Comprehensive ophthalmology

616 Pages·2007·15.511 MB·English

by  Khurana, A. K

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Copyright © 2007, 2003, 1996, A K Khurana
Published by New Age International (P) Ltd., Publishers
All rights reserved.
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ISBN (13) : 978-81-224-2480-5
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To my parents and teachers for their blessings
To my students for their encouragement
To my children, Aruj and Arushi, for their patience
To my wife, Dr. Indu, for her understanding
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P R E F A C E
PREFACE
Fourth edition of the book has been thoroughly revised, updated, and published in an attractive
colour format. This endeavour has enhanced the lucidity of the figures and overall aesthetics of the
book.
The fast-developing advances in the field of medical sciences and technology has beset the present-
day medical students with voluminous university curriculae. Keeping in view the need of the students
for a ready-made material for their practical examinations and various postgraduate entrance tests,
the book has been expanded into two sections and is accompanied with ‘Review of Ophthalmology’
as a pocket companion, and converted into a comprehensive book.
Section 1: Anatomy, Physiology and Diseases of the Eye. This part of the book includes 20
chapters, 1 each on Anatomy and Physiology of Eye and rest 18 on diseases of the different structures
of the eye.
Section II: Practical Ophthalmology. This section includes chapter on ‘Clinical Methods in
Ophthalmology’ and different other aspects essential to the practical examinations viz. Clinical
Ophthalmic Cases, Darkroom Procedures, and Ophthalmic Instruments.
Review of Ophthalmology: Quick Text Review and Multiple-Choice Questions. This pocket
companion provides an indepth revision of the subject at a glance and an opportunity of self-assessment,
and thus makes it the book of choice for preparing for the various postgraduate entrance examinations.
Salient Features of the Book
(cid:1) Each chapter begins with a brief overview highlighting the topics covered followed by relevant
applied anatomy and physiology. The text is then organized in such a way that the students
can easily understand, retain and reproduce it. Various levels of headings, subheadings, bold
face and italics given in the text will be helpful in a quick revision of the subject.
(cid:1) Text is complete and up-to-date with recent advances such as refractive surgery, manual small
incision cataract surgery (SICS), phacoemulsification, newer diagnostic techniques as well as
newer therapeutics.
(cid:1) To be true, some part of the text is in more detail than the requirement of undergraduate
students. But this very feature of the book makes it a useful handbook for the postgraduate
students.
(cid:1) The text is illustrated with plenty of diagrams. The illustrations mostly include clinical
photographs and clear-line diagrams providing vivid and lucid details.
(cid:1) Operative steps of the important surgical techniques have been given in the relevant chapters.
(cid:1) Wherever possible important information has been given in the form of tables and flowcharts.
(cid:1) An attraction of this edition of the book is a very useful addition of the ‘Practical
Ophthalmology’ section to help the students to prepare for the practical examinations.
(viii)
It would have not been possible for this book to be in its present form without the generous help
of many well wishers and stalwarts in their fields. Surely, I owe sincere thanks to them all. Those
who need special mention are Prof. Inderbir Singh, Ex-HOD, Anatomy, PGIMS, Rohtak, Prof.
R.C. Nagpal, HIMS, Dehradun, Prof. S. Soodan from Jammu, Prof. B. Ghosh, Chief GNEC, New
Delhi, Prof. P.S. Sandhu, GGS Medical College, Faridkot, Prof. S.S. Shergil, GMC, Amritsar, Prof.
R.K. Grewal and Prof. G.S. Bajwa, DMC Ludhiana, Prof. R.N. Bhatnagar, GMC, Patiala, Prof.
V.P. Gupta, UCMS, New Delhi, Prof. K.P. Chaudhary, GMC, Shimla, Prof. S. Sood, GMC,
Chandigarh, Prof. S. Ghosh, Prof. R.V. Azad and Prof. R.B. Vajpayee from Dr. R.P. Centre for
Opthalmic Sciences, New Delhi, and Prof. Anil Chauhan, GMC, Tanda.
I am deeply indebted to Prof. S.P. Garg. Prof. Atul Kumar, Prof. J.S. Tityal, Dr. Mahipal S.
Sachdev, Dr. Ashish Bansal, Dr. T.P. Dass, Dr. A.K. Mandal, Dr. B. Rajeev and Dr. Neeraj
Sanduja for providing the colour photographs.
I am grateful to Prof. C.S. Dhull, Chief and all other faculty members of Regional Institute of
Opthalmology (RIO), PGIMS, Rohtak namely Prof. S.V. Singh, Dr. J.P. Chugh, Dr. R.S. Chauhan,
Dr. Manisha Rathi, Dr. Neebha Anand, Dr. Manisha Nada, Dr. Ashok Rathi, Dr. Urmil Chawla
and Dr. Sumit Sachdeva for their kind co-operation and suggestions rendered by them from time
to time. The help received from all the resident doctors including Dr. Shikha, Dr. Vivek Sharma
and Dr. Nidhi Gupta is duly acknowledged. Dr. Saurabh and Dr. Ashima deserve special thanks
for their artistic touch which I feel has considerably enhanced the presentation of the book. My
sincere thanks are also due to Prof. S.S. Sangwan, Director, PGIMS, Rohtak for providing a working
atmosphere. Of incalculable assistance to me has been my wife Dr. Indu Khurana, Assoc. Prof.
in Physiology, PGIMS, Rohtak. The enthusiastic co-operation received from Mr. Saumya Gupta,
and Mr. R.K. Gupta, Managing Directors, New Age International Publishers (P) Ltd., New Delhi
needs special acknowledgement.
Sincere efforts have been made to verify the correctness of the text. However, in spite of best
efforts, ventures of this kind are not likely to be free from human errors, some inaccuracies,
ambiguities and typographic mistakes. Therefore, all the users are requested to send their feedback
and suggestions. The importance of such views in improving the future editions of the book cannot
be overemphasized. Feedbacks received shall be highly appreciated and duly acknowledged.
Rohtak A K Khurana
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CONTENTS
CONTENTS
Preface............................................................................................................................................ vii
SECTION I: ANATOMY, PHYSIOLOGY AND DISEASES OF THE EYE
1. Anatomy and Development of the Eye............................................................................... 3
2. Physiology of Eye and Vision............................................................................................ 13
3. Optics and Refraction......................................................................................................... 19
4. Diseases of the Conjunctiva............................................................................................... 51
5. Diseases of the Cornea ...................................................................................................... 89
6. Diseases of the Sclera...................................................................................................... 127
7. Diseases of the Uveal Tract ............................................................................................ 133
8. Diseases of the Lens........................................................................................................ 167
9. Glaucoma........................................................................................................................... 205
10. Diseases of the Vitreous................................................................................................... 243
11. Diseases of the Retina...................................................................................................... 249
12. Neuro-ophthalmology........................................................................................................ 287
13. Strabismus and Nystagmus.............................................................................................. 313
14. Diseases of the Eyelids .................................................................................................... 339
15. Diseases of the Lacrimal Apparatus................................................................................ 363
16. Diseases of the Orbit ....................................................................................................... 377
17. Ocular Injuries .................................................................................................................. 401
18. Ocular Therapeutics, Lasers and Cryotherapy in Ophthalmology ................................ 417
19. Systemic Ophthalmology.................................................................................................. 433
20. Community Ophthalmology.............................................................................................. 443
SECTION II: PRACTICAL OPHTHALMOLOGY
21. Clinical Methods in Ophthalmology................................................................................. 461
22. Clinical Ophthalmic Cases................................................................................................ 499
23. Darkroom Procedures....................................................................................................... 543
24. Ophthalmic Instruments and Operative Ophthalmology................................................. 571
Index ........................................................................................................................................... 593