Kanski’s Clinical Ophthalmology. A Systematic Approach

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Kanski\'s Clinical Ophthalmology: A Systematic Approach
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Contents
Dedication
In Memoriam
Preface to the Ninth Edition
Abbreviations
1 Examination Techniques
	Introduction
	Psychophysical tests
		Visual acuity
			Snellen visual acuity
			Very poor visual acuity
			LogMAR acuity
			LogMAR charts
		Near visual acuity
		Contrast sensitivity
		Amsler grid
			Charts
			Technique
		Light brightness comparison test
		Photostress test
		Colour vision testing
			Introduction
			Colour vision tests
		Plus lens test
	Perimetry
		Definitions
		Testing algorithms
			Threshold
			Suprathreshold
			Fast algorithms
		Testing patterns
		Analysis
			Reliability indices
			Sensitivity values
			Summary values
			Computer analysis of serial fields
		High-sensitivity field modalities
		Sources of error
		Microperimetry
	Slit lamp biomicroscopy of the anterior segment
		Direct illumination
		Scleral scatter
		Retroillumination
		Specular reflection
	Fundus examination
		Direct ophthalmoscopy
			Technique
		Slit lamp biomicroscopy
			Technique
		Goldmann three-mirror examination
		Head-mounted binocular indirect ophthalmoscopy
		Fundus drawing
	Tonometry
		Goldmann tonometry
			Principles
			Technique
			Sources of error
		Other forms of tonometry
		Ocular response analyser and corneal hysteresis
	Gonioscopy
		Introduction
			Overview
			Optical principles
			Disinfection
		Indirect gonioscopy
			Non-indentation gonioscopy
			Indentation (dynamic, compression) gonioscopy
		Direct gonioscopy
		Identification of angle structures
		Pathological findings
	Central corneal thickness
2 Eyelids
	Introduction
		Anatomy
			Epidermis
			Dermis
		Terminology
			Clinical
			Histological
		General considerations
	Non-neoplastic lesions
		Chalazion (meibomian cyst)
			Pathogenesis
			Diagnosis
			Treatment
		Other eyelid cysts
		Xanthelasma
			Introduction
			Diagnosis
			Treatment
	Benign epidermal tumours
		Squamous cell papilloma
		Seborrhoeic keratosis
		Actinic keratosis
	Benign pigmented lesions
		Freckle
		Congenital melanocytic naevus
		Acquired melanocytic naevus
			Diagnosis
			Treatment
	Benign adnexal tumours
		Syringoma
		Pilomatricoma
	Miscellaneous benign tumours
		Capillary haemangioma
		Port-wine stain
			Introduction
			Diagnosis
			Treatment
			Sturge–Weber syndrome
		Pyogenic granuloma
		Neurofibroma
	Malignant tumours
		Rare predisposing conditions
		Basal cell carcinoma
			Introduction
			Histopathology
			Clinical features
		Squamous cell carcinoma
			Introduction
			Histopathology
			Clinical features
		Keratoacanthoma
			Introduction
			Diagnosis
			Treatment
		Sebaceous gland carcinoma
			Introduction
			Clinical features
		Lentigo maligna and melanoma
			Introduction
			Lentigo maligna
			Melanoma
		Merkel cell carcinoma
		Kaposi sarcoma
		Treatment of malignant tumours
			Biopsy
			Surgical excision
			Reconstruction
			Laissez-faire
			Radiotherapy
			Cryotherapy
	Disorders of the eyelashes
		Misdirected lashes
			Introduction
			Clinical features
			Treatment
		Eyelash ptosis
		Trichomegaly
		Madarosis
		Poliosis
	Allergic disorders
		Acute allergic oedema
		Contact dermatitis
		Atopic dermatitis
	Immune-related inflammation
		Dermatomyositis
		Systemic monoclonal antibody therapy
	Bacterial infections
		External hordeolum
		Impetigo
		Erysipelas
		Necrotizing fasciitis
	Viral infections
		Molluscum contagiosum
			Introduction
			Diagnosis
			Treatment
		Herpes zoster ophthalmicus
		Herpes simplex
			Introduction
			Treatment
	Blepharitis
		Chronic blepharitis
			Introduction
			Diagnosis
			Treatment
		Phthiriasis palpebrarum
		Tick infestation of the eyelid
		Angular blepharitis
		Childhood blepharokeratoconjunctivitis
	Ptosis
		Classification
		Clinical evaluation
			General
			Pseudoptosis
			Measurements
			Associated signs
		Simple congenital ptosis
			Diagnosis
			Treatment
		Marcus Gunn jaw-winking syndrome
			Introduction
			Diagnosis
			Treatment
		Third nerve misdirection syndromes
		Involutional ptosis
		Mechanical ptosis
		Surgery
			Anatomy
			Conjunctiva–Müller resection
			Levator advancement (resection)
			Brow (frontalis) suspension
	Ectropion
		Involutional ectropion
			Introduction
			Treatment
		Cicatricial ectropion
		Paralytic ectropion/facial nerve palsy
			Introduction
			Treatment
		Mechanical ectropion
	Entropion
		Involutional entropion
			Introduction
			Treatment
		Cicatricial entropion
	Miscellaneous acquired disorders
		Varix
		Dermatochalasis
		Floppy eyelid syndrome
			Introduction
			Diagnosis
			Treatment
		Blepharochalasis
		Eyelid imbrication syndrome
		Upper lid retraction
		Lower lid retraction
	Cosmetic eyelid and periocular surgery
		Involutional changes
		Non-surgical techniques
			Botulinum toxin injection to periocular muscles
			Tissue fillers
			Skin resurfacing
		Surgical techniques
			Upper eyelid blepharoplasty
			Lower eyelid blepharoplasty
			Brow ptosis correction
	Congenital malformations
		Epicanthic folds
		Telecanthus
		Blepharophimosis, ptosis and epicanthus inversus syndrome
		Epiblepharon
		Congenital entropion
		Coloboma
		Cryptophthalmos
		Euryblepharon
		Microblepharon
		Ablepharon
		Congenital upper lid eversion
		Ankyloblepharon filiforme adnatum
3 Lacrimal Drainage System
	Introduction
		Anatomy
		Physiology
		Causes of a watering eye
		Evaluation
			History
			External examination
			Fluorescein disappearance test
			Lacrimal irrigation
			Jones dye testing
			Contrast dacryocystography
			Nuclear lacrimal scintigraphy
			CT and MRI
			Internal nasal examination
	Acquired obstruction
		Conjunctivochalasis
		Primary punctal stenosis
		Secondary punctal stenosis
		Canalicular obstruction
		Nasolacrimal duct obstruction
		Dacryolithiasis
	Congenital obstruction
		Nasolacrimal duct obstruction
		Congenital dacryocoele
	Chronic canaliculitis
	Dacryocystitis
		Acute dacryocystitis
		Chronic dacryocystitis
4 Orbit
	Introduction
		Anatomy
		Clinical features
			Symptoms
			Soft tissue involvement
			Proptosis
			Enophthalmos
			Ophthalmoplegia
			Dynamic properties
			Fundus changes
		Investigation
	Thyroid eye disease
		Introduction
			Thyrotoxicosis
			Risk factors for ophthalmopathy
			Pathogenesis of ophthalmopathy
		Clinical features
			Introduction
			Soft tissue involvement
			Lid retraction
			Proptosis
			Restrictive myopathy
			Optic neuropathy
		Investigations
		Treatment
	Infections
		Preseptal cellulitis
			Introduction
			Diagnosis
			Treatment
		Bacterial orbital cellulitis
			Introduction
			Clinical features
			Investigation
			Treatment
		Rhino-orbital mucormycosis
			Introduction
			Diagnosis
			Treatment
	Non-infective inflammatory disease
		Idiopathic orbital inflammatory disease
			Diagnosis
			Treatment
		Orbital myositis
			Introduction
			Diagnosis
			Treatment
		Acute dacryoadenitis
		Tolosa–Hunt syndrome
		Granulomatosis with polyangiitis
	Non-neoplastic vascular abnormalities
		Cavernous sinus thrombosis
		Carotid–cavernous fistula
			Introduction
			Diagnosis
			Treatment
	Cystic lesions
		Dacryops
		Dermoid cyst
			Introduction
			Diagnosis
			Treatment
		Sinus mucocoele
		Encephalocoele
	Vascular tumours
		Varices
			Introduction
			Diagnosis
			Treatment
		Lymphangioma
			Introduction
			Diagnosis
			Treatment
		Capillary haemangioma
			Introduction
			Diagnosis
			Treatment
		Cavernous haemangioma
			Introduction
			Diagnosis
			Treatment
	Lacrimal gland tumours
		Pleomorphic lacrimal gland adenoma
			Introduction
			Diagnosis
			Treatment
		Lacrimal gland carcinoma
			Diagnosis
			Treatment
	Neural tumours
		Optic nerve glioma
			Introduction
			Diagnosis
			Treatment
		Optic nerve sheath meningioma
			Introduction
			Diagnosis
			Treatment
		Plexiform neurofibroma
		Isolated neurofibroma
	Lymphoma
		Introduction
		Diagnosis
		Treatment
	Rhabdomyosarcoma
		Introduction
		Diagnosis
		Treatment
	Metastatic tumours
		Adult metastatic tumours
			Introduction
			Diagnosis
			Treatment
		Childhood metastatic tumours
			Neuroblastoma
			Myeloid sarcoma
			Langerhans cell histiocytosis
		Orbital invasion from adjacent structures
			Sinus tumours
			Bony invasion
			Orbital invasion from eyelid, conjunctival and intraocular tumours
	The anophthalmic socket
		Surgical procedures
			Enucleation
			Evisceration
			Exenteration
		Rehabilitation
			Cosmetic shell
			Orbital implants
			Ocular prosthesis
	Craniosynostoses
5 Dry Eye
	Introduction
		Definitions
		Physiology
			Tear film constituents
			Spread of the tear film
			Lipid layer
			Aqueous layer
			Mucous layer
			Regulation of tear film components
			Mechanism of disease
		Classification
			Aqueous-deficient
			Evaporative
			Effect of environmental factors
	Sjögren syndrome
	Clinical features
		Symptoms
		Signs
	Investigation
		Tear film break-up time
		Schirmer test
		Ocular surface staining
		Other investigations
	Treatment
		Strategy
			Level 1
			Level 2
			Level 3
			Level 4
		Tear substitutes
		Punctal occlusion
		Anti-inflammatory agents
		Contact lenses
		Optimization of environmental humidity
		Miscellaneous options
6 Conjunctiva
	Introduction
		Anatomy
		Histology
		Clinical features of conjunctival inflammation
			Symptoms
			Discharge
			Conjunctival reaction
			Lymphadenopathy
	Bacterial conjunctivitis
		Acute bacterial conjunctivitis
			Diagnosis
			Treatment
		Giant fornix syndrome
		Adult chlamydial conjunctivitis
			Pathogenesis
			Urogenital infection
			Diagnosis
			Treatment
		Trachoma
			Pathogenesis
			Diagnosis
		Management
		Neonatal conjunctivitis
			Causes
			Diagnosis
			Treatment
	Viral conjunctivitis
		Introduction
		Presentation
		Signs
		Investigation
		Treatment
	Allergic conjunctivitis
		Acute allergic conjunctivitis
		Seasonal and perennial allergic conjunctivitis
			Diagnosis
			Treatment
		Vernal keratoconjunctivitis
			Pathogenesis
			Classification
			Diagnosis
		Atopic keratoconjunctivitis
			Pathogenesis
			Diagnosis
		Treatment of VKC and AKC
			General measures
			Local treatment
			Systemic treatment
			Surgery
		Non-allergic eosinophilic conjunctivitis
		Contact allergic blepharoconjunctivitis
		Giant (mechanically induced) papillary conjunctivitis
			Pathogenesis
			Diagnosis
			Treatment
	Conjunctivitis in blistering mucocutaneous disease
		Mucous membrane pemphigoid
			Introduction
			Ocular features
			Systemic features
			Systemic treatment
			Local treatment
			Reconstructive surgery
		Stevens–Johnson syndrome/toxic epidermal necrolysis (Lyell syndrome)
			Introduction
			Ocular features
			Systemic features
			Systemic treatment
			Ocular treatment
		Graft-versus-host disease
			Introduction
			Treatment
	Miscellaneous disorders of the conjunctiva
		Superior limbic keratoconjunctivitis
			Introduction
			Diagnosis
			Treatment
		Ligneous conjunctivitis
			Introduction
			Diagnosis
			Treatment
		Parinaud oculoglandular syndrome
		Factitious conjunctivitis
			Introduction
			Diagnosis
			Management
	Degenerations
		Pinguecula
			Introduction
			Treatment
		Pterygium
			Introduction
			Clinical features
			Treatment
		Concretions
		Conjunctivochalasis
		Retention (primary epithelial inclusion) cyst
	Subconjunctival haemorrhage
7 Cornea
	Introduction
		Anatomy and physiology
			General
			Dimensions
			Structure
		Signs of corneal disease
			Superficial
			Deep
		Documentation of clinical signs
		Specular microscopy
		Corneal topography
		Principles of treatment
			Control of infection and inflammation
			Promotion of epithelial healing
	Bacterial keratitis
		Pathogenesis
			Pathogens
			Risk factors
		Clinical features
		Investigations
		Treatment
			General considerations
			Local therapy
			Systemic antibiotics
			Management of apparent treatment failure
			Perforation
			Endophthalmitis
			Visual rehabilitation
	Fungal keratitis
		Introduction
			Pathogenesis
			Predisposing factors
		Candida and filamentous keratitis
			Clinical features
			Investigations
			Treatment
		Microsporidial keratitis
			Introduction
			Diagnosis
			Treatment
	Herpes simplex keratitis
		Introduction
			Herpes simplex virus (HSV)
			Primary infection
			Recurrent infection
		Epithelial keratitis
			Clinical features
			Treatment
		Disciform keratitis
			Clinical features
			Treatment
		Necrotizing stromal keratitis
		Neurotrophic keratopathy
		Iridocyclitis
		Other considerations
			Prophylaxis
			Complications
			Keratoplasty
	Herpes zoster ophthalmicus
		Introduction
			Pathogenesis
			Mechanisms of ocular involvement
			Risk of ocular involvement
		Acute shingles
			General features
			Treatment
			Prevention
		Eye disease
			Acute eye disease
			Chronic eye disease
			Relapsing eye disease
		Post-herpetic neuralgia
	Interstitial keratitis
		Introduction
		Syphilitic IK
			Congenital syphilis
			Presentation of syphilitic IK
		Cogan syndrome
			Introduction
			Diagnosis
			Treatment
	Protozoan keratitis
		Acanthamoeba
			Introduction
			Diagnosis
			Treatment
	Helminthic keratitis
		Onchocerciasis
	Bacterial hypersensitivity- mediated corneal disease
		Marginal keratitis
			Introduction
			Diagnosis
			Treatment
		Phlyctenulosis
			Introduction
			Diagnosis
			Treatment
	Rosacea
		Introduction
		Ocular rosacea
	Peripheral corneal ulceration/thinning
		Introduction
		Mooren ulcer
			Introduction
			Diagnosis
			Treatment
		Peripheral ulcerative keratitis associated with systemic autoimmune disease
			Introduction
			Clinical features
			Treatment
		Terrien marginal degeneration
			Diagnosis
			Treatment
	Neurotrophic keratopathy
		Introduction
		Diagnosis
		Treatment
	Exposure keratopathy
		Introduction
		Diagnosis
		Treatment
	Miscellaneous keratopathies
		Infectious crystalline keratopathy
		Thygeson superficial punctate keratitis
			Diagnosis
			Treatment
		Filamentary keratopathy
			Introduction
			Diagnosis
			Treatment
		Recurrent corneal epithelial erosion
			Introduction
			Diagnosis
			Treatment
		Xerophthalmia
			Introduction
			Diagnosis
			Treatment
	Corneal ectasia
		Keratoconus
			Introduction
			Diagnosis
			Treatment
		Pellucid marginal degeneration
			Diagnosis
			Treatment
		Keratoglobus
	Corneal dystrophy
		Epithelial dystrophies
			Cogan (epithelial basement membrane) dystrophy
			Meesmann epithelial dystrophy
			Others
		Bowman layer/anterior stromal dystrophies
			Reis–Bücklers corneal dystrophy
			Thiel–Behnke corneal dystrophy
		Stromal dystrophies
			Lattice corneal dystrophy, TGFB1 type
			Lattice corneal dystrophy, gelsolin type
			Granular corneal dystrophy, type 1 (classic)
			Granular corneal dystrophy, type 2
			Macular corneal dystrophy
			Schnyder (crystalline) corneal dystrophy
			François central cloudy dystrophy
			Others
		Descemet membrane and endothelial dystrophies
			Fuchs endothelial corneal dystrophy
			Posterior polymorphous corneal dystrophy
			Congenital hereditary endothelial dystrophy
	Corneal degeneration
		Age-related degeneration
			Arcus senilis
			Vogt limbal girdle
			Cornea farinata
			Crocodile shagreen
			West Indian punctate keratopathy
			Lipid keratopathy
			Band keratopathy
			Spheroidal degeneration
			Salzmann nodular degeneration
			Advancing wave-like epitheliopathy
	Metabolic keratopathy
		Cystinosis
		Mucopolysaccharidoses
		Wilson disease
		Lecithin-cholesterol-acyltransferase deficiency
		Immunoprotein deposition
		Tyrosinaemia type 2
		Fabry disease
	Contact lenses
		Therapeutic uses
			Optical
			Promotion of epithelial healing
			Pain relief
			Preservation of corneal integrity
			Miscellaneous indications
		Complications
			Mechanical and hypoxic keratitis
			Immune response (hypersensitivity) keratitis
			Toxic keratitis
			Suppurative keratitis
			Contact lens-associated giant papillary conjunctivitis
	Congenital anomalies of the cornea and globe
		Microcornea
		Microphthalmos
		Nanophthalmos
		Anophthalmos
		Megalocornea
		Sclerocornea
		Cornea plana
		Keratectasia
		Posterior keratoconus
8 Corneal and Refractive Surgery
	Keratoplasty
		Introduction
			General indications
			Donor tissue
			Recipient prognostic factors
		Penetrating keratoplasty
			Postoperative management
			Postoperative complications
			Corneal graft rejection
		Superficial lamellar keratoplasty
		Deep anterior lamellar keratoplasty
		Endothelial keratoplasty
		Limbal stem cell grafting
	Keratoprostheses
	Refractive procedures
		Introduction
			Correction of myopia
			Correction of hypermetropia (hyperopia)
			Correction of astigmatism
			Correction of presbyopia
		Laser refractive procedures
			Laser in situ keratomileusis
			Surface ablation procedures
			Refractive lenticule extraction
9 Episclera and Sclera
	Anatomy
	Episcleritis
		Simple episcleritis
		Nodular episcleritis
	Immune-Mediated Scleritis
		Anterior non-necrotizing scleritis
			Diffuse
			Nodular
		Anterior necrotizing scleritis with inflammation
			Clinical features
			Investigations
		Complications of anterior scleritis
		Scleromalacia perforans
		Posterior scleritis
			Diagnosis
			Differential diagnosis
		Important systemic associations of scleritis
			Rheumatoid arthritis
			Granulomatosis with polyangiitis
			Relapsing polychondritis
			Polyarteritis nodosa
			Crohn disease
		Treatment of immune-mediated scleritis
	Porphyria
	Infectious Scleritis
		Causes
		Treatment
	Scleral Discolouration
		Alkaptonuria
		Haemochromatosis
	Blue sclera
		Osteogenesis imperfecta
		Ehlers–Danlos syndrome type VI
	Miscellaneous Conditions
		Congenital ocular melanocytosis
		Idiopathic sclerochoroidal calcification
		Scleral hyaline plaque and senile scleromalacia
10 Lens
	Acquired cataract
		Age-related cataract
			Subcapsular cataract
			Nuclear sclerotic cataract
			Cortical cataract
			Christmas tree cataract
			Cataract maturity
		Cataract in systemic disease
			Diabetes mellitus
			Myotonic dystrophy
			Atopic dermatitis
			Neurofibromatosis type 2
		Secondary cataract
			Chronic anterior uveitis
			Acute congestive angle closure
			High myopia
			Hereditary fundus dystrophies
			Secondary to medication
		Traumatic cataract
	Management of age-related cataract
		Preoperative considerations
			Indications for surgery
			Systemic preoperative assessment
			Ophthalmic preoperative assessment
			Informed consent
			Biometry
			Postoperative refraction
		Intraocular lenses
			Positioning
		Design
		Anaesthesia
		Manual cataract surgery
		Phacoemulsification
			Introduction
			Phacodynamics
			Pump type
			Handpiece
			Ophthalmic viscosurgical devices
			Technique
		Femtosecond lasers in cataract surgery
		Operative complications
			Rupture of the posterior lens capsule
			Posterior loss of lens fragments
			Posterior dislocation of IOL
			Suprachoroidal haemorrhage
		Acute postoperative endophthalmitis
			Pathogenesis
			Prophylaxis
			Clinical features
			Differential diagnosis
			Identification of pathogens
			Treatment
			Subsequent management
		Delayed-onset postoperative endophthalmitis
			Pathogenesis
			Diagnosis
		Posterior capsular opacification
			Diagnosis
			Treatment
		Anterior capsular fibrosis and contraction
		Miscellaneous postoperative complications
			Cystoid macular oedema
			Dysphotopsia
			Corneal decompensation
			Ptosis
			Malposition of the IOL
			Retinal detachment
			Refractive ‘surprise’
	Congenital cataract
		Aetiology
		Associated metabolic disorders
			Galactosaemia
			Lowe syndrome
			Fabry disease
			Mannosidosis
			Other metabolic disorders
		Associated intrauterine infections
			Rubella
			Toxoplasmosis
			Cytomegalovirus infection
			Varicella
			Others
		Other systemic associations
			Down syndrome (trisomy 21)
			Edwards syndrome (trisomy 18)
			Miscellaneous
		Management
			Ocular assessment
			Systemic investigations
			Treatment
			Postoperative complications
			Visual rehabilitation
	Ectopia lentis
		Introduction
		Causes
		Without systemic associations
		With systemic associations
		Management
	Abnormalities of lens shape
		Anterior lenticonus
		Posterior lenticonus
		Lentiglobus
		Microspherophakia and microphakia
		Coloboma
11 Glaucoma
	Introduction
		Aqueous production
		Aqueous outflow
			Anatomy
			Physiology
		Intraocular pressure
			Concept of normal intraocular pressure
			Fluctuation
			Measurement of IOP
	Ocular hypertension
		Definition
		Risk factors for developing glaucoma in OHT
		Genetics of ocular hypertension
		Clinical evaluation
		Pre-perimetric glaucoma
		Management
	Overview of glaucoma
		Definition
		Goal of treatment
		Classification
		Epidemiology
		Natural history of open-angle glaucoma
	Primary open-angle glaucoma
		Introduction
			Definition
			Risk factors
			Genetics
			Pathogenesis of glaucomatous optic neuropathy
		Screening
		Diagnosis
			History
			Examination
		Evaluation of the optic nerve head
			Normal optic nerve head
			Changes in glaucoma
			Imaging in glaucoma
			Visual field defects (see Ch. 1, perimetry)
			Management
			Patient instruction
			Treatment goals
			Medical therapy
	Normal-tension glaucoma
		Introduction
		Pathogenesis
		Risk factors
		Differential diagnosis
		Clinical features
		Treatment
	Primary angle-closure glaucoma
		Introduction
			Overview
			Gonioscopy
			Grading of angle width
				Shaffer system.
				Other systems
			Classification
			Mechanism
			Risk factors
		Diagnosis
			Symptoms
			Signs
			Investigation
			Differential diagnosis of acute IOP elevation
		Treatment
			APAC
			PACS
			PAC and PACG
	Classification of secondary glaucoma
		Open-angle
		Closed angle
	Pseudoexfoliation
		Introduction
		Pathogenesis
		Clinical features
		Treatment
	Pigment dispersion syndrome and pigmentary glaucoma
		Introduction
		Pathogenesis
		Diagnosis
		Treatment
		Acute bilateral iris pigment loss with raised IOP
	Neovascular glaucoma
		Pathogenesis
		Causes
		Clinical features
		Treatment
		Prognosis
	Inflammatory glaucoma
		Introduction
			Overview
			Diagnostic dilemmas
		Angle-closure glaucoma with pupillary block
			Pathogenesis
			Diagnosis
		Angle-closure glaucoma without pupillary block
		Open-angle glaucoma
			In acute anterior uveitis
			In chronic anterior uveitis
		Treatment
			Medical
			Laser iridotomy
			Surgery
		Posner–Schlossman syndrome (PSS)
			Introduction
			Diagnosis
			Treatment
	Steroid-induced glaucoma
		Introduction
		Risk factors
		Treatment
	Lens-related glaucoma
		Phacolytic glaucoma
			Introduction
			Diagnosis
			Treatment
		Phacomorphic glaucoma
			Pathogenesis
			Diagnosis
			Treatment
		Pupillary block from disruption of lens position
			Causes
			Diagnosis
			Treatment
	Traumatic glaucoma
		Hyphaema
			Introduction
			Treatment
		Angle recession glaucoma
			Introduction
			Diagnosis
			Treatment
	Ghost cell ‘glaucoma’
		Pathogenesis
		Clinical features
		Treatment
	Iridocorneal endothelial syndrome
		Introduction
		Diagnosis
		Treatment
	Glaucoma associated with intraocular tumours
	Glaucoma secondary to epithelial ingrowth
		Introduction
		Diagnosis
		Treatment
	Iridoschisis
	Primary congenital glaucoma
		Introduction
		Diagnosis
		Treatment
		Differential diagnosis
	Iridocorneal dysgenesis
		Posterior embryotoxon
		Axenfeld–Rieger syndrome
			Introduction
			Clinical features
		Peters anomaly
			Introduction
			Clinical features
		Aniridia
			Genetics
			Diagnosis
			Treatment
	Glaucoma in phacomatoses
		Sturge–Weber syndrome
			Introduction
			Treatment
		Neurofibromatosis type 1
	Medical treatment of glaucoma
		Introduction
		Prostaglandin derivatives
			Introduction
			Agents
			Side effects
		Beta-blockers
			Introduction
			Side effects
			Agents
		Alpha-2 agonists
			Introduction
			Agents
		Topical carbonic anhydrase inhibitors
			Introduction
			Agents
		Miotics
			Introduction
			Agents
		Combined preparations
		New topical medications
		Systemic carbonic anhydrase inhibitors
			Introduction
			Agents
			Side effects
		Osmotic agents
			Introduction
			Agents
	Laser treatment of glaucoma
		Laser trabeculoplasty
			Introduction
			Indications
			Technique
		Laser iridotomy
			Introduction
			Technique
			Complications
		Diode laser cycloablation
			Indications
			Technique of trans-scleral cyclophotocoagulation
			Technique of endo-cyclophotocoagulation
			Complications
		Laser iridoplasty
			Technique
	Trabeculectomy
		Indications
		Technique
		Ex-Press™ mini-shunt
		Antimetabolites in filtration surgery
			Indications
			5-fluorouracil
			Mitomycin C
			Bevacizumab
		Shallow anterior chamber
			Pupillary block
			Overfiltration
			Malignant glaucoma
		Failure of filtration
			Diagnosis
			Causes
			Management
		Late bleb leakage
		Bleb-associated bacterial infection and endophthalmitis
			Blebitis
			Treatment
			Endophthalmitis
	Non-penetrating glaucoma surgery
		Overview
		Indications
		Technique
	Minimally invasive glaucoma surgery (MIGS)
		Indications
		Complications
		Results of surgery
	Drainage shunts
		Shunts using episcleral explants
			Introduction
			Indications
			Complications
			Results
12 Uveitis
	Classification
	Clinical features
		Anterior uveitis
			Introduction
			Clinical features
		Posterior uveitis
	Investigation
	Treatment
	Immunomodulatory therapy for non-infectious uveitis
		Introduction
		Indications
		Side effects of medication
		Classes of medication
	Uveitis in spondyloarthropathies
		Ankylosing spondylitis
			Introduction
			Systemic features
			Ocular features
		Reactive arthritis
			Introduction
			Systemic features
			Ocular features
		Psoriatic arthritis
			Introduction
			Systemic features
			Ocular features
	Fuchs uveitis syndrome
		Introduction
		Clinical features
		Investigation
		Treatment
	Uveitis in juvenile idiopathic arthritis (JIA)
		Introduction
		Clinical features
		Investigation
		Treatment
	Uveitis in bowel disease
		Ulcerative colitis
			Introduction
			Systemic features
			Ocular features
		Crohn disease
			Introduction
			Systemic features
			Ocular features
		Whipple disease
			Introduction
			Systemic features
			Ocular features
	Uveitis in renal disease
		Tubulointerstitial nephritis and uveitis
			Introduction
			Systemic features
			Ocular features
		IgA nephropathy
	Intermediate uveitis
		Introduction
		Clinical features
		Investigation
		Treatment
	Vogt–koyanagi–harada (VKH) syndrome
		Introduction
		Clinical features
		Investigation
		Treatment
	Sympathetic ophthalmitis
		Introduction
		Clinical features
		Investigation
		Treatment
	Lens-induced uveitis
		Introduction
		Clinical features
		Investigation
		Treatment
	Sarcoidosis
		Introduction
		Systemic features
		Ocular features
		Investigation
		Treatment
	Behçet disease
		Introduction
		Systemic features
		Ocular features
		Investigation
		Treatment
	Parasitic uveitis
		Toxoplasmosis
			Introduction
			Systemic features
			Ocular features
			Investigation
			Treatment
		Toxocariasis
			Introduction
			Clinical features
			Investigation
			Ocular treatment
		Onchocerciasis
			Introduction
			Clinical features
			Treatment
		Cysticercosis
			Introduction
			Clinical features
			Treatment
		Diffuse unilateral subacute neuroretinitis (DUSN)
			Introduction
			Clinical features
			Treatment
	Viral uveitis
		Uveitis in human immunodeficiency virus infection
			Introduction
			Systemic features
			Ocular features
		Cytomegalovirus retinitis
			Introduction
			Systemic features
			Ocular features
			Treatment
		Progressive retinal necrosis
			Introduction
			Ocular features
			Investigation
			Treatment
		Acute retinal necrosis (ARN)
			Introduction
			Investigation
			Treatment
		Herpes simplex anterior uveitis
			Introduction
			Treatment
		Varicella zoster virus (VZV) anterior uveitis
			Introduction
			Treatment
		Cytomegalovirus anterior uveitis
			Introduction
			Treatment
		Rubella
		Measles
		Mumps
		Vaccinia
		Zika
		Ebola
	Fungal uveitis
		Presumed ocular histoplasmosis syndrome (POHS)
			Introduction
			Ocular features
			Investigations
			Treatment
		Pneumocystis choroiditis
		Cryptococcal choroiditis
		Endogenous Candida endophthalmitis
			Introduction
			Clinical features
			Investigation
			Treatment
		Aspergillus endophthalmitis
		Coccidioidomycosis
	Bacterial uveitis
		Tuberculosis
			Introduction
			Ocular features
			Investigation
			Treatment
		Acquired syphilis
			Introduction
			Systemic features
			Ocular features
			Investigation
			Treatment
		Lyme disease
			Introduction
			Ocular features
			Investigations
			Treatment
		Brucellosis
		Endogenous bacterial endophthalmitis
			Introduction
			Ocular features
			Investigation
			Treatment
		Cat-scratch disease
			Introduction
			Ocular features
			Investigation
			Treatment
		Leprosy
			Introduction
			Systemic features
			Ocular features
			Investigation
			Treatment
	Miscellaneous idiopathic chorioretinopathies
		Multiple evanescent white dot syndrome (MEWDS)
			Introduction
			Clinical features
			Investigation
			Treatment
		Acute idiopathic blind spot enlargement syndrome (AIBSE)
		Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)
			Introduction
			Clinical features
			Investigation
			Treatment
		Serpiginous choroidopathy
			Introduction
			Clinical features
			Investigation
			Treatment
		Relentless placoid chorioretinitis (RPC)
		Persistent placoid maculopathy (PPM)
		Acute macular neuroretinopathy (AMN)
		Acute zonal occult outer retinopathy (AZOOR)
		Punctate inner choroidopathy (PIC)
			Introduction
			Clinical features
			Investigation
			Treatment
		Multifocal choroiditis and panuveitis (MFC, MCP)
			Introduction
			Clinical features
			Investigation
			Treatment
		Progressive subretinal fibrosis and uveitis syndrome (SFU)
		Birdshot retinochoroiditis
			Introduction
			Clinical features
			Investigation
			Treatment
		Acute retinal pigment epitheliitis (ARPE)
		(Unilateral) acute idiopathic maculopathy (AIM)
		Acute multifocal retinitis
		Solitary idiopathic choroiditis (SIC)
		Frosted branch angiitis (FBA)
		Idiopathic retinal vasculitis, aneurysms and neuroretinitis syndrome (IRVAN)
13 Retinal Vascular Disease
	Retinal circulation
		Arterial system
		Capillaries
		Venous system
	Diabetic retinopathy
		Introduction
			Ophthalmic complications of diabetes
			Prevalence
			Risk factors
		Pathogenesis
		Classification
		Signs
			Microaneurysms
			Retinal haemorrhages
			Exudates
			Diabetic macular oedema (DMO)
			Ischaemic maculopathy
			Clinically significant macular oedema
			Cotton-wool spots
			Venous changes
			Intraretinal microvascular abnormalities
			Arterial changes
			Proliferative retinopathy
		Treatment
			General
			Treatment of diabetic macular oedema
			Laser treatment for proliferative retinopathy
			VEGF inhibition for proliferative retinopathy
			Targeted retinal photocoagulation (TRP)
		Advanced diabetic eye disease
			Clinical features
			Indications for pars plana vitrectomy
		Diabetic papillopathy
	Non-diabetic retinopathy
	Retinal venous occlusive disease
		Introduction
		Risk factors
		Systemic assessment
			All patients
			Selected patients according to clinical indication
		Branch retinal vein occlusion
			Diagnosis
			Management
			Prognosis
		Impending central retinal vein occlusion
		Non-ischaemic central retinal vein occlusion
			Diagnosis
		Ischaemic central retinal vein occlusion
			Diagnosis
		Hemiretinal vein occlusion
			Diagnosis
		Treatment of the complications of CRVO
		Systemic management in retinal vein occlusion
		Papillophlebitis
	Retinal arterial occlusive disease
		Aetiology
		Systemic assessment
			All patients
			Selected patients
		Amaurosis fugax
		Branch retinal artery occlusion
		Central retinal artery occlusion
		Cilioretinal artery occlusion
		Treatment of acute retinal artery occlusion
		Systemic management following retinal arterial occlusion
		Asymptomatic retinal embolus
	Ocular ischaemic syndrome
		Introduction
		Diagnosis
		Management
	Hypertensive eye disease
		Retinopathy
		Choroidopathy
	Sickle-cell retinopathy
		Sickling haemoglobinopathies
		Anterior segment
		Non-proliferative retinopathy
		Proliferative retinopathy
			Diagnosis
			Treatment
	Thalassaemia retinopathy
	Retinopathy of prematurity
		Introduction
		Active disease
			Location
			Staging
			Type
			Screening
			Treatment
		Cicatricial disease
	Retinal artery macroaneurysm
		Diagnosis
		Treatment
	Primary retinal telangiectasia
		Idiopathic macular telangiectasia
		Coats disease
			Introduction
			Diagnosis
			Treatment
	Eales disease
		Introduction
		Diagnosis
		Treatment
	Radiation retinopathy
	Purtscher retinopathy
	Valsalva retinopathy
	Lipaemia retinalis
	Retinopathy in blood disorders
		Leukaemia
			Introduction
			Ocular features
		Anaemia
		Hyperviscosity
14 Acquired Macular Disorders
	Introduction
		Retinal pigment epithelium
		Bruch membrane
	Clinical evaluation of macular disease
		Symptoms
	Investigation of macular disease
		Fundus fluorescein angiography
			Introduction
			Technique
			Angiographic phases
			Causes of hyperfluorescence
			Causes of hypofluorescence
			Systematic approach to fluorescein angiogram analysis
		Indocyanine green angiography
			Introduction
			Adverse effects
			Diagnosis
			Indications
		Optical coherence tomography
			Introduction
			Normal appearance
		OCT-angiography
			Applications
		Fundus autofluorescence
		Wide-field imaging
			Definitions
	Age-related macular degeneration
		Introduction
			Classification
			Epidemiology
			Risk factors
		Drusen
			Histopathology
			Clinical features
			OCT
			Fluorescein angiography
			Differential diagnosis
		Antioxidant supplementation
			Introduction
			AREDS2
			Other considerations
		Non-exudative (dry, non-neovascular) AMD
			Diagnosis
			Management
		Retinal pigment epithelial detachment
			Pathogenesis
			Serous PED
			Fibrovascular PED
			Drusenoid PED
			Haemorrhagic PED
		Retinal pigment epithelial tear
		Choroidal neovascularization (CNV)
			Introduction
			Clinical features
			Fluorescein angiography
			Indocyanine green angiography
			Optical coherence tomography
			Treatment with anti-VEGF agents
			Treatment with photodynamic therapy (PDT)
			Combination and other experimental therapies
			Laser
		Haemorrhagic AMD
	Retinal angiomatous proliferation
		Diagnosis
		Treatment
	Polypoidal choroidal vasculopathy
		Introduction
		Diagnosis
		Treatment
	Peripheral exudative haemorrhagic chorioretinopathy
	Idiopathic choroidal neovascularization
	Vitreomacular interface disorders
		Epiretinal membrane
			Introduction
			Diagnosis
			Treatment
		Full-thickness macular hole
			Introduction
			Clinical features
			Investigation
			Treatment
		Vitreomacular traction
			Introduction
			Diagnosis
			Treatment
	Central serous chorioretinopathy
		Overview
		Clinical features
		Investigation
		Management
	Idiopathic macular telangiectasia
		Type 1: aneurysmal telangiectasia
		Type 2: perifoveal telangiectasia
		Type 3: occlusive telangiectasia
	Cystoid macular oedema
		Introduction
		Diagnosis
	Microcystic macular oedema
	Degenerative myopia
		Introduction
		Diagnosis
	Angioid streaks
		Introduction
		Diagnosis
		Treatment
	Choroidal folds
		Introduction
		Diagnosis
	Hypotony maculopathy
		Introduction
		Diagnosis
	Solar retinopathy
	Focal choroidal excavation
	Dome-shaped macula
	Low visual aids
15 Hereditary Fundus Dystrophies
	Introduction
		General
		Anatomy
		Inheritance
		Classification
	Investigation
		Electroretinography
			Introduction
			Full-field ERG
			Multifocal ERG
			Focal ERG
			Pattern ERG
		Electro-oculography
		Dark adaptometry
		Genetic testing
	Generalized photoreceptor dystrophies
		Retinitis pigmentosa
			Introduction
			Diagnosis
			Treatment
		Atypical retinitis pigmentosa
			Introduction
			Atypical RP associated with a systemic disorder (syndromic RP)
			Retinitis pigmentosa sine pigmento
			Retinitis punctata albescens
			Sector retinitis pigmentosa
			Leber congenital amaurosis
			Pigmented paravenous chorioretinal atrophy
		Cone dystrophy
			Introduction
			Diagnosis
			Treatment
		Stargardt disease/fundus flavimaculatus
			Introduction
			Diagnosis
			Investigation
			Treatment
		Bietti crystalline corneoretinal dystrophy
		Alport syndrome
		Familial benign fleck retina
		Congenital stationary night blindness
			Introduction
			With a normal fundus appearance
			With an abnormal fundus appearance
		Congenital monochromatism (achromatopsia)
			Rod monochromatism (complete achromatopsia)
			Blue cone monochromatism (incomplete achromatopsia)
	Macular dystrophies
		Best vitelliform macular dystrophy
			Introduction
			Diagnosis
		Multifocal vitelliform lesions without Best disease
		Adult-onset vitelliform macular dystrophy
		Pattern dystrophy of the retinal pigment epithelium
		North Carolina macular dystrophy
		Familial dominant drusen
		Sorsby pseudoinflammatory dystrophy
		Concentric annular macular dystrophy
		Central areolar choroidal dystrophy
		Dominant cystoid macular oedema
		Sjögren–Larsson syndrome
		Familial internal limiting membrane dystrophy
		Maternally inherited diabetes and deafness
	Generalized choroidal dystrophies
		Choroideremia
		Gyrate atrophy
		Progressive bifocal chorioretinal atrophy
	Hereditary vitreoretinopathies
		Juvenile X-linked retinoschisis
			Introduction
			Diagnosis
			Treatment
		Stickler syndrome
			Diagnosis
			Treatment
		Wagner syndrome
		Familial exudative vitreoretinopathy
		Enhanced S-cone syndrome and Goldmann–Favre syndrome
		Snowflake vitreoretinal degeneration
		Autosomal dominant neovascular inflammatory vitreoretinopathy
		Autosomal dominant vitreoretinochoroidopathy
		Kniest dysplasia
	Albinism
		Introduction
		Tyrosinase-negative oculocutaneous albinism
		Tyrosinase-positive oculocutaneous albinism
		Ocular albinism
	Cherry-red spot at the macula
16 Retinal Detachment
	Introduction
		Anatomy of the peripheral retina
			Pars plana
			Ora serrata
			Vitreous base
		Innocuous peripheral retinal degenerations (Fig. 16.4A)
		Sites of vitreous adhesion
			Physiological
			Pathological
		Definitions
		Ultrasonography
			Introduction
			Technique
	Peripheral lesions predisposing to retinal detachment
		Lattice degeneration
		Snailtrack degeneration
		Cystic retinal tuft
		Degenerative retinoschisis
		Zonular traction tuft
		White with pressure and white without pressure
		Myopic choroidal atrophy
	Posterior vitreous detachment
		Introduction
		Clinical features
		Management
	Retinal breaks
		Introduction
		Clinical features
		Management
		Treatment techniques
	Rhegmatogenous retinal detachment
		Introduction
			Pathogenesis
			Identification of retinal breaks
		Symptoms
		Signs
			General
			Fresh retinal detachment
			Longstanding retinal detachment
			Proliferative vitreoretinopathy
		Differential diagnosis
			Degenerative retinoschisis
			Choroidal detachment
			Uveal effusion syndrome
		Surgery
			Indications for urgent surgery
			Pneumatic retinopexy
			Principles of scleral buckling
			Drainage of subretinal fluid
			Complications of scleral buckling
			Pars plana vitrectomy
	Tractional retinal detachment
		Pathogenesis of diabetic tractional retinal detachment
		Diagnosis
	Exudative retinal detachment
		Pathogenesis
		Diagnosis
		Treatment
	Pars plana vitrectomy
		Introduction
			Instrumentation
			Tamponading agents
		Indications
			Rhegmatogenous retinal detachment
			Tractional retinal detachment
		Technique
			Goals of surgery
			Basic vitrectomy
			Proliferative vitreoretinopathy
			Tractional retinal detachment
		Complications
			Intraoperative complications
			Postoperative complications
17 Vitreous Opacities
	Introduction
	Muscae volitantes
	Vitreous haemorrhage
		Terson syndrome
	Asteroid hyalosis
	Synchysis scintillans
	Amyloidosis
	Vitreous cyst
	Persistent fetal vasculature
18 Strabismus
	Introduction
		Definitions
		Anatomy of the extraocular muscles
			Principles
			Horizontal recti
			Vertical recti
			Spiral of Tillaux
			Oblique muscles
			Muscle pulleys
			Innervation
		Ocular movements
			Ductions
			Versions
			Vergences
			Positions of gaze
			Laws of ocular motility
		Sensory considerations
			Basic aspects
			Sensory adaptations to strabismus
			Motor adaptation to strabismus
	Amblyopia
		Classification
		Diagnosis
		Treatment
	Clinical evaluation
		History
		Visual acuity
			Testing in preverbal children
			Testing in verbal children
		Tests for stereopsis
			Titmus
			TNO
			Frisby
			Lang
		Tests for binocular fusion in infants without manifest squint
			Base-out prism
			Binocular convergence
		Tests for sensory anomalies
			Worth four-dot test
			Bagolini striated glasses
			4 Δ prism test
			Synoptophore
			Grades of binocular vision
			Detection of abnormal retinal correspondence
		Measurement of deviation
			Hirschberg test
			Krimsky and prism reflection tests
			Cover–uncover test
			Alternate cover test
			Prism cover test
			Maddox wing
			Maddox rod
		Motility tests
			Ocular movements
			Near point of convergence
			Near point of accommodation
			Fusional amplitudes
			Postoperative diplopia test
		Field of binocular single vision
		Hess chart
			Hess screen
			Lees screen
			Interpretation
			Changes over time
			Examples
		Refraction and fundoscopy
			Cycloplegia
			Change of refraction with age in childhood
			When to prescribe
	Pseudostrabismus
	Heterophoria
	Vergence abnormalities
		Convergence insufficiency
		Divergence insufficiency
		Near reflex insufficiency
		Spasm of the near reflex
	Esotropia
		Early-onset esotropia
			Signs
			Initial treatment
			Subsequent treatment
		Accommodative esotropia
			Refractive accommodative esotropia
			Non-refractive accommodative esotropia
			Treatment
		Microtropia
			Treatment
		Other esotropias
			Near esotropia (non-accommodative convergence excess)
			Distance esotropia
			Acute (late-onset) esotropia
			Secondary (sensory) esotropia
			Consecutive esotropia
			Divergence insufficiency
			Cyclic esotropia
			High myopia esotropia
	Exotropia
		Constant (early-onset) exotropia
		Intermittent exotropia
			Diagnosis
			Classification
			Treatment
		Sensory exotropia
		Consecutive exotropia
	Congenital cranial dysinnervation disorders
		Duane retraction syndrome
			Clinical features
			Classification (Huber)
			Treatment
		Möbius syndrome
		Congenital fibrosis of the extraocular muscles
		Strabismus fixus
		Other CCDD syndromes with ophthalmic features
	Monocular elevation deficiency
	Brown syndrome
		Classification
		Treatment
	Alphabet patterns
		‘V’ pattern
			Causes
			Treatment
		‘A’ pattern
			Causes
			Treatment
	Surgery
		Strengthening procedures
		Weakening procedures
			Recession
			Disinsertion
			Posterior fixation suture
		Transposition
		Adjustable sutures
			Indications
			Operative procedure
			Postoperative adjustment
	Complications of strabismus surgery
	Botulinum toxin chemodenervation
19 Neuro-ophthalmology
	Neuroimaging
		Computed tomography
			Physics
			Contrast enhancement
			Indications
		Magnetic resonance imaging
			Physics
			Basic sequences
			Image enhancement
			Limitations
			Neuro-ophthalmic indications
		Angiography
			Magnetic resonance angiography
			Magnetic resonance venography
			Computed tomographic angiography
			Computed tomographic venography
			Conventional catheter angiography
	Optic nerve
		Anatomy
			General structure (Fig. 19.5A–C)
			Anatomical subdivisions
		Visual evoked potential
		Signs of optic nerve dysfunction
		Classification of optic neuropathy by cause
		Optic atrophy
			Introduction
			Primary optic atrophy
			Secondary optic atrophy
			Consecutive optic atrophy
			Glaucomatous optic atrophy
		Classification of optic neuritis
			According to ophthalmoscopic appearance
			According to aetiology
		Demyelinating optic neuritis
			Overview
			Multiple sclerosis
			Association between optic neuritis and multiple sclerosis
			Clinical features of demyelinating optic neuritis
			Management following demyelinating optic neuritis
		Parainfectious optic neuritis
		Infectious optic neuritis
		Non-infectious optic neuritis
			Sarcoidosis
			Autoimmune
		Neuroretinitis
			Introduction
			Diagnosis
			Treatment
		Non-arteritic anterior ischaemic optic neuropathy
			Introduction
			Diagnosis
			Treatment
		Arteritic anterior ischaemic optic neuropathy
			Diagnosis of giant cell arteritis
			Treatment of giant cell arteritis without AAION
		Arteritic anterior ischaemic optic neuropathy
			Other manifestations
		Posterior ischaemic optic neuropathy
		Diabetic papillopathy
		Leber hereditary optic neuropathy
			Introduction
			Diagnosis
			Treatment
		Miscellaneous hereditary optic neuropathies (atrophies)
			Dominant optic atrophy (Kjer type optic atrophy, optic atrophy type 1)
			Behr syndrome
			Wolfram syndrome
		Nutritional optic neuropathy
			Introduction
			Diagnosis
			Treatment
		Papilloedema
			Introduction
			Cerebrospinal fluid
			Diagnosis of raised ICP
			Stages of papilloedema
		Idiopathic intracranial hypertension
			Introduction
			Diagnosis
			Treatment
		Congenital optic disc anomalies
			Tilted disc
			Torsional disc
			Optic disc pit
			Optic disc drusen
			Optic disc coloboma
			Morning glory anomaly
			Optic nerve hypoplasia
			Myelinated nerve fibres
			Aicardi syndrome
			Bergmeister papilla
			Acquired vascular abnormalities
			Miscellaneous anomalies
	Pupils
		Anatomy
			Light reflex
			Near reflex
		Afferent pupillary defect
			Absolute afferent pupillary defect
			Relative afferent pupillary defect
		Horner syndrome (oculosympathetic palsy)
			Anatomy
			Causes
			Presentation
			Pharmacological tests
			Investigation
			Treatment
		Adie pupil
			Introduction
			Diagnosis
			Treatment
		Miscellaneous pupillary abnormalities
	Chiasm
		Anatomy
			Pituitary gland
			Parachiasmal vascular structures
		Physiology
			Pituitary hormones
		Pituitary adenomas
			Ophthalmic features of large adenomas
			Investigation
			Prolactin-secreting (lactotrophic) adenoma
			Corticotrophic adenoma
			Somatotrophic adenoma
			Treatment of pituitary adenomas
		Pituitary apoplexy
		Craniopharyngioma
		Meningioma
	Retrochiasmal pathways
		Optic tracts
			Overview
			Congruity
			Clinical features
		Optic radiations
			Anatomy
			Temporal radiations
			Anterior parietal radiations
			Main radiations
		Occipital cortex
			Clinical features
			Causes
			Benson syndrome
			Balint syndrome
			Posterior reversible encephalopathy syndrome
	Ocular motor nerves
		Third nerve
			Nuclear complex
			Fasciculus
			Basilar
			Intracavernous
			Intraorbital
			Pupillomotor fibres
			Signs
			Aberrant regeneration
			Causes of isolated third nerve palsy
			Investigation
			Treatment
		Fourth nerve
			Anatomy
			Causes of isolated fourth nerve palsy
			Signs
			Parks three-step test
			Investigation
			Treatment
		Sixth nerve
			Brainstem
			Basilar
			Intracavernous and intraorbital
			Diagnosis
			Investigation
			Treatment
	Supranuclear disorders of ocular motility
		Conjugate eye movements
			Saccades
			Smooth pursuit
			Non-optical reflexes
		Abnormalities of horizontal gaze
			Anatomy
			Horizontal gaze palsy
			Internuclear ophthalmoplegia
		Vertical gaze palsy
			Anatomy
			Parinaud (dorsal midbrain) syndrome
			Progressive supranuclear palsy
		Skew deviation
	Nystagmus
		Introduction
			Physiological principles
			Classification
		Physiological nystagmus
		Vestibular nystagmus
		Infantile (congenital) nystagmus
			Introduction
			Sensory deficit (afferent) nystagmus
			Congenital motor (efferent) nystagmus
			Spasmus nutans
			Others
		Acquired nystagmus
			Latent nystagmus
			Periodic alternating nystagmus
			Convergence–retraction nystagmus
			Downbeat nystagmus
			Upbeat nystagmus
			See-saw nystagmus
			Ataxic nystagmus
			Bruns nystagmus
		Treatment of nystagmus
		Nystagmoid movements
			Ocular flutter and opsoclonus
			Ocular bobbing
		Superior oblique myokymia
	Ocular myopathies
		Myasthenia gravis
			Introduction
			Systemic myasthenia
			Ocular myasthenia
			Investigations
			Treatment
		Myotonic dystrophy
			Introduction
			Diagnosis
			Treatment
		Chronic progressive external ophthalmoplegia
			Isolated CPEO
			Kearns–Sayre syndrome
			Oculopharyngeal dystrophy
	Miller fisher syndrome
	Neurofibromatosis
		Neurofibromatosis type I
			Systemic features
			Ophthalmic features
		Neurofibromatosis type II
			Ophthalmic features
	Migraine
		Introduction
		Migraine without aura
		Migraine with aura (classical migraine)
		Other forms of migraine
		Treatment
	Neuralgias
	Facial spasm
		Benign essential blepharospasm
			Introduction
			Treatment
		Hemifacial spasm
	Disorders of circadian rhythm
		Introduction
		Anatomy
		Ocular disease causing abnormal circadian rhythm
		Treatment
	Neuro-ophthalmology of space flight
20 Ocular Tumours
	Benign epibulbar tumours
		Conjunctival naevus
			Introduction
			Clinical features
		Conjunctival papilloma
			Clinical features
			Treatment
		Limbal dermoid
			Systemic associations
		Dermolipoma
		Pyogenic granuloma
		Miscellaneous benign epibulbar tumours
		Benign melanosis
	Malignant and premalignant epibulbar tumours
		Primary acquired melanosis/conjunctival melanocytic intraepithelial neoplasia
			Introduction
			Diagnosis
		Conjunctival melanoma
			Diagnosis
			Treatment
		Ocular surface squamous neoplasia
			Introduction
			Diagnosis
			Treatment
		Lymphoproliferative lesions
			Introduction
			Diagnosis
			Treatment
		Primary amyloidosis
		Kaposi sarcoma
	Iris tumours
		Iris naevus
		Iris freckle (ephelis)
		Brushfield spots
		Lisch nodules
		Iris melanoma
			Introduction
			Diagnosis
			Treatment
		Metastatic tumours
		Miscellaneous iris tumours
	Iris cysts
	Ciliary body tumours
		Ciliary body melanoma
			Introduction
			Diagnosis
			Treatment
		Medulloepithelioma
	Tumours of the choroid
		Choroidal naevus
			Diagnosis
			Treatment
		Choroidal melanoma
			Diagnosis
			Differential diagnosis
			Investigation
			Treatment
		Circumscribed choroidal haemangioma
			Diagnosis
			Treatment
		Diffuse choroidal haemangioma
		Optic disc melanocytoma
			Diagnosis
		Choroidal osteoma
			Diagnosis
		Metastatic tumours
			Diagnosis
			Treatment
	Neural retinal tumours
		Retinoblastoma
			Introduction
			Genetics
			International classification of retinoblastoma
			Clinical features
			Investigation
			Treatment
			Differential diagnosis
		Retinal astrocytoma
			Introduction
			Diagnosis
		Tuberous sclerosis
	Retinal vascular tumours
		Capillary haemangioma
			Introduction
			Diagnosis
			Treatment
			Von Hippel–Lindau disease
		Cavernous haemangioma
			Introduction
			Diagnosis
			Treatment
		Congenital retinal arteriovenous communication (racemose haemangioma)
		Vasoproliferative tumour
	Primary intraocular lymphoma
		Introduction
		Ocular features
		Neurological features
		Investigation
		Treatment
	Tumours of the retinal pigment epithelium
		Congenital hypertrophy of the RPE
			Introduction
			Solitary (unifocal) CHRPE
			Grouped (multifocal) CHRPE
			Atypical congenital hypertrophy of the RPE
		Combined hamartoma of the retina and RPE
			Introduction
			Diagnosis
			Treatment
		Congenital simple hamartoma of the RPE
		Adenoma and adenocarcinoma of the RPE
		Hyperplasia and migration of the RPE simulating uveal melanoma
	Paraneoplastic syndromes
		Bilateral diffuse uveal melanocytic proliferation
		Cancer-associated retinopathy
		Melanoma-associated retinopathy
21 Ophthalmic Side Effects of Systemic Medication
	Eyelids
		Monoclonal antibodies
	Cornea
		Vortex keratopathy (cornea verticillata)
			Clinical features
			Causes
		Chlorpromazine
		Argyrosis
		Chrysiasis
		Amantadine
	Ciliary effusion
		Topiramate
	Lens
		Steroids
		Other drugs
	Uveitis
		Rifabutin
		Cidofovir
		Bisphosphonates
		Sulfonamides
		Fluoroquinolones
		Tumour necrosis factor inhibitors
	Retina
		Chloroquine and hydroxychloroquine
			Introduction
			Diagnosis
			Screening
		Phenothiazines
		Drug-induced crystalline maculopathies
		Other drugs causing retinopathy
	Optic nerve
		Ethambutol
		Isoniazid
		Amiodarone
		Vigabatrin
		Methotrexate
	Visual cortex
		Bevacizumab
22 Trauma
	Eyelid trauma
		Periocular haematoma
		Laceration
	Orbital trauma
		Orbital floor fracture
			Introduction
			Diagnosis
			Treatment
		Roof fracture
			Introduction
			Diagnosis
			Treatment
		Blow-out medial wall fracture
		Lateral wall fracture
		Orbital haemorrhage
			Introduction
			Diagnosis
			Treatment
	Trauma to the globe
		Introduction
			Terminology
			Investigations
		Blunt trauma
			Cornea
			Hyphaema
			Anterior uvea
			Intraocular pressure
			Lens
			Globe rupture
			Vitreous haemorrhage
			Commotio retinae
			Choroidal rupture
			Retinal breaks and detachment
			Traumatic optic neuropathy
			Optic nerve avulsion
			Abusive head trauma
		Penetrating trauma
			Introduction
			Corneal
			Scleral
			Retinal detachment
		Enucleation/evisceration
		Superficial foreign body
			Subtarsal
			Corneal
		Intraocular foreign body
			Introduction
			Diagnosis
			Treatment
			Siderosis
			Chalcosis
		Bacterial endophthalmitis
	Chemical injuries
		Aetiology
		Pathophysiology
		Management
			Emergency treatment
			Grading of severity
			Medical treatment
			Surgery
	Thermal burns