Additional Information
Book Details
Abstract
Many new developments have taken place in ophthalmology since the publication of the last edition. It therefore became mandatory to revise and update the present edition. To accomplish this many new chapters have been added and the existing ones revised.
Thoroughly revised and updated chapters
- Recent Advances in Lamellar Keratoplasty
- Principles of Molecular Genetics
- Intraocular Tumours
- Recent Advances in Oculoplastic Surgery
- Ophthalmic Electrodiagnostic Techniques
- Ultrasonography in Ophthalmology
- Ocular Coherence Tomography
- Anterior Segment Trauma
- Corneal Topography and Wavefront Sensing
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover\t\r | Front Cover | ||
| Front Matter\r | i | ||
| Copyright\r | iv | ||
| Preface | v | ||
| Acknowledgements | vii | ||
| Contributors | ix | ||
| Contents | xiii | ||
| Section I : OCULAR REFRACTION \r | 1 | ||
| Chapter 1 - Corneal Topography and Wavefront Sensing\r | 3 | ||
| Corneal Topography | 4 | ||
| History and Development | 4 | ||
| Corneal Shape and Optics | 4 | ||
| Surface Zones of The Cornea | 5 | ||
| Optics of Keratometer | 5 | ||
| Limitations of Keratometry | 5 | ||
| Principles of Corneal Topography | 6 | ||
| Topography Maps | 6 | ||
| Axial Maps | 6 | ||
| Curvature Maps | 7 | ||
| Elevation Maps | 7 | ||
| Pachymetric Maps | 7 | ||
| Topographic Indices | 7 | ||
| Limitations of Corneal Topography | 8 | ||
| Indications of Corneal Topography | 8 | ||
| Technologies in Corneal Imaging | 8 | ||
| Wavefront Sensing | 15 | ||
| History | 15 | ||
| Aberrations: General Concepts | 16 | ||
| Wavefront Analysis: Techniques and Strategies | 17 | ||
| Wavefront Indices | 18 | ||
| Diagnostic Uses of Wavefront Sensing | 19 | ||
| Wavefront Sensing: The Future | 20 | ||
| Chapter 2 - Overview of Refractive Procedures\r | 21 | ||
| Correction of Refractive Error in Keratoconus | 22 | ||
| Keratomileusis | 23 | ||
| Laser Refractive Corneal Surgery | 23 | ||
| Excimer | 23 | ||
| Historical Perspective | 23 | ||
| Wavelength Selection | 23 | ||
| UV Light and the Eye | 23 | ||
| Excimer Lasers | 24 | ||
| Corneal Tissue Interaction | 24 | ||
| Excimer Laser Instrumentation | 25 | ||
| Current Models of Excimer Lasers | 26 | ||
| Photorefractive Keratectomy | 27 | ||
| Patient Selection | 27 | ||
| Criteria for Patient Selection | 27 | ||
| Preoperative Evaluation | 28 | ||
| Procedure | 28 | ||
| Clinical Results | 28 | ||
| Side Effects and Complications | 29 | ||
| Intraoperative | 29 | ||
| Postoperative | 29 | ||
| Phototherapeutic Keratectomy | 29 | ||
| Contraindications | 30 | ||
| Techniques9-11 | 30 | ||
| Blocking Agents | 31 | ||
| Movement of the Eye | 31 | ||
| Clinical Results | 31 | ||
| Laser-Assisted in Situ Keratomileusis | 31 | ||
| Preoperative Considerations | 31 | ||
| Contraindications of Lasik | 33 | ||
| Operative Procedure | 33 | ||
| Customised Corneal Ablation | 37 | ||
| Corneal Biomechanics After Excimer Keratectomy | 37 | ||
| Wound Healing Response and Customised Ablation | 37 | ||
| Technology for Customised Corneal Ablation | 38 | ||
| Scanning Spot Laser Delivery | 38 | ||
| Eye Tracking | 38 | ||
| Wavefront-Sensing Devices | 39 | ||
| Laser-Wavefront Interface | 39 | ||
| Laser Subepithelial Keratomileusis | 39 | ||
| Lasek and Epi-Lasik (Box 2.4) | 39 | ||
| Complications of Lasik | 40 | ||
| Chapter 3 - Surgical Correction of Hypermetropia and Presbyopia\r | 41 | ||
| Hypermetropia | 42 | ||
| History | 42 | ||
| Management Options | 42 | ||
| Laser Thermal Keratoplasty | 42 | ||
| Conductive Keratoplasty | 43 | ||
| Excimer Laser Techniques | 44 | ||
| Hypermetropic PRK | 44 | ||
| Hypermetropic LASIK | 45 | ||
| Clear Lens Extraction With IOL Implant | 45 | ||
| Phakic IOLs | 45 | ||
| Presbyopia | 45 | ||
| Mechanism of Accommodation | 45 | ||
| Theories of Presbyopia | 46 | ||
| Correction of Presbyopia | 46 | ||
| Multifocal Vision to Correct Presbyopia | 46 | ||
| Monovision to Correct Presbyopia | 46 | ||
| Surgical Correction of Presbyopia | 46 | ||
| Chapter 4 - Contact Lenses\r | 48 | ||
| Introduction | 49 | ||
| Applied Physiology | 49 | ||
| Physical Properties of Materials | 49 | ||
| Manufacture of Contact Lenses (Table 4.6) | 52 | ||
| Examination (Box 4.3) | 54 | ||
| Tear Assessment | 54 | ||
| Soft Lens Fitting (Table 4.7) | 54 | ||
| Frequent (Planned) Replacements and Disposable Lenses | 56 | ||
| Rigid Gas Permeable Contact Lens Fitting | 57 | ||
| Assessment to Fit | 58 | ||
| Toric Lenses | 59 | ||
| Indications | 59 | ||
| Contraindications | 59 | ||
| Lens Stabilisation | 59 | ||
| Methods of Stabilisation | 59 | ||
| Chapter 5 - Low Visual Aids\r | 60 | ||
| Introduction | 61 | ||
| Definitions | 61 | ||
| Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 | 61 | ||
| Low-Vision Examination | 61 | ||
| History | 61 | ||
| Ophthalmic Examination | 61 | ||
| Magnification | 64 | ||
| Non-Optical Aids in Low Vision | 69 | ||
| Aids for Peripheral Field Loss | 70 | ||
| Section II : OCULAR THERAPEUTICS \r | 71 | ||
| Chapter 6 - Newer Drugs in Glaucoma\r | 73 | ||
| Beta-Adrenergic Antagonists (Table 6.2) | 74 | ||
| Betaxolol | 75 | ||
| Levobunolol | 76 | ||
| Metipranolol | 76 | ||
| Carteolol | 76 | ||
| D-Timolol | 77 | ||
| Atenolol | 77 | ||
| Metoprolol | 77 | ||
| Pindolol | 77 | ||
| Nadalol | 77 | ||
| Befunolol | 77 | ||
| Penbutalol | 77 | ||
| Nipradilol | 77 | ||
| Topical Carbonic Anhydrase Inhibitors | 77 | ||
| Dorzolamide | 78 | ||
| Mechanism of Action | 78 | ||
| Chapter 7 - Drugs Used for the Management of Ocular Viral Infections\r | 87 | ||
| Viral Infection and Mechanism of Antiviral Drugs | 88 | ||
| Chapter 8 - Antifungal Drugs for Ophthalmic Use\r | 96 | ||
| Polyene Antifungals | 97 | ||
| Amphotericin B | 97 | ||
| Mechanism of Action | 97 | ||
| Susceptibility Pattern | 97 | ||
| Route and Dosage of Administration | 97 | ||
| Side Effects | 98 | ||
| Current Status | 98 | ||
| Nystatin | 98 | ||
| Mechanism of Action | 98 | ||
| Dosage and Administration | 98 | ||
| Natamycin (Pimaricin) | 98 | ||
| Chapter 9 - Fluoroquinolones and Other Antibiotics\r | 105 | ||
| Use of Antibiotics in the Treatment of Corneal Ulcer | 106 | ||
| Adjunctive Therapy | 108 | ||
| Fluoroquinolones | 108 | ||
| Antimicrobial Spectrum of Fluoroquinolones | 108 | ||
| Mode of Action | 108 | ||
| Development of Resistance | 109 | ||
| Fluoroquinolones Used in Ophthalmology | 109 | ||
| Norfloxacin | 109 | ||
| Ciprofloxacin | 109 | ||
| Ofloxacin | 110 | ||
| Pefloxacin | 110 | ||
| Levofloxacin | 110 | ||
| Sparfloxacin | 111 | ||
| Gatifloxacin | 111 | ||
| Moxifloxacin | 111 | ||
| Toxicity of Fluoroquinolones | 113 | ||
| Chapter 10 - Immunosuppressive Agents in Ophthalmology\r | 123 | ||
| Cyclophosphamide1-6 | 124 | ||
| Mechanism of Action | 124 | ||
| Indications | 124 | ||
| Dose and Route of Administration1,3,4 | 124 | ||
| Toxicity | 124 | ||
| Azathioprine1,3,5 | 124 | ||
| Chapter 11 - Intravitreal VEGF Inhibitors and Corticosteroids\r | 132 | ||
| What is VEGF? | 133 | ||
| Properties of VEGF | 134 | ||
| VEGF in Angiogenesis | 134 | ||
| VEGF in Vascular Permeability | 134 | ||
| Proinflammatory Action of VEGF | 134 | ||
| Neuroprotective Action of VEGF | 134 | ||
| Physiologic Role of VEGF | 134 | ||
| Pathologic Role of VEGF | 135 | ||
| VEGF in Diseased States | 135 | ||
| Stimulus for VEGF Expression | 135 | ||
| Rationale of Anti-VEGF Therapy | 135 | ||
| Anti-VEGF Agents | 135 | ||
| Pegaptanib Sodium (Macugen) | 136 | ||
| Bevacizumab (Avastin) | 136 | ||
| Ranibizumab (Lucentis) | 137 | ||
| Anti-VEGF Agents in Retinal Disorders | 137 | ||
| AGE-Related Macular Degeneration | 137 | ||
| Pegaptanib Sodium (Macugen) | 138 | ||
| Bevacizumab (Avastin) | 139 | ||
| Ranibizumab (Lucentis) | 139 | ||
| Anti-VEGF Agents in Other Diseases | 140 | ||
| Diabetic Retinopathy | 141 | ||
| Retinal Venous Occlusions | 142 | ||
| Potential Side Effects and Problems | 142 | ||
| Ocular | 142 | ||
| Systemic | 142 | ||
| Combination Therapies in AMD | 142 | ||
| Role of Steroids | 143 | ||
| Intravitreal Steroids in AMD | 144 | ||
| Intravitreal Triamcinolone in Other Diseases | 144 | ||
| Diffuse DME | 144 | ||
| Vascular Occlusions | 145 | ||
| Adverse Events | 145 | ||
| Other Agents | 145 | ||
| Anecortave Acetate (Retaane) | 145 | ||
| Squalamine Lactate (Evizon) | 145 | ||
| siRNA | 145 | ||
| VEGF Trap | 146 | ||
| Tyrosine Kinase Inhibitor | 146 | ||
| Radiation | 146 | ||
| Agents in Pipeline | 146 | ||
| Technique of Intravitreal Injection | 147 | ||
| Guidelines for Pre-Injection Management | 147 | ||
| Guidelines for Peri-Injection Management | 147 | ||
| Guidelines for Post-Injection Management | 148 | ||
| Future Trends | 149 | ||
| Section III : CORNEA AND OCULAR SURFACE DISORDERS\r | 155 | ||
| Chapter 12 - Stem Cells in Ophthalmology\r | 157 | ||
| Historical Background | 158 | ||
| Terminology | 158 | ||
| Characteristics of Stem Cells2 | 158 | ||
| Role of Antiapoptotic Survival Factors in Stem Cell Regulation4 | 160 | ||
| Identification of Stem Cells | 160 | ||
| Location of Corneal Epithelial Stem Cells in the Basal Limbal Epithelium | 160 | ||
| Circumstantial Evidence for Location of Corneal Epithelial Stem Cells at the Limbus6 | 161 | ||
| Stem Cell Hierarchy (fig. 12.3) | 161 | ||
| Clinical Manifestations of Limbal Stem Cell Deficiency4 | 162 | ||
| Corneal Disorders Characterised by the Absence or Malfunction of Limbal Stem Cells4 | 163 | ||
| Treatment of Limbal Stem Cell Deficiency | 163 | ||
| Limbal Stem Cell Transplantation | 164 | ||
| Terminology of Epithelial Transplantation Procedures for Ocular Surface Disorders16 | 165 | ||
| Conjunctival Transplantation | 165 | ||
| Limbal Transplantation | 165 | ||
| Procurement of Tissue for Klal Transplantation17 | 165 | ||
| Postoperative Care of Patients13 | 166 | ||
| KALA Rejection18 | 166 | ||
| Topical Therapy | 166 | ||
| Subconjunctival/sub-tenon | 166 | ||
| Systemic | 166 | ||
| Results of Stem Cell Transplantation | 167 | ||
| Amniotic Membrane Transplantation | 167 | ||
| Future Horizons | 168 | ||
| Chapter 13 - Microbial Keratitis: A Guide to Diagnosis and Management\r | 170 | ||
| Clinical Presentation | 171 | ||
| Can the Causative Organism Be Identified? | 172 | ||
| Anterior Chamber Reaction | 175 | ||
| Corneal Vascularisation | 175 | ||
| Corneal Sensations | 175 | ||
| Intraocular Pressure | 176 | ||
| Complications of Microbial Keratitis | 176 | ||
| Laboratory Diagnosis | 176 | ||
| Primary Presentation | 176 | ||
| Conjunctival Swabs | 176 | ||
| Corneal Scraping | 176 | ||
| Treatment | 178 | ||
| Treatment of Viral Keratitis | 178 | ||
| Role of IOP-Lowering Agents | 179 | ||
| Role of Lubricants | 179 | ||
| Ocular Surface Disorders | 179 | ||
| Dacryocystitis | 179 | ||
| Systemic Disease | 179 | ||
| Role of Steroids | 179 | ||
| Impending Perforation/Perforation | 179 | ||
| Technique of Application of Tissue Adhesive | 179 | ||
| Therapeutic Penetrating Keratoplasty | 180 | ||
| Tarsorrhaphy | 180 | ||
| Amniotic Membrane Grafting | 180 | ||
| Optical Rehabilitation | 180 | ||
| Chapter 14 - Ocular Surface Disorders: Classification, Diagnosis and Management\r | 181 | ||
| Anatomy of the Components of the Ocular Surface | 182 | ||
| Conjunctiva | 182 | ||
| Cornea | 182 | ||
| Precorneal Tear Film | 183 | ||
| Pathological Responses of the Conjunctiva | 183 | ||
| Conjunctival Haemorrhages, Ulceration and Necrosis | 183 | ||
| Follicular Conjunctivitis | 183 | ||
| Causes of Follicles (Fig. 14.2a) | 183 | ||
| Chronic Conjunctival Inflammation | 184 | ||
| Papillary Hypertrophy (Figs. 14.2b and 14.3) | 184 | ||
| Subepithelial Scarring and Symblepharon Formation | 184 | ||
| Granulomatous Conjunctivitis | 184 | ||
| Conjunctival Inflammation in Ocular Allergy | 185 | ||
| Vernal Keratoconjunctivitis | 185 | ||
| Giant Papillary Conjunctivitis | 185 | ||
| Conjunctival Inflammation in Collagen Vascular Disorders | 185 | ||
| Other Forms of Conjunctival Inflammation | 185 | ||
| Ligneous Conjunctivitis | 185 | ||
| Superior Limbic Keratoconjunctivitis | 186 | ||
| Conjunctivitis with Floppy Eyelid Syndrome | 186 | ||
| Classification of Ocular Surface Disorders | 186 | ||
| Goblet Cell Deficiency | 186 | ||
| Disorders of Tear Film | 186 | ||
| Causes of Lipid Deficiency and Evaporative Dry Eye | 186 | ||
| Causes of ATD | 187 | ||
| Clinical Tests for Dry Eye | 189 | ||
| Histological Tests | 190 | ||
| Laboratory Tests for Lacrimal Gland Function | 191 | ||
| Limbal Stem Cell Dysfunction | 191 | ||
| Location of Stem Cells in the Eye | 191 | ||
| Pathological Features of Limbal Stem Cell Dysfunction | 191 | ||
| Diseases Associated with Limbal Stem Cell Deficiency | 192 | ||
| Management of OSDs | 192 | ||
| Treatment of Blepharitis | 192 | ||
| Treatment of Meibomian Glands | 192 | ||
| Treatment of Dry Eye | 193 | ||
| Goals of Therapy | 193 | ||
| Correction of Tear Film Deficiency | 193 | ||
| Treating the Underlying Pathological Mechanism | 194 | ||
| Treatment of Limbal Stem Cell Deficiency | 194 | ||
| Medical Management | 194 | ||
| Surgical Management | 194 | ||
| Ocular Surface Stabilisation Procedures | 194 | ||
| Penetrating Keratoplasty in Cases of OSDs | 195 | ||
| Conclusion | 195 | ||
| Chapter 15 - Eye Banking and Corneal Preservation\r | 196 | ||
| Introduction | 197 | ||
| Sources of Human Donor Eyes | 197 | ||
| Willing Donation | 197 | ||
| Consented Eyes | 197 | ||
| Eyes from Medicolegal and Pathological Postmortem Cases | 197 | ||
| Eyes from Unclaimed Bodies | 197 | ||
| Eye Banking and the Law | 198 | ||
| A Good Donor Cornea | 198 | ||
| Preservation of Donor Cornea | 198 | ||
| Short-Term Preservation | 198 | ||
| Mid-Term Preservation | 198 | ||
| Long-Term Preservation | 199 | ||
| Chapter 16 - Recent Advances in Lamellar Keratoplasty\r | 200 | ||
| Deep Anterior Lamellar Keratoplasty | 201 | ||
| Indications for DALK | 201 | ||
| Lamellar Endothelial Replacement Surgery | 202 | ||
| Technique of PLK | 203 | ||
| Small Incision-DLEK | 203 | ||
| Descemet Stripping Endothelial Keratoplasty | 203 | ||
| Preparation of the Donor Tissue | 204 | ||
| Section IV : PAEDIATRIC OPHTHALMOLOGY \r | 207 | ||
| Chapter 17 - Retinopathy of Prematurity | 209 | ||
| Historical Background | 210 | ||
| Classification | 210 | ||
| Zones (Fig. 17.1) | 210 | ||
| Staging of Disease (Figs. 17.2 to 17.7) | 210 | ||
| Rush Disease | 210 | ||
| Plus Disease | 210 | ||
| Threshold Disease | 212 | ||
| Pre-Threshold Disease | 212 | ||
| Pathogenesis of ROP | 212 | ||
| Screening for ROP | 212 | ||
| Procedure | 212 | ||
| Treatment of ROP | 213 | ||
| Control of Excessive Light | 213 | ||
| Vitamin E Supplementation | 213 | ||
| Cryotherapy for ROP | 213 | ||
| Early Treatment for ROP Study | 213 | ||
| Photocoagulation | 213 | ||
| Surgery for Retinal Detachment | 214 | ||
| Chapter 18 - Amblyopia\r | 215 | ||
| Pathophysiology of Amblyopia | 216 | ||
| Retina | 216 | ||
| Lateral Geniculate Nucleus | 216 | ||
| Cortex | 216 | ||
| Prevalence of Amblyopia | 216 | ||
| Classification | 216 | ||
| Congenital Amblyopia | 216 | ||
| Strabismic Amblyopia | 216 | ||
| Form-Deprivation Amblyopia | 217 | ||
| Refractive Amblyopia | 217 | ||
| Features of the Amblyopic Eye | 217 | ||
| Visual Acuity | 217 | ||
| Hyperacuity | 218 | ||
| Light Sense | 218 | ||
| Increment Threshold Spectral Sensitivity | 218 | ||
| Spatial Contrast Sensitivity | 218 | ||
| Temporal Processing of the Visual System | 219 | ||
| Eye Movements | 219 | ||
| Management of Amblyopia | 220 | ||
| Refractive Correction | 220 | ||
| Occlusion | 220 | ||
| Penalisation | 220 | ||
| Cam Stimulator | 220 | ||
| Pleoptics | 220 | ||
| Drug Therapy | 221 | ||
| Chapter 19 - Intermittent Exotropia (Divergent Squint)\r | 222 | ||
| Historical Perspective | 223 | ||
| Demographics, Risk Factors and Genetics | 223 | ||
| Natural History | 223 | ||
| Clinical Characteristics | 224 | ||
| Classification | 224 | ||
| True Divergence Excess | 225 | ||
| Pseudo-Divergence Excess | 225 | ||
| Basic Exodeviation | 225 | ||
| Convergence Insufficiency | 225 | ||
| Clinical Evaluation | 226 | ||
| Measuring the Deviation | 226 | ||
| Assessing Control of X(T) | 226 | ||
| Detecting Amblyopia and Assessing Refractive Error | 227 | ||
| Treatment | 227 | ||
| Non-Surgical Management | 227 | ||
| Surgical Management | 228 | ||
| Surgical Procedures | 228 | ||
| Criteria for Surgical Success | 228 | ||
| Factors Affecting Response to Surgery | 228 | ||
| Common Pitfalls in Management | 229 | ||
| Complications | 230 | ||
| Undercorrection | 230 | ||
| Chapter 20 - Esodeviations\r | 232 | ||
| Accommodative Esotropia | 233 | ||
| Refractive Accommodative Esotropia | 233 | ||
| Non-Refractive Accommodative Esotropia | 234 | ||
| Partially Accommodative Esotropia | 234 | ||
| Non-Accommodative Esotropia | 235 | ||
| Comitant Esotropia | 235 | ||
| Essential Infantile Esotropia1-17 | 235 | ||
| Non-Accommodative Acquired (Basic) Esotropia1-17 | 235 | ||
| Monofixation Syndrome18 | 235 | ||
| Acute Acquired Comitant Esotropia1-22 | 236 | ||
| Sensory Deprivation Esotropia1-6 | 236 | ||
| Consecutive Esotropia1-6 | 236 | ||
| Incomitant Esotropia | 236 | ||
| Medial Wall Fractures of the Orbit | 236 | ||
| Sixth Nerve Palsy | 237 | ||
| Duane's Retraction Syndrome23,24 | 237 | ||
| Pseudo-Esotropia | 238 | ||
| Chapter 21 - Vertical Squint\r | 240 | ||
| Introduction | 241 | ||
| Clinical Presentation1-3 | 241 | ||
| Clinical Examination | 241 | ||
| Head Tilt Test | 242 | ||
| Diplopia Charting | 243 | ||
| Double Maddox Rod Test | 243 | ||
| Fundus Examination | 244 | ||
| Force-Duction Test | 244 | ||
| Binocular Fields of Fixation | 244 | ||
| Differential Diagnosis7,8 | 244 | ||
| Chapter 22 - Nystagmus\r | 247 | ||
| Introduction | 248 | ||
| Definitions and Nomenclature | 248 | ||
| Pathogenesis of Nystagmus | 248 | ||
| Physiological Nystagmus | 248 | ||
| Examination of a Case of Nystagmus | 249 | ||
| Peripheral Versus Central Nystagmus | 249 | ||
| Congenital Nystagmus | 250 | ||
| Latent Nystagmus | 250 | ||
| Monocular Shimmering of Anterior Visual Pathway Lesions | 250 | ||
| Spasmus Nutans | 250 | ||
| Acquired Central Nystagmus | 250 | ||
| Dissociated Nystagmus | 251 | ||
| Miscellaneous Oscillations | 252 | ||
| Treatment of Nystagmus | 253 | ||
| Chapter 23 - Principles of Molecular Genetics\r | 255 | ||
| Inheritance and Medical Genetics: Historical Aspects | 256 | ||
| Mendel's Discovery | 257 | ||
| Mendel's Laws of Inheritance | 257 | ||
| The Cellular And Molecular Basis of Inheritance | 257 | ||
| Nucleic Acids: Composition | 258 | ||
| Structure of DNA | 258 | ||
| Replication of DNA | 258 | ||
| Types of DNA Sequences | 259 | ||
| Nuclear Genes | 259 | ||
| Types of Nuclear Genes | 259 | ||
| Mitochondrial DNA | 260 | ||
| Transcription | 260 | ||
| Translation | 261 | ||
| Genetic Code | 261 | ||
| Mutations | 262 | ||
| Types of Mutations | 262 | ||
| Structural Effects of Mutations on Protein | 262 | ||
| Functional Effects of Mutations on Protein | 263 | ||
| Mutations In Non-Coding DNA | 263 | ||
| DNA Repair | 263 | ||
| Human Chromosomes | 263 | ||
| Structure of A Chromosome | 263 | ||
| Morphology | 264 | ||
| Classification | 264 | ||
| Chromosomal Banding | 264 | ||
| Karyotype Analysis | 265 | ||
| Molecular Cytogenetics | 265 | ||
| Fluorescent In Situ Hybridisation | 265 | ||
| Flow Cytometry | 265 | ||
| Comparative Genomic Hybridisation | 265 | ||
| Microarray Comparative Genomic Hybridisation | 265 | ||
| Chromosomal Abnormalities (Box 23.6) | 265 | ||
| Trisomy | 265 | ||
| Monosomy | 266 | ||
| Polyploidy | 266 | ||
| Translocations | 266 | ||
| Deletions | 266 | ||
| Insertion | 266 | ||
| Inversions | 266 | ||
| Ring Chromosome | 266 | ||
| Isochromosomes | 266 | ||
| Mosaicism | 266 | ||
| Chimerism | 266 | ||
| DNA Cloning And DNA Analysis | 266 | ||
| DNA Preparation | 267 | ||
| In Vivo Cell-Based Cloning | 267 | ||
| Cell-Free, in Vitro DNA Cloning: PCR | 268 | ||
| Isothermal Nucleic Acid Magnification | 269 | ||
| Techniques of DNA Analysis | 269 | ||
| Gene Mapping | 270 | ||
| Mathematical And Population Genetics | 270 | ||
| Applications of Hardy-Weinberg Equilibrium | 271 | ||
| Genetic Counselling | 271 | ||
| The Human Genome Project | 272 | ||
| Objectives of The Human Genome Project | 272 | ||
| Treatment of Genetic Diseases | 272 | ||
| Ophthalmic Genetics | 273 | ||
| Glaucoma | 273 | ||
| Glaucoma Gene Classification | 273 | ||
| Primary Open Angle Glaucoma | 273 | ||
| Retinoblastoma | 273 | ||
| The RB1 Gene (p110 Protein) | 273 | ||
| Keratoconus | 274 | ||
| Leber's Hereditary Optic Neuropathy | 274 | ||
| Dominant Corneal Dystrophies | 274 | ||
| Retinitis Pigmentosa | 275 | ||
| Colour Vision | 275 | ||
| Albinism | 275 | ||
| Section V : LENS AND GLAUCOMA \r | 277 | ||
| Chapter 24 - Recent Advances in Cataract Surgery | 279 | ||
| Anaesthesia for Cataract Surgery | 280 | ||
| General Anaesthesia | 280 | ||
| Local Anaesthesia | 280 | ||
| Technique of Injection | 281 | ||
| Local Anaesthetic Agents | 282 | ||
| Sedation and Premedication | 282 | ||
| Monitoring of Local Anaesthesia | 282 | ||
| Subconjunctival and Topical Anaesthesia | 282 | ||
| Architecture of the Cataract Incision | 282 | ||
| Wound Construction for Phacoemulsification | 282 | ||
| Scleral Tunnel Incisions | 283 | ||
| External Incision | 283 | ||
| Clear Corneal Incisions | 284 | ||
| The Nucleus in Cataract Surgery | 285 | ||
| Non-Phaco Small-Incision Techniques | 285 | ||
| Phacoemulsification | 285 | ||
| Phacoemulsification Machine (Box 24.7) | 285 | ||
| Aspiration System (Box 24.8; Figs. 24.6 and 24.7) | 287 | ||
| Torsional Phacoemulsification | 288 | ||
| Advantages of Phacoemulsification | 288 | ||
| Technique of Phacoemulsification | 288 | ||
| Indications for Phacoemulsification | 292 | ||
| Phaco Trends and Future Directions | 292 | ||
| Making Transition | 292 | ||
| Future Trends in Nuclear Sculpting | 292 | ||
| Phaco Fly (KELMAST) | 293 | ||
| Laser Phacolysis10-13 | 293 | ||
| Microincision Cataract Surgery | 294 | ||
| Intraocular Lenses: Evolution and Recent Advances | 295 | ||
| Generation I (1949-1954) | 295 | ||
| Generation II (1952-1962) | 295 | ||
| Generation III | 295 | ||
| Generation IV | 296 | ||
| Generation V | 296 | ||
| Design Alterations | 296 | ||
| Foldable IOLs | 297 | ||
| History | 297 | ||
| Materials | 298 | ||
| Haptic Materials | 299 | ||
| Advantages and Disadvantages of Foldable Lenses | 299 | ||
| Advantages | 299 | ||
| Disadvantages | 300 | ||
| Accommodative IOLs | 301 | ||
| Pseudoaccommodation | 301 | ||
| Summary | 302 | ||
| Chapter 25 - Aqueous Drainage Devices\r | 305 | ||
| Why Poor Results with Earlier Aqueous Drainage Devices? | 306 | ||
| Properties of an Ideal Implant | 306 | ||
| Currently Used Implants | 306 | ||
| Indications | 307 | ||
| Molteno Implant | 307 | ||
| The Original Implant | 308 | ||
| Newer Molteno Implant | 308 | ||
| Advantages of Molteno Implant8 | 308 | ||
| Disadvantage of Molteno Implant | 308 | ||
| Ahmed Glaucoma Valve | 308 | ||
| The Venturi Effect | 309 | ||
| Non-Obstructive, Self-Regulating Mechanism | 309 | ||
| Models | 309 | ||
| Accessories | 311 | ||
| Schocket Implant | 311 | ||
| Advantages of Schocket Implant | 311 | ||
| Krupin-Denver Implant | 311 | ||
| Modifications | 312 | ||
| Joseph Implant | 312 | ||
| Hoskin-Drake Implant | 312 | ||
| White Pump Shunt | 312 | ||
| Baerveldt Implant | 312 | ||
| Surgical Procedure | 313 | ||
| Postoperative Course | 314 | ||
| Complications | 314 | ||
| Peroperative Complications8 | 314 | ||
| Postoperative Complications | 314 | ||
| Evaluation of Results | 316 | ||
| Common Results | 316 | ||
| Ubiquity of Complications | 316 | ||
| Aqueous Drainage Devices Versus Antimetabolites | 316 | ||
| Conclusion | 316 | ||
| Chapter 26 - Pharmacologic Modulation of Glaucoma Filtering Surgery\r | 318 | ||
| Pharmacologic Modulators | 320 | ||
| Corticosteroids | 320 | ||
| Antifibroblastic Agents | 320 | ||
| 5-Fluorouracil | 320 | ||
| Mitomycin C | 320 | ||
| Bleb Characteristics | 321 | ||
| Complications with Antifibroblastic Agents | 321 | ||
| Alternative Routes of Delivery of 5-FU | 322 | ||
| Other Antifibroblastic Drugs | 322 | ||
| Inhibitors of Collagen Cross-Linking | 322 | ||
| Experimental Drugs | 322 | ||
| Future Prospects | 323 | ||
| Combination Drug Therapy | 323 | ||
| Chapter 27 - Uveoscleral Outflow\r | 325 | ||
| Introduction | 326 | ||
| Morphology of Uveoscleral Outflow Pathways | 326 | ||
| Extracellular Matrix in the Ciliary Muscle | 327 | ||
| Uveoscleral Outflow Pathways in Glaucoma | 327 | ||
| Physiology of the Uveoscleral Pathways | 328 | ||
| Evolution of a Uveoscleral Pathway | 328 | ||
| Composition of Fluid | 328 | ||
| Values of Aqueous Flow | 328 | ||
| Altering Uveoscleral Outflow | 328 | ||
| Chapter 28 - Laser Therapy in Glaucoma\r | 330 | ||
| Introduction | 331 | ||
| Historical Background | 331 | ||
| Laser Iridectomy | 331 | ||
| Complications of Laser Iridectomy | 332 | ||
| Argon Laser Peripheral Iridoplasty | 332 | ||
| Argon Laser Trabeculoplasty | 332 | ||
| Pathophysiology | 332 | ||
| Indications | 332 | ||
| Contraindications | 332 | ||
| Procedure | 332 | ||
| Complications | 333 | ||
| Yag Laser Trabeculoplasty | 333 | ||
| Re-Opening of Closed Filtering Blebs | 333 | ||
| Cyclodestructive Procedures | 333 | ||
| Other Procedures | 333 | ||
| Chapter 29 - Automated Perimetry in Glaucoma\r | 335 | ||
| Introduction | 336 | ||
| Perimeters | 336 | ||
| Hardware | 336 | ||
| Software | 336 | ||
| Basic Understanding of Quantitative Perimetry | 338 | ||
| Short-Term Fluctuation | 341 | ||
| Long-Term Fluctuation | 341 | ||
| Interpretation of a Visual Field | 342 | ||
| Glaucoma Hemifield Test | 356 | ||
| Choice of Test Programme | 356 | ||
| Newer Developments in Automated Perimetry | 363 | ||
| Oculokinetic Perimetry | 363 | ||
| Blue-on-Yellow and Colour Perimetry | 363 | ||
| Flicker and Temporal Modulation Perimetry | 365 | ||
| Pattern Discrimination Perimetry | 365 | ||
| High-Pass Resolution Perimetry | 367 | ||
| Section VI: UVEA, VITREOUS, RETINA, OPTIC NERVE AND PATHWAYS \r | 369 | ||
| Chapter 30 - Basic Concepts in Immunology and Immunological Disorders of the Uvea\r | 371 | ||
| Introduction | 372 | ||
| Hypersensitivity Reactions | 373 | ||
| Type I | 373 | ||
| Type II | 373 | ||
| Type III | 373 | ||
| Type IV | 374 | ||
| Systematic Clinical Work-Up | 374 | ||
| Recommendations of the International Uveitis Group for the Anatomic Classification of Uveitis15 | 375 | ||
| Seronegative Spondyloarthropathies | 375 | ||
| Immunopathogenesis | 376 | ||
| Ankylosing Spondylitis | 376 | ||
| Ocular Symptoms | 376 | ||
| Chapter 31 - Investigations in Uveitis\r | 386 | ||
| Indications for Investigations | 387 | ||
| Selection of Investigation | 387 | ||
| Routine Tests | 387 | ||
| Imaging Techniques | 387 | ||
| Skin Test | 388 | ||
| Mantoux Test | 388 | ||
| Antinuclear Antibody Test | 388 | ||
| Intraocular Fluid Evaluation | 389 | ||
| Antigen-Antibody Estimations | 389 | ||
| Paracentesis of Anterior Chamber (Aqueous Humour) | 389 | ||
| Diagnostic Surgery (Invasive Procedures) | 389 | ||
| HLA Typing | 390 | ||
| Ultrasonography | 390 | ||
| Fluorescein Angiography | 391 | ||
| Conclusion | 391 | ||
| Chapter 32 - Recent Trends in the Management of Ocular Inflammation\r | 392 | ||
| Sequence of Inflammatory Response | 393 | ||
| Immune Response | 394 | ||
| Immune Privilege | 394 | ||
| Human Leucocyte Antigen and Ocular Inflammation | 394 | ||
| Recent Trends in Treatment of Ocular Inflammation | 395 | ||
| Antimetabolites | 395 | ||
| Alkylating Agents | 396 | ||
| T-Cell Inhibitor (Calcineurin Inhibitors) | 396 | ||
| Antibody to Proinflammatory Cytokines-Infliximab | 397 | ||
| Interferon Therapy | 398 | ||
| Steroids | 399 | ||
| Summary | 400 | ||
| Chapter 33 - Ocular Manifestations of AIDS\r | 401 | ||
| Eyelids | 402 | ||
| Conjunctiva | 403 | ||
| Cornea | 403 | ||
| Anterior Uveitis | 403 | ||
| Lens | 404 | ||
| Retina and Vitreous | 404 | ||
| Progressive Outer Retinal Necrosis | 407 | ||
| Choroid | 407 | ||
| Orbit | 408 | ||
| Neuro-Ophthalmology | 408 | ||
| Paediatric AIDS | 409 | ||
| Antiretroviral Therapy | 410 | ||
| Chapter 34 - Endophthalmitis\r | 411 | ||
| Signs and Symptoms | 412 | ||
| Acute Presentation | 412 | ||
| Chronic Presentation | 412 | ||
| Investigations | 413 | ||
| Microbiology | 413 | ||
| Collection of Specimens | 413 | ||
| Role of Polymerase Chain Reaction10,11 | 413 | ||
| Treatment | 414 | ||
| Local Antibiotic Therapy | 414 | ||
| Choice of Antibiotics | 414 | ||
| Systemic Antibiotics | 414 | ||
| Role of Steroids | 414 | ||
| When to Repeat the Intravitreal Drug | 414 | ||
| Role of Surgical Intervention | 414 | ||
| Steps of Surgery | 415 | ||
| Management of Coexistent Corneal and Scleral Problems | 415 | ||
| Penetrating Keratoplasty Combined With Vitrectomy | 415 | ||
| Role of Second Intervention | 415 | ||
| Complications | 416 | ||
| Gist of Data from Endophthalmitis Vitrectomy Study | 416 | ||
| Chapter 35 - Vitreoretinal Surgery: Instrumentation\r | 418 | ||
| Introduction | 419 | ||
| Microscope | 419 | ||
| Myringotome/MVR Blade/Scleral Plugs/Plug Forceps | 419 | ||
| Infusion Cannulas | 419 | ||
| Vitreous Probe | 420 | ||
| Endoilluminator (Light Source/Pipe) | 421 | ||
| Corneal Contact Lenses | 421 | ||
| Membrane Pic/Vitreoretinal Pic | 422 | ||
| Vitreous Forceps | 422 | ||
| End-Gripping Forceps | 422 | ||
| Side-Gripping Forceps | 422 | ||
| Pic Forceps | 422 | ||
| Foreign Body Forceps | 422 | ||
| Subretinal Membrane Forceps (Thomas) | 423 | ||
| Vitreoretinal Scissors | 423 | ||
| Intraocular Magnet | 424 | ||
| Extrusion Needle | 424 | ||
| Automated Air Pump | 424 | ||
| Retinal Tacks | 425 | ||
| Temporary Keratoprosthesis | 425 | ||
| Endodiathermy | 425 | ||
| Endocryopexy | 426 | ||
| Endophotocoagulation | 426 | ||
| Indirect Laser Ophthalmoscope | 426 | ||
| Chapter 36 - Modern Ophthalmic Operation Theatre | 427 | ||
| Operation Theatre Layout | 428 | ||
| Cleaning of the Operation Theatre | 428 | ||
| Operation Theatre Sterilisation | 428 | ||
| Microsurgical Instruments | 429 | ||
| Cleaning and Sterilisation | 429 | ||
| Operating Microscopes | 429 | ||
| Optical System | 429 | ||
| Working Distance | 431 | ||
| Magnification | 431 | ||
| Illumination System | 431 | ||
| Illumination Source | 432 | ||
| Motorised System | 432 | ||
| Mounting System | 432 | ||
| Adjustability | 432 | ||
| Advantages of Operating Microscope | 432 | ||
| Disadvantages of Operating Microscope | 432 | ||
| Features of an Ideal Microscope | 433 | ||
| Care of the Microscope | 433 | ||
| Microsurgical Instruments and Materials | 433 | ||
| Sutures | 433 | ||
| Needles | 434 | ||
| Irrigating Fluids | 435 | ||
| Chapter 37 - Pars Plana Surgery of the Posterior Segment\r | 437 | ||
| Introduction | 438 | ||
| Indications for Pars Plana Surgery | 438 | ||
| Preoperative Evaluation | 438 | ||
| Surgical Principles in Pars Plana Surgery | 438 | ||
| Instrumentation | 439 | ||
| Surgical Technique | 439 | ||
| Vitreous Replacement | 440 | ||
| Special Techniques | 440 | ||
| Complications | 442 | ||
| Chapter 38 - Silicone Oil and Intraocular Gases in the Management of Retinal Detachment\r | 444 | ||
| Introduction | 445 | ||
| Intraocular Gases | 445 | ||
| Physical Properties | 445 | ||
| Mixing of Gases | 445 | ||
| Mechanism for Internal Tamponade | 445 | ||
| Gas Bubble Dynamics | 446 | ||
| Use of Gas as Non-Expansile Mixture | 446 | ||
| Longevity | 446 | ||
| Gas Bubble Geometry | 446 | ||
| Effect of General Anaesthesia | 446 | ||
| Altitude and Intraocular Gas | 447 | ||
| Alterations in Vitreous Morphology | 447 | ||
| Clinical Applications in Vitreoretinal Surgery | 447 | ||
| Use of Gas without Vitrectomy | 447 | ||
| Use of Gas with Vitrectomy | 447 | ||
| Technique of Gas Injection | 448 | ||
| Postoperative Care | 448 | ||
| Complications of Use of Gas | 448 | ||
| Silicone Oil | 449 | ||
| Physicochemical Properties | 449 | ||
| Physics as Applicable to Ophthalmic Use of Silicone Oil | 449 | ||
| Effect of Silicone Oil in The Eye on Investigations | 450 | ||
| Indications for Use of Silicone Oil | 450 | ||
| Technique of Injecting Silicone Oil (Fig. 38.2) | 451 | ||
| Intraoperative Complications | 451 | ||
| Postoperative Complications | 451 | ||
| Silicone Oil Removal | 453 | ||
| Chapter 39 - Liquid Perfluorocarbons in Vitreous Surgery\r | 454 | ||
| Introduction | 455 | ||
| Air | 455 | ||
| Intravitreal Gases6 | 455 | ||
| Silicone Oil7-9 | 455 | ||
| Sodium Hyaluronate | 455 | ||
| Fluorosilicone Oil | 455 | ||
| Perfluorocarbon Liquids | 455 | ||
| Liquid Perfluorocarbons | 456 | ||
| Experimental Studies | 456 | ||
| Technique of Injection | 457 | ||
| Contraindication | 457 | ||
| Precautions | 457 | ||
| Indications | 457 | ||
| Retinal Detachment With PVR4,14 | 457 | ||
| Giant Retinal Tears15,16 | 457 | ||
| Traumatic Retinal Detachment and Detachment in Vascular Vitreoretinopathies | 457 | ||
| Removal of Intravitreal Lens/IOL/Lens Fragments17-19 | 458 | ||
| Management of Suprachoroidal Haemorrhage20 | 458 | ||
| Side Effects | 458 | ||
| Conclusion | 458 | ||
| Proprietary Names of Commonly Available PFCLs | 458 | ||
| Chapter 40 - Age-Related Macular Degeneration | 460 | ||
| Clinical Features and Pathogenesis | 461 | ||
| Choroidal Neovascular Membrane (CNVM) | 462 | ||
| Lesions of the Retinal Pigment Epithelium | 463 | ||
| Fibrovascular Disciform Scar | 464 | ||
| Vitreous Haemorrhage | 464 | ||
| Treatment | 464 | ||
| Non-Exudative Macular Degeneration | 464 | ||
| Exudative Age-Related Macular Degeneration | 464 | ||
| Serous Detachment of the RPE | 464 | ||
| Choroidal Neovascularisation | 464 | ||
| Complications of photocoagulation treatment | 465 | ||
| Disciform Scars | 466 | ||
| Recent Advances in Treatment of ARMD | 466 | ||
| Low Vision Aids | 466 | ||
| Photodynamic Therapy | 467 | ||
| Photobiology and Mechanism of Action | 467 | ||
| Photodynamic Therapy in Neovascularisation | 467 | ||
| Radiation Therapy for ARMD | 468 | ||
| Retinal Pigment Epithelial Transplantation | 469 | ||
| Conclusion | 469 | ||
| Chapter 41 - Lasers in Posterior Segment Diseases | 471 | ||
| Introduction | 472 | ||
| Basic Concept and Physical Properties of Lasers | 472 | ||
| Types of Lasers | 473 | ||
| Tissue Reactions in Laser Photocoagulation | 473 | ||
| Photocoagulation | 473 | ||
| Photodisruption | 473 | ||
| Photosensitisation | 473 | ||
| Delivery System | 474 | ||
| Techniques | 474 | ||
| General Indications for Fundus Photocoagulation9 | 474 | ||
| Destruction of Neoplasms | 475 | ||
| Retinal Neovascularisation | 475 | ||
| Diabetic Retinopathy | 475 | ||
| Eales' Disease | 477 | ||
| Branch Retinal Vein Occlusion | 480 | ||
| Central Retinal Vein Occlusion (Fig. 41.10) | 480 | ||
| Sickle Cell Retinopathy | 481 | ||
| Coats' Disease | 481 | ||
| Central Serous Retinopathy | 481 | ||
| Age-Related Macular Degeneration | 482 | ||
| Chorioretinal Tumours | 482 | ||
| Laser for Retinal Detachment | 482 | ||
| Complications of Laser Treatment | 483 | ||
| Chapter 42 - Newer Ophthalmic Laser Systems\r | 484 | ||
| Introduction | 485 | ||
| Definition | 485 | ||
| Modes of Operation | 485 | ||
| Continuous Wave Operation | 485 | ||
| Conventional Pulsed or Long Pulsed Operation | 485 | ||
| Classification | 485 | ||
| Solid State Lasers | 485 | ||
| Gas Lasers | 485 | ||
| Metal Vapour Lasers | 486 | ||
| Excimer Lasers | 486 | ||
| Dye Lasers | 486 | ||
| Newer Laser Systems | 487 | ||
| Diode Laser | 487 | ||
| Dye Laser | 487 | ||
| CO2 Laser | 488 | ||
| Yag Lasers | 488 | ||
| Excimer Laser | 489 | ||
| Femto Laser | 489 | ||
| Laser Procedures Currently Under Investigation | 490 | ||
| Corneal Laser Surgery | 490 | ||
| Lens Surgery | 490 | ||
| Laser Asepsis | 489 | ||
| Phototherapy | 490 | ||
| Dye Laser-Chromophore Technique | 489 | ||
| Retinal Surgery | 490 | ||
| Chapter 43. - Diode Laser-Instrumentation and Clinical Applications\r | 492 | ||
| Introduction | 493 | ||
| Treatment Schedule for Common Pathological Conditions | 494 | ||
| Application of Diode Laser | 494 | ||
| ICG-Guided Laser Treatment of Choroidal Neovascularisation | 494 | ||
| Treatment of Diabetic Macular Oedema | 495 | ||
| Treatment of Proliferative Diabetic Retinopathy | 495 | ||
| Clinical Advantages of Diode Laser for Pan-Retinal Photocoagulation and Macular Oedema | 496 | ||
| Diode Laser Trabeculoplasty | 496 | ||
| Laser Indirect Ophthalmoscopy | 496 | ||
| Chapter 44 - Clinical Spectrum of Retinitis Pigmentosa and Its Variants\r | 498 | ||
| Introduction | 499 | ||
| History | 499 | ||
| Typical Retinitis Pigmentosa | 499 | ||
| Prevalence | 499 | ||
| Clinical Features | 499 | ||
| Night Blindness | 499 | ||
| Visual Field Loss | 499 | ||
| Central Vision Loss | 500 | ||
| Colour Vision | 500 | ||
| Fundus Findings | 500 | ||
| Vitreous Abnormalities | 501 | ||
| Anterior Segment Abnormalities | 501 | ||
| Keratoconus | 501 | ||
| Glaucoma | 502 | ||
| Refractive Status | 502 | ||
| Other Accessory Features | 502 | ||
| Classification of Retinitis Pigmentosa | 502 | ||
| Subdivision by Rod-Cone Versus Cone-Rod Involvement in ERG | 502 | ||
| Subdivision by Inheritance Type | 502 | ||
| Autosomal Recessive RP | 502 | ||
| Autosomal Dominant RP | 502 | ||
| X-Linked RP | 502 | ||
| Simplex Cases | 503 | ||
| Subdivision by Distribution of Retinal Involvement or Fundus Appearance | 503 | ||
| RP Sine Pigmento | 503 | ||
| Retinitis Punctata Albescens | 503 | ||
| RP Inversus (Pericentral RP and Central RP) | 503 | ||
| Sector RP | 504 | ||
| RP with Exudative Vasculopathy | 504 | ||
| Unilateral RP | 504 | ||
| AR-RP with Preserved Para-Arteriolar RPE | 504 | ||
| Subdivision by Age of Onset | 505 | ||
| Retinitis Pigmentosa with Systemic Disorders | 505 | ||
| Usher Syndrome | 505 | ||
| Lawrence-Moon-Biedl Syndrome | 505 | ||
| Cockayne's Syndrome | 506 | ||
| Familial Juvenile Nephronophthisis (Senior Syndrome/Retinorenal Dysplasia) | 506 | ||
| Alstrom Syndrome | 506 | ||
| Neurological Disorders | 506 | ||
| Spinocerebellar Degenerations | 507 | ||
| Mitochondrial Myopathy (Kearns-Sayre Syndrome) | 507 | ||
| Metabolic Disorders | 507 | ||
| Refsum Syndrome | 507 | ||
| Mucopolysaccharidosis | 507 | ||
| Tests of Visual Function | 507 | ||
| Electroretinography | 507 | ||
| Dark Adaptation and Visual Sensitivity | 508 | ||
| Visual Fields | 508 | ||
| Fundus Reflectometry | 508 | ||
| Contrast Sensitivity | 508 | ||
| Electro-Oculogram | 508 | ||
| Visually Evoked Response | 508 | ||
| Fluorescein Angiography | 509 | ||
| Vitreous Fluorophotometry | 509 | ||
| Clinical Evaluation of the Patient | 509 | ||
| Differential Diagnosis | 509 | ||
| Molecular Genetics of Retinitis Pigmentosa | 511 | ||
| Autosomal Dominant Retinitis Pigmentosa | 511 | ||
| Autosomal Recessive Retinitis Pigmentosa | 511 | ||
| X-linked Retinitis Pigmentosa | 512 | ||
| Management of Retinitis Pigmentosa | 512 | ||
| Vitamin a Therapy | 512 | ||
| Chapter 45 - Intraocular Tumours\r | 514 | ||
| Iris Tumours | 515 | ||
| Iris Cyst | 515 | ||
| Iris Naevus | 516 | ||
| Iris Melanoma | 516 | ||
| Clinical Features | 516 | ||
| Investigations | 516 | ||
| Differential Diagnosis | 516 | ||
| Management | 516 | ||
| Juvenile Xanthogranuloma | 516 | ||
| Ciliary Body Tumours | 517 | ||
| Medulloepithelioma | 517 | ||
| Chapter 46 - Sellar and Suprasellar Lesions\r | 533 | ||
| Anatomy of sella and optic chiasm | 534 | ||
| Lesions | 534 | ||
| Clinical features | 534 | ||
| Visual Loss | 534 | ||
| Visual Field Loss | 534 | ||
| Fundus evaluation | 535 | ||
| Motor Disorders | 535 | ||
| Treatment modalities for sellar and suprasellar lesions | 536 | ||
| Common lesions causing sellar and suprasellar syndrome | 536 | ||
| Pituitary Adenoma | 536 | ||
| Craniopharyngioma | 537 | ||
| Meningiomas | 539 | ||
| Optic Nerve Glioma | 542 | ||
| Internal Carotid Artery Aneurysms | 542 | ||
| Optochiasmatic Arachnoiditis | 543 | ||
| Traumatic Chiasmal Syndrome | 543 | ||
| Empty Sella Syndrome | 543 | ||
| Section VII : OCULAR TRAUMA, ORBITAND OCULOPLASTY \r | 545 | ||
| Chapter 47 - Anterior Segment Trauma: Current Status\r | 547 | ||
| Introduction | 548 | ||
| Evaluation | 548 | ||
| Classification of Eye Injuries | 548 | ||
| Ocular Trauma Score | 548 | ||
| History Taking | 549 | ||
| Examination | 549 | ||
| Blunt Injuries | 549 | ||
| Conjunctival Injuries | 550 | ||
| Corneal Injuries | 550 | ||
| Corneal Oedema | 550 | ||
| Foreign Bodies | 551 | ||
| Corneal Abrasions | 551 | ||
| Corneoscleral Lacerations | 551 | ||
| Iris Trauma | 551 | ||
| Traumatic Iridodialysis | 551 | ||
| Cyclodialysis | 552 | ||
| Traumatic Hyphaema | 553 | ||
| Ghost Cell Glaucoma | 556 | ||
| Glaucoma With Blunt Injury to The Angle | 556 | ||
| Clinical Course and Findings | 557 | ||
| Pathogenesis | 557 | ||
| Treatment | 557 | ||
| Lens Injuries | 557 | ||
| Contusion Cataracts | 557 | ||
| Dislocation or Subluxation of Lens | 558 | ||
| Phacoanaphylactic Uveitis | 558 | ||
| Open Globe Injuries of the Anterior Segment | 558 | ||
| Conjunctival Lacerations | 558 | ||
| Corneal Lacerations | 559 | ||
| Preoperative Management | 559 | ||
| Principles of Induced Astigmatism in Corneal Lacerations and Repair | 559 | ||
| Injury Repair Techniques | 560 | ||
| Special Situations | 561 | ||
| Corneoscleral Lacerations | 562 | ||
| Corneoscleral Lacerations with Uveal and Vitreous Prolapse | 563 | ||
| Laceration with Tissue Loss | 564 | ||
| Irreparable Lacerations | 564 | ||
| Postoperative Management | 564 | ||
| Suture Removal | 564 | ||
| Prognosis in Corneal Lacerations | 564 | ||
| Retained Foreign Body in Anterior Segment | 565 | ||
| History | 565 | ||
| Examination | 565 | ||
| Treatment | 565 | ||
| Anterior Segment Reconstruction Following Ocular Trauma | 565 | ||
| Keratoplasty | 566 | ||
| Combined Anterior and Posterior Segment Injuries | 566 | ||
| Posterior Scleral Lacerations | 566 | ||
| Sympathetic Ophthalmia | 566 | ||
| Clinical Features | 566 | ||
| Aetiology | 567 | ||
| Prevention and Management | 567 | ||
| Chemical Injuries | 567 | ||
| Clinical Course | 568 | ||
| McCulley's Classification | 568 | ||
| Grading of Ocular Chemical Burn Severity: Dua's Classification73 | 568 | ||
| Management | 569 | ||
| Immediate Phase | 569 | ||
| Acute Phase (0-7 Days) | 569 | ||
| Early Reparative Phase (7-21 Days) | 569 | ||
| Late Reparative Phase | 569 | ||
| Role of Amniotic Membrane Transplant And Limbal Stem Cell Transplant in Chemical Burns | 570 | ||
| Amniotic Membrane Transplant | 570 | ||
| Procedure for harvesting amniotic membrane | 570 | ||
| Limbal Stem Cell Transplantation | 570 | ||
| Thermal Injuries | 572 | ||
| Conjunctival and Corneal Burns | 574 | ||
| Chapter 48 - Management of Posterior Segment Trauma: Current Status\r | 577 | ||
| Introduction | 578 | ||
| Pathology and Pathogenesis | 578 | ||
| Evaluation | 579 | ||
| International Classification of Ocular Trauma6 | 579 | ||
| Closed Globe Injury | 580 | ||
| Acute Management of Closed Globe Injury | 580 | ||
| Dislocated Lens | 580 | ||
| Management of Posteriorly Dislocated Lens | 580 | ||
| Option of Intraocular Lens | 581 | ||
| Commotio RETINAE (Berlin's Oedema) | 581 | ||
| Choroidal Rupture | 581 | ||
| Macular Hole | 582 | ||
| Chorioretinitis Sclopetaria | 582 | ||
| OPTIC NERVE AVULSION | 582 | ||
| Vitreous Base Avulsion | 582 | ||
| Retinal Dialysis and Retinal Detachment | 583 | ||
| Vitreous Haemorrhage | 583 | ||
| Surgery for Vitreous Haemorrhage in Blunt Trauma | 584 | ||
| Subhyaloid Haemorrhage | 584 | ||
| Subretinal Haemorrhage | 584 | ||
| Management of Submacular Haemorrhage | 585 | ||
| Open Globe Injury | 585 | ||
| Acute Management of Open Globe Injury | 585 | ||
| Repair of Scleral Ruptures | 585 | ||
| Post-Primary Repair Evaluation | 586 | ||
| Role of Vitrectomy in Management of Perforating Injury | 586 | ||
| Timing of Vitrectomy | 586 | ||
| Indications for Vitrectomy | 586 | ||
| Traumatic vitreous haemorrhage | 586 | ||
| Tractional and combined retinal detachment | 587 | ||
| Double perforation | 588 | ||
| Intraocular foreign body | 589 | ||
| Accidental Globe Perforation During Retrobulbar Anaesthesia | 591 | ||
| Accidental Intraocular Steroid Injection | 592 | ||
| Use of Temporary Keratoprosthesis | 592 | ||
| Prognosis | 593 | ||
| Chapter 49 - Evaluation of a patient with orbital disease\r | 595 | ||
| Functional anatomy of the orbit | 596 | ||
| Contents of the orbit | 597 | ||
| Evaluation of an orbital disorder | 597 | ||
| A detailed history | 597 | ||
| Examination of the patient | 598 | ||
| Investigations | 599 | ||
| Radiology in orbital disease4-11 | 599 | ||
| Pathology in orbital disease4,12-14 | 602 | ||
| Laboratory investigations15-18 | 602 | ||
| Some common disorders of the orbit | 603 | ||
| Orbital cellulitis19-23 | 603 | ||
| Dysthyroid ophthalmopathy17-19,24-31 | 604 | ||
| Idiopathic orbital inflammatory disease11,16,32-36 | 605 | ||
| Orbital trauma37-42 | 605 | ||
| Approaches to the orbit (Fig. 49.13) | 607 | ||
| Lateral orbitotomy | 607 | ||
| Anterior orbitotomy | 608 | ||
| Chapter 50 - Basic Principles of Oculoplastic Surgery\r | 611 | ||
| Preoperative Considerations | 612 | ||
| Surgical Principles: Intraoperative | 612 | ||
| Incisions | 612 | ||
| Haemostasis | 612 | ||
| Preoperative Measures | 612 | ||
| Intraoperative Measures | 612 | ||
| Postoperative Measures | 613 | ||
| Wound Closure | 613 | ||
| Suture Needles for Oculoplastic Surgery | 613 | ||
| Suture Material | 614 | ||
| Absorbable Sutures | 614 | ||
| Non-Absorbable Sutures | 615 | ||
| Permanent Sutures | 615 | ||
| Closure of Skin Defects | 615 | ||
| Direct Closure | 615 | ||
| Technique of Suture Placement | 615 | ||
| Interrupted Sutures | 615 | ||
| Running Sutures | 616 | ||
| Continuous Interlocking Sutures | 616 | ||
| Mattress Sutures | 616 | ||
| Suturing in Special Situations | 617 | ||
| Dog-Ear Deformities | 617 | ||
| Other Methods for Skin Defects' Closure | 617 | ||
| Flaps (Box 50.1) | 617 | ||
| Local Flaps | 617 | ||
| Pedicle Flaps | 618 | ||
| Plasties (Box 50.2) | 618 | ||
| Z-Plasty | 618 | ||
| V-Y-plasty | 618 | ||
| Grafts | 618 | ||
| Skin Grafts | 619 | ||
| Mucous Membrane Grafting | 620 | ||
| Fascia Lata Graft | 621 | ||
| Dermis Fat Graft | 621 | ||
| Cartilage Graft | 621 | ||
| Postoperative Measures | 621 | ||
| Chapter 51 - Advances in lacrimal surgery\r | 623 | ||
| Role of mitomycin c in external DCR | 624 | ||
| Endoscopic DCR | 624 | ||
| Endonasal DCR | 624 | ||
| Transcanalicular DCR | 625 | ||
| Endocanalicular recanalisation | 626 | ||
| Conjunctivodacryocystorhinostomy | 626 | ||
| Chapter 52 - Recent Advances in Oculoplastic Surgery\r | 629 | ||
| Introduction | 630 | ||
| Materials Used in Sling Surgery for Ptosis | 630 | ||
| Autologous/Homologous Materials | 630 | ||
| Synthetic Materials | 631 | ||
| Materials Used in Orbital Floor Fracture Repair | 632 | ||
| Anophthalmic Implants | 634 | ||
| Facial Nerve Palsy: Management | 637 | ||
| Benign Essential Blepharospasm | 637 | ||
| Psychotherapy | 637 | ||
| Drug Therapy | 638 | ||
| Botulinum Toxin Injection | 638 | ||
| Surgical Management | 638 | ||
| Section VIII : OCULAR DIAGNOSIS\r | 641 | ||
| Chapter 53 - Ophthalmic Electrodiagnostic Techniques\r | 643 | ||
| Introduction | 644 | ||
| History | 644 | ||
| Electroretinogram | 644 | ||
| Components | 644 | ||
| Various types of Erg Studies Available | 645 | ||
| Recording of erg | 645 | ||
| Materials Required | 645 | ||
| Classification of abnormal erg Waves | 647 | ||
| Factors Influencing The Normal ERG | 647 | ||
| Electro-Oculogram | 648 | ||
| Components | 648 | ||
| Recording of EOG | 648 | ||
| Visually Evoked Potential | 649 | ||
| Types of VEP | 649 | ||
| Recording of VEP8 | 650 | ||
| Electronystagmography | 651 | ||
| Recording of ENG | 651 | ||
| Various testing procedures with ENG | 652 | ||
| Electromyography | 652 | ||
| Uses in Ophthalmology | 653 | ||
| Clinical significance and Application of Electrodiagnostic Procedures | 653 | ||
| Hereditary degenerations of Retina | 653 | ||
| Acquired Disorders of Retina | 654 | ||
| Electrodiagnosis when fundus Is Normal | 655 | ||
| Electrodiagnosis in Cases of Media Opacity | 655 | ||
| Toxic and Deficiency States | 655 | ||
| Role in Injury | 655 | ||
| Medicolegal Value | 656 | ||
| Role in Neurology and Neurosurgery | 656 | ||
| All tests considered-which, When, why? | 656 | ||
| Erg Versus EOG | 656 | ||
| ERG Versus VEP | 657 | ||
| Diagnosis and Confirmation of Visual Loss | 657 | ||
| When Fundus Is Obscured | 657 | ||
| Chapter 54 - Fundus Fluorescein Angiography of Retinochoroidal Disorders\r | 659 | ||
| Fundus Fluorescein Angiography | 660 | ||
| Procedure and Adverse Effects | 660 | ||
| Interpretation of Normal Fluorescein Angiogram | 662 | ||
| Abnormal Fluorescence | 663 | ||
| Clinical Interpretation of Fluorescein Angiograms | 665 | ||
| Indocyanine Green Angiography | 665 | ||
| Clinical Situations Requiring FFA | 666 | ||
| Diabetic Retinopathy | 666 | ||
| Non-Proliferative Diabetic Retinopathy | 666 | ||
| Proliferative Diabetic Retinopathy | 668 | ||
| Laser Marks | 668 | ||
| Large Vessel Occlusive Diseases | 669 | ||
| Macular Diseases | 670 | ||
| PED and Neurosensory Detachment | 670 | ||
| Cystoid Macular Oedema | 670 | ||
| Hereditary Macular Degenerations | 670 | ||
| Age-Related Macular Degeneration | 671 | ||
| Choroidal Lesions | 677 | ||
| Choroidal Tumours | 677 | ||
| Choroiditis | 678 | ||
| Other Lesions Classically Studied on FFA | 678 | ||
| Summary | 678 | ||
| Chapter 55 - Determination of \rIntraocular Lens Implant Power | 679 | ||
| Introduction | 680 | ||
| First-Generation IOL Power Formulas | 680 | ||
| Second-Generation IOL Power Formulas | 680 | ||
| Third-Generation IOL Power Formulas | 681 | ||
| The Lens Constants and Personalisation | 681 | ||
| Factors Affecting Lens Constants | 681 | ||
| Fourth-Generation IOL Power Formulas | 682 | ||
| The Measurement of Axial Length | 683 | ||
| Echography Principles | 683 | ||
| Biometry Technique | 684 | ||
| Avoiding Errors in Biometry | 685 | ||
| A-Scan Biometer Features | 686 | ||
| Partial Coherence Laser Interferometry | 687 | ||
| Biometry and IOL Power Calculation in Special Situations | 688 | ||
| The Pseudophakic Eye | 688 | ||
| The Aphakic Eye | 689 | ||
| Intumescent Cataract | 689 | ||
| The Highly Myopic Eye With Posterior Staphyloma | 690 | ||
| The Very Short Eye | 691 | ||
| Silicone-Filled Eyes | 691 | ||
| Measurement of Corneal Power | 691 | ||
| IOL Power Calculation in Eyes After Previous Corneal Refractive Surgery | 692 | ||
| IOL Power Calculation After Radial Keratotomy | 695 | ||
| Scarred Corneas, Keratoconus | 695 | ||
| Corneal Transplantation Combined with Cataract Surgery | 695 | ||
| Pre-Existing Astigmatism | 696 | ||
| Selecting the Appropriate IOL Power | 697 | ||
| Multifocal IOLs | 698 | ||
| IOL Power Selection in Children | 698 | ||
| Analysing Results and Dealing with Refractive Surprises | 698 | ||
| Chapter 56 - Ultrasonography in Ophthalmology | 703 | ||
| Introduction | 704 | ||
| Physics | 704 | ||
| Instrumentation | 704 | ||
| Indications | 706 | ||
| Anterior Segment | 706 | ||
| Posterior Segment | 706 | ||
| Biometry | 706 | ||
| Orbital Examination | 706 | ||
| Examination Technique | 706 | ||
| Ultrasonographic Characteristics of Ocular Disorders | 707 | ||
| Vitreoretinal Disorders | 707 | ||
| Retinal Detachment | 708 | ||
| Choroid | 709 | ||
| Evaluation of Pupil | 709 | ||
| Sclera | 709 | ||
| Cornea | 709 | ||
| Trauma | 710 | ||
| Intraocular Foreign Bodies | 710 | ||
| Axial Eye Length Measurements | 710 | ||
| Intraocular Tumours | 710 | ||
| Ocular Melanoma | 711 | ||
| Measurement of Tumour Dimensions | 711 | ||
| Ciliary Body and Iris Melanomas | 711 | ||
| Retinoblastomas | 711 | ||
| Orbit | 712 | ||
| Soft Tissue Evaluation | 712 | ||
| Evaluation of Extraocular Muscles | 712 | ||
| Evaluation of Optic Nerve | 713 | ||
| Ultrasonography in Paediatric Patients | 713 | ||
| Pitfalls/Shortcomings of Ultrasonography | 714 | ||
| Artefacts | 714 | ||
| Tumours | 714 | ||
| Vitreoretinal Disease | 714 | ||
| Intraocular Foreign Body | 714 | ||
| Orbit | 714 | ||
| Biometry | 714 | ||
| Very High Frequency Ultrasound and Ultrasound Biomicroscopy | 715 | ||
| Doppler Scan Mode | 716 | ||
| Chapter 57 - Ocular Coherence Tomography\r | 718 | ||
| Introduction | 719 | ||
| Principle | 719 | ||
| Techniques | 719 | ||
| OCT Machine | 719 | ||
| Macular Holes | 719 | ||
| Epiretinal Membranes | 720 | ||
| Diabetic Macular Oedema | 721 | ||
| Cystoid Macular Oedema | 721 | ||
| Central Serous Retinopathy | 721 | ||
| Choroidal Neovascularisation | 722 | ||
| Glaucoma | 723 | ||
| Future Considerations | 723 | ||
| Chapter 58 - Evaluation of Macular Function in Opaque Media\r | 732 | ||
| Introduction | 733 | ||
| Rudimentary Clinical Techniques | 733 | ||
| Two-Light Discrimination Test | 733 | ||
| Pinhole Test | 733 | ||
| Relative Luminance | 733 | ||
| Maddox Rod Test | 733 | ||
| Amsler Grid | 734 | ||
| Colour Perception | 734 | ||
| Tests based on entoptic Phenomena | 734 | ||
| Purkinje Vessel Shadows | 734 | ||
| Blue Field Entoptoscope | 734 | ||
| Interferometers and potential Acuity meter | 734 | ||
| Potential Acuity Meter | 736 | ||
| Tests Based On Hyperacuity | 736 | ||
| Stereoacuity | 737 | ||
| Vernier Acuity | 737 | ||
| Oscillatory Displacement Threshold Tests | 737 | ||
| Electrophysiological Techniques | 737 | ||
| Tests to assess Anatomic Integrity | 737 | ||
| Ultrasonography | 737 | ||
| Ocular Coherence Tomography | 737 | ||
| Chapter 59 - Retinal Laser Scanning and Digital Imaging\r | 739 | ||
| Retinal Laser Scanning | 740 | ||
| Principle1-3 | 740 | ||
| Operation of SLO | 740 | ||
| Confocal Arrangement | 740 | ||
| Confocal scanning laser Ophthalmoscope4 | 740 | ||
| Retinal imaging: Advantages of CSLO | 740 | ||
| What is new and Better about SLO and CSLO | 741 | ||
| Future Applications of CSLO and SLO | 741 | ||
| Retinal Digital Imaging | 741 | ||
| Analysis of Displayed Image | 741 | ||
| Enhancement functions | 741 | ||
| Measurement functions | 741 | ||
| Storing the Images | 741 | ||
| Chapter 60 - Imaging of the \rOrbit | 743 | ||
| Normal Orbital Anatomy | 744 | ||
| Imaging Techniques | 744 | ||
| Computed Tomography | 744 | ||
| Magnetic Resonance Imaging | 744 | ||
| Anatomy | 745 | ||
| Anterior Orbit | 746 | ||
| Globe | 746 | ||
| Retrobulbar Space | 746 | ||
| Fissures | 746 | ||
| Optic Canal | 746 | ||
| Extraocular Muscles And Intermuscular Compartment | 746 | ||
| Optic Nerve and Visual Pathways | 746 | ||
| Vascular Structures | 747 | ||
| Abnormalities of Size and Contour | 747 | ||
| Anophthalmos | 747 | ||
| Microphthalmos | 747 | ||
| Buphthalmos or Macrophthalmia | 747 | ||
| Coloboma | 747 | ||
| Staphyloma | 748 | ||
| Leukokoria | 748 | ||
| Diagnostic Imaging | 748 | ||
| Persistent Hyperplastic Primary Vitreous | 749 | ||
| Retinopathy of Prematurity | 750 | ||
| Coats' Disease | 750 | ||
| Malignant Uveal Melanoma | 750 | ||
| Uveal Metastasis | 751 | ||
| Choroidal and Retinal Haemangiomas | 751 | ||
| Orbital Imaging | 752 | ||
| Orbital Pathology | 752 | ||
| Developmental Orbital Cysts | 753 | ||
| Inflammatory Diseases of the Orbit | 753 | ||
| Orbital Cellulitis | 754 | ||
| Orbital and Subperiosteal Abscess | 755 | ||
| Orbital Pseudotumours | 755 | ||
| Thyroid Orbitopathy | 755 | ||
| Vascular Diseases | 756 | ||
| Lymphangiomas | 757 | ||
| Carotid Cavernous Fistulas And Vascular Malformations | 758 | ||
| Neoplasms | 759 | ||
| Rhabdomyosarcoma | 759 | ||
| Granulocytic Sarcoma | 760 | ||
| Eosinophilic Granuloma | 760 | ||
| Fibrous Dysplasia | 761 | ||
| Secondary Tumours | 761 | ||
| Orbital Lymphomas | 761 | ||
| Optic Nerve Lesions | 761 | ||
| Non-Tumoural Enlargement of the Optic Nerve | 761 | ||
| Optic Neuritis | 761 | ||
| Schwannoma | 762 | ||
| Plexiform Neurofibroma | 761 | ||
| Optic Nerve Sheath Meningiomas | 763 | ||
| Lacrimal Gland Lesions | 763 | ||
| Trauma and Foreign Bodies | 764 | ||
| Intracranial Visual Pathways | 764 | ||
| Section IX : COMMUNITY OPHTHALMOLOGY\r | 768 | ||
| Chapter 61 - VISION 2020\r | 769 | ||
| Introduction | 770 | ||
| The Challenge | 770 | ||
| Vision 2020: The Right to Sight-a Global Initiative | 771 | ||
| Global Initiative: Salient Features | 771 | ||
| Implementation of The Initiative | 771 | ||
| Disease-Specific Approaches | 771 | ||
| Cataract | 771 | ||
| Trachoma | 772 | ||
| Onchocerciasis | 772 | ||
| Childhood blindness | 772 | ||
| Refractive errors and low vision | 773 | ||
| Human Resource Development | 773 | ||
| Vision 2020: The Partners | 773 | ||
| Chapter 62 - Strategic Plan for VISION 2020: The Right to Sight Initiative in India\r | 775 | ||
| Introduction | 776 | ||
| Global Trends in Blindness | 776 | ||
| Blindness in India | 776 | ||
| Constraints in Controlling Blindness in India | 777 | ||
| Inequitable Distribution of Eye Surgeons | 777 | ||
| Suboptimal Utilisation of Human Resources | 777 | ||
| Inadequate Number of Paramedical Eye Care Personnel | 777 | ||
| Variation in Quality | 777 | ||
| Suboptimal Coverage | 777 | ||
| Overemphasis on Cataract | 777 | ||
| Lack of Public Awareness | 777 | ||
| Strategies for VISION 2020 in India | 777 | ||
| Strengthening Advocacy | 777 | ||
| National and State Level | 777 | ||
| District Level | 778 | ||
| Reduction of Disease Burden | 778 | ||
| Strategies of Cataract, Diabetic Retinopathy and Glaucoma | 778 | ||
| Childhood Blindness | 779 | ||
| Corneal Blindness | 779 | ||
| Low Vision and Refractive Errors | 780 | ||
| Strategies | 780 | ||
| Human Resource Development | 780 | ||
| Undergraduate Medical Education | 780 | ||
| Postgraduate Ophthalmology | 780 | ||
| Paramedical Education in Ophthalmology | 781 | ||
| Eye Care Management | 781 | ||
| Eye Care Infrastructure | 781 | ||
| Management Information System | 781 | ||
| National Level Activities | 782 | ||
| Annexure | 783 | ||
| Chapter 63 - World Bank Assisted Cataract Blindness Control Project in India: A Brief Outline\r | 784 | ||
| Introduction | 785 | ||
| Rationale for Selection of the Project States | 785 | ||
| Objectives | 785 | ||
| Strategies | 785 | ||
| Expected Outcome | 786 | ||
| Financial Outlay | 786 | ||
| Chapter 64 - Policy Norms and Technical Standards Adopted Under World Bank Assisted Cataract Blindness Control Project\r | 787 | ||
| Introduction | 788 | ||
| Revised Strategies | 788 | ||
| High Standards of Eye-Care Services | 788 | ||
| Technological Advancement | 788 | ||
| Coordinated Effort | 788 | ||
| Demand Generation | 788 | ||
| Team Approach | 788 | ||
| Technical Standards | 788 | ||
| Quality Visual Outcomes | 788 | ||
| Grievance Committees | 788 | ||
| Guidelines to Organise Eye Camps | 788 | ||
| Guidelines for Involvement of NGOs | 789 | ||
| Criteria for Selection | 789 | ||
| Standards for Efficient Ophthalmic Services | 789 | ||
| Standard Patient Card for Preoperative, Operative and Postoperative Care | 790 | ||
| Guidelines for Type of Cataract Surgery | 790 | ||
| Criteria for Monitoring Performance | 791 | ||
| Quality of Eye Care Service (Table 64.4) | 791 | ||
| Conclusion | 791 | ||
| Chapter 65 - Planning and Conducting Surveys | 792 | ||
| Basic Epidemiological Principles | 793 | ||
| Definition of Epidemiology | 793 | ||
| Uses of Epidemiology in Ophthalmology | 793 | ||
| Case Definitions | 794 | ||
| Measuring Ocular Morbidity | 794 | ||
| Prevalence Rate | 794 | ||
| Cumulative Incidence Rate | 794 | ||
| Incidence Rate | 795 | ||
| Sampling for Surveys | 795 | ||
| Individual Sampling Techniques | 796 | ||
| Group Sampling Techniques | 796 | ||
| Sample Size Estimation | 796 | ||
| Practical issues in Conducting Surveys | 796 | ||
| Problems Commonly Encountered in Surveys | 797 | ||
| Survey Instruments | 798 | ||
| Observational Recording Formats | 799 | ||
| Making a Good Survey Instrument | 800 | ||
| Equipment Care | 800 | ||
| Questionnaires/Schedules/Recording Forms | 800 | ||
| Characteristics of a Satisfactory Instrument | 801 | ||
| Collection of Survey Information | 801 | ||
| Survey Logistics | 802 | ||
| Survey Data Management | 803 | ||
| Organising the Findings of a Survey | 804 | ||
| Writing the Survey Report | 804 | ||
| Chapter 66 - Managing Eye Care Services\r | 806 | ||
| Introduction | 807 | ||
| Management | 807 | ||
| Functions of Manager and Management | 807 | ||
| Planning Eye Care Programmes | 807 | ||
| Planning Cycle | 807 | ||
| Identify Eye Care Problems | 808 | ||
| Determination of Priority Eye Condition | 808 | ||
| Conducting a Situational Analysis | 808 | ||
| Defining Goals and Objectives | 809 | ||
| Alternative Strategies | 809 | ||
| Developing a Plan of Action | 809 | ||
| Implementation | 809 | ||
| Monitoring | 809 | ||
| Evaluation | 810 | ||
| Reprogramming | 810 | ||
| The Team Approach | 811 | ||
| Features of Effective Working Teams | 811 | ||
| Techniques for efficient Teamwork | 812 | ||
| Group Work | 812 | ||
| Meetings | 812 | ||
| Index | 813 | ||
| A | 813 | ||
| B | 814 | ||
| C | 814 | ||
| D | 815 | ||
| E | 816 | ||
| F | 817 | ||
| G | 817 | ||
| H | 818 | ||
| I | 818 | ||
| J | 819 | ||
| K | 819 | ||
| L | 819 | ||
| M | 819 | ||
| N | 820 | ||
| O | 820 | ||
| P | 821 | ||
| Q | 822 | ||
| R | 822 | ||
| S | 823 | ||
| T | 824 | ||
| U | 824 | ||
| V | 825 | ||
| W | 825 | ||
| Y | 825 | ||
| Z | 825 |