Manual for Eye Examination and Diagnosis
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Manual for Eye Examination and Diagnosis, 9th edition is a classic guide that provides a thorough update to basic eye examination techniques and the use of instruments and major ophthalmic disorders. Its popular approach takes the reader through the eye exam, covering anatomy, differential diagnosis, and treatment.
Lavishly illustrated with over 550 color and black and white images, this accessible introductory text is designed for students who need a concise and thorough introduction to this complex and ever-changing specialty.
Students and trainees across the healthcare professions will welcome the practical approach which focuses on the most commonly encountered eye diseases, their examination and treatment.
semi-circular canals and the vestibule of the inner ear. Their axons connect in a complex system to the nuclei of CN III, IV and VI in the brainstem. These nuclei control the muscles 32 NEURO-OPHTHALMOLOGY Fig. 3.33 In CN VII paralysis, the inability to close the eye causes corneal dessication. To remedy this, in the above patient, the left lateral upper and lower tarsus were sutured together (tarsorraphy). It may be temporary or permanent. 9780470671122_4_003.qxd 12/2/11 7:40 PM Page 33
that move the eye. This vestibulo-ocular reflex maintains fixation and balance when the head moves. Diseases of this pathway cause nystagmus and the illusionary whirling sensation called vertigo. The cochlear division of this nerve is responsible for hearing. Normal nystagmus This is an involuntary rhythmic movement of the eyes in a horizontal, vertical, or rotary fashion. Pendular nystagmus means equal motion in each direction, while the jerky type has a quicker movement in one direction than
ominous since they immediately penetrate the depths of the cornea and permanently scar (Figs 6.15 and 6.16). Acid burns usually do not penetrate stroma or scar. Rx: irrigate all chemical injuries immediately and profusely. Fig. 6.13 Superficial punctate keratitis (SPK) from trichiasis. Epidemic keratoconjunctivitis (Fig. 6.17) is a common, highly infectious condition due to one of the adenoviruses that cause the common cold. There may be a severe conjunctivitis lasting up to 3 weeks associated
If discovered early, laser treatment may reduce visual complications by 50%. Therefore all diabetics should be examined yearly. Autoimmune (Graves’) thyroid disease This is a condition in which an orbitopathy may be present with hyper- but also hypo- or euthyroid disease. 1 It is the most common cause of bulging eyes, referred to as exophthalmos or proptosis. This is due to fibroblast proliferation and mucopolysacharide infiltration of the orbit. A small white area of sclera appearing between the
the A-P diameter of the eye. This length, together with the corneal curvature, as determined with a keratometer, gives the exact power of the intraocular lens implant needed. Intraocular lens use in infants is presently being evaluated as to its safety profile, but has gained wide acceptance after 1-2 years of age. The lens is usually placed behind the iris (Figs 6.169–6.171), unless the posterior capsule or zonules are torn and can’t support it. In these cases, it is placed in front of the iris