Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatment Second Edit ion Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatment Second Edit ion Amar Agarwal, MS, FRCS, FRCOphth Professor of Ophthalmology Ramachandra Medical College Private Practice Che nnai, India Soosan Jacob, MS, FRCS, DNB, MNAMS Private Practice Che nnai, India Th iem e New York • Stuttgart Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Editorial Director: Michael Wachinger Managing Editor: J. Owen Zurhellen IV Editorial Assistant: Dominik Pucek Vice President, Production and Electronic Publishing: Anne T. Vinnicombe Production Editor: Kenneth L. Chumbley, Publication Services Vice President, International Marketing and Sales: Cornelia Schulze Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Cover illustration drawn by Karl Wesker Compositor: MPS Content Services Printer: Gopsons Papers Ltd. Library of Congress Cataloging-in-Publication Data Color atlas of ophthalmology : the quick-reference manual for diagnosis and treatment / [edited by] Amar Agarwal, Soosan Jacob.—2nd ed. p. ; cm. Includes index. Prev. ed. has subtitle: Manhattan Eye, Ear & Throat Hospital pocket guide. ISBN 978-1-60406-211-3 (alk. paper) 1. Eye—Diseases—Atlases. 2. Eye—Diseases—Handbooks, manuals, etc. 3. Ophthalmology—Atlases. 4. Ophthalmology—Handbooks, manuals, etc. I. Agarwal, Amar. II. Jacob, Soosan. [DNLM: 1. Eye Diseases—diagnosis—Atlases. 2. Eye Diseases—diagnosis—Handbooks. 3. Eye Diseases—pathology—Atlases. 4. Eye Diseases—pathology—Handbooks. 5. Eye— pathology—Atlases. 6. Eye—pathology—Handbooks. 7. Opthalmologic Surgical Procedures— Atlases. 8. Ophthalmologic Surgical Procedures—Handbooks. WW 17 C7195 2009] RE71.C65 2009 617.70022'3—dc22 2009020093 Copyright © 2010 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is le- gally protected by copyright. Any use, exploitation, or commercialization outside the narrow lim- it s set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage. Im p o rt a n t n o t e : Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindi- cations for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a represent ation by the publisher that it is in the public dom ain. Printed in India 5 4 3 2 1 ISBN 978-1-60406-211-3 Nothing in this world m oves w ithout Him , and so also this book was only w ritten by Him . This book is dedicated to a great friend, Brian S. Boxer Wachler, MD Co n t e n t s Fo re w o rd . .ix Preface . .xi Abo u t th e Edito rs . xiii Co n t r i b u t o r s . xv Ch a p t e r 1 Ocular Traum a . 1 Daniele Veritti, Carlo Sborgia, Francesco Boscia, Giuseppe Smaldone, and Paolo Lanzetta Ch a p t e r 2 Eyelids and Lacrimal System . 33 Christopher I. Zoumalan, Andrea Olmos, and Kimberly P. Cockerham Ch a p t e r 3 Orbital Infections, In ammation, and Neoplasms . 69 Praveen Saluja, Swati Ravani, Soosan Jacob, and Amar Agarwal Ch a p t e r 4 External Diseases . .100 Guillermo Simón-Castellví, Pablo Gili-Manzanaro, Sarabel Simón-Castellví, José María Simón-Castellví, Cristina Simón-Castellví, and José María Simón-Tor Ch a p t e r 5 Cornea . .141 W. Barry Lee and Ivan R. Schwab Ch a p t e r 6 In traocular In ammation . .194 Soosan Jacob, Dhivya Ashok Kumar, Athiya Agarwal, and Am ar Agarw al Ch a p t e r 7 Lens and Cataract . .218 Athiya Agarwal, Soosan Jacob, and Amar Agarwal Ch a p t e r 8 Glaucom a . 244 Soosan Jacob and Amar Agarwal Ch a p t e r 9 Medical Retina. .260 Mandeep Lamba, Soosan Jacob, and Amar Agarwal Ch a p t e r 1 0 Surgical Retina. .288 Clement K. Chan and Dariusz G. Tarasewicz Ch a p t e r 1 1 Ocular Neoplasm s. .322 Soosan Jacob, Santosh Hanovar, and Amar Agarwal Ch a p t e r 1 2 Strabism us . .339 Federico G. Velez, Noa Ela-Dalman, and Arthur L. Rosenbaum Ch a p t e r 1 3 Neuro-Ophthalm ology . .359 Soosan Jacob and Amar Agarwal vii viii Co nt e nt s Ch a p t e r 1 4 Ophthalm ic Pharm acology. .405 James M. Hill, Lori Vidal Denham, Blake A. Booth, Duncan A. Friedman, Je ery A. Hobden, Andrea T. Murina, Marie D. Acierno, Jean T. Jacob, Herbert E. Kaufman, and Donald R. Bergsm a Ch a p t e r 1 5 Ocular Manifestations of System ic Disease . .430 Soosan Jacob and Amar Agarwal Ch a p t e r 1 6 Contact Lenses. .447 Ken n et h M. Dan iels Ch a p t e r 1 7 Ophthalm ic Instrum ents and Diagnostic Tests. .486 Samuel Boyd and Amar Agarwal Ch a p t e r 1 8 Ophthalm ic O ce Procedures. .507 Sam uel Boyd Ch a p t e r 1 9 Refractive Surgery . .518 David R. Hardten, Natalia Kramarevsky, Louis E. Probst, and Richard L. Lindstrom In dex . 539 Fo re w o rd For some authors of ophthalmology, writing or editing 50 book chapters is a size- able accomplishment over a lifetime, let alone a decade. This is not true for Professor Agarwal. Since 1998, Amar Agarwal has edited on average more than four books a year, which is an unprecedented and virtually unimaginable yearly number for any one person. His books span top- ics from diagnostics and imaging (such as aberrometry, angiography, topogra- phy, dry eyes, and neuro-ophthalmology) to therapeutics and surgery (including contact lenses, lasers, LASIK, strabismus, oculoplastics, cataracts, phako, and more), and many have been bestsellers. He has authored several comprehensive hand- books and textbooks of ophthalmology, and Color Atlas of Ophthalmology stands out as one of his best. In its 19 subspe- cialty chapters, this second edition illus- trates over 500 diagnostics and therapeu- tic conditions. The comprehensive and systematic format helps the reader find and view the facts about any condition in ophthalmology instantly, making it an essential resource for both the student and the practitioner in the field. Anyone who knows Professor Agarwal can tell you that he is a consummate innovator and teacher. As a professor of ophthalmology and internationally re- nowned lecturer, his experience and dedication to teaching speak for themselves. Over the years, I have participated in several American Academy of Ophthalmolo- gy and American Society of Cataract and Refractive Surgery courses with Professor Agarwal and have learned a great deal about microincision cataract surgery and the management of challenging LASIK cases from them. Personally, I look forward to reviewing and referring to the content of this book on a regular basis. I recom- mend that you do so as well! Ronald R. Krueger, MD, MSE Medical Director, Department of Refractive Surgery Co le Eye In st it u t e Clevela n d Clin ic Cle vela n d , Oh io ix Preface Every day you may make progress. Every step may be fruitful. Yet there will stretch out before you an ever-lengthening, ever-ascending, ever-improving path. You know you will never get to the end of the journey. But this, so far from discouraging, only adds to the joy and glory of the climb. Winston Churchill (1874–1965) What is an ophthalmologist? One who has graduated from medical school and is interested in the eye. One who has completed three years of specialized ophthal- mic training. One who has spent a further two years in sub-specialization. One who has mentored the next generation of ophthalmologists. One who has inno- vated and changed preferred practice patterns in ophthalmology. All these classes of ophthalmologists need solid knowledge combined with patient empathy to best serve patients. The purpose of this fully revised second edition of the successful Co lo r At la s o f Ophthalmology: The Quick-Reference Manual for Diagnosis and Treatment is to give you the knowledge needed to face with confidence the full range of patients’ oph- thalmic disorders.