| Elective admission | 519 | ||
| Operative booking schedule | 519 | ||
| For previous retinal surgery | 520 | ||
| Consent form | 521 | ||
| Preparing the child and parent for surgery | 521 | ||
| Preparing the adult for major ocular surgery | 522 | ||
| Eye surgery | 522 | ||
| Can an eye be transplanted? | 523 | ||
| Is the eye taken out for surgery? | 523 | ||
| Will there be any unsightly scars on the eye after surgery? | 523 | ||
| Will both eyes be patched after surgery? | 523 | ||
| Is there a great deal of pain after ocular surgery? | 523 | ||
| Must the head be placed between heavy sandbags after surgery? | 523 | ||
| Can both eyes be operated on at the same time? | 523 | ||
| Types of anesthesia | 523 | ||
| Chapter 31: Highlights of ocular surgery | 527 | ||
| Strabismus surgery | 527 | ||
| Preparation | 527 | ||
| Surgery | 527 | ||
| Postoperative routine | 528 | ||
| Cataract surgery | 529 | ||
| Preoperative evaluation | 529 | ||
| Preparation | 531 | ||
| Surgery | 532 | ||
| Phacoemulsification | 532 | ||
| Skin and eye preparation | 532 | ||
| Anesthesia | 532 | ||
| Incision construction | 532 | ||
| Continuous curvilinear capsulorrhexis | 533 | ||
| Hydrodissection and hydrodelineation | 533 | ||
| Machine design | 534 | ||
| Phaco technique | 534 | ||
| Sutures | 534 | ||
| Femtosecond laser | 534 | ||
| Intraocular lenses | 536 | ||
| Lens materials and design | 537 | ||
| Accommodating intraocular implants | 538 | ||
| Corneal inlays for reading vision | 539 | ||
| Historical methods | 539 | ||
| Intracapsular cataract surgery | 539 | ||
| Extracapsular cataract surgery | 539 | ||
| Femtosecond laser cataract surgery | 541 | ||
| Femtosecond lasers: mechanism of action | 541 | ||
| Education and training | 542 | ||
| Cataract postoperative care | 542 | ||
| Early complications after cataract surgery | 543 | ||
| Subconjunctival hemorrhage | 543 | ||
| Hyphema | 543 | ||
| Raised intraocular pressure | 543 | ||
| Corneal edema (Figure 31.17) | 543 | ||
| Shallow anterior chamber | 543 | ||
| Flat anterior chamber | 543 | ||
| Iritis | 543 | ||
| Retinal detachment | 544 | ||
| Cystoid macular edema (Figure 31.18) | 544 | ||
| Intraocular lens decentration | 544 | ||
| Incorrect intraocular lens power | 544 | ||
| Retained lens material (Figure 31.19) | 544 | ||
| Endophthalmitis (Figure 31.20) | 544 | ||
| Astigmatism | 545 | ||
| Capsular opacification (Figure 31.21) | 545 | ||
| Pseudophakic bullous keratopathy (Figure 31.22) | 545 | ||
| Questions often asked about cataract surgery | 546 | ||
| Summary | 546 | ||
| Glaucoma surgery | 546 | ||
| Retinal detachment surgery | 547 | ||
| Summary of retinal surgery and postop care | 548 | ||
| Additional information for patients having retinal surgery | 548 | ||
| Vitreous surgery | 548 | ||
| Laser surgery | 549 | ||
| Corneal transplantation | 549 | ||
| Eyelid surgery | 552 | ||
| Pterygium removal | 553 | ||
| Dacryocystorhinostomy | 553 | ||
| Enucleation and evisceration | 553 | ||
| Eye dressings | 553 | ||
| Summary | 553 | ||
| Chapter 32: Surgical correction of presbyopia | 556 | ||
| Introduction | 556 | ||
| The underlying problem | 557 | ||
| Surgical corrective procedures | 557 | ||
| Scleral procedures | 557 | ||
| Corneal procedures | 557 | ||
| PresbyLASIK | 557 | ||
| Corneal inlays (Table 32.1) | 558 | ||
| KAMRA inlay (Acufocus) | 558 | ||
| Raindrop corneal inlay (revision optics) | 559 | ||
| FlexiVue microlens (Presbia) | 559 | ||
| ICOLENS inlay (Neoptics) | 560 | ||
| Corneal intrastromal femtosecond laser treatment (INTRACOR procedure) | 560 | ||
| Monovision | 560 | ||
| Classic monovision | 560 | ||
| Laser-blended vision | 561 | ||
| Intraocular procedures | 561 | ||
| Multifocal IOLs | 561 | ||
| Defractive multifocal IOLs | 561 | ||
| Apodized defractive multifocal IOLs | 561 | ||
| Nonapodized defractive multifocal IOLs | 562 | ||
| Rotationally asymmetric multifocal IOLs | 562 | ||
| Accommodating IOLs (Table 32.2) | 563 | ||
| Femtosecond laser photodisruption of the crystalline lens | 563 | ||
| Lens refilling | 564 | ||
| Summary | 564 | ||
| References | 565 | ||
| Chapter 33: Assisting the surgeon | 566 | ||
| Bedside ophthalmic assistant | 566 | ||
| Visually impaired patient | 566 | ||
| Patient orientation | 567 | ||
| The ophthalmic assistant | 567 | ||
| Preoperative preparation | 567 | ||
| Postoperative care | 568 | ||
| Alarming postoperative signs and symptoms | 568 | ||
| Instructions to patient on discharge | 569 | ||
| Operating room assistant | 569 | ||
| Aseptic technique in the operating room | 570 | ||
| Routine procedure for the operating room assistant | 570 | ||
| Before scrubbing | 570 | ||
| Bringing the patient to surgery | 572 | ||
| Scrubbing | 572 | ||
| Gowning | 572 | ||
| Gloving | 572 | ||
| Arranging the preparation table | 572 | ||
| Arranging the back table | 573 | ||
| Arranging the instrument stand (Figure 33.4) | 573 | ||
| Example of a set of instruments for basic intraocular procedures | 573 | ||
| Instruments for extraocular procedures | 574 | ||
| Demagnetization | 574 | ||
| Diamond knives | 574 | ||
| Sapphire blade | 575 | ||
| Ruby blade | 575 | ||
| Special care of gem blades | 575 | ||
| Sutures | 575 | ||
| Types of ophthalmic sutures | 576 | ||
| Suture evaluation | 576 | ||
| Ophthalmic needles | 577 | ||
| Preparing the patients eyelids | 577 | ||
| Draping the patient | 577 | ||
| Amoric environment | 577 | ||
| Care and handling of surgical instruments | 577 | ||
| Rust | 578 | ||
| How to avoid a stained appearance | 578 | ||
| Brown or orange stain | 578 | ||
| Light and dark spots | 579 | ||
| Purplish black stains | 579 | ||
| Bluish black stains | 579 | ||
| Multicolor stains | 579 | ||
| Black stains | 579 | ||
| Bluish gray stains | 579 | ||
| Steps in cleaning and sterilization | 580 | ||
| Cleaning | 580 | ||
| Lubrication | 580 | ||
| Inspection | 580 | ||
| Preparing a set of instruments | 581 | ||
| Sterilization | 581 | ||
| Boiling | 581 | ||
| Dry heat (oven) | 581 | ||
| Moist heat (autoclave) | 581 | ||
| Chemical | 582 | ||
| Cold sterilization (germicidal solution bath) | 583 | ||
| Acetone sterilization | 583 | ||
| Alcohol disinfection | 583 | ||
| Gas and radiation | 584 | ||
| Effectiveness | 584 | ||
| Sterile packs | 584 | ||
| Operating room microscope | 584 | ||
| Troubleshooting | 584 | ||
| Lamp failure | 584 | ||
| Failure of the zoom operation | 585 | ||
| Power focus | 585 | ||
| Failure of foot switch | 585 | ||
| Blurred image | 585 | ||
| Filters | 585 | ||
| Back-up generators | 585 | ||
| Ethical behavior of the ophthalmic assistant | 585 | ||
| Medicolegal tips | 585 | ||
| Chapter 34: Lasers in ophthalmology | 588 | ||
| Laser theory | 588 | ||
| Pumping and spontaneous emission | 589 | ||
| Stimulated emission | 590 | ||
| Types of lasers and their clinical use | 590 | ||
| Thermal mechanism | 590 | ||
| Tunable dye laser systems (Figure 34.5) | 591 | ||
| Diode lasers | 592 | ||
| Photodisruptive (ionizing) mechanism | 592 | ||
| Photochemical mechanism | 593 | ||
| Photorefractive and phototherapeutic keratotomy | 593 | ||
| Safety in the laser clinic | 594 | ||
| Future applications of laser technology | 594 | ||
| Chapter 35: Ambulatory surgery | 596 | ||
| Ambulatory surgery centers | 596 | ||
| Tips on medical/legal protection | 597 | ||
| Preparation for admission | 598 | ||
| Admission for surgery | 598 | ||
| Postoperative recovery | 601 | ||
| Summary | 601 | ||
| Chapter 36: Refractive surgery | 604 | ||
| Basic principles of refractive surgery | 604 | ||
| Photorefractive keratectomy, phototherapeutic keratectomy, and laser in situ keratomileusis | 604 | ||
| History | 605 | ||
| Photorefractive keratectomy | 605 | ||
| Results | 605 | ||
| How does it work? | 605 | ||
| Advantages and disadvantages | 606 | ||
| Therapeutic corneal surgery (phototherapeutic keratectomy) | 606 | ||
| Laser-assisted in situ keratomileusis | 606 | ||
| Advantages and disadvantages | 607 | ||
| Follow-up | 607 | ||
| Initial follow-up | 607 | ||
| When to use a bandage lens | 607 | ||
| Postoperative pain | 608 | ||
| Follow-up schedule | 608 | ||
| Infection | 608 | ||
| EpiLASIK | 608 | ||
| Additional procedures | 608 | ||
| Small-incision intrastromal lenticule extraction (SMILE) | 608 | ||
| Intracorneal ring | 608 | ||
| Keratomileusis | 608 | ||
| Automated lamellar keratoplasty | 609 | ||
| Epikeratoplasty | 609 | ||
| Phakic implant | 609 | ||
| Refractive lens exchange | 609 | ||
| Corneal inlays | 609 | ||
| Holmium laser for hyperopia | 609 | ||
| Thermokeratoplasty (thermal collagen shrinkage) | 610 | ||
| Surgery: patient selection, counseling, and examination | 610 | ||
| Indications | 610 | ||
| Laser vision correction | 610 | ||
| Phakic intraocular lens and refractive lens exchange | 611 | ||
| Monovision | 612 | ||
| Problematic candidates | 612 | ||
| Medicolegal issues | 613 | ||
| Patient selection | 613 | ||
| Managing patient expectations | 613 | ||
| The preoperative examination | 613 | ||
| Interaction with the refractive surgeon | 616 | ||
| Informed consent | 617 | ||
| Postoperative care | 617 | ||
| Laser vision correction | 617 | ||
| Refractive lens exchange | 618 | ||
| Phakic intraocular lens | 618 | ||
| The bottom line | 618 | ||
| Summary | 618 | ||
| Chapter 37: Corneal collagen crosslinking in the management of ectatic diseases | 620 | ||
| Keratoconus | 620 | ||
| Clinical signs of keratoconus | 620 | ||
| Computerized topography | 621 | ||
| Etiology of keratoconus | 621 | ||
| Pellucid marginal degeneration | 622 | ||
| Corneal ectasia following LASIK | 622 | ||
| Development of Corneal Crosslinking | 622 | ||
| Basic research on safety of CXL | 622 | ||
| Technique of CXL | 624 | ||
| Contraindication to CXL | 624 | ||
| Clinical outcomes of CXL | 624 | ||
| Post-LASIK ectasia and CXL | 628 | ||
| Topographically linked ablation | 628 | ||
| Intrastromal corneal rings | 628 | ||
| Potential future advances in CXL | 630 | ||
| Summary | 630 | ||
| Further Reading | 630 | ||
| Chapter 38: Wavefront aberrations and custom ablation | 631 | ||
| Chapter 39: Optical coherence tomography | 635 | ||
| The technicians role | 636 | ||
| Normative databases | 636 | ||
| Progression analysis | 636 | ||
| Nonexudative age-related macular degeneration | 637 | ||
| Exudative age-related macular degeneration | 637 | ||
| Other macular abnormalities | 637 | ||
| Vitreomacular traction | 638 | ||
| Glaucoma | 638 | ||
| Keratoconus screening | 638 | ||
| Refractive surgery | 641 | ||
| Corneal pathologies | 643 | ||
| Femtosecond laser cataract surgery | 644 | ||
| Summary | 644 | ||
| Chapter 40: Computerized corneal topography | 645 | ||
| Introduction and basics | 645 | ||
| Axial map or sagittal map | 646 | ||
| Elevation map | 647 | ||
| Corneal thickness map | 647 | ||
| Clinical Uses | 647 | ||
| Corneal topography analysis in refractive surgery | 648 | ||
| Preoperative analysis | 649 | ||
| Postoperative assessment of the cornea | 651 | ||
| Corneal topography and cataract surgery | 651 | ||
| Corneal topography and contact lens fitting | 653 | ||
| Keratoconus | 653 | ||
| Summary | 659 | ||
| Chapter 41: Specular microscopy | 660 | ||
| Specular microscope | 660 | ||
| Endothelial specular photomicrography | 661 | ||
| Chapter 42: Diagnostic ultrasound | 663 | ||
| General considerations and conventional ultrasound diagnoses | 663 | ||
| Theoretic considerations | 663 | ||
| Technique of examination | 664 | ||
| Machine settings | 665 | ||
| Basic examination | 665 | ||
| Office biometry | 665 | ||
| Intraocular disease | 666 | ||
| Retinal detachment | 666 | ||
| Choroidal detachment | 666 | ||
| Intraocular tumors | 666 | ||
| Anterior segment tumors | 666 | ||
| Orbital ultrasound | 667 | ||
| Ultrasound biomicroscopy | 667 | ||
| Technique | 668 | ||
| Measuring ocular structures | 668 | ||
| Ultrasound biomicroscopy in ocular disease | 668 | ||
| Glaucoma | 668 | ||
| Pupillary block | 668 | ||
| Anterior synechiae | 669 | ||
| Plateau iris syndrome | 669 | ||
| Supraciliary effusions and malignant glaucoma | 669 | ||
| Pigmentary dispersion | 670 | ||
| Anterior segment tumors | 670 | ||
| Iris and ciliary body tumors | 670 | ||
| Cysts | 670 | ||
| The zonule | 671 | ||
| Corneal and scleral disease | 671 | ||
| Intraocular lens complications | 671 | ||
| Hypotony and trauma | 671 | ||
| Conjunctival and adnexal disease | 672 | ||
| Future directions | 672 | ||
| Acknowledgment | 672 | ||
| Further Reading | 672 | ||
| Chapter 43: Ocular motility, binocular vision, and strabismus | 673 | ||
| Evaluation of strabismus | 673 | ||
| History | 673 | ||
| Vision testing | 674 | ||
| Hirschbergs test | 674 | ||
| Krimskys test | 674 | ||
| Cover test | 674 | ||
| Eye rotations (versions) | 675 | ||
| Measurement of a heterophoria | 676 | ||
| Hess screen test, Lees screen test, and Lancaster screen test | 676 | ||
| Retinal correspondence | 677 | ||
| Worth four-dot test | 677 | ||
| Bagolini striated-glasses test | 677 | ||
| Afterimage test (Figure 43.5) | 677 | ||
| Major amblyoscope | 678 | ||
| Clinical measurements of strabismus using the major amblyoscope | 679 | ||
| Detection and treatment of suppression | 679 | ||
| Amblyopia | 680 | ||
| Eccentric fixation | 681 | ||
| Treatment of strabismus | 682 | ||
| Summary | 682 | ||
| Chapter 44: Ophthalmic photography | 685 | ||
| Photographic terms | 685 | ||
| The imaging sensor and film | 686 | ||
| Focal length | 686 | ||
| Lens speed | 686 | ||
| Depth of field | 686 | ||
| Resolution | 686 | ||
| Shutter speed | 687 | ||
| Setting | 687 | ||
| Sensor sensitivity | 687 | ||
| Digital imaging | 687 | ||
| Digital imaging chips | 687 | ||
| Color balance | 688 | ||
| Digital imaging software | 688 | ||
| Resolution | 688 | ||
| File formats | 688 | ||
| Exposure | 689 | ||
| Exposure meters | 689 | ||
| Flash illumination | 689 | ||
| External photography | 689 | ||
| Illumination | 690 | ||
| Photo slit-lamp biomicrography | 690 | ||
| Goniography | 693 | ||
| Endothelial specular photomicrography | 697 | ||
| Fundus photography | 697 | ||
| Stereo fundus photography | 700 | ||
| Fluorescein angiography | 702 | ||
| Indocyanine green chorioangiography | 703 | ||
| Video recording | 704 | ||
| Image presentation | 705 | ||
| Summary | 705 | ||
| Chapter 45: Visual aids for the partially sighted | 707 | ||
| Factor of age | 707 | ||
| Low-vision optical devices | 708 | ||
| Refraction | 708 | ||
| Spectacles | 709 | ||
| Optical aids | 709 | ||
| Types of magnifying devices (Figures 45.2-45.5) | 710 | ||
| Hand readers | 710 | ||
| Stand magnifiers | 711 | ||
| Telescopes | 711 | ||
| Desktop projection devices | 711 | ||
| Strong convex lenses | 711 | ||
| Distance magnifiers | 712 | ||
| Lighting | 712 | ||
| Nonoptical visual aids | 713 | ||
| Reading rectangle (typoscope) | 713 | ||
| Large type | 713 | ||
| Yellow filter | 713 | ||
| Writing guides | 713 | ||
| Marking pens | 713 | ||
| Additional aids and devices | 713 | ||
| Selection of low-vision aids | 714 | ||
| The partially sighted child | 714 | ||
| Selection of a visual aid | 714 | ||
| Chapter 46: Blind persons in the modern world | 717 | ||
| Blindness defined | 717 | ||
| Partial sight and blindness | 718 | ||
| Recent vision loss | 718 | ||
| Total blindness | 718 | ||
| Ophthalmic assistants role | 719 | ||
| The blind child | 719 | ||
| Braille | 720 | ||
| Ophthalmic assistants role | 721 | ||
| Rehabilitation | 721 | ||
| Career development and employment | 722 | ||
| Vocations | 722 | ||
| Vocational teaching | 722 | ||
| Available aids | 722 | ||
| Chapter 47: Art and the eye | 725 | ||
| El Greco (1541-1614) | 725 | ||
| The eyes of the Impressionists | 726 | ||
| Claude Monet (1840-1926) | 726 | ||
| Vincent van Gogh (1853-1890) | 729 | ||
| Van Goghs halos | 730 | ||
| Xanthopsia | 730 | ||
| Edgar Degas (1834-1917) | 732 | ||
| Camille Pissarro (1830-1903) | 733 | ||
| Mary Cassatt (1844-1926) | 734 | ||
| Summary | 736 | ||
| Dedication | 737 | ||
| Further Reading | 737 | ||
| Chapter 48: Reading problems in children | 738 | ||
| Whose problem is it? | 738 | ||
| Terminology | 739 | ||
| Act of reading | 739 | ||
| Types of slow readers | 740 | ||
| Classification of dyslexia | 741 | ||
| Characteristics of the child with a reading disability | 741 | ||
| Sex | 741 | ||
| Behavior | 741 | ||
| Learning disability | 741 | ||
| Perceptual motor defects | 742 | ||
| Role of brain and eye dominance | 743 | ||
| Neurologic factors | 743 | ||
| Educational considerations | 743 | ||
| Problems at home | 744 | ||
| Conditions that are confused with a learning disability | 745 | ||
| Hearing deficit | 745 | ||
| Mental retardation | 745 | ||
| Childhood schizophrenia versus autism | 745 | ||
| Emotional disturbance | 745 | ||
| Treatment | 745 | ||
| Clinical tests | 746 | ||
| Vision | 746 | ||
| Letter reversal | 746 | ||
| Color vision | 746 | ||
| Dominance test | 746 | ||
| Line drawings | 746 | ||
| Visual perception and comprehension tests | 746 | ||
| Auditory perception test | 746 | ||
| Summary | 746 | ||
| Acknowledgment | 747 | ||
| Chapter 49: Cardiopulmonary resuscitation | 750 | ||
| Cardiopulmonary resuscitation | 750 | ||
| How does CPR work? | 750 | ||
| The first step of CPR: identify the need | 750 | ||
| Common mistakes | 751 | ||
| The second step of CPR: call for help and get an automated external defibrillator | 751 | ||
| The third step of CPR: check for a pulse | 751 | ||
| Hints | 751 | ||
| The fourth and most important step of CPR: perform chest compressions | 752 | ||
| How to perform chest compressions | 752 | ||
| Tips | 752 | ||
| How it works | 753 | ||
| Rescue breathing | 753 | ||
| Hints | 755 | ||
| The AED | 755 | ||
| How AEDs work | 756 | ||
| Special situations | 756 | ||
| Children | 756 | ||
| Hint | 757 | ||
| Airway foreign body | 757 | ||
| Trauma and motor vehicle accidents | 758 | ||
| Cervical spine injury | 759 | ||
| Bag-mask ventilation | 760 | ||
| Hints | 760 | ||
| Advanced cardiac life support/advanced airways | 760 | ||
| Final thoughts | 761 | ||
| Chapter 50: Computers in ophthalmic practice | 763 | ||
| Computer basics | 763 | ||
| Computer components | 764 | ||
| Central processing unit | 764 | ||
| Input devices | 764 | ||
| Output devices | 764 | ||
| Storage devices (memory) | 764 | ||
| Back-ups | 764 | ||
| Computer tasks | 765 | ||
| Applications software | 765 | ||
| General office software | 765 | ||
| Practice management software | 765 | ||
| Appointment scheduling | 765 | ||
| Billing and accounting | 765 | ||
| Management reporting | 765 | ||
| Electronic medical records | 766 | ||
| Computer-controlled ophthalmologic equipment | 766 | ||
| Automated lensmeters | 766 | ||
| Automated refractors | 766 | ||
| Automated keratometers | 766 | ||
| Visual field analyzers | 766 | ||
| Scanning laser ophthalmoscopy | 767 | ||
| Ophthalmic digital imaging | 767 | ||
| Computerized video keratography | 767 | ||
| Ultrasonic biometry | 767 | ||
| Optical coherence biometry | 767 | ||
| Wavefront analysis aberrometry | 767 | ||
| Emerging and future computerized technologies | 767 | ||
| Special ophthalmologic applications | 768 | ||
| Online databases and Internet resources | 768 | ||
| HIPAA and patient privacy | 768 | ||
| Summary | 768 | ||
| Chapter 51: Allied health personnel in ophthalmology | 769 | ||
| Clinical roles for ophthalmic medical personnel | 770 | ||
| General ophthalmic assistant | 770 | ||
| Specialized ophthalmic assistant | 770 | ||
| Education of ophthalmic medical personnel and the certification process | 771 | ||
| Informal training: on the job | 771 | ||
| Formal training: institutional programs | 771 | ||
| The certification process of ophthalmic medical personnel | 771 | ||
| Government recognition of ophthalmic training and certification programs | 773 | ||
| Recertification | 773 | ||
| Ophthalmic medical personnel subspecialty areas in the JCHAPO family | 773 | ||
| Ophthalmic surgical assistants | 773 | ||
| Certified diagnostic ophthalmic sonographer | 773 | ||
| Registered ophthalmic ultrasound biometrist | 773 | ||
| Corporate certified ophthalmic assistant | 773 | ||
| Ophthalmic scribe certification | 773 | ||
| Ophthalmic medical personnel allied with JCAHPO | 774 | ||
| Ophthalmic photographers | 774 | ||
| Orthoptists | 774 | ||
| Independent allied health personnel in visual science | 774 | ||
| Ophthalmic operating room nurses | 774 | ||
| Opticians | 774 | ||
| The future of allied health personnel in ophthalmology | 774 | ||
| Chapter 52: Ophthalmology ethics | 775 | ||
| Introduction | 775 | ||
| Informed consent | 777 | ||
| Confidentiality | 777 | ||
| Truth telling | 778 | ||
| Boundary issues | 778 | ||
| Multiculturalism | 778 | ||
| Vulnerable populations | 779 | ||
| Pediatric ethics | 779 | ||
| Futility | 779 | ||
| Medical error | 780 | ||
| Impaired physicians and ophthalmic professionals | 780 | ||
| Resource allocation | 780 | ||
| Research ethics | 781 | ||
| Innovation | 781 | ||
| Genetics ethics | 782 | ||
| Advertising | 782 | ||
| Fee splitting | 783 | ||
| Medical industry | 783 | ||
| Cosmetic surgery | 784 | ||
| Financial issues | 784 | ||
| Trainees in patient care | 784 | ||
| Resolution of ethical dilemmas | 785 | ||
| Chapter 53: Ophthalmic allied health personnel: scope of practice | 786 | ||
| Introduction | 786 | ||
| Defining scope of practice | 786 | ||
| Licensure and certification | 787 | ||
| Determining the scope of practice | 787 | ||
| Insurance risk and malpractice | 787 | ||
| Privacy practices | 787 | ||
| Treatment | 788 | ||
| Payment | 788 | ||
| Provider internal operations | 788 | ||
| Law enforcement | 788 | ||
| Public health reporting | 788 | ||
| Ethics and scope of practice | 788 | ||
| Summary | 788 | ||
| Further Reading | 789 | ||
| Chapter 54: Testing and certification of ophthalmic skills | 790 | ||
| Introduction | 790 | ||
| Knowledge-based examinations | 790 | ||
| Examination format and administration | 790 | ||
| Skill-based examinations | 792 | ||
| Summary | 794 | ||
| Chapter 55: The development of ophthalmic assistants in North America | 795 | ||
| Introduction and history | 795 | ||
| Nature of the work | 796 | ||
| Working conditions | 797 | ||
| Chapter 56: Ophthalmic assisting in the international community and in the prevention of blindness | 798 | ||
| Introduction | 798 | ||
| VISION 2020: The Right to Sight | 799 | ||
| Latin America | 799 | ||
| Puerto Rico | 799 | ||
| Haiti | 800 | ||
| Peru | 800 | ||
| Brazil | 800 | ||
| Sub-Saharan Africa | 801 | ||
| Kenya | 801 | ||
| Ophthalmic clinical officers | 801 | ||
| Ophthalmic nurses | 802 | ||
| Ophthalmic assistants | 802 | ||
| Tanzania | 802 | ||
| Uganda | 803 | ||
| Malawi | 803 | ||
| Mali | 804 | ||
| North Africa and the Middle East | 805 | ||
| South and Southeast Asia | 805 | ||
| India | 805 | ||
| Paramedical training programs in ophthalmic practice | 807 | ||
| Certificate course in clinical and supervisory skills development | 807 | ||
| Short-term course in ophthalmic dispensing | 807 | ||
| Postgraduate diploma in ophthalmic assistance | 807 | ||
| Postgraduate diploma in optometry | 807 | ||
| Bangladesh | 808 | ||
| Australia | 809 | ||
| Orthoptists | 809 | ||
| Ophthalmic nurses | 810 | ||
| Aboriginal eye health workers | 810 | ||
| Ophthalmic assistants elsewhere | 810 | ||
| Summary | 811 | ||
| Acknowledgments | 811 | ||
| Chapter 57: Atlas of common eye diseases and disorders | 812 | ||
| References to Figures | 820 | ||
| Chapter : Glossary | 821 | ||
| Appendices | 834 | ||
| Appendix 1 Ocular emergenciesa | 834 | ||
| Appendix 2 Following universal precautions1,2 | 837 | ||
| Appendix 3 Principles of informed consent | 838 | ||
| Informed consent | 838 | ||
| Contents of an informed consent document | 838 | ||
| Duty of disclosure | 838 | ||
| Material risks | 838 | ||
| Special and unusual risks | 838 | ||
| Consent | 838 | ||
| Exceptions | 838 | ||
| Failure to disclose | 838 | ||
| Appendix 4 Abbreviations and symbols in clinical use | 839 | ||
| Appendix 5 Metric conversion (US) | 841 | ||
| Mass | 841 | ||
| Length | 841 | ||
| Volume (US) | 841 | ||
| Temperature | 841 | ||
| Appendix 6 Optical constants of the eye1 | 842 | ||
| Supplementary resources | 843 | ||
| Index | 848 | ||
| Appendices | e1 | ||
| Appendix 7 Office supplies in common use1 | e1 | ||
| Appendix 8 Estimating visual loss | e2 | ||
| Estimating loss of visual field | e2 | ||
| Estimating loss of muscle function | e3 | ||
| Appendix 9 Vision and driving | e4 | ||
| Visual acuity | e4 | ||
| Visual fields | e4 | ||
| Ocular muscle imbalance | e4 | ||
| Color blindness | e4 | ||
| Dark adaptation | e5 | ||
| Depth perception | e5 | ||
| Appendix 10 Translations of commonly asked questions and commands | e6 | ||
| Appendix 11 Diopters to millimeters of radius conversion tables | e13 | ||
| Appendix 12 Vertex conversion table | e15 | ||
| Appendix 13 Diopters of corneal refracting power to millimeters of radius of curvature* | e17 | ||
| Appendix 14 Compensation for effect of vertex distances when plus lens is moved away from the eye | e19 | ||
| Appendix 15 Compensation for effect of vertex distances when plus lens is moved toward the eye | e21 | ||
| Appendix 16 Dioptric curves for extended range of keratometer | e23 | ||
| Appendix 17 Skill checklists | e25 | ||
| Inside Back cover | ES3 |