Manual for Eye Examination and Diagnosis

Preface v Introduction to the eye team and their instruments vi 1 Medical history 1 Table 1 - Common chief complaints 1 Medical illness 3 Medications (ocular side effects) 4 Family history of eye disease 7 2 Measurement of vision and refraction 9 Visual acuity 9 Optics 10 Refraction 14 Contact lenses 18 Common problems 21 Refractive surgery 21 3 Neuro-ophthalmology 28 Eye movements 28 Table 2 - Extraocular muscles 30 Table 3 - Nerves to ocular structures 30 Strabismus 31 Table 4 - Types of eye-turn 32 Table 5 - Comparison of paralytic and nonparalytic strabismus 36 Cranial nerves III-VIII 37 Nystagmus 41 Common brain tumors 47 The pupil 49 Adie's pupil (tonic pupil) 51 Visual field testing 52 Table 6 - Causes of small (miotic) and large (mydriatic) pupil (Fig. 125) 53 Color vision 56 Circulatory disturbances affecting vision 56 Table 7 - Visual disturbances due to compromised blood flow (Fig. 81) 58 4 External structures 61 Lymph nodes 61 Lacrimal system 61 Failure of the tear to reach the puncta 68 Obstruction at the puncta or canaliculus 68 Tearing due to NLD obstructions 69 Table 8 - Common topical anti-infectives 70 Lids 71 Lashes 74 Phakomatoses 77 Anterior and posterior blepharitis 78 5 The orbit 83 Imaging 83 Sinusitis 84 Exophthalmos 87 Enophthalmos 88 6 Slit lamp examination 91 Cornea 91 Corneal epithelial disease 93 Table 9 - Superficial punctate keratitis (commonly causes photophobia) 94 Table 10 - Conjunctivitis - redness more pronounced in peripheral conjunctiva (see Figs 305 and 395) 96 Corneal endothelial disease 100 Corneal transplantation (keratoplasty) 102 Conjunctiva 108 Sclera 114 7 Glaucoma 117 Glaucoma vs. glaucoma suspect 118 The iridocorneal angle 119 The optic disk (optic papilla) 120 Signs of nerve fiber damage 122 Medical treatment (Table 11) 125 Table 11 - Common glaucoma medications and side effects 126 Table 12 - Common types of glaucoma 134 8 Uvea 137 Malignant uveal tumors 139 Inflammation of the uvea (uveitis) 142 Table 13 - Common

MARK W. LEITMAN is Clinical Assistant Professor, Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine.

"I have thoroughly enjoyed reading this book and would recommend this manual to readers wanting an overview and general understanding of ophthalmology in order to link the basic anatomy and science with the clinical environment" - eyenews