Clinical Diagnosis and Management of OCULAR TRAUMA System requirement: • Windows XP or above • Power DVD player (Software) • Windows media player 10.0 version or above Accompanying DVD ROM is playable only in Computer and not in DVD player. Kindly wait for few seconds for DVD to autorun. If it does not autorun then please do the following: • Click on my computer • Click the DVD drive labelled JAYPEE and after opening the drive, kindly double click the file Jaypee Clinical Diagnosis and Management of OCULAR TRAUMA Editors Ashok Garg MS PhD FIAO (Bel) FRSM FAIMS ADM FICA Jose M Ruiz-Moreno MD PhD International and National Gold Medalist Professor of Ophthalmology Chairman and Medical Director Albacete Medical School, University of Garg Eye Institute and Research Centre Castilla La Mancha 235-Model Town, Dabra Chowk Avendia de Almansa, 14 02006, ALBACETE Hisar-125005, India Spain B Shukla MS PhD MAMS FICS T Mark Johnson MD FRCS Director of Research Consultant Vitreo Retinal Surgeon RJN Institute of Ophthalmology National Retina Institute Chandra Bhawan, 1, Jhansi Road Suite 101, 5530 Wisconsin Ave Gwalior-474002, India Chevy Chase 20815, USA Jerome Jean Bovet MD Keiki R Mehta MS DO FRSH FIOS Consultant Ophthalmic Surgeon FMH Chairman and Medical Director Clinique de L’oeil Mehta International Eye Institute and 15, Avenue Du Bois-de-law-Chapelle Colaba Eye Hospital CH-1213, Onex, Switzerland Seaside, 147, Shahid Bhagat Singh Road, Mumbai-400005 Mahipal S Sachdev MD India Chairman and Medical Director Centre for Sight, B-5/24, Safdarjung Enclave Bojan Pajic MD New Delhi-110029, India Chief of the Cornea and Refractive Surgery Department CS Dhull MS PhD FIAO Klinik Pallas Louis Giroud- Professor and Head Str. 20 4600, Olten Regional Eye Institute of Ophthalmology Switzerland Pt. BD PGIMS, Rohtak-124001, India Belquiz A Nassaralla MD PhD Consultant Ophthalmic Surgeon Department of Cornea and Refractive Surgery Goiania Eye Institute, Goiania GO, Brazil Cyres K Mehta MS FSVH FAGE Director and Consultant Mehta International Eye Institute and Colaba Eye Hospital Seaside, 147, Sahid Bhagat Singh Road, Mumbai-400005, India Foreword Bruce Wallace ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • Ahmedabad • Bengaluru • Chennai • Hyderabad • Kochi • Kolkata Lucknow • Mumbai • Nagpur • St Louis (USA) Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, +91-11-43574357 (20 lines) Registered Office B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected], Website: www.jaypeebrothers.com Branches • 2/B, Akruti Society, Jodhpur Gam Road Satellite Ahmedabad 380 015, Phones: +91-79-26926233, Rel: +91-79-32988717 Fax: +91-79-26927094, e-mail: [email protected] • 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East Bengaluru 560 001, Phones: +91-80-22285971, +91-80-22382956, +91-80-22372664 Rel: +91-80-32714073, Fax: +91-80-22281761, e-mail: [email protected] • 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza, Pantheon Road Chennai 600 008, Phones: +91-44-28193265, +91-44-28194897, Rel: +91-44-32972089, Fax: +91-44-28193231, e-mail: [email protected] • 4-2-1067/1-3, 1st Floor, Balaji Building, Ramkote Cross Road Hyderabad 500 095, Phones: +91-40-66610020, +91-40-24758498, Rel:+91-40-32940929 Fax:+91-40-24758499, e-mail: [email protected] • No. 41/3098, B & B1, Kuruvi Building, St. Vincent Road Kochi 682 018, Kerala, Phones: +91-484-4036109, +91-484-2395739, +91-484-2395740 e-mail: [email protected] • 1-A Indian Mirror Street, Wellington Square Kolkata 700 013, Phones: +91-33-22651926, +91-33-22276404, +91-33-22276415 Rel: +91-33-32901926, Fax: +91-33-22656075, e-mail: [email protected] • Lekhraj Market III, B-2, Sector-4, Faizabad Road, Indira Nagar Lucknow 226 016, Phones: +91-522-3040553, +91-522-3040554 e-mail: [email protected] • 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, Parel Mumbai 400012, Phones: +91-22-24124863, +91-22-24104532, Rel: +91-22-32926896 Fax: +91-22-24160828, e-mail: [email protected] • “KAMALPUSHPA” 38, Reshimbag, Opp. Mohota Science College, Umred Road Nagpur 440 009 (MS), Phone: Rel: +91-712-3245220 Fax: +91-712-2704275, e-mail: [email protected] USA Office 1745, Pheasant Run Drive, Maryland Heights (Missouri), MO 63043, USA, Ph: 001-636-6279734 e-mail: [email protected], [email protected] Clinical Diagnosis and Management of Ocular Trauma © 2009, Editors All rights reserved. No part of this publication and DVD ROM should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher. This book has been published in good faith that the material provided by Contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only. First Edition: 2009 ISBN 978-81-8448-470-0 Typeset at JPBMP typesetting unit Printed at Ajanta Offset Dedicated to - My Respected Param Pujya Guru Sant Gurmeet Ram Rahim Singh Ji for his blessings and motivation. - My Respected Parents, teachers, my wife Dr Aruna Garg, son Abhishek and daughter Anshul for their constant support and patience during all these days of hard work. - My dear friend Dr Amar Agarwal, a renowned International Ophthalmologist for his constant support, guidance and expertise. Ashok Garg My family (Magali, my wife and Jorge, Guillermo and Magali my children) for the time, comprehension and patience that they have had with me during all these years of hard work. Jose M Ruiz-Moreno Sir Stewart Duke-Elder, my ideal and inspiration for ophthalmology. B Shukla My wife Joanne and my son Connor for providing me with their love, wisdom and support throughout the years. T Mark Johnson - Yveric, Luc and Fanny Laure. - Silvio Korol, who was not only a teacher but also an intellectual guide and a friend. Jerome Jean Bovet Zena the light of my life. Keiki R Mehta My family without whose help it would not have been possible to do book. Mahipal S Sachdev To my son Valentin Aleksandar. Bojan Pajic My dear wife Dr Indira Dhull and my children Tushar and Chirag. CS Dhull To my parents Lucia and Justino, for their blessings and motivation. To my husband Joao, a great partner at home and at work. To my children Arthur, Joao Neto and Anna Paula, who have been giving me constant support and love. Belquiz A Nassaralla - My parents for everything. - To Vini my Best friend. Cyres K Mehta Contributors Ajay Aurora MS Athiya Agarwal MD DO FRSH Chandresh Baid MS Divector Consultant Dr. Agarwal’s Eye Hospital Retina-Clinic Dr. Agarwal’s Eye Hospital 19, Cathedral Road Dr. Chaudhary Eye Centre and 19, Cathedral Road Chennai-600086, India Laser Vision, 4802 Bharat Ram Road Chennai-600086, India 24, Daryaganj, Chitra Ramamurthy MS New Delhi Belquiz A Nassaralla MD PhD Director India Consultant Ophthalmic Surgeon The Eye Foundation Department of Cornea and DB Road, Coimbatore-641002 Refractive Surgery Amar Agarwal MS FRCS FRC Ophth India Goiania Eye Institute, Goiania Consultant GO, Brazil Dr. Agarwal’s Eye Hospital Cristina Masini MD 19, Cathedral Road B Shukla MS PhD MAMS FICS Institute of Ophthalmology Chennai-600086, Director of Research University of Modena and Reggio Emilia India RJN Institute of Ophthalmology via del Pozzo 71-41100, Modena Chandra Bhawan, 1, Jhansi Road Italy Amol Mhatre MS Gwalior-474002, India Aditya Jyot Eye Hospital Pvt. Ltd Cyres K Mehta MS FSVH FAGE Binoo Nayer DOMS Plot No. 153, Road No.9 Director and Consultant Consultant Ophthalmologist Major Parmeshwaran Road Mehta International Eye Institute and Hindu Rao Hospital Opp. SIWS College, Gate No.3 Colaba Eye Hospital New Delhi, India Seaside, 147, Sahid Bhagat Singh Wadala, Mumbai-400031 Road, Mumbai-400005 India Bojan Pajic MD India Chief of the Cornea and Refractive Arturo Perez-Arteaga MD Surgery Department Klinik Pallas Louis Giroud- Daljit Singh MS DSC Medical Director Director Centro Oftalmologico Tlalnepantla Str.20 4600, Olten Switzerland Dr Daljit Singh’s Eye Hospital Dr Perez - Arteaga Vallarta No. 42 57-Joshi Colony Tlalnepantla, Centro, Boris Malyugin MD Phd Amritsar-143001, India Estado de Mexico Chief of Department of Cataract and 54000, Mexico Implant Surgery David F Chang MD Dy. Director General Clinical Professor of Ophthalmology Ashok Garg MS PhD FIAO (Bel) S. Fyodorov Eye Microsurgery University of California FRSM FAIMS ADM FICA Complex State Institution, 762, Altos Oaks Drive, Suite-1 International and National Gold Medalist 127486 Moscow Los Altos, CA 94024, Chairman and Medical Director Beskudnikovsky blvd 59A USA Garg Eye Institute and Research Centre Russia 235-Model Town, Dhivya A MS Brigitte Pajic-Eggspuhler MD Dabra Chowk AugenZentrumPajic (AZP) Dr. Agarwal’s Eye Hospital Hisar-125005 Research Institute 19, Cathedral Road India Titlisstrasse 44, 5734 Chennai-600086, Reinach, Switzerland India Ashok Sharma MS Director CS Dhull MS PhD FIAO Douglas W Morck MD Dr. Ashok Sharma’s Corneal Centre Professor and Head Department of Ophthalmology SCO 833-834 (2nd Floor) Regional Eye Institute of The Eye Care Centre Sector 22-A, Ophthalmology 2550, Willow St., Section G Chandigarh-160022 Pt. BD PGIMS, Rohtak-124001 Vancouver, BC V5Z3N9 India India Canada viii Clinical Diagnosis and Management of Ocular Trauma D Ramamurthy MS GK Das MD Jerome Jean Bovet MD Medical Director Professor of Ophthalmology Consultant Ophthalmic Surgeon FMH The Eye Foundation UCMS and GTB Hospital Clinique de L’oeil D.B.