Kanski's Synopsis of Clinical Ophthalmology

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Cover IBC Copyright Contents Preface Acknowledgements Abbreviations Dedication 1 Examination of the Eye Ophthalmic history Common ocular symptoms Visual acuity Snellen visual acuity LogMAR visual acuity Contrast sensitivity Amsler grid Colour vision Ishihara Farnsworth–Munsell 100-hue test Visual field Analysis of visual fields Microperimetry External examination Slit lamp biomicroscopy of the anterior segment Direct ophthalmoscopy Indirect ophthalmoscopy Tonometry Central corneal thickness Gonioscopy Optical coherence tomography (OCT) OCT angiography Fundus angiography Fluorescein angiography (FA) Indocyanine green angiography (ICG) 2 Eyelids Benign Nodules and Cysts Chalazion (meibomian cyst) Miscellaneous Benign Tumours Squamous cell papilloma Basal cell papilloma (seborrhoeic keratosis) Actinic (solar, senile) keratosis Congenital melanocytic naevus Acquired melanocytic naevus Capillary haemangioma (strawberry naevus) Port-wine stain (naevus flammeus) Xanthelasma Neurofibroma Malignant Tumours Rare predisposing conditions Basal cell carcinoma (BCC) Squamous cell carcinoma (SCC) Keratoacanthoma Sebaceous gland carcinoma Malignant melanoma Principles of surgical treatment Disorders of Eyelashes Trichiasis Congenital distichiasis Acquired distichiasis (metaplastic lashes) Eyelash ptosis Trichomegaly Madarosis Poliosis Allergic Disorders Acute allergic oedema Contact dermatitis Atopic dermatitis (eczema) Viral Infections Molluscum contagiosum Herpes zoster ophthalmicus Herpes simplex Chronic Blepharitis Chronic marginal blepharitis Phthiriasis palpebrarum Ptosis Simple congenital ptosis Involutional ptosis Ectropion Involutional ectropion Cicatricial ectropion Paralytic ectropion Entropion Involutional entropion Cicatricial entropion Miscellaneous Acquired Disorders Blepharochalasis Floppy eyelid syndrome Cosmetic Eyelid and Periocular Surgery Nonsurgical cosmetic techniques Surgical cosmetic techniques Congenital Malformations Epicanthus Telecanthus Epiblepharon Blepharophimosis, ptosis and epicanthus inversus syndrome Coloboma Cryptophthalmos Ankyloblepharon filiforme adnatum 3 Lacrimal Drainage System Anatomy Causes of a watering eye Acquired obstruction Primary punctal stenosis Secondary punctal stenosis Canalicular obstruction Nasolacrimal duct obstruction Dacryolithiasis Congenital obstruction Nasolacrimal duct obstruction Congenital dacryocoele (amniontocoele) Principles of adult lacrimal surgery Infections Chronic canaliculitis Dacryocystitis 4 Orbit Thyroid eye disease Infections Preseptal cellulitis Bacterial orbital cellulitis Non-infective inflammatory disease Idiopathic orbital inflammatory disease (IOID) Acute dacryoadenitis Tolosa–Hunt syndrome Vascular abnormalities Varices Carotid-cavernous fistula Cystic lesions Dacryops Dermoid cyst ENCEPHALOCOELE Tumours Capillary haemangioma Cavernous haemangioma Pleomorphic lacrimal gland adenoma (benign mixed cell tumour) Lacrimal gland carcinoma Optic nerve glioma Optic nerve sheath meningioma Plexiform neurofibroma Lymphoma Rhabdomyosarcoma (embryonal sarcoma) Adult metastatic tumours Childhood metastatic tumours Orbital invasion from adjacent structures Anophthalmic socket Surgical procedures for removal of an eye or the contents of the orbit Rehabilitation of the anophthalmic socket Craniosynostoses Crouzon syndrome Apert syndrome 5 Dry Eye Definitions Physiology Mechanism of disease Classification of keratoconjunctivitis sicca Sjögren syndrome Diagnosis of dry eye syndrome Treatment 6 Conjunctiva Bacterial conjunctivitis Acute bacterial conjunctivitis Adult chlamydial conjunctivitis Trachoma Neonatal conjunctivitis (ophthalmia neonatorum) Viral conjunctivitis Adenoviral conjunctivitis Molluscum contagiosum conjunctivitis Allergic conjunctivitis Acute allergic conjunctivitis Seasonal and perennial allergic conjunctivitis Vernal keratoconjunctivitis (VKC) Atopic keratoconjunctivitis (AKC) Giant papillary conjunctivitis Conjunctivitis in blistering mucocutaneous disease Mucous membrane (cicatricial) pemphigoid Stevens–Johnson syndrome/toxic epidermal necrolysis Graft vs host disease Miscellaneous conjunctivitis Superior limbic keratoconjunctivitis Ligneous conjunctivitis Parinaud oculoglandular syndrome Factitious conjunctivitis Pathogenesis: Diagnosis Treatment: Pathogenesis: Diagnosis Treatment Pathogenesis: Diagnosis: Treatment: Pathogenesis: Diagnosis: Treatment: Pathogenesis: Diagnosis Treatment: Degenerations Pingueculum Pterygium Concretions Conjunctivochalasis Retention (epithelial inclusion) cyst 7 Cornea Bacterial keratitis Fungal keratitis Herpes simplex keratitis Pathogenesis Epithelial keratitis Disciform keratitis Necrotizing stromal keratitis Neurotrophic ulceration Other considerations Herpes zoster ophthalmicus Interstitial keratitis Pathogenesis Syphilitic Cogan syndrome Protozoan keratitis Acanthamoeba Onchocerciasis Bacterial hypersensitivity-mediated corneal disease Marginal keratitis Phlyctenulosis Rosacea Severe peripheral corneal ulceration Mooren ulcer Peripheral ulcerative keratitis associated with systemic autoimmune disease Terrien marginal degeneration Neurotrophic keratopathy Exposure keratopathy Miscellaneous keratopathies Infectious crystalline keratopathy Thygeson superficial punctate keratitis Filamentary keratopathy Recurrent corneal epithelial erosion Xerophthalmia Corneal ectasias Keratoconus Pellucid marginal degeneration Keratoglobus Corneal dystrophies Epithelial dystrophies Bowman layer/anterior stromal dystrophies Stromal dystrophies Endothelial dystrophies Corneal degenerations Age-related degenerations Lipid keratopathy Band keratopathy Spheroidal degeneration (Labrador keratopathy) Salzmann nodular degeneration Metabolic keratopathies Cystinosis Mucopolysaccharidoses Wilson disease Fabry disease Contact lenses Therapeutic uses Complications Congenital anomalies of the cornea and globe Microcornea Megalocornea Microphthalmos Sclerocornea Anophthalmos 8 Corneal and Refractive Surgery Keratoplasty Introduction Penetrating keratoplasty Corneal graft rejection Superficial lamellar keratoplasty Deep anterior lamellar keratoplasty Descemet stripping endothelial keratoplasty Limbal stem cell grafting Keratoprosthesis Refractive procedures Introduction Laser refractive procedures 9 Episclera and Sclera Episcleritis Simple episcleritis Nodular episcleritis Immune-mediated scleritis Anterior non-necrotizing scleritis Anterior necrotizing scleritis with inflammation Scleromalacia perforans Posterior scleritis Treatment of immune-mediated scleritis Systemic associations of scleritis Scleral discoloration 10 Lens Introduction Acquired cataract Effect on vision Age-related cataract Cataract in systemic disease Causes of secondary cataract Causes of traumatic cataract Management of age-related cataract Preoperative considerations Intraocular lenses Anaesthesia Phacoemulsification Operative complications Acute postoperative endophthalmitis Delayed-onset postoperative endophthalmitis Posterior capsular opacification Miscellaneous postoperative complications Congenital cataract Ectopia lentis Abnormalities of shape 11 Glaucoma Ocular Hypertension Primary Open-Angle Glaucoma (POAG) Optic Disc Changes Normal-Pressure Glaucoma (NTG) Primary Angle-Closure Glaucoma (PACG) Pseudoexfoliation Syndrome Pseudoexfoliation glaucoma Pigment Dispersion Pigment dispersion syndrome Pigmentary glaucoma Neovascular Glaucoma Introduction Rubeosis iridis Secondary open-angle glaucoma Secondary angle-closure glaucoma Inflammatory Glaucoma Angle-closure glaucoma with pupillary block Angle-closure glaucoma without pupillary block Open-angle glaucoma Treatment of inflammatory glaucoma Posner–Schlossman syndrome (glaucomatocyclitic crisis) Steroid-Induced Glaucoma Lens-related glaucoma Phacolytic glaucoma Phacomorphic glaucoma Lens dislocation into the anterior chamber Traumatic Glaucoma Hyphaema Angle recession glaucoma Iridocorneal Endothelial Syndrome Glaucoma Associated With Intraocular Tumours Glaucoma Associated With Iridoschisis Primary Congenital Glaucoma Iridocorneal Dysgenesis Posterior embryotoxon Axenfeld–Rieger syndrome Aniridia Glaucoma Medication Prostaglandin analogues Beta-blockers Alpha-2 agonists Topical carbonic anhydrase inhibitors Miotics Combined preparations New topical medications Systemic carbonic acid inhibitors Osmotic agents Laser Therapy Argon laser trabeculoplasty Selective laser trabeculoplasty Nd:YAG laser iridotomy Diode laser ablation (cyclodiode) Laser iridoplasty Trabeculectomy Shallow anterior chamber Failure of filtration Late bleb leakage Bleb-associated bacterial infection and endophthalmitis Nonpenetrating surgery Drainage Shunts Shunts using episcleral explants Mini shunts Minimally Invasive Glaucoma Surgery (MIGS) 12 Uveitis Terminology Clinical Features Acute anterior uveitis Chronic anterior uveitis Posterior uveitis Principles of Treatment Mydriatics Topical steroids Periocular steroid injection Intraocular steroids Systemic steroids Antimetabolites Alkylating agents Other drugs Intermediate Uveitis Uveitis In Spondyloarthropathies Ankylosing spondylitis Reiter syndrome Psoriatic arthritis Juvenile idiopathic arthritis Uveitis in Bowel Disease Ulcerative colitis Crohn disease Sarcoidosis Behçet Syndrome Toxoplasmosis Pathogenesis Toxoplasma retinitis Toxocariasis Onchocerciasis Uveitis in Individuals With AIDS AIDS Ocular involvement in AIDS HIV microangiopathy Cytomegalovirus retinitis Progressive retinal necrosis Acute Retinal Necrosis Fungal Uveitis Presumed ocular histoplasmosis syndrome (POHS) Cryptococcosis Endogenous fungal endophthalmitis Bacterial Uveitis Tuberculosis Syphilis Lyme disease (borreliosis) Endogenous (metastatic) bacterial endophthalmitis Cat-scratch disease Leprosy White dot syndromes Multiple evanescent white dot syndrome (MEWDS) Acute idiopathic blind spot enlargement syndrome Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) Multifocal choroiditis and panuveitis Punctate inner choroidopathy Birdshot retinochoroiditis Serpiginous choroidopathy Acute Zonal Occult Outer Retinopathy (Azoor) Primary Stromal Choroiditis Vogt–Koyanagi–Harada syndrome (VKH) Sympathetic ophthalmitis Fuchs Uveitis Syndrome 13 Retinal Vascular Disease Diabetic retinopathy Introduction Classification Signs Treatment of clinically significant macular oedema (CSMO) Treatment of proliferative retinopathy Advanced diabetic eye disease Retinal venous occlusive disease Introduction Predisposing factors Systemic assessment Branch retinal vein occlusion Non-ischaemic central retinal vein occlusion Ischaemic central retinal vein occlusion Hemiretinal vein occlusion Retinal arterial occlusive disease Introduction Pathogenesis Systemic assessment Amaurosis fugax Branch retinal artery occlusion Central retinal artery occlusion Treatment of acute retinal artery occlusion Systemic prophylaxis following retinal arterial occlusion Asymptomatic retinal embolus Hypertensive disease Retinopathy Choroidopathy Sickle cell retinopathy Nonproliferative retinopathy Proliferative retinopathy Retinopathy of prematurity Retinal artery macroaneurysm Primary retinal telangiectasia Idiopathic macular telangiectasia Coats disease Purtscher retinopathy Valsalva retinopathy Retinopathy in blood disorders 14 Acquired Macular Disorders Anatomy Age-related macular degeneration (AMD) Introduction Drusen Prophylactic antioxidant supplementation in AMD Non-exudative AMD Retinal pigment epithelial detachment Retinal pigment epithelial tear Exudative AMD Retinal angiomatous proliferation Polypoidal choroidal vasculopathy Age-related macular hole Central serous chorioretinopathy Cystoid macular oedema Macular epiretinal membrane Degenerative myopia Angioid streaks Choroidal folds Hypotony maculopathy Vitreomacular traction syndrome 15 Hereditary Fundus Dystrophies Introduction Generalized photoreceptor dystrophies Retinitis pigmentosa Important systemic associations Progressive cone dystrophy Leber congenital amaurosis Stargardt disease and fundus flavimaculatus Bietti crystalline corneoretinal dystrophy Congenital stationary night blindness Congenital monochromatism Macular dystrophies Best macular dystrophy Pattern dystrophy Familial dominant drusen (malattia leventinese) Sorsby pseudoinflammatory dystrophy Generalized choroidal dystrophies Choroideremia Gyrate atrophy Vitreoretinal dystrophies Juvenile X-linked retinoschisis Stickler syndrome Familial exudative vitreoretinopathy Albinism Tyrosinase-negative (complete) oculocutaneous albinism Tyrosinase-positive (incomplete) oculocutaneous albinism Ocular albinism Cherry-red spot at the macula 16 Retinal Detachment Definitions Degenerative (acquired) retinoschisis Rhegmatogenous retinal detachment Tractional retinal detachment Exudative retinal detachment Pars plana vitrectomy 17 Vitreous Opacities Muscae volitantes Vitreous haemorrhage Asteroid hyalosis Synchysis scintillans 18 Strabismus Amblyopia Heterophoria Vergence abnormalities Convergence insufficiency Divergence insufficiency Near reflex insufficiency Spasm of the near reflex Esotropia Definition Early onset (essential) esotropia Accommodative esotropia Microtropia Other forms of esotropia Exotropia Constant (early onset) exotropia Intermittent exotropia Other forms of exotropia Special syndromes Duane retraction syndrome Brown syndrome Alphabet patterns Strabismus surgery 19 Neuro-Ophthalmology Optic nerve Optic atrophy Classification of optic neuritis Demyelinating optic neuritis Miscellaneous optic neuritis (see Chapter 12) Neuroretinitis Non-arteritic anterior ischaemic optic neuropathy Arteritic anterior ischaemic optic neuropathy Posterior ischaemic optic neuropathy Diabetic papillopathy Leber hereditary optic neuropathy Nutritional optic neuropathy (tobacco–alcohol amblyopia) Papilloedema Terson syndrome Congenital optic disc anomalies Pupils Relative afferent pupillary defect (RAPD) Horner syndrome (oculosympathetic palsy) Adie pupil Other abnormal pupillary reactions Pituitary adenoma Retrochiasmal pathways Introduction Optic tracts Optic radiations Ocular motor nerves Third (oculomotor) nerve disease Fourth (trochlear) nerve disease Sixth (abducens) nerve disease Supranuclear disorders of ocular motility Horizontal gaze palsy Vertical gaze palsy Nystagmus Introduction Physiological nystagmus Motor imbalance nystagmus Sensory deprivation nystagmus Surgery for nystagmus Nystagmoid movements Ocular myopathies Myasthenia gravis Myotonic dystrophy Chronic progressive external ophthalmoplegia Neurofibromatosis Genetics NF1 NF2 Migraine Neuralgias Facial spasm Essential blepharospasm Hemifacial spasm 20 Ocular Tumours Benign epibulbar tumours Conjunctival naevus Conjunctival papilloma Dermoid Dermolipoma Pyogenic granuloma Conjunctival (racial) epithelial melanosis Malignant and premalignant epibulbar tumours Primary acquired melanosis (PAM) Conjunctival melanoma Ocular surface squamous neoplasia Lymphoproliferative lesions Kaposi sarcoma Iris tumours Iris naevus Iris melanoma Iris cysts Primary Secondary Ciliary body melanoma Tumours of the choroid Choroidal naevus Choroidal melanoma Circumscribed choroidal haemangioma Diffuse choroidal haemangioma Optic disc melanocytoma Choroidal osteoma Metastatic tumours Neural retinal tumours Retinoblastoma Astrocytoma Vascular retinal tumours Capillary haemangioma Cavernous haemangioma Racemose haemangioma Primary intraocular lymphoma Congenital hypertrophy of the retinal pigment epithelium (CHRPE) Combined hamartoma of the retina and RPE 21 Ocular Side Effects of Systemic Medication Eyelids Cornea Vortex keratopathy (cornea verticillata) Chlorpromazine Argyrosis Chrysiasis Amantadine Ciliary body Lens Steroids Other drugs Uveitis Rifabutin Cidofovir Retina Chloroquine and hydroxychloroquine Phenothiazines Drug-induced crystalline maculopathies Other drugs Optic nerve Ethambutol Amiodarone Vigabatrin Sildenafil 22 Trauma Eyelid trauma Periocular haematoma Laceration Blow-out orbital floor fracture Trauma to the globe Definitions Imaging Blunt trauma to the anterior segment Blunt injuries to the posterior segment Shaken baby syndrome (non-accidental head injury) Penetrating trauma Superficial foreign bodies Intraocular foreign bodies Enucleation/evisceration Bacterial endophthalmitis Chemical injuries Index Index