Dedication.......................................................................viii
In Memoriam.....................................................................ix
Preface to the Ninth Edition................................................x
Abbreviations.....................................................................xi
1 Examination Techniques................................................1
Introduction.......................................................................2
Psychophysical tests........................................................2
Perimetry..........................................................................9
Slit lamp biomicroscopy of the anterior segment.............20
Fundus examination........................................................21
Tonometry.......................................................................27
Gonioscopy.....................................................................30
Central corneal thickness...............................................36
2 Eyelids.........................................................................37
Introduction.....................................................................38
Non-neoplastic lesions....................................................39
Benign epidermal tumours...............................................43
Benign pigmented lesions................................................44
Benign adnexal tumours..................................................47
Miscellaneous benign tumours.........................................47
Malignant tumours...........................................................50
Disorders of the eyelashes...............................................60
Allergic disorders.............................................................66
Immune-related inflammation..........................................66
Bacterial infections..........................................................67
Viral infections.................................................................68
Blepharitis.......................................................................70
Ptosis..............................................................................74
Ectropion.........................................................................80
Entropion.........................................................................85
Miscellaneous acquired disorders....................................87
Cosmetic eyelid and periocular surgery............................91
Congenital malformations................................................93
3 Lacrimal Drainage System............................................99
Introduction......................................................................100
Acquired obstruction.........................................................105
Congenital obstruction......................................................108
Chronic canaliculitis..........................................................109
Dacryocystitis...................................................................110
4 Orbit...............................................................................113
Introduction.......................................................................114
Thyroid eye disease..........................................................118
Infections...........................................................................124
Non-infective inflammatory disease...................................126
Non-neoplastic vascular abnormalities...............................129
Cystic lesions......................................................................131
Vascular tumours................................................................134
Lacrimal gland tumours........................................................140
Neural tumours.....................................................................142
Lymphoma............................................................................144
Rhabdomyosarcoma............................................................147
Metastatic tumours...............................................................148
The anophthalmic socket.....................................................150
Craniosynostoses................................................................153
5 Dry Eye............................................................................155
Introduction.........................................................................156
Sjögren syndrome...............................................................158
Clinical features...................................................................158
Investigation........................................................................159
Treatment............................................................................162
6 Conjunctiva.....................................167
Introduction...................................................................168
Bacterial conjunctivitis...................................................171
Viral conjunctivitis..........................................................177
Allergic conjunctivitis.....................................................180
Conjunctivitis in blistering mucocutaneous disease........188
Miscellaneous disorders of the conjunctiva....................194
Degenerations...............................................................197
Subconjunctival haemorrhage........................................200
7 Cornea............................................203
Introduction...................................................................204
Bacterial keratitis...........................................................209
Fungal keratitis..............................................................216
Herpes simplex keratitis.................................................218
Herpes zoster ophthalmicus...........................................224
Interstitial keratitis.........................................................229
Protozoan keratitis.........................................................232
Helminthic keratitis........................................................234
Bacterial hypersensitivity-mediated
corneal disease..........................................................234
Rosacea........................................................................236
Peripheral corneal ulceration/thinning...........................238
Neurotrophic keratopathy...............................................241
Exposure keratopathy.....................................................242
Miscellaneous keratopathies..........................................243
Corneal ectasia..............................................................248
Corneal dystrophy..........................................................252
Corneal degeneration.....................................................261
Metabolic keratopathy....................................................266
Contact lenses...............................................................268
Congenital anomalies of the cornea and globe...............270
8 Corneal and Refractive Surgery........275
Keratoplasty..................................................................276
Keratoprostheses...........................................................283
Refractive procedures....................................................283
9 Episclera and Sclera..................................................291
Anatomy........................................................................292
Episcleritis.....................................................................292
Immune-mediated scleritis.............................................293
Porphyria.......................................................................300
Infectious scleritis..........................................................300
Scleral discolouration....................................................301
Blue sclera....................................................................301
Miscellaneous conditions...............................................302
10 Lens..........................................................................307
Acquired cataract..........................................................308
Management of age-related cataract..............................311
Congenital cataract........................................................335
Ectopia lentis.................................................................338
Abnormalities of lens shape...........................................342
11 Glaucoma.................................................................345
Introduction...................................................................346
Ocular hypertension.......................................................347
Overview of glaucoma....................................................349
Primary open-angle glaucoma.......................................349
Normal-tension glaucoma..............................................367
Primary angle-closure glaucoma....................................370
Classification of secondary glaucoma............................378
Pseudoexfoliation..........................................................379
Pigment dispersion syndrome and
pigmentary glaucoma.................................................381
Neovascular glaucoma...............................................383
Inflammatory glaucoma.................................................385
Steroid-induced glaucoma.............................................388
Lens-related glaucoma..................................................389
Traumatic glaucoma.......................................................390
Ghost cell ‘glaucoma’.....................................................392
Iridocorneal endothelial syndrome.................................392
Glaucoma associated with intraocular tumours..............394
Glaucoma secondary to epithelial ingrowth....................394
Iridoschisis....................................................................395
Primary congenital glaucoma.........................................395
Iridocorneal dysgenesis..................................................399
Glaucoma in phacomatoses...........................................403
Medical treatment of glaucoma......................................404
Laser treatment of glaucoma.........................................407
Trabeculectomy..............................................................412
Non-penetrating glaucoma surgery.................................419
Minimally invasive glaucoma surgery (MIGS)..................420
Drainage shunts.............................................................421
12 Uveitis.............................................423
Classification.................................................................424
Clinical features.............................................................424
Investigation..................................................................429
Treatment.......................................................................432
Immunomodulatory therapy for
non-infectious uveitis.................................................433
Uveitis in spondyloarthropathies....................................435
Fuchs uveitis syndrome..................................................437
Uveitis in juvenile idiopathic arthritis (JIA)......................439
Uveitis in bowel disease.................................................441
Uveitis in renal disease..................................................442
Intermediate uveitis.......................................................443
Vogt–Koyanagi–Harada (VKH) syndrome.........................445
Sympathetic ophthalmitis..............................................448
Lens-induced uveitis......................................................449
Sarcoidosis....................................................................450
Behçet disease..............................................................454
Parasitic uveitis..............................................................456
Viral uveitis....................................................................465
Fungal uveitis.................................................................473
Bacterial uveitis.............................................................477
Miscellaneous idiopathic chorioretinopathies.................484
13 Retinal Vascular Disease..................495
Retinal circulation..........................................................496
Diabetic retinopathy.......................................................496
Non-diabetic retinopathy................................................513
Retinal venous occlusive disease...................................514
Retinal arterial occlusive disease...................................525
Ocular ischaemic syndrome...........................................531
Hypertensive eye disease...............................................532
Sickle-cell retinopathy....................................................533
Thalassaemia retinopathy..............................................536
Retinopathy of prematurity.............................................536
Retinal artery macroaneurysm.......................................540
Primary retinal telangiectasia.........................................543
Eales disease................................................................546
Radiation retinopathy.....................................................546
Purtscher retinopathy.....................................................547
Valsalva retinopathy.......................................................549
Lipaemia retinalis..........................................................549
Retinopathy in blood disorders.......................................550
14 Acquired Macular Disorders......................................555
Introduction...................................................................556
Clinical evaluation of macular disease...........................557
Investigation of macular disease....................................558
Age-related macular degeneration..................................572
Retinal angiomatous proliferation...................................589
Polypoidal choroidal vasculopathy..................................589
Peripheral exudative haemorrhagic
chorioretinopathy.......................................................591
Idiopathic choroidal neovascularization..........................591
Vitreomacular interface disorders...................................592
Central serous chorioretinopathy....................................598
Idiopathic macular telangiectasia...................................601
Cystoid macular oedema...............................................602
Microcystic macular oedema..........................................604
Degenerative myopia......................................................604
Angioid streaks..............................................................607
Choroidal folds..............................................................609
Hypotony maculopathy...................................................610
Solar retinopathy...........................................................610
Focal choroidal excavation.............................................611
Dome-shaped macula...................................................612
Low visual aids..............................................................613
15 Hereditary Fundus Dystrophies.........615
Introduction...................................................................616
Investigation..................................................................616
Generalized photoreceptor dystrophies...........................619
Macular dystrophies.......................................................631
Generalized choroidal dystrophies..................................640
Hereditary vitreoretinopathies........................................641
Albinism........................................................................649
Cherry-red spot at the macula.......................................652
16 Retinal Detachment.........................653
Introduction...................................................................654
Peripheral lesions predisposing to
retinal detachment.....................................................657
Posterior vitreous detachment........................................663
Retinal breaks................................................................666
Rhegmatogenous retinal detachment.............................668
Tractional retinal detachment.........................................681
Exudative retinal detachment.........................................681
Pars plana vitrectomy.....................................................683
17 Vitreous Opacities...........................691
18 Strabismus......................................697
Introduction...................................................................698
Amblyopia.....................................................................707
Clinical evaluation..........................................................708
Pseudostrabismus.........................................................726
Heterophoria..................................................................727
Vergence abnormalities..................................................727
Esotropia.......................................................................728
Exotropia.......................................................................733
Congenital cranial dysinnervation disorders....................735
Monocular elevation deficiency......................................737
Brown syndrome............................................................737
Alphabet patterns..........................................................738
Surgery..........................................................................739
Complications of strabismus surgery..............................742
Botulinum toxin chemodenervation................................743
19 Neuro-ophthalmology.......................745
Neuroimaging................................................................746
Optic nerve....................................................................751
Pupils............................................................................779
Chiasm..........................................................................786
Retrochiasmal pathways................................................792
Ocular motor nerves.......................................................795
Supranuclear disorders of ocular motility.......................806
Nystagmus.....................................................................809
Ocular myopathies.........................................................814
Miller Fisher syndrome...................................................819
Neurofibromatosis.........................................................819
Migraine........................................................................820
Neuralgias.....................................................................823
Facial spasm.................................................................824
Disorders of circadian rhythm.........................................825
Neuro-ophthalmology of space flight..............................825
20 Ocular Tumours................................827
Benign epibulbar tumours..............................................828
Malignant and premalignant epibulbar tumours.............833
Iris tumours...................................................................839
Iris cysts........................................................................841
Ciliary body tumours......................................................843
Tumours of the choroid..................................................846
Neural retinal tumours...................................................860
Retinal vascular tumours................................................868
Primary intraocular lymphoma.......................................872
Tumours of the retinal pigment epithelium......................875
Paraneoplastic syndromes.............................................878
21 Ophthalmic Side Effects of Systemic Medication....882
Cornea..........................................................................882
Ciliary effusion...............................................................882
Lens..............................................................................883
Uveitis...........................................................................884
Retina............................................................................884
Optic nerve--------------------------------------------------------891
Eyelid trauma.................................................................892
Orbital trauma...............................................................894
Trauma to the globe.......................................................898
Chemical injuries...........................................................912
Thermal burns................................................................916
Index.............................................................................917