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The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel PDF

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Any screen. Any time. Anywhere. Activate the eBook version of this title at no additional charge. Elsevier eBooks for Practicing Clinicians gives you the power to browse and search content, view enhanced images, highlight and take notes—both online and offline. Unlock your eBook today. 1. Visit expertconsult.inkling.com/redeem 2. Scratch box below to reveal your code 3. Type code into “Enter Code” box 4. Click “Redeem” 5. Log in or Sign up 6. Go to “My Library” It’s that easy! Place Peel Off Sticker Here For technical assistance: email [email protected] call 1-800-401-9962 (inside the US) call +1-314-447-8300 (outside the US) Use of the current edition of the electronic version of this book (eBook) is subject to the terms of the nontransferable, limited license granted on expertconsult.inkling.com. Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means. 2020_PC • OPHTHALMIC THE ASSISTANT This page intentionally left blank • ELEVENTH EDITION OPHTHALMIC THE ASSISTANT A TEXT FOR ALLIED AND ASSOCIATED OPHTHALMIC PERSONNEL Harold A. Stein, MD, MSc(Ophth), FRCSC, Melvin I. Freeman, MD, FACS, FACEHP DOMS(London) Clinical Professor of Ophthalmology, Emeritus, University Professor of Ophthalmology and Visual Sciences, University of of Washington School of Medicine, Seattle, Washington; Toronto, Toronto, Ontario, Canada; Emeritus and Past Chairman, Affiliate Clinical Investigator, Benaroya Research Institute at Department of Ophthalmology, Scarborough General Hospital, Virginia Mason, Seattle, Washington; Past Head, Section of Scarborough, Ontario, Canada; Emeritus, Mount Sinai Hospital, Ophthalmology, Virginia Mason Clinic and Medical Center, Toronto, Ontario, Canada; Past Secretary General, International Seattle, Washington; Medical Director, Emeritus, Department of Contact Lens Society of Ophthalmologists, Denver, Colorado; Continuing Medical Education, Virginia Mason Medical Center, Past President, International Joint Commission on Allied Health Seattle, Washington; Past President, Alliance for Continuing Personnel in Ophthalmology, St Paul, Minnesota; Past President, Medical Education, Birmingham, Alabama; Past President, Contact Lens Association of Ophthalmologists, New Orleans, Contact Lens Association of Ophthalmologists, New Orleans, Louisiana; Past President, Canadian Ophthalmological Society, Louisiana; Past President, International Joint Commission on Ottawa, Canada; Co-Director, Bochner Eye Institute, Toronto, Allied Health Personnel in Ophthalmology, St Paul, Minnesota; Ontario, Canada Chair, Joint Commission on Allied Health Personnel in Ophthalmology Education and Research Foundation, St Paul, Raymond M. Stein, MD, FRCSC Minnesota Medical Director, Bochner Eye Institute, Toronto, Ontario, Canada; Rebecca L. Stein, MD, FRCSC Professor of Ophthalmology and Visual Sciences, University of Toronto, Ontario, Canada; Board of Directors, Foundation Fighting Medical Degree from University of St Andrews, Scotland, and Blindness, Toronto, Ontario, Canada; Attending Ophthalmologist, University of Manchester, England; Ophthalmology Residency, Scarborough Hospital, Scarborough, Ontario, Canada; Attending University of Toronto, Ontario, Canada; Fellowship in Cornea, Ophthalmologist, Mount Sinai Hospital, Toronto, Ontario, Canada; External Disease, Cataract, and Refractive Surgery, Ophthalmic Consultants of Long Island, New York; Staff Ophthalmologist, Editor, Past President, Canadian Society of Cataract and Refractive Surgery, Montreal, Quebec, Canada; Past Commissioner, Bochner Eye Institute, Toronto, Ontario, Canada International Joint Commission on Allied Health Personnel in Ophthalmology, St Paul, Minnesota Elsevier 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 THE OPHTHALMIC ASSISTANT: A TEXT FOR ALLIED AND ASSOCIATED OPHTHALMIC PERSONNEL, ELEVENTH EDITION ISBN: 978-0-323-75754-6 Copyright © 2023 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www. elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors, or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2018, 2013, 2006, 2000, 1994, 1988, 1983, 1976, 1971, and 1968. Library of Congress Control Number: 2021943343 Senior Content Strategist: Kayla Wolfe Content Development Manager: Meghan Andress Content Development Specialist: Nicole Congleton Publishing Services Manager: Shereen Jameel Senior Project Manager: Manikandan Chandrasekaran Design Direction: Margaret Reid Printed in India Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contents Preface �����������������������������������������������������������������������vii Section Three: Common Clinical Acknowledgments ���������������������������������������������������viii List of Contributors ���������������������������������������������������ix Eye Problems or Common Clinical List of Reviewers ������������������������������������������������������xiii Conditions Dedication ����������������������������������������������������������������xv 21. Ocular injuries �����������������������������������������������370 22. The urgent case ����������������������������������������������388 Section One: Basic Sciences 23. Common eye disorders ���������������������������������401 24. Common retinal disorders ����������������������������416 1. Anatomy of the eye ��������������������������������������������1 25. Glaucoma �������������������������������������������������������437 2. Physiology of the eye ���������������������������������������13 26. Uveitis ������������������������������������������������������������484 3. Optics ���������������������������������������������������������������27 27. Dry eye disease �����������������������������������������������497 4. Pharmacology ��������������������������������������������������46 28. Examination of the newborn, infant, and 5. Microbiology ����������������������������������������������������65 small child �����������������������������������������������������509 29. Ocular motility, binocular vision, and strabismus ������������������������������������������������������520 Section Two: Clinical Practice Section Four: Surgical Technique 6. Office efficiency and public relations �������������75 7. History taking ��������������������������������������������������96 30. Aseptic technique and minor office surgery ���532 8. Preliminary examination ������������������������������109 31. The operative patient �������������������������������������546 9. Visual function and impairment ������������������143 32. Highlights of ocular surgery ��������������������������555 10. Understanding ophthalmic 33. Assisting the surgeon �������������������������������������585 equipment ������������������������������������������������������152 34. Ambulatory surgery ���������������������������������������608 11. Maintenance of ophthalmic equipment 35. Lasers in ophthalmology �������������������������������616 and instruments ���������������������������������������������180 36. Refractive surgery: today and the future �������624 12. Refractive errors and how to correct 37. Corneal collagen crosslinking in the them ���������������������������������������������������������������185 management of ectactic diseases ������������������633 13. Facts about glasses �����������������������������������������210 38. Wavefront aberrations and custom ablation ���645 14. Rigid contact lenses: basics ���������������������������240 15. Soft contact lenses �����������������������������������������275 Section Five: Ocular Imaging 16. Advanced techniques in soft and rigid contact lens fitting �����������������������������������������305 17. Managing a contact lens practice ������������������329 39. Ophthalmic photography �����������������������������649 18. Visual fields ����������������������������������������������������336 40. Optical coherence tomography ��������������������671 19. Automated visual field testing ����������������������350 41. Computerized corneal topography ��������������681 20. Computers in ophthalmic 42. Specular microscopy ��������������������������������������696 practice �����������������������������������������������������������363 43. Diagnostic ultrasound �����������������������������������699 v Contents Section Six: Special Procedures Appendices 44. Blind persons in the modern world �������������712 Appendix 1: Ocular emergencies �������������������������831 45. Cardiopulmonary resuscitation ��������������������720 Appendix 2: Following universal precautions ����835 Appendix 3: Principles of informed consent ������837 Appendix 4: Abbreviations and symbols in Section Seven: Ocular Vignettes clinical use �����������������������������������������������������839 Appendix 5: Optical constants of the eye �����������841 46. History of spectacles ��������������������������������������734 Appendix 6: Metric conversion (United States) ��842 47. Art and the eye �����������������������������������������������742 Appendices 7-17 appear online only Appendix 7: Skill checklists �����������������������������������e1 Section Eight: Role of Assistants in Appendix 8: Translations of commonly asked questions and commands �����������������������������e12 Eye Care Appendix 9: Office supplies in common use ������e20 Appendix 10: Estimating visual loss ��������������������e21 48. Allied health personnel in ophthalmology ��756 Appendix 11: Vision and driving �������������������������e23 49. Ophthalmology ethics �����������������������������������762 Appendix 12: Diopters to millimeters of radius 50. Allied ophthalmic health personnel: conversion tables �������������������������������������������e25 scope of practice ��������������������������������������������774 Appendix 13: Vertex conversion table �����������������e27 51. Testing and certification of ophthalmic Appendix 14: Diopters of corneal refracting power skills ����������������������������������������������������������������779 to millimeters of radius of curvature ������������e30 52. The development of allied ophthalmic Appendix 15: Compensation for effect of vertex personnel in North America distances when plus lens is moved away and worldwide �����������������������������������������������784 from the eye ���������������������������������������������������e33 53. Ophthalmic assisting in the international Appendix 16: Compensation for effect of vertex community and in the prevention of distances when plus lens is moved toward blindness ��������������������������������������������������������788 the eye ������������������������������������������������������������e36 54. Eye banking ����������������������������������������������������801 Appendix 17: Dioptric curves for extended range of keratometer �������������������������������������e39 Section Nine: Atlas of Clinical Supplementary resources ....................................e41 Ophthalmic Disorders Supplementary resources ....................................844 55. Atlas of common eye diseases and disorders �������������������������������������������������810 Index ......................................................................847 Glossary ������������������������������������������������������������������818 vi Preface Many ophthalmic assistants and technicians have no opportunity for formal training and learn their duties on the job. Experience and repetition alone may become excellent teachers. To paraphrase Sir William Osler, experience without knowledge is to sail an uncharted course, but knowledge without experience is never to go to sea at all. The Ophthalmic Assistant was written expressly for ancillary ophthalmic workers who assist eye doctors in the day-to-day care of eye patients. This book was designed to fill a vacuum in our community by providing a training basis for eye care personnel and meeting their needs for a reference source. The textbook has become a textbook of practical ophthalmology. Originally published over 55 years ago in 1968, The Ophthalmic Assistant has grown in size by over 300%. It became necessary to continually expand the textbook to reflect the explosive growth of ophthalmic knowledge and ophthalmic technology. Over the years, we broadened the scope of the textbook to provide not only practical technical information but also background information on ophthalmic disease processes and surgical procedures. In this 11th edition, we attempted to keep pace with the ever-expanding new developments in the field of eye care by updating each chapter. At the same time, we have tried to retain the original concept: to provide a concise, up-to-date review of the field of eye care that is easily readable, interesting, and illustrated. The Ophthalmic Assistant provides reliable and competent information on eye care procedures, including visits to offices, clinics, and hospitals. Ophthalmic assistants must be familiar with ster- ile procedures, types of emergencies, and many technical aspects of eye care. This knowledge can increase the ophthalmic assistant’s efficiency, ensuring that all details of diagnostic workup and regi- men are understood and carried out. Although The Ophthalmic Assistant emphasizes the paramedical functions of the ophthalmic assistant and not the secretarial duties, we recognize that both positions in a small office may have to be carried out by the same individual. We purposely avoided controversial subjects and highly specialized technical areas because of the varying degrees of training of eye care assistants throughout the world. Rather, the emphasis is placed on illustrations and photographs that illuminate and clarify ophthalmic technology and foster interest wherever possible. Although the main thrust of this book is toward the ophthalmic assistant, we hope the clar- ity, organization, and readability of the book will attract others in the ophthalmic community. To accommodate these readers, we included sections for the hospital ophthalmic assistant who aids in surgery, for the nurse who aids in the surgical and postoperative care of patients after surgery, and for the optometrist and their assistants to provide information in recognizing diseases and disor- ders, particularly glaucoma and retinal disorders. We also include material of interest to those indi- viduals working for optical and associated pharmaceutical companies. We have added and updated material for contact lens technicians, with a more detailed review to be found in our companion book, Fitting Guide for Hard and Soft Contact Lenses, 4th edition, published by Mosby. A companion book, Ophthalmic Terminology, 3rd edition, published by Mosby, serves to expand the glossary and is designed for learning vocabulary and the origins of words. An additional publication, Ophthalmic Dictionary and Vocabulary Builder for Eye Care Professionals, 4th edition, authored by H.A. Stein, R.M. Stein, M.I. Freeman, and J.S. Massare and published by Jaypee-Highlights Medical Publishers, is also available for learning vocabulary and original words. vii Preface Refractive surgery and computerized corneal topography are two areas of eye care delivery that generate great clinical interest. The 11th edition expands on the chapter on refractive surgery with new emphasis on corneal and intraocular techniques, as well as the section on computerized cor- neal topography. We miss the influence and contributions of our previous coauthor, Dr. Bernard Slatt, whose pass- ing came shortly after the seventh edition was published. His memory gave us input, motivation, and direction in continuing this work. We are also deeply saddened by the passing, just after the 11th edition manuscript was submitted to the publisher, of our dear colleague, Harold A. Stein, MD, FRCSC. Dr. Stein was a true scholar, a visionary, a gentleman, a leader, and a true friend and mentor. He took his coauthors under his wing and offered us opportunities to participate with him in his many lectures, programs, books, and papers. He will truly be missed by all of us, but his accomplishments will live on in those he mentored and in his vast contributions to medicine, ophthalmology, and the education of allied ophthalmic personnel. We are delighted that Rebecca L. Stein, MD, FRCSC has joined us as a coauthor and editor of the text. She represents the fourth generation of the Bochner/Stein’s in their dedication to optimal patient eye care and the education of allied and associate ophthalmic personnel. We gratefully acknowledge our newly invited 23 chapter authors and coauthors whose names appear in the List of Contributors with our continuing chapter authors. Our deep appreciation is extended to our nine retiring chapter authors and coauthors whose names join our Acknowledgments list of past contributors and reviewers of previous editions. New chapters have been added for the 11th edition on refractive surgery, eye banking, and an updated, atlas of common ocular conditions. Harold A. Stein Raymond M. Stein Melvin I. Freeman Rebecca L. Stein Acknowledgments For aid and support for the eleventh edition, we thank Kayla Wolfe, Nicole Congleton, Manikandan Chandrasekaran, and the contributors and reviewers. Acknowledgments for aid as reviewers or contributors in previous editions: Bud Appleton Therese Fredette Laurette LaRocque Penny Cook Pilliar Richard Augustine Ivan Gareau Les Landecker Christine Quach Howard S. Barneby Alice Gelinas Daniella Karen Quam Joseph T. Barr Paul Graczyk Lent-Schochet Paula Quigley Tony Benson Desmond Grant John Lloyd Robert Rosen Bernard R. Blais Mark Grieve Sze Kong Luke Barnet Sakler Maxwell K. Bochner Darrell Guthmiller Bernice Mandelcorn Abraham Schlossman Arielle Brickman David L. Guyton Theodore Martens Ernest R. Simpson Zijie Cai G. Peter Halberg Lynn D. Maund Anne Skryzpnik Albert Cheskes Barbara T. Harris Gerald E. Meltzer Bruce E. Spivey Jordan Cheskes Keith Harrison Richard P. Mills Laurie Stein John Crawford William Hunter Edyie G. Miller-Ellis Kenneth Swanson Norman Deer John Hymers Donald Morin Spencer Thornton Katherine Delmer Anne Jackson Korosh Nikeghbal Alyssa Tipple William H. Ehlers Mo Jalie Sherrine Nunes Russell N. Van Gelder Saul Fainstein Jerome Kazdan Kenneth Ogle Perry Yan Tina Felfeli Edna Kelly Thomas D Padrick Len Waldbaum Zoraida Fiol-Silva D’Arcy Kingsmill John Parker Becky Walsh Desmond Fonn Jill Klintworth Thomas Pashby E. Edward Wilson, Jr. John Fowler Steven Kraft Charles J. Pavlin Sheffield Wo Scot M Peterson Kenneth Woodward viii

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