Academy of ophthalmology. Basic Ophthalmology | Cynthia A. Bradford, MD

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Автор: Cynthia A. Bradford, MD

Год: 2004

Формат: DjVu

Качество: E-Book

Количество страниц: 237


Описание


Basic Ophthalmology is designed to help the user obtain an appropriate ocular history and learn the examination techniques for a complete eye evaluation.

From the history and clinical findings the reader should be able to diagnose and manage or refer common ocular disorders. The history of this textbook began in 1975 with the publication by the American Academy of Ophthalmology of a study guide in outline form for medical students.

The book’s developers identified seven common problem areas in ophthalmology and developed study objectives. Each subsequent edition was changed based on suggestions from users.

The fifth edition, which was developed by the joint committee of the Amer­ican Academy of Ophthalmology and the Association of University Professors of Ophthalmology, abandoned the outline form for chapters with expository text.

The sixth edition, published in 1993, was one of the American Academy of Ophthalmology's most popular clinical education products.

The seventh edition, equally popular with thousands of stu­dents in hundreds of medical schools, was an update of the excellent work of Dr. Frank Berson and the Medical Student Education Committee in response to changes in health-care delivery.

The seventh edition was also translated into Chinese as well as a Russian dialect. This eighth edition places greater emphasis on historical information in evaluating visual complaints and assessing risk factors for ocular disease. Medical students learn risk factors for heart disease, but risk factors for blindness are often overlooked in new patient evaluations.

Primary care physicians have responsibility in the area of diagnosis, management, and referral of ocular disease and can learn to confidently evaluate patients' ocular complaints.

Prior to undertaking this revision, a user evaluation of the seventh edition was conducted among previous authors, Academy members Involved in medical student education, medical students, and primary care physicians.

Chapters have been revised based on the resulting recommendations. Much information and many photographs have been improved and updated.

Once again glaucoma care has undergone significant changes in the past few years, and these are reflected in this edition's descriptions of glaucoma medications and the indication for tonometry.

The eighth edition also acknowledges the increasing geriatric population with more detail on eye-related aging changes.

As in previous editions, the eighth edition features updated figures and expanded annotated resources.

Where appropriate, tables are presented to summarize textual information and facilitate study.

This book can be used in a variety of settings. The concise presen­tation of information makes it ideal for brief ophthalmology rotations. If greater time is available, the resources can be consulted for more detail.

This book is intended to be a flexible instrument that summarizes the important concepts, techniques, and facts of ophthalmology for all physicians, especially those in primary care.

The Ophthalmology Liaisons Committee anticipates that medical students will use this book in conjunction with comprehensive texts and other related resources annotated at the end of each chapter.

The current contributors would like to thank their predecessors on the Medical Student Education Committee who partially through this book built a great foundation for medical student learning. Current con­tributors include Cynthia A. Bradford, MD, executive editor; Hilary A. Beaver, MD; Reagan Bradford, Jr., MD; Bradley K. larris, MD; Karla J. Johns, MD; Carla J. Siegfried, MD; Scott C. Siglcr, MD; and Deana S. Watts, MD. Special thanks to the reviewers of the revised manuscript: David Sarraf, MD; L. Peter Schwiebert, MD; Emanuel New-mark, MD, FACS; and Undreth G. Dubois, CO, COMT.


Contents


FIGURES

PREFACE

WHO'S WHO IN EYE CARE

TEST YOUR KNOWLEDGE

CHAPTER 1 THE EYE EXAMINATION

OBJECTIVES

RELEVANCE

BASIC INFORMATION

THE PATIENT'S HISTORY

ANATOMY

ANATOMIC AGING CHANGES

OPTICS

VISUAL ACUITY 8

WHEN TO EXAMINE 9

ADDITIONAL TESTS 9

HOW TO EXAMINE 9

DISTANCE VISUAL ACUITY TESTING 10

NEAR VISUAL ACUITY TESTING 12

VISUAL ACUITY ESTIMATION IN AN UNCOOPERATIVE PATIENT 12

CONFRONTATION FIELD TESTING 13

AMSLER GRID TESTING 14

EXTERNAL INSPECTION 14

UPPER LID EVERSION 15

OCULAR MOTILITY TESTING 15

PUPILLARY REACTION TESTING 15

ANTERIOR CHAMBER DEPTH ASSESSMENT 16

INTRAOCULAR PRESSURE MEASUREMENT 17

COLOR VISION TESTING 19

FLUORESCEIN STAINING OF CORNEA 19

OPHTHALMOSCOPY 19

SUMMARY OF STEPS IN EYE EXAMINATION 24

MANAGEMENT OR REFERRAL 25

REDUCED VISUAL ACUITY 25

ABNORMAL FUNDUS APPEARANCE 25

SHALLOW ANTERIOR CHAMBER DEPTH/ELEVATED

INTRAOCULAR PRESSURE 26

POINTS TO REMEMBER 26

SAMPLE PROBLEMS 26

ANNOTATED RESOURCES 28

CHAPTER 2 ACUTE VISUAL LOSS

OBJECTIVES 31

RELEVANCE 31

BASIC INFORMATION 31

HOW TO EXAMINE 32

VISUAL ACUITY TESTING 32

CONFRONTATION FIELD TESTING 32

PUPILLARY REACTIONS 32

OPHTHALMOSCOPY 32

PENLIGHT EXAMINATION 33

TONOMETRY 33

HOW TO INTERPRET THE FINDINGS 33

MEDIA OPACITIES 33

CORNEAL EDEMA 33

HYPHEMA 33

CATARACT 34

VITREOUS HEMORRHAGE 34

RETINAI DISEASE 35

OPTIC NERVE DISEASE 39

VISUAL PATHWAY DISORDERS 42

FUNCTIONAL DISORDERS 43

ACUTE DISCOVERY OF CHRONIC VISUAL LOSS 43

POINTS TO REMEMBER 43

SAMPLE PROBLEMS 44

ANNOTATED RESOURCES 46

CHAPTER 3 CHRONIC VISUAL LOSS 49

OBJECTIVES 49

CHRONIC VISUAL LOSS IN THE GERIATRIC POPULATION 49

GLAUCOMA 50

RELEVANCE 50

BASIC INFORMATION 52

INTRAOCULAR PRESSURE 52

TYPES OF GLAUCOMA 53

OPTIC NERVE 53

RELATIONSHIP OF ЮР AND OPTIC NERVE 54

WHEN TO EXAMINE 54

HOW TO EXAMINE 54

HOW TO INTERPRET THE FINDINGS 55

MANAGEMENT OR REFERRAL 57

CATARACT 57

RELEVANCE 57

BASIC INFORMATION 58

LENS 59

CATARACT 59

SYMPTOMS OF CATARACT 59

WHEN TO EXAMINE 60

HOW TO EXAMINE 61

HOW TO INTERPRET THE FINDINGS 62

MANAGEMENT OR REFERRAL 62

MACULAR DEGENERATION 63

RELEVANCE 63

BASIC INFORMATION 63

MACULAR ANAIOMY 63

AGE-RELATED MACULAR CHANGES 64

WHEN TO EXAMINE 67

HOW TO EXAMINE 67

HOW TO INTERPRET THE FINDINGS 68

MANAGEMENT OR REFERRAL 68

THE VISUALLY IMPAIRED PATIENT 69

POINTS TO REMEMBER 70

SAMPLE PROBLEMS 71

ANNOTATED RESOURCES 72

CHAPTER 4 THE RED EYE

OBJECTIVES 75

RELEVANCE 75

BASIC INFORMATION 75

DISORDERS ASSOCIATED WITH A RED EYE 76

HISTORY 79

HOW TO EXAMINE 80

HOW TO INTERPRET THE FINDINGS 82

SYMPTOMS OF RED EYE 83

SIGNS OF RED EYE 85

ASSOCIATED SYSTEMIC PROBLEMS 87

LABORATORY DIAGNOSIS 87

MANAGEMENT OR REFERRAL 88

BLEPHARITIS 88

STYE AND CHALAZION 9C

SUBCONJUNC TIVAL HEMORRHAGE 91

CONJUNCTIVITIS 91

THERAPEUTIC WARNINGS 92

TOPICAL ANESTHETICS 92

TOPICAL CORTICOSTEROIDS 92

POINTS TO REMEMBER 92

SAMPLE PROBLEMS 93

ANNOTATED RESOURCES 97

CHAPTER 5 OCULAR AND ORBITAL INJURIES OBJECTIVES 99

RELEVANCE 99

BASIC INFORMATION 100

ANATOMY AND FUNCTION 100

WHEN TO EXAMINE 103 HOW TO EXAMINE 103

HISTORY 104

VISUAI ACUITY TESTING 104

EXTERNAL EXAMINATION 105

PUPILLARY REACTIONS 107

OCULAR MOTILITY TESTING 107

OPHTHALMOSCOPY 107

RADIOLOGIC STUDIES 107

MANAGEMENT OR REFERRAL 108

TRUE EMERGENCY 108

URGENT SITUATION 108

SEMIURGENT CONDI HON 11С

TREATMENT SKILLS 111

OCULAR IRRIGATION 111

FOREIGN-BODY REMOVAL 112

PRESCRIBING EYE MEDICATION 112

PATCHING 112

SUTURING 113

POINTS TO REMEMBER 113

SAMPLE PROBLEMS 114

ANNOTATED RESOURCES 118

CHAPTER 6 AMBLYOPIA AND STRABISMUS

OBJECTIVES 121

RELEVANCE 121

BASIC INFORMATION 122

AMBLYOPIA 122

STRABISMUS 124

HOW TO EXAMINE AND INTERPRET THE FINDINGS 126

AMBLYOPIA TESTING 127

STRABISMUS TESTING 129

OTHER TESTS 133

MANAGEMENT OR REFERRAL 134

AMBLYOPIA 134

STRABISMUS 135

POINTS TO REMEMBER 136

SAMPLE PROBLEMS 136

ANNOTATED RESOURCES 140

CHAPTER 7 NEURO-OPHTHALMOLOGY

OBJECTIVES 141

RELEVANCE 141

HOW TO EXAMINE 142

VISUAL ACUITY TESTING 142

VISUAL FIELD TESTING 142

PUPILLARY REACTIONS 143

OCULAR MOTILITY TESTING 144

OPHTHALMOSCOPY 145

HOW TO INTERPRET THE FINDINGS 146

PUPILLARY DISORDERS 146

OTHER CRANIAL NERVE PALSIES 150

OPTIC NERVE DISEASE 153

VISUAL FIELD DEFECTS 156

VISUAL HALLUCINATIONS 157

COGNITIVE VISUAL LOSS: THE VISUAL VARIANT OF ALZHEIMER-S DISEASE 159

POINTS TO REMEMBER 159

SAMPLE PROBLEMS 160

ANNOTATED RESOURCES 164

CHAPTER 8 OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE

OBJECTIVES 165

RELEVANCE 165

DIABETES MELLITUS 166

HYPERTENSION 170

ARTERIOLAR SCLEROSIS 170

ELEVATED BLOOD PRESSURE 172

DIAGNOSTIC CONCERNS 172

MANAGEMENT 172

PREGNANCY 173

SICKLE CELL ANEMIA 174

THYROID DISEASE 174

SARCOIDOSIS AND OTHER INFLAMMATORY AND AUTOIMMUNE CONDITIONS 175

MALIGNANCY 176

ACQUIRED IMMUNODEFICIENCY SYNDROME 177

SYPHILIS 179

OTHER SYSTEMIC INFECTIONS 179

POINTS TO REMEMBER 180

SAMPLE PROBLEMS 181

ANNOTATED RESOURCES 182

CHAPTER 9 DRUGS AND THE EYE

OBJECTIVES 185

RELEVANCE 185

BASIC INFORMATION 187

TOPICAL OCULAR DIAGNOSTIC DRUGS 188

FLUORESCEIN DYE 188 ANESTHETICS 188 MYDRIATICS 189

TOPICAL OCULAR THERAPEUTIC DRUGS 190

DECONGESTANTS 190

AGENTS FOR RELIEF OF ALLERGIC CONJUNCTMTIS 191

ANTI-INFLAMMATORY AGENTS 191

AGENTS FOR THF RELIEF ОГ DRY EYE SYMPTOMS 191

ANTIBIOTICS 191

ANTIVIRAL AGENTS 192

SYSTEMIC SIDE EFFECTS OF GLAUCOMA MEDICATIONS 192

BETA-ADRENERGIC BLOCKERS 192

CHOLINFRGIC-STIMULATING DRUGS 193

ALPHA-2 ADRENORECEPTOR AGONISTS 194

ADRENERGIC-STIMULATING DRUGS 194

PROSTAGLANDIN ANALOGUES 195

CARBONIC ANHYDRASE INHIBITORS 195

OCULAR SIDE EFFECTS OF SYSTEMIC DRUGS 195

AMIODARONE 195

BIPHOSPHONATES 196

CHLOROQUINES 196

CHLORPROMAZINE 197

CORTICOSTEROIDS 197

DIGITALIS 197

DIPHENYLHYDANTOIN 197

ETHAMBUTOL 197

HMG-COA REDUCTASE INHIBITORS (STATINS) 198

RIFABUTIN (MYCOBUTIN) 198

SILDENAFIL (VIAGRA) AND TADALIFIL (CIALIS) 198

THIORIDAZINE 198

TOPIRAMATE (TOPIMAX) 198

POINTS TO REMEMBER 199

SAMPLE PROBLEMS 199

ANNOTATED RESOURCES 202

INDEX 203

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