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دانلود کتاب Ophthalmology
دانلود کتاب چشم پزشکی
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Ophthalmology
دسته بندی: چشم پزشکی ویرایش: 5 نویسندگان: Myron Yanoff, Jay S Duker سری: Eğitim Tanrısı ISBN (شابک) : 0323528198, 9780323528191 ناشر: Elsevier سال نشر: 2018 تعداد صفحات: 1671 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 800 مگابایت
قیمت کتاب (تومان) : 34,000
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توجه داشته باشید کتاب چشم پزشکی نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی در مورد کتاب چشم پزشکی
این عنوان برنده جایزه توسط Drs. مایرون یانوف و جی اس. دوکر تقریباً برای هر موضوعی در این زمینه به سرعت در حال تغییر مرجع اصلی شما هستند. در یک جلد راحت، راهنمای دقیق و فوق العاده مصور تقریباً در مورد هر بیماری و روش چشم پزشکی که ممکن است با آن روبرو شوید ارائه می دهد، و بدون توجه به سطح تجربه شما، آن را به منبعی ضروری تبدیل می کند. به روز رسانی های گسترده در سراسرشما را در جریان همه چیزهای جدید در هر زمینه فوق تخصصی در این زمینه قرار می دهد.
توضیحاتی درمورد کتاب به خارجی
Long consideredone of ophthalmology's premier texts, this award-winning title by Drs. Myron Yanoff and Jay S. Duker remains your go-to reference for virtually any topic in this fast-changing field. In a single, convenient volume, it offersdetailed, superbly illustrated guidanceon nearly every ophthalmic condition and procedure you may encounter, making it a must-have resource no matter what your level of experience.Extensive updates throughoutkeep you current with all that's new in every subspecialty area of the field.
فهرست مطالب
Ophthalmology Copyright Page User Guide Color Coding ExpertConsult Website Video Contents Preface Preface to First Edition List of Contributors Acknowledgments Dedication 1.1 Fundamentals of Human Genetics Key Features DNA and the Central Dogma of Human Genetics Human Genome Mitosis and Meiosis Basic Mendelian Principles Mutations Genes and Phenotypes Patterns of Human Inheritance Autosomal Dominant Autosomal Recessive X-Linked Recessive Mitochondrial Inheritance Pseudodominance X-Linked Dominant Inheritance Digenic Inheritance and Polygenic Inheritance Imprinting Molecular Mechanisms of Disease Autosomal Dominant Haploinsufficiency Gain-of-Function Dominant Negative Effect Autosomal and X-Linked Recessive Gene Therapy Key References References 1.2 Molecular Genetics of Selected Ocular Disorders Key Features Introduction Dominant Corneal Dystrophies Aniridia, Peter’s Anomaly, Autosomal Dominant Keratitis Rieger’s Syndrome Juvenile Glaucoma Congenital Glaucoma Nonsyndromic Congenital Cataract Retinitis Pigmentosa Stargardt Disease X-Linked Juvenile Retinoschisis Norrie’s Disease Sorsby’s Macular Dystrophy Gyrate Atrophy Color Vision Retinoblastoma Albinism Leber’s Optic Neuropathy Congenital Fibrosis Syndromes and Disorders of Axon Guidance Autosomal Dominant Optic Atrophy Complex Traits Key References References 1.3 Genetic Testing and Genetic Counseling Key Features Genetic Testing Role of Genetic Testing in the Clinic Methods for DNA-Based Genetic Testing Current Recommendations for Genetic Testing for Ophthalmic Diseases CLIA Laboratories Genetic Reports Genetic Counseling Clinical Evaluation and Family History Risk Prediction Based on Inheritance Indications to Refer for Genetic Counseling Known Inherited Condition Ocular and Systemic Congenital Anomalies Specific Eye Diseases Ocular Defects Associated With Genetic Diseases Confidentiality Key References References 2.1 Light Key Features Introduction Geometrical Optics Basic Stigmatic Optics Astigmatic Optics Wave Properties of Light Interference Diffraction Polarization Dispersion Quantum Effects Fluorescence and Phosphorescence Lasers Key References References 2.2 Optics of the Human Eye Key Features Introduction Cornea Pupil Lens Accommodation Range and Amplitude Scattering Aberrations Monochromatic Aberrations Chromatic Aberrations Retina Resolution and Focal Length Refractive Errors Change in Size or Position or Absence of Optical Elements Change in the Shape of Optical Elements Change in Refractive Indexes Myopia Hypermetropia Astigmatism Presbyopia Key References References 2.3 Clinical Refraction Key Features Introduction History Visual Acuity Testing Distance Other Considerations Contrast Sensitivity Contrast Targets Sine Waves Recording Contrast Sensitivity Spherical Equivalent Detecting Astigmatism Utility of the Test Procedure Instrumentation Determination of the Cylinder Axis Determination of Cylinder Power Rechecking the Sphere Final Checks Accommodation Binocular Balance Refracting at Near Additional Subjective Techniques Retinoscopy Retinoscope Optics of Retinoscopy Neutrality With and Against Motion Other Clues Myopia Estimation Astigmatism Key References References 2.4 Correction of Refractive Errors Key Features Introduction Spectacle Correction Spectacle Material Monofocal Spectacles Bifocals Progressive Spectacles Occupational Bifocals Pantoscopic Tilt and Wrap Angle Base Curve and Center Thickness Contact Lenses Vertex Correction Rigid Contact Lenses Special Purpose Contact Lenses Contact Lens Complications Soft Contacts Contact Lens Correction of Presbyopia Orthokeratology Intraocular Lenses Monofocal Intraocular Lenses Toric IOLs Presbyopia Correcting Intraocular Lenses Keratorefractive Surgery Corneal Inlays Key References References 2.5 Ophthalmic Instruments Key Features Introduction Direct Ophthalmoscope Binocular Indirect Ophthalmoscope Illumination System Observation System Contrast Inverted Image Field of View Magnification Stereopsis Fundus Camera Lighting Reducing Reflections From the Cornea and Instrument The Observation System Field of View Optical Coherence Tomography Slit-Lamp Biomicroscope Illumination Improving Tissue Contrast Observation System Slit-Lamp Fundus Lenses Goldmann Applanation Tonometer Specular Microscope Operating Microscope Keratometer and Corneal Topographer Lensmeter Automated Refractor Magnifying Devices Angular Magnification Magnifying Glass Galilean Telescope Simple Microscope (Operating Loupe) Key References References 2.6 Wavefront Optics and Aberrations of the Eye Key Features Introduction Ray Aberrations The Wavefront Approach to Aberrations Spherical Aberration Coma Distortion Field Curvature (FC) Oblique Astigmatism (OA) Higher-Order Aberrations (HOA) Chromatic Aberration Measurement of Ocular Aberrations Mathematical Considerations An Overall Perspective on Aberration Theory Key References References 3.1 Current Concepts, Classification, and History of Refractive Surgery Key Features Associated Features Introduction Excimer Laser and Ablation Profiles Laser Ablation Profiles Munnerlyn’s Formula Wavefront-Guided Ablation Topography-Guided Ablation Wavefront-Optimized/Aspherical/ Q-Factor-Adjusted Laser Profiles Presbyopia Correction Concepts in Development Classification of Refractive Procedures Cornea Central Cornea Corneal Surface: Addition Epikeratophakia. Corneal Surface: Subtraction Photorefractive Keratectomy. Laser Subepithelial Keratomileusis. EpiLASIK. Epi-Bowman Keratectomy (EBK). Corneal Stroma: Subtraction Keratomileusis. Laser-Assisted in situ Keratomileusis. Femto-LASIK. Intrastromal Laser Ablation. Intrastromal Lenticule Extraction. Corneal Stroma: Addition Keratophakia. Intracorneal Inlays. Corneal Stroma: Relaxation Lamellar Keratotomy (Hyperopic Automated Lamellar Keratoplasty). Peripheral Cornea Peripheral Cornea: Addition Intracorneal Rings. Intracorneal Ring Segments. Peripheral Cornea: Subtraction Wedge Resection. Peripheral Cornea: Relaxation Radial Keratotomy. Hexagonal Keratotomy. Astigmatic Keratotomy. Peripheral Cornea: Coagulation–Compression Thermokeratoplasty. Microwave-Induced Thermokeratoplasty: Keraflex Procedure. Circular Keratorrhaphy. Peripheral Cornea: Oppression Orthokeratology. Intraocular Lenses and Refractive Lensectomy Refractive Lens Exchange Toric Intraocular Lenses Multifocal Intraocular Lenses Potentially Accommodative Intraocular Lenses Light-Adjustable Intraocular Lenses Phakic Intraocular Lenses Add-on Intraocular Lenses in Pseudophakic Eyes New or Alternative Approaches Photorefractive Intrastromal Cross-Linking (PiXL) LASIK Extra Prophylactic IntraCor Ciliary Muscle–Zonular Complex Axial Length Refractive Indexes Summary Key References References 3.2 Preoperative Evaluation for Refractive Surgery Key Features Introduction General Considerations Age Degree of Correction Patient Expectations Systemic Contraindications to Keratorefractive Surgery Diabetes Mellitus Pregnancy and Lactation Autoimmune Diseases Dermatological Keloid Human Immunodeficiency Virus Medications Ophthalmic Diseases Corneal Dystrophy Corneal Curvature Ocular Surface Disease Herpes Reactivation Glaucoma Other Considerations Ophthalmic Examination Ancillary Testing Wavefront Measurement (Aberrometry) Computerized Videokeratography Pachymetry Counseling Key References References 3.3 Excimer Laser Surface Ablation Key Features Introduction Ablation Profiles Indications Preoperative Evaluation PRK Surgical Technique Patient Preparation and Epithelial Removal Stromal Ablation LASEK Surgical Technique (see Fig. 3.3.3) Epi-LASIK Surgical Technique (Fig. 3.3.4) Surface Ablation With Mitomycin-C Wavefront-Guided Surface Ablation Results Photorefractive Keratectomy for Myopia and Astigmatism Photorefractive Keratectomy for Hyperopia Wavefront-Guided PRK Complications General Complications for All Surface Ablation Procedures Undercorrection or Overcorrection Epithelial Problems Corneal Haze/Scar Formation Dry Eyes Infectious Keratitis Specific Intraoperative Complications Related to LASEK Alcohol Leakage During Surgery Incomplete Epithelial Detachment Specific Intraoperative Complications Related to Epi-LASIK Conclusions Key References References 3.4 LASIK Key Features Associated Features Historical Review LASIK Excimer Lasers Patient Selection Preoperative Evaluation and Diagnostic Approach Limitations and Contraindications Microkeratomes and Femtosecond Lasers Operative Technique Microkeratome Surgical Technique Femtosecond Laser Flap Creation Excimer Laser Ablation Postoperative Care Complications Intraoperative Complications Ablation Complications Postoperative Complications Keratectasia Results LASIK Enhancements LASIK in Complex Cases LASIK After Radial Keratotomy LASIK After Photorefractive Keratectomy LASIK After Penetrating Keratoplasty LASIK After Intraocular Lens Implantation and Bioptics Intraocular Lens Calculations After LASIK Summary Key References References 3.5 Small Incision Lenticule Extraction (SMILE) Key Features Introduction Femtosecond Laser System Treatment Range for SMILE Patient Evaluation Surgical Procedure Femtosecond Laser Application Lenticule Removal Postoperative Management Complications Perioperative Complications Postoperative Complications Higher-Order Aberrations Biomechanical Stability Refractive and Visual Outcome Retreatments Conclusions Key References References 3.6 Wavefront-Based Excimer Laser Refractive Surgery Key Features Introduction Wavefront Optics Higher-Order Aberrations Ideal Corneal Shape Measurements of Wavefront Aberrations Quality of Vision and Measures of Optical Quality Wavefront-Measuring Devices Wavefront-Based Surgery Results Wavefront Platforms (Table 3.6.1) Conclusions Key References References 3.7 Phakic Intraocular Lenses Key Features Associated Features Introduction History of Phakic Lenses Indications of Phakic Lenses Moderate and High Myopia High Hyperopia High Astigmatism Advantages and Disadvantages of Phakic Iols Intraocular Lens Power Calculation Sizing the Phakic IOLs Visual Outcomes Anterior Chamber Angle-Supported Phakic Intraocular Lenses Complications Pupillary Ovalization Endothelial Damage Elevation of Intraocular Pressure Uveitis Cataract Iris-Fixated Phakic Intraocular Lenses Surgical Procedure Complications Glare and Halos Anterior Chamber Inflammation/Pigment Dispersion Endothelial Cell Loss Glaucoma Iris Atrophy or Dislocation Cataract Other Complications Posterior Chamber Phakic Intraocular Lenses Surgical Technique Complications Cataract ICL Replacement Pigmentary Dispersion and Elevated Intraocular Pressure Endothelial Cell Damage Bioptics Conclusion Key References References 3.8 Astigmatic Keratotomy Key Features Historical Review Incisional Keratotomy Surgical Techniques for Astigmatic and Radial Keratotomy Preoperative Considerations Patient Selection Visual Axis Determination and Marking Intraoperative Corneal Pachymetry Incision Technique Diamond Blade–Assisted AK Full Penetrating Femtosecond AK Femtosecond Intrastromal Astigmatic Keratotomy (ISAK) Wedge Resection Using Laser Arcuate Resection (LAR) Surgical Protocol Axis of Astigmatism Postoperative Protocol Outcome Comparison for Various Astigmatism Correction Methods Complications and Management of Astigmatism Correction Methods Complications Related to Corneal Incisions Incision Beyond Clear Cornea Optical Zone Invasion Complications Related to Corneal Perforations Postoperative Complications Progressive Hyperopia Induced Astigmatism Contact Lens Intolerance Stromal Melting Infectious Keratitis Conclusions Key References References 3.9 Intrastromal Corneal Ring Segments and Corneal Cross-Linking Key Features Introduction Intracorneal Ring Segments Corneal Cross-Linking (CXL) CXL Plus Surgical Procedure: ICRS Patient Selection Preoperative Considerations ICRS Selection Single Versus Paired ICRS ICRS Surgical Technique Clinical Outcomes Postoperative Complications Surgical Procedure: CXL CXL Clinical Outcomes Postoperative Complications Combining ICRS With CXL Conclusions Key References References 3.10 Surgical Correction of Presbyopia Key Features Introduction Presbyopia Correction at the Corneal Level Monovision Presby-LASIK Central Presby-LASIK Laser Blended Vision Intracorneal Inlays Historical Background Corneal Reshaping Inlay Raindrop Refractive Inlays Presbia Flexivue Microlens Icolens (Neoptics AG) Small Aperture Inlays KAMRA Presbyopic IOLs Multifocal IOLs Rotationally Symmetrical Diffractive IOLs. Refractive IOLs. Rotationally Asymmetrical IOLs (Varifocal) Patient Selection Criteria AcrySof Restor SN6AD3 (Alcon Laboratories, Inc.) Lentis Mplus LS-313 (Oculentis GmbH) Symfony (Abbott Medical Optics, Inc.) AT LISA tri 839 MP (Carl Zeiss Meditec AG) Fine Vision Micro F (Physiol) Panoptix (Alcon) Clinical Outcomes and Quality of Life Complications Accommodating IOLs 1) IOLs With Change in Axial Position, Single Optic Crystalens HD (Bauch & Lomb) 1CU (Human Optics AG) Tetraflex (Lenstec Inc) 2) IOLs With Change in Axial Position, Dual Optic Synchrony (Visiogen Inc.) 3) IOLs With Change in Shape or Curvature FluidVision (Powervision, Inc). Nulens (DynaCurve). 4) IOL With Change in Refractive Index or Power Lumina (Akkolens). Comments. Other Treatments Scleral Expansion Bands Topical Treatment FOV Tears Liquid Vision EV06 (Encore Vision) Key References References 4.1 Corneal Anatomy, Physiology, and Wound Healing Key Features Introduction Embryology, Anatomy, and Physiology of the Cornea Epithelium Stroma Endothelium Endothelial Responses to Stress Corneal Wound Healing Epithelial Injury Stromal Injury Endothelial Injury Key References References 4.2 Anterior Segment Imaging Modalities Key Features Introduction Anterior Segment Optical Coherence Tomography Clinical Applications Tear Film Evaluation Refractive Surgery and Ectasia-Related Disorders Penetrating and Endothelial Keratoplasty–Related Procedures Ocular Surface Tumors Cataract Surgery and Intraocular Lens Implantation Keratitis Miscellaneous Uses Limitations Specular Microscopy Clinical Applications Corneal Dystrophies Intraocular Surgery Evaluation Donor Cornea Evaluation Limitations Ultrasound Biomicroscopy Clinical Applications Ocular Masses Glaucoma Ocular Trauma Limitations Meibography Clinical Applications Meibomian Gland Dysfunction Limitations In vivo Confocal Microscopy Clinical Applications Dry Eye Disease and Neuropathic Corneal Pain Infectious Keratitis and Demodex Corneal Deposits and Corneal Dystrophies Limitations Topography and Tomography Clinical Applications Refractive Surgery Ectasia-Related Disorders Astigmatism Wavefront Analysis Clinical Applications Refractive Surgery Limitations Summary Key References References 4.3 Congenital Corneal Anomalies Key Features Introduction Size and Shape Anomalies Microcornea Epidemiology, Pathogenesis, and Ocular Manifestations Treatment Megalocornea Epidemiology, Pathogenesis, and Ocular Manifestations Treatment Corneal Absence Congenital Anterior Staphyloma Anomalies of Corneal Clarity Anterior Embryotoxon Posterior Embryotoxon Corneal Keloids Dermoids Axenfeld’s Anomaly and Rieger’s Syndrome Peters’ Anomaly Ocular Manifestations Systemic Associations Pathology Treatment and Outcome Sclerocornea Congenital Hereditary Endothelial Dystrophy and Congenital Stromal Corneal Dystrophy Key References References 4.4 Blepharitis Key Features Associated Features Introduction Epidemiology Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Treatment Key References References 4.5 Herpes Zoster Ophthalmicus Key Features Associated Features Epidemiology and Pathogenesis Ophthalmic Herpes Zoster Clinical Manifestations Postherpetic Neuralgia Herpes Zoster Ophthalmicus in Acquired Immune Deficiency Syndrome Diagnosis Management Management of Ocular Manifestation Postherpetic Neuralgia Prevention Key References References 4.6 Conjunctivitis Key Features Infectious Conjunctivitis Bacterial Infections Acute Bacterial Conjunctivitis Hyperacute Bacterial Conjunctivitis Chronic Bacterial Conjunctivitis Adenoviral Conjunctivitis Follicular Conjunctivitis Pharyngoconjunctival Fever Epidemic Keratoconjunctivitis Acute Hemorrhagic Conjunctivitis Herpes Simplex Conjunctivitis Other Causes of Viral Conjunctivitis Chronic Follicular Conjunctivitis Trachoma Adult Inclusion Conjunctivitis Neonatal Conjunctivitis (Ophthalmia Neonatorum) Chlamydial Infections Neisserial Infections Other Bacterial Infections Viral Infections Fungal and Parasitic Conjunctivitis Microsporidial Keratoconjunctivitis Loiasis Parinaud’s Oculoglandular Syndrome Noninfectious Conjunctivitis Toxic Follicular Conjunctivitis Erythema Multiforme Major (Stevens–Johnson Syndrome) and Toxic Epidermal Necrolysis Epidermolysis Bullosa Graft-versus-Host Disease Xeroderma Pigmentosa Kawasaki Disease Ligneous Conjunctivitis Key References References 4.7 Allergic Conjunctivitis Key Features Acute Allergic Conjunctivitis: Seasonal/Perennial Chronic Atopic Keratoconjunctivitis Vernal Conjunctivitis Treatment of Allergic/Atopic Keratoconjunctivitis Allergic Dermatoconjunctivitis Microbial Allergic Conjunctivitis Giant Papillary Conjunctivitis Key References References 4.8 Tumors of the Conjunctiva Key Features Conjunctival Malignant Neoplasms Ocular Surface Squamous Neoplasia Conjunctival Melanoma Conjunctival Lymphoma Benign Conjunctival Neoplasms and Neoplasias Conjunctival Nevus Benign Acquired Melanosis of Conjunctiva Conjunctival Hemangioma Conjunctival Squamous Papilloma Conjunctival Lymphangioma Conjunctival Choristomas Limbal Dermoid Conjunctival Solid Dermoid Conjunctival Dermolipoma Conjunctival Osteoma Nonneoplastic Lesions and Disorders Simulating Malignant Conjunctival Neoplasms and Neoplasias Lesions Simulating Ocular Surface Squamous Neoplasms and Neoplasias Conjunctival Hyperplasia Conjunctival Keratosis/Hyperkeratosis/Dyskeratosis Inflamed Pinguecula/Hypertrophic Pterygium Inflammatory Granuloma of Conjunctiva Viral Papilloma of Conjunctiva Lesions Simulating Conjunctival Melanoma and Malignant Primary Acquired Melanosis Posterior Uveal Melanoma With Anterior Transcleral Extension Occult Eyewall Laceration With Incarceration of Uveal Tissue Nodular Anterior Scleritis Ciliary Body Staphyloma Conjunctival Argyrosis Lesions Simulating Conjunctival Lymphoma Benign Reactive Lymphoid Hyperplasia of the Conjunctiva Inflammatory Granulomas of Conjunctiva Management of Conjunctival Tumors Suspected of Being Malignant Neoplasms or Neoplasias Key References References 4.9 Pterygium and Conjunctival Degenerations Key Features Associated Features Introduction Pinguecula Pterygium Senile Scleral Plaques Conjunctival Amyloid Conjunctival Melanosis Key References References 4.10 Ocular Cicatricial Pemphigoid/Mucous Membrane Pemphigoid Key Features Associated Features Introduction Pathogenesis Clinical Findings Diagnosis Treatment Conclusions Key References References 4.11 Episcleritis and Scleritis Key Features Associated Feature Key Features Associated Features Introduction Inflammatory Diseases Episcleritis Epidemiology and Pathogenesis Diagnosis and Ocular Manifestations Differential Diagnosis Systemic Associations Treatment Scleritis Epidemiology and Pathogenesis Ocular Manifestations Differential Diagnosis Diagnosis and Ancillary Testing Systemic Associations Pathology Treatment Medical Treatment Surgical Treatment Course and Outcome Key References References 4.12 Bacterial Keratitis Key Feature Associated Features Introduction Epidemiology and Pathogenesis Clinical Features Gram-Positive Cocci Staphylococcus Streptococcus Gram-Positive Bacilli Bacillus Corynebacterium Listeria Clostridium Propionibacterium acnes Filamentous Bacteria Actinomyces and Nocardia Gram-Negative Rods Pseudomonas Serratia Escherichia, Klebsiella, and Proteus Moraxella Haemophilus Gram-Negative Cocci Neisseria Moraxella (Branhamella) catarrhalis Mycobacteria Nontuberculous Mycobacteria Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Outcome Key References References 4.13 Fungal Keratitis Key Feature Associated Features Introduction Epidemiology and Pathogenesis Clinical Features Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Outcome Key References References 4.14 Parasitic Keratitis Key Feature Associated Features Introduction Acanthamoeba Keratitis Epidemiology and Pathogenesis Clinical Features Diagnosis Differential Diagnosis Pathology Treatment Outcome Microsporidiosis Epidemiology and Pathogenesis Clinical Features Diagnosis Differential Diagnosis Systemic Associations Treatment Outcome Onchocerciasis Epidemiology and Pathogenesis Clinical Features Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Outcome Key References References 4.15 Herpes Simplex Keratitis Key Features Associated Features Epidemiology Herpes Simplex Virus Life Cycle of HSV Primary HSV Infection Recurrent HSV Infections Epithelial Keratitis Dendritic Ulcer Geographical Ulcer Marginal Keratitis Metaherpetic (Trophic) Ulcer Stromal/Endothelial Keratitis Endotheliitis Localized Endotheliitis Diffuse and Linear Endotheliitis Necrotizing Keratitis Immune Stromal Keratitis Lipid Keratopathy Keratouveitis Miscellaneous Syndromes Diagnosis Culture DNA Testing Fluorescent Antibody Testing Tzanck’s Smear Serum Antibody Testing Herpetic Eye Disease Study Treatment Infectious Epithelial Keratitis Stromal Keratouveitis Metaherpetic Keratitis Medications Antivirals Corticosteroids Surgery Penetrating Keratoplasty Conjunctival Flap Amniotic Membrane Transplantation Future Directions Key References References 4.16 Peripheral Ulcerative Keratitis Key Features Associated Features Introduction Anatomy and Pathogenesis Ocular Manifestations Systemic Associations Differential Diagnosis Diagnostic and Ancillary Testing Treatment Medical Treatment Surgical Treatment Course and Outcome Key References References 4.17 Noninfectious Keratitis Key Feature Associated Feature Introduction Thygeson’s Superficial Punctate Keratitis Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Superior Limbic Keratoconjunctivitis of Theodore Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Mooren’s Ulcer Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Neurotrophic Keratitis Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Terrien’s Marginal Degeneration Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Lax Eyelid Condition, Lax Eyelid Syndrome, and Floppy Eyelid Syndrome Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Key References References 4.18 Keratoconus and Other Ectasias Key Features Associated Features Keratoconus Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Pellucid Corneal Degeneration Keratoglobus Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Posterior Keratoconus Post–Refractive Surgery Corneal Ectasia Key References References 4.19 Anterior Corneal Dystrophies Key Features Associated Features Introduction Anterior Basement Membrane Dystrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Meesmann’s Epithelial Dystrophy Reis–Bückler Dystrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Thiel–Behnke Dystrophy Key References References 4.20 Stromal Corneal Dystrophies Key Features Associated Features Introduction Gelatinous Drop-Like Dystrophy Lattice Dystrophy Type I Genetics Ocular Manifestations Clinical Presentation Pathology Treatment Systemic Amyloidosis With Corneal Lattice Genetics Ocular Manifestations Patient Presentation Pathology Treatment Other Lattice Dystrophies Granular Corneal Dystrophy Type I Genetics Ocular Manifestation Patient Presentation Pathology Treatment Granular Corneal Dystrophy Type 2 Genetics Ocular Manifestations Patient Presentation Pathology Treatment Macular Corneal Dystrophy Genetics Ocular Manifestations Patient Presentation Pathology Treatment Schnyder’s Corneal Dystrophy Genetics Ocular Manifestations Patient Presentations Pathology Treatment Central Cloudy Dystrophy Genetics Ocular Manifestations Patient Presentations Pathology Treatment Fleck Dystrophy Genetics Ocular Manifestations Patient Presentation Pathology Treatment Posterior Amorphous Corneal Dystrophy Genetics Ocular Manifestations Patient Presentation Pathology Treatment Congenital Stromal Corneal Dystrophy Genetics Ocular Manifestations Differential Diagnosis Pathology Treatment Key References References 4.21 Diseases of the Corneal Endothelium Key Features Associated Features Introduction Fuchs’ Dystrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Course and Outcome Congenital Hereditary Endothelial Dystrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Posterior Polymorphous Corneal Dystrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Key References References 4.22 Corneal Degenerations Key Features Associated Features Introduction Corneal Arcus (Arcus Senilis) Lipid Keratopathy Vogt’s White Limbal Girdle Senile Corneal Furrow Degeneration Terrien’s Marginal Corneal Degeneration Peripheral Corneal Guttae Calcific Band Keratopathy Spheroidal Degeneration Iron Deposition Crocodile Shagreen Cornea Farinata Salzmann’s Corneal Degeneration Corneal Keloids Corneal Amyloid Degeneration Key References References 4.23 Dry Eye Disease Key Features Associated Features Introduction Epidemiology Pathogenesis Normal Physiology Pathophysiology Diagnosis and Classification Aqueous Tear-Deficient Dry Eye Non-Sjögren’s Tear Deficiency Sjögren’s Syndrome Tear Deficiency Evaporative Dry Eye Disease Meibomian Gland Disease and Blepharitis Exposure Mucin Deficiency Extrinsic Causes Ocular Manifestations Diagnosis and Ancillary Testing Diagnostic Dye Evaluation Tear Film Stability Measurement of Tear Production Other Tests Treatment Aqueous Tear Deficiency Evaporative Dry Eye Disease Ocular Surface Inflammation Key References References 4.24 Complications of Contact Lens Wear Key Features Introduction Toxic, Allergic and Mechanical Reactions Solutions Giant Papillary Conjunctivitis Superior Limbic Keratoconjunctivitis Conditions Reflecting Metabolic Challenge Corneal Hypoxia and Edema Neovascularization Limbal Stem Cell Deficiency Abrasions Corneal Inflammatory Events and Microbial Keratitis The Role of Lens Care Systems Corneal Inflammatory Events Microbial Keratitis Fungal Keratitis Acanthamoeba Keratitis Unsupervised Lens Wear FDA and CDC Recommendations Conclusions Key References References 4.25 Corneal and External Eye Manifestations of Systemic Disease Key Feature Associated Feature Introduction Congenital Disorders Chromosomal Disorders Inherited Connective Tissue Disorders Metabolic Disorders Protein and Amino Acid Metabolic Disorders Mucopolysaccharidoses Sphingolipidoses Dyslipoproteinemias Mucolipidoses Other Oculosystemic Disorders Conclusions Key References References 4.26 Acid and Alkali Burns Key Features Associated Feature Introduction Alkali Injuries Acid Injuries Pathophysiology Clinical Course Therapy Immediate Phase Acute and Reparative Phases Surgical Therapy Key References References 4.27 Corneal Surgery Key Features Associated Feature Keratoplasty Introduction Historical Review Anesthesia Specific Techniques Penetrating Keratoplasty Preoperative Evaluation and Diagnostic Approach Donor Selection Surgical Techniques Complications and Postoperative Management Wound Leak. Flat Anterior Chamber With Increased Intraocular Pressure. Endophthalmitis. Persistent Epithelial Defect. Primary Graft Failure. Suture-Related Problems. Graft Rejection. Treatment for Astigmatism. Corneal Ulcers. Recurrence of Diseases. Anterior Lamellar Keratoplasty Preoperative Evaluation and Diagnostic Approach Donor Selection Donor Preparation. Surgical Techniques Anterior Lamellar Dissection of the Host Tissue. Complications and Postoperative Management Perforation of Descemet’s Membrane. Pseudo-Anterior Chamber. Triple Procedure (Combined Procedure) Preoperative Evaluation and Diagnostic Approach Surgical Techniques Open Sky Cataract Extraction. Artificial Cornea (Keratoprosthesis) Boston K-Pro AlphaCor Modified Osteo-Odonto-Keratoprosthesis Outcome Superficial Corneal Procedures Historical Review Anesthesia Specific Techniques Superficial Keratectomy Preoperative Evaluation and Diagnostic Approach Surgical Techniques Complications and Postoperative Management Corneal Biopsy Preoperative Evaluation and Diagnostic Approach Surgical Techniques Complications and Postoperative Management Outcome Phototherapeutic Keratectomy Preoperative Evaluation and Diagnostic Approach Surgical Techniques Corneal Dystrophies, Scars, and Elevated Opacities Postoperative Care Complications Hyperopia Myopia/Myopic Astigmatism Irregular Astigmatism and Decentration Pain Delayed Epithelization Bacterial Keratitis Viral Keratitis Recurrence and Haze Graft Rejection Outcome Key References References 4.28 Conjunctival Surgery Key Features Associated Feature Historical Review Anesthesia Specific Techniques Conjunctival Flap Preoperative Evaluation and Diagnostic Approach Surgical Techniques Complications and Postoperative Management Pterygium Surgery Preoperative Evaluation and Diagnostic Approach Surgical Techniques Bare Sclera Technique/Simple Closure Autograft Amniotic Membrane Other Techniques. Recurrent Pterygium Excision. Antimetabolites and Radiation Fibrin Glue Complications and Postoperative Management Conjunctivochalasis Management Surgical Techniques Complications Key References References 4.29 Endothelial Keratoplasty Key Feature Associated Features Introduction Evolution of EKP Techniques Indications Surgical Technique Anesthesia and Recipient Preparation Donor Tissue Preparation and Insertion Descemet’s Stripping With Endothelial Keratoplasty Descemet’s Membrane Endothelial Keratoplasty Combined Procedures Outcomes Visual Acuity Refractive Changes Graft Survival Complications Graft Detachment Immunological Rejection Postkeratoplasty Intraocular Pressure Elevation Infrequent Complications Outlook Key References References 4.30 Surgical Ocular Surface Reconstruction Key Features Associated Features Introduction Historical Perspectives General Concepts Preoperative Considerations Operative Procedures Unilateral Disease Partial Stem Cell Deficiency Mechanical Debridement Amniotic Membrane Grafting Autologous Limbal Stem Cell Transplantation Total Stem Cell Deficiency Autologous Limbal Stem Cell Transplantation Bilateral Disease Keratolimbal Allograft and Allogeneic SLET Ex Vivo Expanded Limbal Stem Cells and Nonocular Tissue Special Considerations in Ocular Surface Reconstruction Ocular Surface Optimization Corneal Transplantation Conclusions Key References References 4.31 Management of Corneal Thinning, Melting, and Perforation Key Features Associated Features Introduction Corneal Thinning From Noninflammatory Disorders Corneal Thinning and Melting From Inflammatory Disorders Surgical Treatment of Corneal Perforations Tissue Adhesives Penetrating Keratoplasty Patch Graft Miscellaneous Treatments Conclusions Key References References 5.1 Basic Science of the Lens Key Features Associated Features Key References References 5.1 Basic Science of the Lens Key Features Introduction Anatomy of the Lens Capsule Epithelial Cells Lens Substance Sutures Growth Mass Dimensions Physiology of the Lens Permeability, Diffusion, and Transport Transport of Ions Amino Acid and Sugar Transport Biophysics Light Transmission Transparency Refractive Indices Chromatic Aberration Spherical Aberration Accommodation Biochemistry Sugar Metabolism Protein Metabolism Glutathione Amino Acid Transport Antioxidant Mechanisms Lens Crystallins Crystallin Structure Crystallin Gene Expression During Lens Growth Crystallin Function Age Changes Morphology Physiological Changes Biophysical Changes Accommodation Changes Biochemical Changes Crystallins Secondary Cataract Fibrosis-Type Posterior Capsule Opacification Pearl-Type Posterior Capsule Opacification Soemmerring’s Ring Prevention and Treatment of Posterior Capsule Opacification Key References References 5.2 Evolution of Intraocular Lens Implantation Key Features Introduction Lens Design and Fixation Generation I (Original Ridley Posterior Chamber Lens) Generation II (Early Anterior Chamber Lenses) Generation III (Iris-Supported Lenses) Generation IV (Intermediate Anterior Chamber Lenses) Generation V (Improved Posterior Chamber Lenses) Generation VI (Modern Capsular Lenses – Rigid PMMA, Soft Foldable, and Modern Anterior Chamber) Recent Advances Key References References 5.2 Evolution of Intraocular Lens Implantation Key features Introduction Lens Design and Fixation Generation I (Original Ridley Posterior Chamber Lens) Generation II (Early Anterior Chamber Lenses) Generation III (Iris-Supported Lenses) Generation IV (Intermediate Anterior Chamber Lenses) Generation V (Improved Posterior Chamber Lenses) Generation VI (Modern Capsular Lenses—Rigid PMMA, Soft Foldable, and Modern Anterior Chamber) Recent Advances Key References References 5.3 Epidemiology, Pathophysiology, Causes, Morphology, and Visual Effects of Cataract Key Features Epidemiology of Cataracts Pathophysiology of Cataracts Genetics Cell Proliferation and Differentiation Metabolic Disturbance and Osmotic Regulation Failure Calpains Protein Modification Oxidation Defensive Mechanisms Other Factors Cataract Causes, Associations, and Prevention Age Sunlight and Irradiation Smoking and Alcohol Body Mass Index Myopia Trauma Systemic Disorders Dermatological Disorders Central Nervous System Disorders Ocular Disease and Cataracts Toxic Causes Congenital and Juvenile Cataracts Prevention of Cataracts Morphology and Visual Effects of Cataract Morphology Assessment and Grading of Cataracts Visual Effects of Cataracts Visual Acuity Contrast Sensitivity, Glare, and Wavefront Aberrometry Other Effects Anomalies of Lens Growth Aphakia Microspherophakia Lenticonus and Lentiglobus Lens Coloboma Ectopia Lentis Key References References 5.4 Patient Workup for Cataract Surgery Key Features Introduction Medical History and Current Therapeutic Regimen General Ophthalmic History and Examination Assessment of Lens Opacities Introduction Diagnosis of Lens Opacities Classification of Lens Opacities Nuclear Opacities Cortical Opacities Posterior Subcapsular Opacities Advanced Cataracts Grading of Lens Opacities Lens Opacities Classification System III (Fig. 5.4.2) Effects of Opacities on Vision Visual Acuity Reduction Contrast Sensitivity Reduction Myopic Shift Monocular Diplopia Glare Color Shift Visual Field Loss Investigations for Further Surgical Refinement Corneal Topography Preoperative Topography Determination of IOL Type and Power Planning the Incision Good Clinical Practice (Social and Legal Aspects) Key References References 5.5 Intraocular Lens Power Calculations Key Features Introduction Ocular Biometry Ultrasound Biometry Optical Biometry IOL Power Formulas Vergence Formulas Ray Tracing Formulas Artificial Intelligence Formulas Combination Formulas IOL Calculations in Special Eyes IOL Power Calculation in Short Eyes IOL Power Calculation in Long Eyes IOL Power Calculation in Eyes With Previous Corneal Refractive Surgery Factors Contributing to Challenges in IOL Power Calculation Methods to Improve the Accuracy of IOL Power Calculations in Postrefractive Eyes Methods Relying on Prior Clinical Data Methods Using a Combination of the Surgically Induced Refractive Change (ΔMR) and Current Corneal Power Values Methods Requiring No Historical Data Web-Based Post-Refractive IOL Calculator Radial Keratotomy IOL Power Calculation in Keratoconic Eyes IOL Power Calculation in Eyes Following Keratoplasty Toric IOL Calculation Impact of Posterior Corneal Astigmatism Selection of Toric IOL Toricity Imaging and Guidance Systems for Toric IOL Alignment Intraoperative Wavefront Aberrometry Postoperative IOL Adjustment Conclusion Key References References 5.6 Indications for Lens Surgery/Indications for Application of Different Lens Surgery Techniques Key Features Introduction Medical Indications for Lens Surgery Lenticular Opacification (Cataract) Cataract in the Presence of Other Ocular Disorders Lenticular Malposition Lenticular Malformation Lens-Induced Ocular Inflammation Lens-Induced Glaucoma Inflammatory Glaucoma (Phacolytic Glaucoma) Pupil Block and Angle Closure (Phacomorphic Glaucoma) Refractive Indications for Lens Surgery Indications for Different Lens Surgery Techniques Intracapsular Cataract Extraction Extracapsular Extraction (Large-Incision Nuclear Expression Cataract Surgery) Small-Incision Nuclear Expression Cataract Surgery (“Mini-nuc” and Other Techniques) Phacoemulsification Surgery of the Lens Capsule Zonular Surgery Surgery for Presbyopia Monovision Astigmatism Key References References 5.7 The Pharmacotherapy of Cataract Surgery Key Features Introduction Preoperative Medications Pupil Dilatation Anti-infective Prophylaxis Anesthetics Intraoperative Medications Additives to Irrigating Solutions, Intracameral Antibiotics, and Other Intraocular Drugs Used During the Surgical Procedure Irrigating Solutions Ophthalmic Viscosurgical Devices Intracameral Medications to Replace Postoperative Drops Postoperative Medications Antibiotics Corticosteroids and Nonsteroidal Anti-inflammatory Drugs Late Postoperative Medications Treatment of Endophthalmitis Treatment of Cystoid Macular Edema Key References References 5.8 Anesthesia for Cataract Surgery Key Features Introduction Medical Aspects of Anesthesia for Cataract Surgery Cataract Type and Associated Medical Conditions Specific Conditions Ischemic Heart Disease Anticoagulants Diabetes Mellitus Local Anesthesia General Considerations Topical Anesthesia (see Box 5.8.1) Retrobulbar Block (see Box 5.8.2) Peribulbar Block (see also Table 5.8.1) Technique Local Anesthetic Agent Complications Sub-Tenon’s Block (see also Table 5.8.1) Anatomy Technique Sedative Agents General Anesthesia Technique Spontaneous Respiration Ventilation Conclusions Postoperative Care Key References References 5.9 Phacoemulsification Key Features Introduction Handpieces and Tips Power Modulation Pumps and Fluidics Flow-Based (Peristaltic) Vacuum-Based Anterior Chamber Hydrodynamics Fluidics of Microincisional Phaco Postocclusion Surge Key References References 5.10 Refractive Aspects of Cataract Surgery Key Features Introduction Value of Corneal Topography Intraoperative Management of Preoperative Corneal Astigmatism to Prevent Induction of Corneal Astigmatism Corneal Incisions To Treat Preoperative Corneal Astigmatism Astigmatic Incisions Limbal Relaxing Incisions Opposite Clear Corneal Incisions Toric Intraocular Lens Implantation Postoperative Management of Residual or Induced Corneal Astigmatism Corneal Laser Ablative Techniques Post–Cataract Surgery Piggyback IOLs Light-Adjustable Intraocular Lens Implant Key References References 5.11 Small Incision and Femtosecond Laser-Assisted Cataract Surgery Key Features Associated Feature Introduction Incision Construction and Architecture Continuous Curvilinear Capsulorrhexis Hydrodissection and Hydrodelineation Nucleofractis Techniques Divide and Conquer Phaco Chop Power Modulations Biaxial Microincision Cataract Surgery B-MICS Vertical Chop Technique Femtosecond Laser-Assisted Cataract Surgery Anterior Capsulectomy Lens Fragmentation Corneal Incisions Conclusions Key References References 5.12 Manual Cataract Extraction Key Features Introduction Historical Issues Manual (Large-Incision) Cataract Surgery Incision Wound Closure Intracapsular Cataract Extraction General Comments Specific Techniques Iris Management Vitreous Presentation or Prolapse Intraocular Lenses Extracapsular Cataract Extraction Anterior Capsulectomy “Can Opener” Capsulectomy Linear Capsulectomy and Intercapsular Techniques Capsulorrhexis Size, Type, and Position of Capsulectomy Nucleus Expression Cortical Washout Intraocular Lens Insertion Mininuc Technique Anterior Chamber Maintainer Capsulorrhexis Sclerocorneal Pocket Tunnel Nucleus Manipulation Nucleus Expression Cortex Removal and Intraocular Lens Implantation Complications Discussion Key References References 5.13 Combined Procedures Key Features Introduction Combined Glaucoma Surgery Overview Trabeculectomy and Cataract Surgery Nonpenetrating Glaucoma Surgery and Cataract Minimally Invasive Glaucoma Surgery Aqueous Shunts Outcomes Lens Surgery Combined With Keratoplasty Historical Review Surgical Options Specific Techniques Complications Outcomes Combined Phacovitrectomy Introduction Indications and Advantages Over Sequential Noncombined Surgery Disadvantages Specific Techniques Conclusion Key References References 5.14 Cataract Surgery in Complex Eyes Key Features Associated Features Introduction Zonular Instability Uveitis Compromised Endothelium Key References References 5.15 Pediatric Cataract Surgery Key Features Introduction Historical Review Preoperative Evaluation and Diagnostic Approach Alternatives to Surgery Anesthesia General Techniques Specific Techniques Pars Plana Approach Corneolimbal Approach Choices for Correction of Aphakia in Children Spectacles Contact Lenses Intraocular Lenses Selection of Intraocular Lenses Implantation in Children Under 2 Years of Age Implantation in Children Above 2 Years of Age Postoperative Treatment Complications Postoperative Complications Amblyopia Management Options to Correct Myopic Shift Outcome Key References References 5.16 Complications of Cataract Surgery Key Features Associated Feature Introduction Intraoperative Complications Cataract Incision Tunnel Perforation Descemet’s Detachment Thermal Burns Anterior Capsulectomy Preventing Radial Tears in the Anterior Capsule Excessively Small Capsulorrhexis Minimizing Complications When Radial Tears Are Present Nucleus Expression Cataract Extraction Complications During Phaco Hydrodissection Iris Prolapse or Damage Floppy Iris Syndrome Trapped Nucleus Subluxated Lens Ruptured Posterior Capsule Before Nucleus Removal During Cortical Irrigation–Aspiration Intraocular Lens Insertion Capsular Bag Iris Fixated (Retropupillary or Prepupillary) Ciliary Sulcus Sutured Posterior Chamber Anterior Chamber Dropped Nucleus Anterior Segment Hemorrhage Postoperative Complications Wound Dehiscence Wound Leakage Inadvertent Filtering Bleb Epithelial Ingrowth Postoperative Astigmatism Corneal Edema and Bullous Keratopathy Hyphema Endocapsular Hematoma Intraocular Pressure Elevation Capsular Block Syndrome Intraocular Lens Miscalculation Intraocular Lens Decentration and Dislocation Asymmetrical Haptic Placement Sunset Syndrome Lens-Bag Decentration Pupillary Capture Sulcus-Fixated Intraocular Lens Dislocation Posterior and Anterior Dislocation Intraocular Lens Exchange Cystoid Macular Edema Endophthalmitis Posterior Capsular Opacification Retinal Detachment Key References References 5.17 Secondary Cataract Key Features Introduction Pathogenesis Treatment and Prevention Hydrodissection-Enhanced Cortical Cleanup In-the-Bag IOL Fixation Capsulorrhexis Size Biocompatible Intraocular Lens Contact Between the IOL Optic and the Posterior Capsule Intraocular Lens Optic Geometry Intraocular Lenses Maintaining the Capsular Bag Open or Expanded Key References References 5.18 Outcomes of Cataract Surgery Key Features Introduction Evaluation of Outcomes Five Parameters That Describe Visual Function Visual Acuity Testing Standardized Visual Acuity Testing Potential Retinal Acuity Testing Contrast Sensitivity Testing Glare Testing Visual Fields Color Vision Objective Findings of Cataract Surgery Outcomes Best-Corrected Visual Acuity Uncorrected Visual Acuity Target Refraction Prediction Error Contrast Sensitivity Glare Visual Fields Color Vision Subjective Findings of Cataract Surgery Outcomes Patients’ Self-Assessment of the Visual Outcome Cataract Surgery of One or Both Eyes Cataract Surgery in Eyes With Ocular Comorbidity Summary Key References References 6.1 Structure of the Neural Retina Key Feature Introduction Center of the Macula: Umbo Foveola Fovea Parafovea Perifovea Macula, or Central Area Extra-Areal Periphery Layers of the Neural Retina Key References References 6.2 Retinal Pigment Epithelium Key Features Introduction Structure and Metabolism Cellular Architecture and Blood–Retinal Barrier Pigments Metabolism and Growth Factors Membrane Properties and Fluid Transport Ion Channels and Transport Systems Electrical Activity Photoreceptor–Retinal Pigment Epithelium Interactions Visual Pigment Regeneration Photoreceptor Renewal and Phagocytosis Retinal Adhesion and Interphotoreceptor Matrix Repair, Regeneration, and Therapy References 6.3 Retinal and Choroidal Circulation Key Features Introduction Posterior Segment Vascular Anatomy Retinal Vascular Anatomy Choroidal Vascular Anatomy Blood–Retinal Barrier Retinal and Choroidal Blood Flow Retina and Choroidal Circulation Evaluated by OCTA Regulation of Retinal and Choroidal Blood Flows Key References References 6.4 Vitreous Anatomy and Pathology Key Features Associated Features Introduction Molecular Morphology Supramolecular Organization Vitreous Anatomy Macroscopic Morphology Microscopic Morphology Age-Related Changes Embryology and Postnatal Development Developmental Anomalies Aging of the Vitreous Body Posterior Vitreous Detachment Anomalous Posterior Vitreous Detachment Premacular (Epiretinal) Membrane/Macular Pucker Macular Holes Diabetic Vitreopathy Asteroid Hyalosis Key References References 6.5 Contact B-Scan Ultrasonography Key Features Associated Features Introduction Devices Technique of Examination Concepts of B-Scan Interpretation Real Time Gray Scale Three-Dimensional Analysis Display Presentation and Documentation Normal Vitreous Cavity Vitreous Hemorrhage Retinal Detachment Choroidal Detachment Tumors Digital Contact Ultrasonography What’s New? Anterior Segment High-Frequency Ultrasonography Summary Key References References 6.6 Camera-Based Ancillary Retinal Testing Key Features Key Features Key Features Fluorescein Angiography Introduction Purpose of the Test Properties of Sodium Fluorescein Dye Procedure Complications Interpretation of Results Normal Fluorescein Angiogram Abnormal Fluorescein Angiography Indocyanine Green Angiography Introduction Properties of Indocyanine Green Procedure Complications Interpretation of Results Fundus Autofluorescence Acknowledgments Key References References 6.7 Optical Coherence Tomography in Retinal Imaging Key Features Associated Features Introduction OCT Technology Platforms Time-Domain OCT Spectral-Domain OCT Multifunctional OCT Time-Encoded Frequency-Domain OCT (Swept-Source OCT) High-Speed, Ultra-High-Resolution OCT Adaptive Optics OCT Anatomical Results Image Optimization OCT Image Interpretation Preretinal Posterior Vitreous Detachment Vitreomacular Traction Epiretinal Membrane Macular Holes Lamellar Holes Pseudo-Hole Intraretinal Macular Edema Irvine–Gass Syndrome: Cystoid Macular Edema After Cataract Surgery Retinal Exudates Subretinal Subretinal Fluid Pigment Epithelial Detachment RPE Tear Choroidal Pathology Choroidal Neovascularization OCT Artifacts Time-Domain OCT Spectral-Domain OCT Key References References 6.8 Optical Coherence Tomography Angiography Key Features Introduction Biological Basis of OCTA OCTA Versus Dye-Based Angiography Methods Key Applications of SD-OCTA Detection of Impaired Perfusion (or “Nonperfusion”) Detection of Choroidal Neovascularization Quantification of Vascular Changes Conclusions Key References References 6.9 Retinal Electrophysiology Key Features Introduction Full-Field ERG Multifocal ERG Electro-oculography Key References References 6.10 Light and Laser Injury Key Features Associated Features Introduction Light Interaction With the Retina Photic Retinopathy Solar Retinopathy Welding Arc Exposure Lightning Maculopathy Retinal Phototoxicity From Ophthalmic Instruments Light Exposure and Age-Related Macular Degeneration Laser Injury Laser Pointers Complications of Therapeutic Retinal Laser Photocogulation Key References References 6.11 Scleral Buckling Surgery Key Features Associated Features Introduction Historical Review Preoperative Evaluation and Diagnostic Approach Differential Diagnosis Alternatives to Scleral Buckling Anesthesia General Techniques Treatment of Retinal Breaks Explant Scleral Buckling Techniques Drainage of Subretinal Fluid Chandelier-Assisted Scleral Buckling Closure Complications Intraoperative Complications Scleral Perforation Drainage Complications Postoperative Complications Glaucoma Infection and Extrusion Choroidal Effusion Cystoid Macular Edema and Residual Subretinal Fluid Macular Pucker Diplopia Changes in Refractive Error Outcome Key References References 6.12 Vitrectomy Key Features Introduction Historical Review Preoperative Evaluation and Diagnostic Approach Indications and Alternatives to Surgery Anesthesia General Techniques Specific Techniques Lensectomy Vitreous Cutters Epiretinal Membrane Dissection Intraoperative Tissue Staining Perfluorocarbon Liquids Endophotocoagulation Gas and Silicone Oil Tamponade Complications Outcomes Key References References 6.13 Intravitreal Injections and Medication Implants Key Features Associated Features Introduction Preinjection Preparation Pupillary Dilation Anesthesia Antisepsis Injection Postinjection Complications Endophthalmitis Hemorrhage Intraocular Pressure Changes Retinal Pigment Epithelium Tears Retinal Tears and Detachments Other Complications Other Considerations Implants Conclusions Key References References 6.14 Progressive and “Stationary” Inherited Retinal Degenerations Key Features Associated Features Key Features Associated Features Progressive Diffuse/Panretinal Degenerations Introduction Epidemiology and Pathogenesis Rod-Cone Dystrophy Cone-Rod Dystrophy Diagnosis and Ancillary Testing Electroretinography Monitoring Disease Progression Visual Field Testing Dark Adaptation Testing Color Vision Tests Fluorescein Angiography Fundus Autofluorescence Optical Coherence Tomography Electro-oculography Multifocal Electroretinography Visual Evoked Cortical Potential Genetic Testing Ocular Findings/Manifestations Typical Retinitis Pigmentosa X-Linked Retinitis Pigmentosa Leber’s Congenital Amaurosis Cone Dystrophy Genetics and Pathology Systemic Associations and Differential Diagnosis of Pigmentary Retinopathy Course and Outcomes “Stationary” Retinal Disorders Congenital Stationary Night Blindness Congenital Stationary Night Blindness With Normal Fundus Oguchi’s Disease Fundus Albipunctatus Congenital Red–Green Color Deficiency Blue Cone Monochromatism Achromatopsia Ocular Albinism Female Carriers of X-Linked Retinal Degenerations Treatment of Retinal Degenerations Vitamin A Docosahexaenoic Acid Carbonic Anhydrase Inhibitors for Cystoid Macular Edema Gene Therapy Neurotrophic Factors Stem Cell–Based Therapies Retinal Prostheses/Implants References Key References 6.15 Macular Dystrophies Key Features Associated Features Introduction Stargardt Disease and Fundus Flavimaculatus Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Vitelliform Macular Dystrophy (Best Disease) Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Adult Vitelliform Macular Dystrophy/ Adult-Onset Foveomacular Dystrophy (Pattern Dystrophy) Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Dominant Drusen (Doyne’s Drusen, Malattia Leventinese) Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Pattern Dystrophy Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Dominant Cystoid Macular Edema Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Sorsby’s Macular Dystrophy Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome North Carolina Macular Dystrophy Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Atrophia Areata Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Treatment, Course, and Outcome Cone Dystrophy Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Treatment, Course, and Outcome Central Areolar Choroidal Dystrophy Epidemiology and Pathogenesis Ocular Manifestations and Diagnosis Pathology Treatment, Course, and Outcome Key References References 6.16 Choroidal Dystrophies Key Features Choroideremia Gyrate Atrophy Associated Features Introduction Choroideremia Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment, Course, and Outcome Gyrate Atrophy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment, Course, and Outcome Key References References 6.17 Hereditary Vitreoretinopathies Key Features Associated Features Introduction Stickler’s Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Systemic Associations Treatment, Course, and Outcome X-Linked Juvenile Retinoschisis Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Treatment, Course, and Outcome Autosomal Dominant Vitreoretinochoroidopathy Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Treatment, Course, and Outcome Familial Exudative Vitreoretinopathy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Systemic Associations Treatment, Course, and Outcome Norrie’s Disease Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Systemic Associations Treatment, Course, and Outcome Key References References 6.18 Hypertensive Retinopathy Chronic Hypertensive Retinopathy Key Features Associated Retinal Findings Malignant Acute Hypertensive Retinopathy Key Features Associated Feature Introduction Epidemiology and Pathogenesis Ocular Manifestations Hypertensive Retinopathy Hypertensive Choroidopathy Hypertensive Optic Disc Edema Diagnosis and Ancillary Testing Treatment and Future Directions Key References References 6.19 Retinal Arterial Obstruction Central Retinal Artery Obstruction Key Features Associated Features Branch Retinal Artery Obstruction Key Features Associated Features Central Retinal Artery Obstruction Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Branch Retinal Artery Obstruction Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Ophthalmic Artery Obstruction Cilioretinal Artery Obstruction Combined Artery and Vein Obstructions Key References References 6.20 Venous Occlusive Disease of the Retina Central Retinal Vein Occlusion Key Features Associated Features Branch Retinal Vein Occlusion Key Features Associated Features Introduction Epidemiology Central Retinal Vein Occlusion Pathogenesis Ocular Manifestations Ancillary Testing Differential Diagnosis Systemic Associations and Laboratory Evaluation Pathology Treatment Neovascular Glaucoma Macular Edema Course and Outcome Branch Retinal Vein Occlusion Pathogenesis Ocular Manifestations Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 6.21 Retinopathy of Prematurity Key Features Avascular Retina Associated Features Introduction Pathogenesis Clinical Features and Classification Diagnosis and Screening Role of Telemedicine in ROP Screening Differential Diagnosis Pathology Treatment Ablation of Peripheral Avascular Retina Role of Anti-VEGF Therapy in ROP Treatment Surgery in ROP Treatment Late Complications of ROP Key References References 6.22 Diabetic Retinopathy Key Features Associated Features Introduction Epidemiology Pathogenesis Aldose Reductase Vasoproliferative Factors Platelets and Blood Viscosity Ocular Manifestations Early Nonproliferative Diabetic Retinopathy Advanced Nonproliferative Diabetic Retinopathy Proliferative Diabetic Retinopathy Other Ocular Complications of Diabetes Mellitus Cornea Glaucoma Lens Optic Neuropathy Cranial Neuropathy Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Medical Therapy Antiplatelet Therapy Antihypertensive Agents Antiangiogenesis Agents Bevacizumab Pegaptanib Aflibercept Additional Medical Therapies Pharmacotherapy for Proliferative Diabetic Retinopathy Corticosteroids Surgical Therapy Panretinal Photocoagulation Peripheral Retinal Cryotherapy Focal Laser for Macular Edema Vitrectomy in Diabetic Retinopathy Conclusions Key References References 6.23 Ocular Ischemic Syndrome Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Symptoms Anterior Segment Posterior Segment Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment, Course, and Outcome Key References References 6.24 Hemoglobinopathies Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Treatment Course and Outcome Key References References 6.25 Coats’ Disease and Retinal Telangiectasia Key Features Associated Features Introduction Epidemiology Ocular Manifestations Diagnosis Ancillary Testing Differential Diagnosis Idiopathic Juxtafoveal Retinal Telangiectasia Group 1A Group 1B Group 2 Group 3 The MacTel Project Potential Treatments for Idiopathic Juxtafoveal Retinal Telangiectasia Systemic Associations Treatment Complications of Treatment Course and Outcome Key References References 6.26 Radiation Retinopathy and Papillopathy Key Features Associated Features Radiation Retinopathy Pathology and Pathogenesis Clinical Features Diagnostic Studies Risk Factors Brachytherapy Teletherapy Differential Diagnosis Treatment Reducing the Dose of Radiation Laser Photocoagulation Intravitreal Anti–Vascular Endothelial Growth Factor Agents Corticosteroids Other Treatments Prognosis Radiation Papillopathy Pathology and Pathogenesis Clinical Features Diagnostic Studies Differential Diagnosis Treatment Prognosis Summary Key References References 6.27 Proliferative Retinopathies Key Features Associated Features Introduction Retinal Angiogenesis Overview of Diagnosing Neovascularization Overview of Treating Neovascularization Entities Associated With Retinal Neovascularization Systemic Diseases Diabetes Mellitus Hyperviscosity Syndromes Aortic Arch Syndromes and Ocular Ischemic Syndromes Carotid–Cavernous Fistula Multiple Sclerosis Retinal Vasculitis Sarcoidosis Systemic Diseases That Have a Strong Hereditary Component Hemoglobinopathies Incontinentia Pigmenti Retinal Vascular and Ocular Inflammatory Diseases Eales’ Disease Retinal Vein Occlusion Retinal Embolization Retinopathy of Prematurity Uveitis Acute Retinal Necrosis Birdshot Chorioretinopathy Long-Standing Retinal Detachment Choroidal Melanoma and Hemangioma Hereditary Retinal Diseases Familial Exudative Vitreoretinopathy Inherited Retinal Venous Beading Retinoschisis Retinitis Pigmentosa Autosomal Dominant Vitreoretinochoroidopathy Key References References 6.28 Retinal Arterial Macroaneurysms Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment, Course, and Outcome Key References References 6.29 Age-Related Macular Degeneration Key Features Associated Features Introduction Epidemiology Pathogenesis Ocular Manifestations Dry AMD Drusen and Focal Hyperpigmentation of the RPE Geographic Atrophy Neovascular AMD Detachment of the RPE Diagnosis and Ancillary Testing Fundus Autofluorescence Optical Coherence Tomography Fluorescein Angiography Indocyanine Green Angiography Optical Coherence Tomography Angiography Differential Diagnosis Pathology Natural History and Prognosis Treatment and Prevention Dry AMD Neovascular AMD Verteporfin Photodynamic Therapy Anti-VEGF Therapies Pegaptanib Sodium Ranibizumab Bevacizumab Ranibizumab Versus Bevacizumab Aflibercept Anti-VEGF Treatment Regimens Combination Therapies Anti-VEGF Therapy Plus PDT Anti-VEGF Therapy Plus PDGF Inhibitors Long-Term Outcomes With Anti-VEGF Therapy Conclusions Key References References 6.30 Secondary Causes of Choroidal Neovascularization Key Features Associated Feature Traumatic Ruptures of Bruch’s Membrane Treatment Angioid Streaks Treatment Pathological Myopia Treatment Inflammatory Disorders Key References References 6.31 Central Serous Chorioretinopathy Key Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 6.32 Macular Hole Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Gass Stage 1 Macular Hole Gass Stage 2 Macular Hole Gass Stage 3 Macular Hole Gass Stage 4 Macular Hole Vitreomacular Adhesion Vitreomacular Traction Full-Thickness Macular Hole Lamellar Macular Hole Pseudo-Macular Hole “Stage 0” Macular Hole Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Course and Outcome Key References References 6.33 Epiretinal Membrane Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Course and Outcomes Key References References 6.34 Vitreomacular Traction Key Features Associated Features Introduction Natural History of Vitreomacular Traction Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Vitrectomy Pharmacological Vitreolysis Pneumatic Vitreolysis Conclusions Key References References 6.35 Cystoid Macular Edema Key Features Associated Features Introduction Pathogenesis and Etiology Vascular Postoperative Uveitis-Related Medication-Related Retinal Dystrophies Tractional Causes Anatomical Intraocular Neoplasms Diagnosis and Ancillary Testing Fundoscopy Optical Coherence Tomography Autofluorescence Fluorescein Angiography Treatment Vascular Diabetic Macular Edema (See Chapter 6.22, Diabetic Retinopathy) Retinal Venous Occlusive Disease (See Chapter 6.20, Venous Occlusive Disease of the Retina) Branch Retinal Vein Occlusion Central Retinal Vein Occlusion Macroaneurysms (See Chapter 6.28, Retinal Arterial Macroaneurysms) Juxtafoveal Retinal Telangiectasias (See Chapter 6.25, Coats’ Disease and Retinal Telangiectasia) Radiation Retinopathy (See Chapter 6.26, Radiation Retinopathy and Papillopathy) Age-Related Macular Degeneration (See Chapter 6.29, Age-Related Macular Degeneration) Postoperative Inflammatory (See Part 7: Uveitis and Other Intraocular Inflammations) Medication Induced (See Chapter 6.45, Retinal Toxicity of Systemically Administered Drugs) Retinal Dystrophy (See Chapter 6.14, Progressive and ‘Stationary’ Inherited Retinal Degenerations) Tractional (See Chapter 6.32, Macular Hole, Chapter 6.33, Epiretinal Membrane, Chapter 6.34, Vitreomacular Traction Syndrome) Anatomical Abnormalities (See Chapter 6.36, Coexistent Optic Nerve and Macular Abnormalities) Neoplastic (See Part 8: Intraocular Tumors) Conclusions Key References References 6.36 Coexistent Optic Nerve and Macular Abnormalities Key Features Associated Features Introduction Congenital Anomalies of the Optic Disc Congenital Optic Disc Pit Morning Glory Optic Disc Anomaly Optic Nerve Coloboma Treatment of Retinal Detachments Secondary to Congenital Anomalies of the Optic Disc Other Optic Nerve Abnormalities Associated With Macular Pathology Optic Nerve Abnormalities Associated With Choroidal Neovascularization Abnormalities Associated With Exudation Key References References 6.37 Peripheral Retinal Lesions Key Features Associated Features Introduction and Anatomy Ora Serrata Vitreous Base Ocular Manifestations and Diagnosis of Peripheral Retinal Lesions Meridional Folds or Radial Folds Pars Plana Cysts Ora Serrata Pearls Degenerative Adult Retinoschisis Congenital X-Linked Retinoschisis Paving Stone Degeneration Lattice Degeneration and Retinal Breaks Key References References 6.38 Retinal Breaks Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Retinal Tears Round Holes With Opercula Round Holes Without Opercula (Atrophic Holes) Traumatic Retinal Breaks Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Treatment of Retinal Breaks Cryopexy Photocoagulation Anesthesia Course and Outcome Key References References 6.39 Rhegmatogenous Retinal Detachment Key Features Associated Features Introduction Epidemiology and Pathogenesis Factors Causing Retinal Detachment Retinal Breaks Vitreous Liquefaction and Detachment Traction on the Retina Liquid Currents Conditions Predisposing an Eye to Retinal Detachment Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Key References References 6.40 Serous Detachments of the Neural Retina Key Features Associated Features Introduction Pathophysiology Alterations in Choroidal Flow Idiopathic Central Serous Chorioretinopathy Tumors of the Choroid and Retina Systemic Disease With Disrupted Choroidal Blood Flow Vasculitis and Autoimmune Disease Poor Scleral Outflow Nanophthalmos and Uveal Effusion Syndrome Posterior Scleritis Breakdown of the RPE and Retina Vogt–Koyanagi–Harada Disease, Sympathetic Ophthalmia, and Sarcoidosis Infectious Diseases Retinal Vascular Diseases Miscellaneous Diagnostic and Ancillary Testing Diagnostic Ultrasonography Optical Coherence Tomography Fluorescein Angiography and Indocyanine Green Angiography Optical Coherence Tomography Angiography Computed Tomography and Magnetic Resonance Imaging Differential Diagnosis Treatment Course and Outcome Key References References 6.41 Choroidal Hemorrhage Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Treatment Primary Management Secondary Management Choroidal Hemorrhage in Trauma Choroidal Hemorrhage in Other Conditions Course and Outcome Key References References 6.42 Proliferative Vitreoretinopathy Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 6.43 Posterior Segment Ocular Trauma Key Features Associated Features Introduction Ocular Manifestations and Clinical Examination History Clinical Examination Ancillary Testing Nonpenetrating Trauma Commotio Retinae Choroidal Rupture Traumatic Macular Hole Chorioretinitis Sclopetaria Retinal Tear Retinal Detachment Retinal Dialysis Retinal Pigment Epithelium Contusion/Traumatic Choroidopathy Macular Hemorrhage Optic Nerve Avulsion Penetrating Trauma Initial Closure Intraocular Foreign Bodies Metallosis Secondary Infection Rehabilitation: Secondary Surgical Timing Rehabilitation: Surgical Technique Traumatic Endophthalmitis Course and Outcome Prognosis Sympathetic Ophthalmia Additional Considerations Key References References 6.44 Distant Trauma With Posterior Segment Effects Terson Syndrome Key Features Associated Features Purtscher Retinopathy Key Features Associated Features Shaken Baby Syndrome Key Features Associated Features Terson Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Treatment and Outcome Purtscher Retinopathy Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Systemic Associations Pathology Treatment and Course Shaken Baby Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment, Course, and Outcome Miscellaneous Conditions Whiplash Injury Fat Embolism Syndrome Valsalva Retinopathy Key References References 6.45 Retinal Toxicity of Systemically Administered Drugs Key Features Associated Features Introduction Chloroquine and Hydroxychloroquine Sildenafil Thioridazine Niacin Canthaxanthine Tamoxifen Fingolimod Paclitaxel Deferoxamine Didanosine Clofazimine Thiazolidinediones Imatinib Mitogen-Activated Protein Kinase Inhibitors and Immune Checkpoint Inhibitors Key References References 7.1 Anatomy of the Uvea Key Feature Associated Features Introduction Iris Ciliary Body Choroid Key References References 7.2 Mechanisms of Uveitis Key Feature Associated Features Introduction Innate and Adaptive Immunities Cells of the Immune System Nonlymphocytic Leukocytes B Cells T Cells Mast Cells NK and NK T Cells Antigen-Presenting Cells Molecules of the Immune System Involved in Uveitis Antibodies Cytokines Chemokines and Chemokine Receptors Adhesion Molecules Other Molecules Tolerance and Autoimmunity Central Tolerance Peripheral Tolerance Ignorance Mechanisms That Trigger and Promote Uveitogenic Processes Genetic Background Trauma Microbial Infection Mechanisms of Inflammation Types of Immunopathogenic Processes Immunopathogenic Processes of Uveitis in Humans Mechanisms That Inhibit Inflammation in the Eye Key References References 7.3 General Approach to the Uveitis Patient and Treatment Strategies Key Feature Associated Features Introduction Classification Epidemiology Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Treatment Mydriatic and Cycloplegic Agents Nonsteroidal Anti-inflammatory Drugs Corticosteroids Topical Periocular Intravitreal Systemic Immunosuppressive Therapy Course and Outcome Key References References 7.4 Herpetic Viral Uveitis Herpes Simplex and Varicella Zoster Herpetic Anterior Uveitis Key Features Associated Features Varicella-Zoster and Herpes Simplex Virus–Induced Acute Retinal Necrosis Key Features Associated Features Progressive Outer Retinal Necrosis Key Features Associated Features Herpes Simples Virus and Varicella-Zoster Virus Introduction Epidemiology and Pathogenesis Ocular Presentation Differential Diagnosis Pathology Treatment Course and Outcome Cytomegalovirus Cytomegalovirus Retinitis Key Features Associated Features Cytomegalovirus-Associated Anterior Uveitis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Epstein–Barr Virus Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Treatment and Outcome Key References References 7.5 Nonherpetic Viral Infections Key Features West Nile Virus Introduction Epidemiology Ocular Manifestations Diagnosis Treatment Chikungunya Introduction Epidemiology Ocular Manifestations Diagnosis Treatment Zika Introduction Epidemiology Ocular Manifestations Diagnosis Treatment Ebola Introduction Epidemiology Ocular Manifestations Diagnosis Treatment Human T-Cell Lymphotropic Virus Type I Introduction Epidemiology/Pathogenesis Ocular Manifestations Diagnosis Treatment Measles Virus Introduction Epidemiology/Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Pathology Treatment Rubella Virus Summary Key References References 7.6 Syphilitic and Other Spirochetal Uveitis Syphilitic Uveitis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Lyme Disease Key Features Associated Features Introduction Epidemiology and Pathogenesis Systemic Associations Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Leptospirosis Key Features Associated Feature Introduction Epidemiology and Pathogenesis Systemic Manifestations Ocular Manifestations Diagnosis Differential Diagnosis Treatment Course and Outcome Key References References 7.7 Tuberculosis, Leprosy, and Brucellosis Key Ocular Features Tuberculous Uveitis Leprosy Uveitis Brucellosis Uveitis Associated Systemic Features Tuberculosis Introduction Epidemiology and Pathogenesis Ocular Manifestations Anterior Uveitis Intermediate Uveitis Posterior and Pan-Uveitis Diagnosis Pathology Treatment Leprosy Introduction Epidemiology Systemic Manifestations and Pathogenesis of Ocular Disease Clinical Presentation Diagnosis Treatment Brucellosis Introduction Systemic Manifestations Ocular Manifestations Diagnosis Treatment Acknowledgements Key References References 7.8 Bartonella-Related Infectious Uveitis (Cat Scratch Disease) and Whipple’s Disease Key Features Cat Scratch Disease Whipple’s Disease Introduction Cat Scratch Disease: Bartonella Henselae–Associated Uveitis Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Imaging Differential Diagnosis Pathology Treatment Whipple’s Disease: Tropheryma Whipplei–Associated Uveitis Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Key References References 7.9 Infectious Endophthalmitis Key Features Associated Features Introduction Epidemiology and Risk Factors Exogenous Endophthalmitis Trauma Cataract Surgery Penetrating Corneal Surgery Glaucoma Filtration Procedures Vitrectomy Intravitreal Injections Endogenous Endophthalmitis Pathology and Pathogenesis Clinical Presentation and Evaluation Microbiological Testing Differential Diagnosis Treatment Medications Surgical Intervention Outcomes Conclusions Key References References 7.10 Histoplasmosis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Key References References 7.11 Fungal Endophthalmitis Key Features Associated Features Candidal Intraocular Infection Aspergillus Endogenous Endophthalmitis Coccidioidal Intraocular Inflammation Candida Introduction Epidemiology and Pathogenesis Ocular Manifestations Histopathology Aspergillus Epidemiology and Pathogenesis Ocular Manifestations Histopathology Fusarium Epidemiology and Pathogenesis Ocular Manifestations Coccidioides Immitis—Ocular Coccidioidomycosis Cryptococcal Endophthalmitis Histoplasma Endophthalmitis Diagnosis of Fungal Endophthalmitis Differential Diagnosis Treatment of Fungal Endophthalmitis Course and Outcome Key References References 7.12 Ocular Toxoplasmosis Key Features Associated Features Introduction Organism and Life Cycle Epidemiology Pathology and Pathogenesis Clinical Manifestations Systemic Disease Ocular Disease Diagnosis Differential Diagnosis Therapy Course and Prognosis Key References References 7.13 Posterior Parasitic Uveitis Key Features Introduction Ocular Cysticercosis Clinical Presentation Treatment Ocular Toxocariasis Chronic Endophthalmitis Posterior Pole Granuloma Peripheral Granuloma Atypical Presentations Differential Diagnosis Ancillary Testing Treatment Onchocerciasis Gnathostomiasis Diffuse Unilateral Subacute Neuroretinitis Amebiasis Giardiasis Malaria Leishmaniasis Ocular Manifestation Pediatric Presumed Trematode Infection Ophthalmomyiasis Acknowledgement Key References References 7.14 Uveitis Related to HLA-B27 and Juvenile Idiopathic Arthritis–Associated Uveitis Uveitis Related to HLA-B27 Key Features Associated Features Juvenile Idiopathic Arthritis-Associated UveiTIS Key Features Associated Features Uveitis Related to HLA-B27 Introduction Pathogenetic Mechanisms Clinical Features and Laboratory Investigations Associated Systemic Disease Treatment and Prevention Juvenile Idiopathic Arthritis Introduction Pathogenetic Mechanisms Clinical Picture Uveitis in JIA Risk Factors Clinical Picture Complications and Prognosis Management Management of Complications Outcomes Screening Key References References 7.15 Sarcoidosis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 7.16 Behçet’s Disease Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Corticosteroids Immunophilin Ligands Cytotoxic Agents Biological Agents Course and Outcome Key References References 7.17 Vogt–Koyanagi–Harada Disease Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Prodromal Phase Uveitic Phase Chronic and Recurrent Phases Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Auditory Signs Neurological Signs Dermal Signs Other Signs Pathology Uveitic Phase Chronic and Recurrent Phases Treatment Course and Outcome Key References References 7.18 Phacogenic Uveitis Key Feature Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcome Key References References 7.19 Sympathetic Uveitis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Prevention Treatment Course and Outcome Key References References 7.20 Idiopathic and Other Anterior Uveitis Syndromes Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Fuchs’ Heterochromic Iridocyclitis Posner–Schlossman Syndrome Drug-Induced Anterior Uveitis Schwartz–Matsuo Syndrome Ellingson Syndrome Key References References 7.21 Pars Planitis and Other Intermediate Uveitis Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Findings and Complications Diagnosis Management Medical Management Surgical Management Prognosis Key References References 7.22 Posterior Uveitis of Unknown Cause—White Spot Syndromes Key Feature Associated Features Introduction Birdshot Chorioretinopathy Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Course and Outcome Acute Posterior Multifocal Placoid Pigment Epitheliopathy Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcomes Serpiginous Choroiditis Epidemiology Ocular Manifestations Diagnosis Differential Diagnosis Pathology Treatment Course and Outcomes Relentless Placoid Chorioretinitis Epidemiology Ocular Manifestations Diagnosis Differential Diagnosis Treatment Course and Prognosis Persistent Placoid Maculopathy Epidemiology and Pathogenesis Ocular Manifestations Differential Diagnosis Treatment Course and Outcome Multifocal Choroiditis/Punctate Inner Choroidopathy Epidemiology Ocular Manifestations Diagnosis Systemic Associations Course and Outcomes Differential Diagnosis Treatment Multiple Evanescent White Dot Syndrome Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Course and Outcomes Acute Zonal Occult Outer Retinopathy Epidemiology Ocular Manifestations and Diagnosis Differential Diagnosis Course and Outcome Acute Macular Neuoretinopathy Epidemiology and Pathogenesis Diagnosis Differential Diagnosis Course and Outcomes Acknowledgment Key References References 7.23 Masquerade Syndromes Key Features Associated Features Introduction Primary Neoplasms Primary Intraocular (Vitreoretinal) Lymphoma Diagnosis Treatment Primary Choroidal Lymphomas and Lymphoid Hyperplasia Melanoma Other Primary Neoplasms Secondary Neoplasms and Metastases Lymphoma and Leukemia Metastatic Carcinoma Metastatic Melanoma Paraneoplastic Syndromes Conclusions Key References References 8.1 Malignant Intraocular Neoplasms Key Features Introduction Primary Malignant Intraocular Neoplasms Retinoblastoma Primary Uveal Melanoma Primary Anterior Uveal Melanoma Primary Posterior Uveal Melanoma Primary Intraocular Lymphoma Primary Vitreoretinal Lymphoma Primary Uveal Lymphoma Medulloepithelioma Adenocarcinomas of Intraocular Neuroectodermal Epithelial Layers Primary Nonophthalmic Malignant Neoplasms Metastatic to the Eye Secondary Malignant Intraocular Neoplasms Hematological Neoplasias Involving the Eyes Key References References 8.2 Benign Intraocular Neoplasms, Hamartomas, and Choristomas Key Features Introduction Benign Intraocular Neoplasms Uveal Nevus Anterior Uveal Nevus Posterior Uveal Nevus Retinal Astrocytoma Retinal Capillary Hemangioma Uveal Leiomyoma Uveal Neurilemoma Adenomas of Intraocular Neuroectodermal Epithelial Tissues Intraocular Hamartomas Circumscribed Choroidal Hemangioma Combined Hamartoma of the Retina Intraocular Choristomas Benign Cellular Tumors of Uncertain Category Choroidal Osteoma Key References References 8.3 Non-Neoplastic Intraocular Lesions and Disorders Simulating Malignant Intraocular Neoplasms Key Features Introduction Non-Neoplastic Lesions and Disorders Simulating Malignant Intraocular Neoplasms of the Anterior Ocular Segment Neuroepithelial Cysts of Iris and Ciliary Body Epithelial Inclusion Cyst of Iris Anterior Scleral Staphyloma Iridocorneal Endothelial Syndrome Inflammatory Tumor of Iris or Ciliary Body Iris Foreign Body Advanced Cataract Simulating Ciliary Body Melanoma on B-Scan Ultrasonography Non-Neoplastic Lesions and Disorders Simulating Malignant Intraocular Neoplasms of the Posterior Ocular Segment Other Than Retinoblastoma Congenital Hypertrophy of Retinal Pigment Epithelium Focal Retinal Pigment Epithelial Hyperplasia Spontaneous Subretinal Hematomas Localized Suprachoroidal Hematoma Acquired Nonfamilial Retinal Hemangiomatous Lesion Nodular Posterior Scleritis Bilateral Diffuse Uveal Melanocytic Proliferation Associated With Systemic Carcinoma Vortex Vein Varicosity Orbital Tumor Indenting Eye Wall Sclerochoroidal Calcification Endogenous Microbial Subretinal Abscess Atypical Retinal Pigment Epithelial Detachment Bullous Central Serous Chorioretinopathy Ciliochoroidal Effusion and Idiopathic Uveal Effusion Syndrome Multifocal Best Vitelliform Retinal Dystrophy and Vitelliform Paraneoplastic Retinopathy Massive Gliosis of Retina Inflammatory Chorioretinal Granuloma Harada’s Disease Idiopathic Uveitis in the Elderly Vitiliginous (Birdshot) Choroiditis Endogenous Endophthalmitis Non-Neoplastic Intraocular Lesions and Disorders Simulating Intraocular Retinoblastoma Non-Neoplastic Lesions and Disorders Simulating Intraretinal Retinoblastoma Vitreoretinal Toxocara Granuloma Extensive Myelination of Retinal Nerve Fiber Layer Chorioretinal Coloboma Toxoplasmic Retinitis Focal Retinal Gliosis Lesions and Disorders Simulating Exophytic Retinoblastoma Advanced Coats’ Disease Persistent Hyperplastic Primary Vitreous (Persistent Fetal Vasculature) Congenital Retinal Dysplasia Advanced Retinopathy of Prematurity (Retrolental Fibroplasia) Advanced Familial Exudative Vitreoretinopathy (Fev) Advanced Incontinentia Pigmenti Retinopathy Lesions and Disorders Simulating Endophytic Retinoblastoma Pars Planitis (Intermediate Uveitis) Endogenous Endophthalmitis Simulating Endophytic Retinoblastoma Key References References 8.4 Phakomatoses Key Features Introduction Neurofibromatosis Epidemiology and Pathogenesis Extraophthalmic Manifestations Ocular Manifestations Systemic Manifestations Treatment Course and Outcomes Tuberous Sclerosis Epidemiology and Pathogenesis Extraophthalmic Manifestations Ocular Manifestations Systemic Evaluation Treatment Course and Outcome Von Hippel–Lindau Syndrome Epidemiology and Pathogenesis Extraophthalmic Manifestations Ocular Manifestations Systemic Evaluation Treatment Course and Outcomes Sturge–Weber Syndrome Epidemiology and Pathogenesis Extraophthalmic Manifestations Ocular Manifestations Systemic Evaluation Treatment Course and Outcome Wyburn–Mason Syndrome Epidemiology and Pathogenesis Extraophthalmic Manifestations Ocular Manifestations Systemic Evaluation Treatment Course and Outcomes Key References References 9.1 Principles of Imaging in Neuro-Ophthalmology Key Features Introduction Ophthalmologist’s Role in Neuroimaging Computed Tomography Principles Clinical Applications Safety Magnetic Resonance Imaging Principles Imaging Parameters T1 and T2 TR and TE Special Sequences and Techniques in the Production of an Image Spin Echo, Gradient-Echo, Fluid-Attenuated Inversion Recovery, and Fat Suppression Diffusion-Weighted Imaging Contrast Enhancement Surface and Head Coils Magnetization Transfer Imaging Safety Angiography Magnetic Resonance Angiography Principles Clinical Applications of MRA Computed Tomographic Angiography Principles Clinical Applications CTA Versus MRA Conventional Angiography Principles Ultrasonography Principles Functional Imaging Positron Emission Technology and Single-Photon Emission Computed Tomography Principles Clinical Applications Magnetic Resonance Spectroscopy Principles Functional Magnetic Resonance Imaging Principles Imaging Strategies in Neuro-Ophthalmology Key References References 9.2 Optical Coherence Tomography in Neuro-Ophthalmology Key Features Introduction OCT Interpretation Peripapillar Retinal Nerve Fiber Layer Macular Ganglion Cells Layer Microcystic Inner Nuclear Layer Abnormalities Papilledema Nonarteritic Ischemic Optic Neuropathy Compressive Optic Neuropathy Transsynaptic Retrograde Degeneration in Homonymous Hemianopia Multiple Sclerosis OCT and Brain Atrophy Neuromyelitis Optica Neurodegenerative Diseases Parkinson’s Disease Alzheimer’s Disease Friedreich’s Ataxia and Other Rare Neurological Syndromes Hereditary Optic Neuropathies Leber’s Hereditary Optic Neuropathy Dominant Optic Atrophy Nutritional and Toxic Optic Neuropathies Optical Coherence Tomography Angiography Key References References 9.3 Anatomy and Physiology Key Features Historical Review General Anatomy Constituent Elements Axons Glia Four Portions of the Optic Nerve Optic Disc Intraorbital Optic Nerve Intracanalicular Optic Nerve Intracranial Optic Nerve Circulation of the Optic Nerve Key References References 9.4 Differentiation of Optic Nerve From Macular Retinal Disease Key Features Diagnostic Features Introduction Ocular Features Diagnosis and Ancillary Testing History Physical Examination Ancillary Testing Key References References 9.5 Congenital Optic Disc Anomalies Key Feature Associated Feature Introduction Age Association Central Nervous System Malformations Optic Nerve Hypoplasia Morning Glory Disc Anomaly Optic Disc Coloboma Optic Pit Megalopapilla Congenital Tilted Disc Syndrome Congenital Optic Disc Pigmentation Aicardi Syndrome Key References References 9.6 Papilledema and Raised Intracranial Pressure Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Testing Differential Diagnosis Compressive Optic Neuropathies Papillitis Anterior Ischemic Optic Neuropathy Central Retinal Vein Occlusion Diabetic Papillopathy Optic Disc Vasculitis Other Causes Systemic Associations Pathology Treatment Course and Outcome Key References Reference 9.7 Inflammatory Optic Neuropathies and Neuroretinitis Key Features Associated Feature Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Viral and Postviral Syndromes Sarcoidosis Syphilis Lyme Disease Cat Scratch Disease Toxoplasmosis Optic Neuropathy in HIV Disease Systemic Lupus Erythematosus and Other Vasculitides Neuromyelitis Optica Association With Multiple Sclerosis Pathology Treatment Other Treatments Management Recommendations Course and Outcome Key References References 9.8 Ischemic Optic Neuropathy Key Features Associated Features Ischemic Optic Neuropathy Introduction Anterior Ischemic Optic Neuropathy Epidemiology and Pathogenesis Arteritic Anterior Ischemic Optic Neuropathy Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) Ocular Manifestations Arteritic Anterior Ischemic Optic Neuropathy Nonarteritic Anterior Ischemic Optic Neuropathy Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Treatment Arteritic Anterior Ischemic Optic Neuropathy Nonarteritic Anterior Ischemic Optic Neuropathy Course and Outcome Arteritic Anterior Ischemic Optic Neuropathy Nonarteritic Anterior Ischemic Optic Neuropathy Posterior Ischemic Optic Neuropathy Diabetic Papillopathy Pathogenesis and Features Course and Outcome Key References References 9.9 Hereditary, Nutritional, and Toxic Optic Atrophies Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 9.10 Prechiasmal Pathways—Compression by Optic Nerve and Sheath Tumors Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Treatment Optic Nerve Compression by Optic Nerve and Sheath Tumors Introduction Gliomas and Malignant Gliomas Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Optic Nerve Sheath Meningiomas Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Pathology Treatment Course and Outcome Other Intracanalicular and Intracranial Compressive Lesions Key References References 9.11 Traumatic Optic Neuropathies Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Pathology Treatment Key References References 9.12 Lesions of the Optic Chiasm, Parasellar Region, and Pituitary Fossa Key Feature Associated Features Introduction Anatomy Epidemiology and Pathogenesis Pituitary Adenomas Meningiomas Craniopharyngiomas Optic Gliomas Other Causes of Chiasmal Syndrome Ocular Manifestations Signs and Symptoms of Chiasmal Lesions Signs and Symptoms of Parasellar Lesions Diagnosis Visual Field Testing Neuroimaging Other Diagnostic Testing Differential Diagnosis Systemic Associations Pathology Pituitary Adenomas Meningiomas Craniopharyngiomas Optic Pathway Gliomas Treatment, Course, and Outcome Pituitary Adenomas Surgical Treatment Radiation Therapy Meningiomas Craniopharyngiomas Optic Gliomas Key References References 9.13 Lesions of Retrochiasmal Pathways, Higher Cortical Function, and Nonorganic Visual Loss Key Features Retrochiasmal Pathways and Higher Cortical Function Optic Tracts Lateral Geniculate Bodies Optic Radiations Higher Cortical Function Topographical Diagnosis of Retrochiasmal Disease Cortical Representation of Vision Introduction Object Identification and Memory Reading and Dyslexia Color Perception Integration of Visual–Auditory Space Motion Detection Nonorganic Visual Loss Key References References 9.14 Disorders of Supranuclear Control of Ocular Motility Key Features Associated Features Introduction Anatomy of Eye Movement Anatomy of Supranuclear Eye Movement Control Horizontal Eye Movements Vertical Eye Movements Slow Eye Movements Pursuit Eye Movements Vestibular System Optokinetic System Vergence System Diagnostic Testing Saccades Fixation Pursuit Vergence Eye Movements Ocular Alignment Differentiating Supranuclear From Nuclear and Infranuclear Lesions Oculocephalic (Doll’s Eyes) Reflex Vestibulo–Ocular Reflex Testing Disorders of Supranuclear Ocular Motility Congenital Gaze Palsies Acquired Gaze Palsies Disorders of Pursuit Internuclear Ophthalmoplegia Disorders of Vertical Gaze Ocular Motility Disorders and the Cerebellum Ocular Motility Disorders and the Vestibular System Vergence Disorders Development of the Ocular Motor System Transient Ocular Motility Abnormalities in Infancy Key References References 9.15 Nuclear and Fascicular Disorders of Eye Movement Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Palsies of the Third Cranial Nerve Third Cranial Nerve Nuclear Lesions Third Cranial Nerve Fascicular Palsies Congenital Third Cranial Nerve Palsies Palsies of the Fourth Cranial Nerve Fourth Cranial Nerve Nuclear and Fascicular Lesions Palsies of the Sixth Cranial Nerve Sixth Cranial Nerve Nuclear Palsies Sixth Cranial Nerve Fascicular Palsies Diagnosis Palsies of the Third Cranial Nerve Palsies of the Fourth Cranial Nerve Palsies of the Sixth Cranial Nerve Treatment, Course, and Outcome Palsies of the Third Cranial Nerve Palsies of the Fourth Cranial Nerve Palsies of the Sixth Cranial Nerve Key References References 9.16 Paresis of Isolated and Multiple Cranial Nerves and Painful Ophthalmoplegia Key Features Associated Features Introduction Anatomy Ocular Manifestations General Symptoms Isolated Cranial Neuropathies Isolated Sixth Cranial Nerve Palsy Isolated Fourth Cranial Nerve Palsy Isolated Third Cranial Nerve Palsy Divisional Third Cranial Nerve Palsy Nonisolated Cranial Neuropathies Multiple Cranial Neuropathies Bilateral Ophthalmoplegia Subarachnoid Involvement Nonisolated Third Cranial Nerve Palsies Diagnosis Isolated Cranial Neuropathies Isolated Sixth Cranial Nerve Palsy Isolated Fourth Cranial Nerve Palsy Isolated Third Cranial Nerve Palsy Nonisolated Cranial Neuropathies Multiple Cranial Neuropathies Bilateral Ophthalmoplegia Differential Diagnosis Isolated Cranial Neuropathies Isolated Sixth Cranial Nerve Palsy Isolated Fourth Cranial Nerve Palsy Isolated Third Cranial Nerve Palsy Nonisolated Cranial Neuropathies Treatment Nonisolated Cranial Neuropathies Key References References 9.17 Disorders of the Neuromuscular Junction Key Feature Associated Features Myasthenia Gravis Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Systemic Associations Treatment Course and Outcome Botulism Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Treatment Lambert–Eaton Myasthenic Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Treatment Course and Outcome Key References References 9.18 Ocular Myopathies Key Features Associated Features Introduction Mitochondrial Myopathies Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Systemic Associations Pathology Treatment Course and Outcome Dystrophic Myopathies Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Systemic Associations Pathology Treatment Course and Outcome Inflammatory and Infiltrative Myopathies Epidemiology and Pathogenesis Orbital Myositis Ocular Manifestations Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 9.19 Nystagmus, Saccadic Intrusions, and Oscillations Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Congenital Nystagmus Latent and Manifest Latent Nystagmus Spasmus Nutans Vestibular Nystagmus Peripheral Vestibular Nystagmus Central Vestibular Nystagmus Positional Vestibular Nystagmus Benign Paroxysmal Positional Nystagmus Gaze-Evoked Nystagmus Rebound Nystagmus Alternating Nystagmus Upbeat Nystagmus Downbeat Nystagmus Dissociated Nystagmus Acquired Pendular Nystagmus in Adults Monocular Visual Loss and Bilateral Visual Loss See-Saw Nystagmus Abducting Nystagmus in Internuclear Ophthalmoplegia Ocular Bobbing Saccadic Intrusions Superior Oblique Myokymia Convergence–Retraction Nystagmus and Convergence Nystagmus Square-Wave Jerks Macrosquare-Wave Jerks Macrosaccadic Oscillations Voluntary “Nystagmus” Saccadic Pulses Ocular Flutter Opsoclonus Treatment Drug Treatment Optical Treatment Surgical Treatment Other Treatments Key References References 9.20 Pupillary Signs of Neuro-Ophthalmic Disease Key Features Associated Features Introduction Relative Afferent Pupillary Defects Efferent Pupillary Defects Anisocoria Pupillary Inequality That Increases in the Dark Physiological Anisocoria Horner’s Syndrome Diagnosis of Horner’s Syndrome—Cocaine and Apraclonidine Pharmacological Testing Location of Damage to the Sympathetic Pathway Horner’s Syndrome in Children and Infants Pupillary Inequality That Increases With Light Slit-Lamp Examination of the Iris No or Little Residual Light Reaction Segmental Paralysis of the Iris Sphincter Pupillary Supersensitivity to Cholinergic Drugs Pupillary Undersensitivity to a Miotic Dose of Pilocarpine Tonic Pupil of Adie’s Syndrome Third Nerve Palsy Aberrant Regeneration of the Third Cranial Nerve Poor Pupil Dilation Retinal Origin of the Pupil Light Reflex—The Melanopsin-Containing Retinal Ganglion Cell Key References References 9.21 Presbyopia and Loss of Accommodation Key Feature Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Key References References 9.22 Headache and Facial Pain Key Features Associated Feature Introduction The Art and Science of Taking a Headache History Basic Outline of the Headache History Date of Onset, Age at Onset, and Frequency of Symptoms Location Duration Predisposing Factors Preceding Symptoms Quality and Severity of Pain Accompanying Symptoms Differential Diagnosis of Headache Syndromes Migraine Epidemiology of Migraine Clinical Features of Various Migraine Syndromes Migraine Without Aura (Previously Termed Common Migraine) Migraine With Aura (Previously Termed Classic Migraine) Structural Lesions That Mimic Migraine With Aura Recurrent Painful Ophthalmoplegic Neuropathy (Previously Termed Ophthalmoplegic Migraine) Retinal Migraine Pathogenesis of Migraine Treatment of Migraine With Aura and Migraine Without Aura Tension-Type Headache Cluster Headache Paroxysmal Hemicrania Temporal Arteritis Headache as a Result of Intracranial Processes Differential Diagnosis of Facial Pain Headache Attributed to Disorders of the Nose or Paranasal Sinuses (Previously Termed Sinus Headache) Orbital Inflammation and Neoplasia Classic Trigeminal Neuralgia (Previously Termed Tic Douloureux) Paratrigeminal Oculosympathetic (Raeder’s) Syndrome Primary Stabbing Headache (Ice-Pick Headaches, Jabs and Jolts Syndrome) Key References References 9.23 Tumors, Infections, Inflammations, and Neurodegenerations Key Features Associated Features Tumors Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Course and Outcome Infections Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Testing Pathology Treatment Course and Outcome Inflammations Introduction Epidemiology and Pathogenesis Ocular Manifestations Systemic Necrotizing Vasculitides Diagnosis and Testing Pathology Treatment Course and Outcome Neurodegenerations Introduction Epidemiology and Pathogenesis Ocular Manifestations Cerebellar Neurodegenerative Diseases Parkinsonism Progressive Supranuclear Palsy Chorea Dementias With Eye Findings Alzheimer’s Disease Charles Bonnet’s Syndrome Cerebrovascular Diseases Dementia Complex Associated With HIV Prion Diseases Diagnosis and Testing Pathology Treatment Course and Outcome Key References References 9.24 Urgent Neuro-Ophthalmic Disorders Key Features Introduction Epidemiology and Pathogenesis Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis Orbital Apex Syndrome Pituitary Apoplexy Ocular Manifestations Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis Orbital Apex Syndrome Pituitary Apoplexy Diagnosis and Ancillary Testing Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis and Orbital Apex Syndrome Pituitary Apoplexy Differential Diagnosis Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis and Orbital Apex Syndrome Pituitary Apoplexy Pathology Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis and Orbital Apex Syndrome Pituitary Apoplexy Treatment Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis and Orbital Apex Syndrome Pituitary Apoplexy Course and Outcomes Giant Cell Arteritis Aneurysm Cavernous Sinus Thrombosis Orbital Apex Syndrome Pituitary Apoplexy Key References References 9.25 Trauma, Drugs, and Toxins Key Features Associated Features Trauma and the Brain Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment Course and Outcome Drugs, Toxins, and the Brain Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Systemic Associations Pathology Treatment, Course, and Outcome Key References References 9.26 Vascular Disorders Key Feature Associated Features Introduction Aneurysms Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Head Pain Ophthalmoplegia Pupillary Involvement Differential Diagnosis Treatment, Course, and Outcome Carotid–Cavernous Sinus Fistulas and Dural Shunts Epidemiology and Pathogenesis Ocular Manifestations Differential Diagnosis Treatment, Course, and Outcome Arteriovenous Malformations Transient Visual Loss Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Nature of the Episodes Type of Visual Loss Length of Episodes Frequency of Episodes Associated Symptoms Underlying Risk Factors Treatment, Course, and Outcome Transient Isolated Bilateral Loss of Vision Aura Without Headache Strokes Epidemiology and Pathogenesis Transient Ischemic Attacks and Stroke Carotid–Ophthalmic Ischemic Attacks and Stroke Ocular Manifestations Key References References 9.27 Electrophysiology Key Features Introduction NonOrganic Vision Loss Optic Nerve Disease Key References References 10.1 Epidemiology of Glaucoma Key Features Introduction Prevalence and Rates of Associated Blindness Primary Open-Angle Glaucoma Demographic Risk Factors for Primary Open-Angle Glaucoma Race Age Gender Family History Ocular Risk Factors for Primary Open-Angle Glaucoma Intraocular Pressure Optic Nerve Parameters Nerve Fiber Layer Imaging Myopia Peripapillary Atrophy Corneal Thickness and Hysteresis Systemic Risk Factors for Primary Open-Angle Glaucoma Diabetes Hypertension Cigarette Smoking, Alcohol Use, and Caffeine Consumption Primary Angle-Closure Glaucoma Demographic Risk Factors for Primary Angle-Closure Glaucoma Race Gender Family History Ocular Risk Factors for Primary Angle-Closure Glaucoma Anterior Chamber Depth Anterior Segment Optical Coherence Tomography Limbal Anterior Chamber Depth Axial Length/Refractive Error Lens Thickness Radius of Corneal Curvature Systemic Risk Factors for Primary Angle-Closure Glaucoma Secondary Glaucomas Ocular Hypertension Glaucoma Suspects Key References References 10.2 Screening for Glaucoma Key Features Introduction Historical Review Screening Programs Prior Glaucoma Screening Efforts Current Definition of Open-Angle Glaucoma Purpose of the Test Utility of the Test and Interpretation of Results Procedure Complications Alternative Tests Analysis of Tests Telemedicine and Glaucoma Screening Marker Testing for Glaucoma Future Direction of Glaucoma Screening Key References References 10.3 Mechanisms of Glaucoma Key Features Introduction Physiology of Aqueous Production Structural and Functional Overview of Aqueous Humor Formation Three Steps in Aqueous Secretion Ion and Fluid Uptake From the Stroma Fluid Transfer Through Gap Junctions Fluid Transfer Into the Aqueous Humor Regulation of Net Aqueous Humor Formation Conclusions and Future Directions The Aqueous Humor Outflow Pathway Pathology of the Glaucomatous Outflow Pathway Conclusions and Future Directions Pathophysiology of Glaucomatous Optic Neuropathy Glaucomatous Neuropathy Occurs in Response to Increased Cell Stress Conditions Disrupted Axon Transport Vascular Hypothesis Excitotoxicity Due to Excessive Glutamate Oxidative Stress and Free Radical Damage Inflammatory Cytokines Aberrant Immunity Cellular Mechanisms of Apoptosis in Glaucoma Neurotrophic Factors for Survival and Growth Central Visual Pathway Degeneration in Glaucoma Conclusions and Future Directions Key References References 10.4 Clinical Examination of Glaucoma Key Features Introduction Obtaining Clinically Relevant Information Assessing the Patient’s Functional Status Obtaining the Patient’s History Medical History Ocular History Family History Ethnicity Examination Techniques Visual Acuity Testing Pupillary Response Testing Tonometry The Role of Intraocular Pressure in Glaucoma Applanation Tonometry Pachymetry External Examination Slit-lamp Examination Conjunctiva, Sclera, and Episclera Cornea Anterior Chamber Iris Lens Gonioscopy Estimation of the Peripheral Anterior Chamber Angle Principles of Gonioscopy Direct Gonioscopy Indirect Gonioscopy Gonioscopic Grading Systems Gonioscopic Anatomy of the Angle Shaffer System Spaeth System Occludable Angles Specific Findings of the Anterior Chamber Angle Optic Nerve Examination Testing for Glaucoma Key References References 10.5 Visual Field Testing in Glaucoma Key Features Associated Features Introduction Standard Automated Perimetry Testing Algorithms in Standard Automated Perimetry Visual Field Testing and Glaucoma Diagnosis Visual Field and Assessing the Severity of Glaucoma Visual Field and Assessing Progression in Glaucoma Key References References 10.6 Advanced Psychophysical Tests for Glaucoma Key Features Introduction Test Strategies Test Procedures Analysis Methods Conclusion Key References References 10.7 Optic Nerve Analysis Key Features Associated Features Diagnostic Technologies Introduction Normal Anatomy Clinical Examination: Glaucomatous Features Disc Cup Blood Vessels Peripapillary Atrophy Imaging Optic Disc Photography Confocal Scanning Laser Ophthalmoscopy Optical Coherence Tomography Conclusions Key References References 10.8 Optic Nerve Blood Flow Measurement Key Features Associated Features Introduction Applied Anatomy Physiology Experimental Investigations Clinical Studies Optical Coherence Tomography Angiography Retinal Oximetry Ocular Blood Flow and Visual Field Loss Systemic Vascular Disease and Glaucoma Pharmacology Statement of Disclosure Key References References 10.9 Ocular Hypertension Key Features Introduction Epidemiology and Pathogenesis Predictive Factors for Conversion of OHT to POAG Central Corneal Thickness Intraocular Pressure Age Pattern Standard Deviation Optic Nerve Optic Disc Hemorrhage Other Predictive Factors Diagnosis Differential Diagnosis Treatment Course and Outcome Key References References 10.10 Primary Open-Angle Glaucoma Key Features Associated Features Definition and Classification Intraocular Pressure, Risk Factors, and Aspects of Molecular Pathogenesis Diagnosis Nature of Progressive Visual Loss Preperimetric Glaucoma Threshold and Conversion Critical Phase Blindness Treatment and Monitoring Key References References 10.11 Normal-Tension Glaucoma Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Treatment Lower Intraocular Pressure Course and Outcome Key References References 10.12 Angle-Closure Glaucoma Key Features Introduction Epidemiology and Pathogenesis Prevalence Incidence Risk Factors Pupillary Block Nonpupillary Block Mechanisms Plateau Iris Configuration Aqueous Misdirection Diagnosis External Examination Penlight Examination Slit-Lamp Examination Gonioscopy Other Imaging Techniques Ultrasound Biomicroscopy Anterior-Segment Optical Coherence Tomography Provocative Tests Differential Diagnosis Management of Acute Angle Closure After 1 to 2 Hours Later Even Later Management of Chronic Angle-Closure Glaucoma Management of Angle-Closure Glaucoma Medical Treatment Laser Treatment Surgical Treatment Surgical Iridectomy Lens Extraction Goniosynechialysis Trabeculectomy Glaucoma Drainage Implant Cyclodestructive Procedures Micropulse Laser Prognosis Acknowledgments Key References References 10.13 Glaucoma Associated With (Pseudo)-Exfoliation Syndrome Key Features Associated Features Introduction Epidemiology and Genetics Clinical Presentation and Ocular Manifestations Glaucoma in Exfoliation Syndrome Systemic Manifestations Differential Diagnosis Key References References 10.14 Pigmentary Glaucoma Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Differential Diagnosis Treatment Course and Outcome Key References References 10.15 Neovascular Glaucoma Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Course and Outcome Emerging Treatments Key References References 10.16 Inflammatory and Corticosteroid-Induced Glaucoma Key Features Associated Features Introduction Pathophysiology Mechanisms of Elevated IOP Secondary Open-Angle Glaucoma Pre-Existing Open-Angle Glaucoma Secondary Angle-Closure Glaucoma Pre-Existing Disposition to Primary Angle Closure Combined-Mechanism Glaucoma Principles of Management Uveitis Diagnosis Management Mydriasis and Cycloplegia Glaucoma Medical Management Surgical Management Specific Entities Glaucomatocyclitic Crisis (Posner–Schlossman Syndrome) Fuchs’ Uveitis Syndrome (Fuchs’ Heterochromic Iridocyclitis) Key References References 10.17 Glaucoma Associated With Ocular Trauma Key Features Associated Features Introduction Immediate or Early-Onset Glaucoma After Ocular Trauma Contusion Trabecular Disruption Hyphema Massive Choroidal Hemorrhage Chemical Trauma Late-Onset Glaucoma After Ocular Trauma Angle Recession Peripheral Anterior Synechiae Ghost Cell (Hemolytic) Glaucoma Lens-Induced Glaucoma Lens Dislocation Phacomorphic Glaucoma Phacolytic Glaucoma Phacoantigenic Glaucoma Lens Particle Glaucoma Delayed Closure of a Cyclodialysis Cleft Epithelial Downgrowth Retained Intraocular Foreign Body Rhegmatogenous Retinal Detachment Key References References 10.18 Glaucoma With Raised Episcleral Venous Pressure Key Feature Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Treatment Course and Outcome Key References References 10.19 Malignant Glaucoma Key Features Associated Features Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Medical Laser Surgery Fellow Eye Key References References 10.20 Glaucomas Secondary to Abnormalities of the Cornea, Iris, Retina, and Intraocular Tumors Key Features Ghost Cell Hemolytic Glaucoma Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Schwartz’s Syndrome Iridocorneal Endothelial Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Progressive (Essential) Iris Atrophy Chandler’s Syndrome Iris–Nevus Syndrome (Cogan–Reese Syndrome) Pathology Treatment Axenfeld–Rieger Syndrome Epidemiology and Pathogenesis Ocular Manifestations Systemic Associations Pathology Treatment Epithelial Downgrowth and Fibrous Ingrowth (Proliferation) Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Aniridia Introduction Epidemiology and Pathogenesis Ocular Manifestations Systemic Associations Pathology Treatment Tumors and Glaucoma Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Penetrating Keratoplasty Introduction Epidemiology and Pathogenesis Ocular Manifestations Treatment Alkali Chemical Trauma Introduction Epidemiology and Pathogenesis Ocular Manifestations Pathology Treatment Key References References 10.21 Congenital Glaucoma Key Features Associated Features Introduction Epidemiology and Pathogenesis Primary Congenital Glaucoma (PCG) Glaucoma Following Cataract Surgery Secondary Glaucomas Associated With Ocular Anomalies or Systemic Syndromes Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Classification Schemes Pathology Treatment Course and Outcome Key References References 10.22 When to Treat Glaucoma Key Features Introduction Analysis of Risk Factors Risk Factors Intraocular Pressure Optic Disc Characteristics Central Corneal Thickness and Corneal Hysteresis Age Race and Ethnicity Family History Principles of Initiation of Therapy Initiation of Therapy in the Glaucoma Patient Initiation of Therapy in the Glaucoma Suspect Conclusions Key References References 10.23 Which Therapy to Use in Glaucoma Key Feature Introduction Historical Review Treatment Modalities Medical Treatment Laser Trabeculoplasty Surgery Cyclodestructive Procedures Treatment Algorithms Conclusions Key References References 10.24 Current Medical Management of Glaucoma Key Features Introduction Drugs That Decrease Aqueous Production Beta-Blockers Mechanism Efficacy Side Effects Alpha-Adrenergic Agonists Mechanism Efficacy Side Effects Carbonic Anhydrase Inhibitors Mechanism Efficacy Side Effects Oral Topical Drugs That Increase Aqueous Outflow Miotics Mechanism Efficacy Side Effects Prostaglandin Analogues Mechanism Efficacy Side Effects Systemic Safety Fixed Combination Medications Drug Development Pipeline The Medical Armamentarium for Glaucoma Treatment Key References References 10.25 Laser Trabeculoplasty and Laser Peripheral Iridectomy Key Features Associated Features: Laser Trabeculoplasty Associated Features: Laser Peripheral Iridectomy Laser Trabeculoplasty Introduction and Historical Review Preoperative Evaluation and Diagnostic Approach General Techniques Patient Preparation Lens Choice Equipment Preparation Treatment Guidelines Follow-Up Re-treatment Complications Outcome Laser Peripheral Iridectomy Introduction and Historical Review Preoperative Evaluation and Diagnostic Approach Indications Contraindications General Techniques Argon versus Nd:YAG Laser Patient Preparation Lens Choice Specific Techniques Argon Laser Nd:YAG Laser Combined Argon–Nd:YAG Technique Second Iridectomy Complications Intraocular Pressure Spikes Laser-Induced Inflammation Iridectomy Failure Diplopia Bleeding Lens Opacities Corneal Injury Other Complications Outcome Laser Iridoplasty Micropulse Laser Trabeculoplasty Key References References 10.26 Cyclodestructive Procedures in Glaucoma Key Features Associated Features Introduction Historical Review Preoperative Evaluation and Diagnostic Approach Mechanism of Action Alternatives to a Cyclodestructive Procedure Anesthesia Specific Techniques Cyclocryotherapy Transscleral Cyclophotocoagulation Noncontact and Contact Nd:YAG Laser Cyclophotocoagulation Semiconductor Diode Laser Transscleral Cyclophotocoagulation Micropulse Diode Cyclophotocoagulation Endoscopic Laser Cyclophotocoagulation Complications Outcome Key References References 10.27 Goniotomy and Trabeculotomy Key Features Associated Feature Introduction Indications Instruments Preoperative Care Examination Under Anesthesia Procedures Goniotomy Trabeculotomy Postoperative Care Results Complications Key References References 10.28 Minimally Invasive and Microincisional Glaucoma Surgeries Key Features Introduction Considerations for Patient Selection Angle Surgeries Trabecular Microbypass Stents Concept iStent G2 Inject (GTS-400) Technique Results iStent G1 Technique Results Hydrus: Ab Interno Schlemm’s Canal Scaffold Concept Technique Results Laser-Assisted Endoscopic Trabeculotomy Concept Endoscopic Excimer Laser Trabeculotomy Technique Results Trabeculectomy Ab Interno: Trabectome Concept Technique Results Phaco Combined With Trabectome Trabectome Alone in Pseudo-Phakic and Phakic Eyes Trabectome and Goniosynechialysis in Narrow Angles and Angle Closure Trabectome After Failed Trabeculectomy or Tube Shunt Surgery Adjuvant Trabectome Surgery at the Time of Tube Shunt Surgery Trabectome Surgery in Severe Glaucoma Other Ab Interno Trabeculectomy and Trabeculotomy Techniques Subconjunctival Microshunts Concept Technique Results Suprachoroidal Drainage Devices Concept Ab Externo Suprachoroidal Shunts SOLX Gold Micro-Shunt Technique Results Ab Interno Suprachoroidal Shunts CyPass Micro-Stent Technique Results iStent G3 Supra Conclusions Key References References 10.29 Trabeculectomy Key Features Associated Features Introduction Indications Surgical Planning Preoperative Factors to Consider Patient Counseling Surgical Techniques Intraoperative Technique: Limbal-Based Conjunctival Flap Surgical Technique: Fornix-Based Conjunctival Flap Avoiding Intraoperative Complications Postoperative Care Conclusions Key References References 10.30 Antifibrotic Agents in Glaucoma Surgery Key Features Associated Features Introduction Types of Antifibrotic Agents Indications for Antimetabolite Use Patient Groups With a High Risk of Scarring Patient Groups With an Intermediate or Low Risk of Scarring Application Techniques Type and Concentration of Intraoperative Agent and Time of Exposure Type of Sponge Larger Areas of Antimetabolite Treatment Position of Drainage Area Under Eyelid Closure of Scleral Flap and Associated Surgical Techniques Postoperative Injections Complications Future Strategies to Prevent Fibrosis Key References References 10.31 Drainage Implants Key Feature Associated Features Historical Perspective Basic Concept Indications Preoperative Considerations Implant Selection Surgical Technique Anesthesia Quadrant Selection Conjunctival Flap and Dissection Endplate Attachment Implant Preparation Tube Insertion Patch Graft Placement Conjunctival Closure Postoperative Management Complications Intraoperative Postoperative Evidence From Randomized Clinical Trials Drainage Implants Versus Trabeculectomy Valved Versus Nonvalved Drainage Implants Drainage Implants of Different Endplate Sizes Conclusions Key References References 10.32 Complications of Glaucoma Surgery and Their Management Key Features Associated Features Introduction Trabeculectomy Intraoperative Complications Conjunctival Buttonhole Trabeculectomy Scleral Flap Tear/Disinsertion Intraoperative Bleeding Early Postoperative Complications Shallow Anterior Chamber Low Filtration Choroidal Effusion Late Postoperative Complications Late Hypotony Late Bleb Failure Cataract Formation Late Bleb Leaks Blebitis and Endophthalmitis Glaucoma Drainage Implants Key References References 10.33 Genes Associated With Human Glaucoma Key Features Associated Feature Introduction Congenital Glaucoma Developmental Glaucoma Primary Open-Angle Glaucoma: Juvenile Onset Pigment Dispersion Syndrome and Glaucoma Adult-Onset Primary Open-Angle Glaucoma Normal-Tension Glaucoma Exfoliation Syndrome and Glaucoma Angle-Closure Glaucoma Key References References 10.34 Evidence-Based Medicine in Glaucoma Key Features Introduction Tools of Evidence-Based Medicine Randomized Clinical Trials Meta-Analyses and Systematic Reviews Other Study Designs Case Reports Cross-Sectional Studies Case-Control Studies Cohort Study Other Limitations Selection Bias Information Bias Evaluation of Diagnostic Testing in Glaucoma Examples of Evidence-Based Medicine in Glaucoma Therapy Barriers to the Practice of Evidence-Based Medicine Future Directions Conclusions Key References References 11.1 Anatomy and Physiology of the Extraocular Muscles and Surrounding Tissues Key Features Embryology General Structure of Extraocular Muscles Gross Anatomy of the Extraocular Muscles Origins of the Extraocular Muscles Compartments of the Extraocular Muscles Insertions of the Extraocular Muscles Paths and Actions of the Extraocular Muscles Innervation Blood Supply The Orbital Infrastructure and Anatomy Clinical Correlates Extraocular Muscle Physiology Hering’s and Sherrington’s Laws Key References References 11.2 Evaluating Vision in Preverbal and Preliterate Infants and Children Key Features Introduction Historical and Observational Techniques Fixation Targets Optokinetic Nystagmus Visual Evoked Potentials Forced-Choice Preferential Looking Graded Optotypes Digital Photoscreening Maturation of Visual Acuity Key References References 11.3 Examination of Ocular Alignment and Eye Movements Key Features Evaluation of Ocular Alignment Introduction Laboratory Methods Clinical Methods Objective Clinical Methods Corneal Light Reflex Tests Cover Tests Subjective Clinical Methods Eye Movement Examinations Introduction Mechanical Tests of Eye Movement Limitation Forced Duction Test Active Force Generation Test Key References References 11.4 Sensory Adaptations in Strabismus Key Features Visual Confusion and Diplopia Introduction Ocular Manifestations Treatment, Course, and Outcome Suppression and Anomalous Retinal Correspondence Introduction Ocular Manifestations Diagnosis and Ancillary Testing Treatment, Course, and Outcome Monofixation Syndrome Introduction Ocular Manifestations Diagnosis and Ancillary Testing Course and Outcome Key References References 11.5 Sensory Status in Strabismus Key Features Introduction Sensory Fusion Depth Perception and Stereopsis Clinical Testing Testing for Binocularity (Simultaneous Perception) Tests of Retinal Correspondence Stereopsis Tests Test for Monofixation Syndrome Key References References 11.6 Esotropia Key Features of Infantile Esotropia Associated Features (Often Appear After the First Year of Life) Key Features of Accommodative Esotropia Associated Feature Key Features of Duane’s Syndrome Associated Features of Duane’s Syndrome Introduction Infantile Esotropia Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Course and Outcome Accommodative Esotropia Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis and Ancillary Testing Differential Diagnosis Treatment, Course, and Outcome Cyclic Esotropia Moebius’ Sequence Duane’s Syndrome Epidemiology and Pathogenesis Ocular Manifestations Treatment Systematic Associations Strabismus Fixus Esotropia in the Neurologically Impaired Esotropia Associated With Visual Deficit (Sensory Esotropia) The “Heavy Eye Syndrome” and the “Sagging Eye Syndrome” Key References References 11.7 Exotropia Key Feature Associated Features Introduction Epidemiology and Pathogenesis of Intermittent Exotropia Ocular Manifestations of Intermittent Exotropia Classification of Intermittent Exotropia According to Distance/Near Angle Control of Intermittent Exotropia Complications of Exotropia Diagnosis and Ancillary Testing for Exotropia Differential Diagnosis Treatment Correction of Refractive Errors Orthoptic Treatment Therapeutic Occlusion Overcorrecting Minus Lenses Optical Treatment Pharmacological Treatment Surgical Treatment Course and Outcome Key References References 11.8 Torsional Strabismus Key Features Introduction Definitions of Inferior Oblique Overaction, Superior Oblique Overaction, A-Pattern, and V-Pattern The Three Axes of Strabismus Example: Child With Accommodative Esotropia Who Develops a V-Pattern Summary of Upcoming Sections Clinical Observations Epidemiology Age of Observation How to Observe or Measure Torsion Directly With Fundoscopy or Photography Correlation of the Appearance of Oblique Overaction, Pattern Strabismus, and Fundus Torsion Blind Spot Mapping Location of Rectus Muscle Insertions at Surgery Forced Ductions Double Maddox Rod Lancaster Red-Green Test Magnetic Resonance Imaging of the Orbits Parks’ Three-Step Test Torsion Is Sufficient to Cause the Appearance of Oblique Dysfunction A- and V-Patterns From Excyclotorsion of the Globe Absent Primary Oblique Dysfunction The Observation of Normal Version Testing After Denervation and Extirpation (D&E) of the IOs Etiology Sensory Torsion Well-Known Examples of Sensory Esotropia or Sensory Exotropia Muscle Length Adaptation Bias Sensory Deprivation or the Lack of Fusion Leads to Tropia Pulley Arrays Other Causes of Oblique Dysfunctions and Pattern Strabismus Superior Oblique Muscle Palsy Brown’s Syndrome Duane’s Syndrome Dissociated Vertical Deviation Craniosynostosis Pseudo-Oblique Overaction Occurs in Patients With a Large Quantity of Exotropia Management Observation Oblique Muscle Surgery Surgical Variations Rectus Transpositions Summary Key References References 11.9 Paralytic Strabismus Key Features Associated Features Introduction Third Nerve Palsy (Oculomotor) Introduction Ocular Manifestations Congenital Third Nerve Palsies Acquired Third Cranial Nerve Palsies Nonsurgical Treatment Surgical Treatment Fourth Nerve Palsy (Trochlear) Introduction Epidemiology and Pathogenesis Ocular Manifestations Nonsurgical Treatment Surgical Treatment Sixth Nerve Palsy Introduction Epidemiology and Pathogenesis Ocular Manifestations Nonsurgical Treatment Surgical Treatment Summary Key References References 11.10 Other Vertical Strabismus Forms Key Features Introduction Dissociated Vertical Divergence Introduction Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Treatment Primary Inferior Oblique Muscle Overaction Epidemiology and Pathogenesis Ocular Manifestations Differential Diagnosis Treatment Monocular Elevation Deficiency (Previously Termed “Double Elevator Palsy”) Introduction Epidemiology and Pathogenesis Differential Diagnosis Treatment, Course, and Outcome Brown’s Syndrome Introduction Epidemiology and Pathogenesis Ocular Manifestations Treatment Congenital Fibrosis Fractures of the Orbital Floor Ocular Manifestations Diagnosis Treatment Graves’ Ophthalmopathy (Dysthyroid Orbitopathy) Introduction Ocular Manifestations Diagnosis Treatment Heavy Eye Syndrome Key References References 11.11 Amblyopia Key Features Associated Features Experimental Findings Introduction Classification of Amblyopia (the Three Ds) Strabismic Amblyopia (Deviated Image) Anisometropic Amblyopia (Defocused Image) Stimulus-Deprivation Amblyopia (Deprived Image) Pathophysiology Diagnosis Treatment Occlusion Atropine Penalization Optical Penalization Systemic Pharmacological Treatment Course and Outcome Considerations Key References References 11.12 Forms of Nonsurgical Strabismus Management Key Feature Orthoptics Prisms Botulinum Toxin Bupivicaine Occlusion Key References References 11.13 Techniques of Strabismus Surgery Key Feature Introduction Historical Review Preoperative Evaluation and Diagnostic Approach Anesthesia General Techniques Specific Techniques Recession of a Rectus Muscle Lateral Rectus Medial Rectus and Vertical Recti Resection of a Rectus Muscle Lateral Rectus Medial Rectus and Vertical Recti Other Surgical Techniques Complications Violation of the Posterior Tenon’s Capsule/Fat Adherence Anterior Segment Ischemia Epithelial Cysts/Suture Granulomas Corneal Dellen Globe Perforation Underresponse or Overresponse Lost or Slipped Muscles/Stretch Scar Muscle Rupture or Pulled in Two Syndrome (Pits) Outcomes Key References References 12.1 Clinical Anatomy of the Eyelids Key Features Introduction Anatomy of the Eyelids Orbicularis Muscle Orbital Septum Preaponeurotic Fat Pockets Major Eyelid Retractors Sympathetic Accessory Retractors Tarsal Plates Canthal Tendons Conjunctiva Nerves to the Eyelids Vascular Supply of the Eyelids Key References References 12.2 Clinical Anatomy of the Orbit Key Features Introduction General Organization Osteology of the Orbit Orbital Roof Lateral Orbital Wall Orbital Floor Medial Orbital Wall Connective Tissue System Periorbita Orbital Septal System Tenon’s Capsule Muscles of Ocular Motility Motor Nerves of the Orbit Sensory Nerves of the Orbit Arterial Supply to the Orbit Venous Drainage From the Orbit Key References References 12.3 Orbital Imaging Key Features Introduction Normal Orbital Anatomy in the Axial Plane Axial Section Through the Lowermost Orbit Axial Section Through the Inferior Orbit Axial Section Through the Midorbit Axial Section Through the Superior Orbit Axial Section Through the Orbital Roof Normal Orbital Anatomy in the Coronal Plane Coronal Section Through the Anteriormost Orbit Coronal Section Through the Anterior Orbit Coronal Section Through the Central Orbit Coronal Section Through the Anterior Orbital Apex Coronal Section Through the Posterior Orbital Apex Computed Tomographic Imaging Features of Some Orbital Pathologies Cavernous Hemangioma Dermoid Cyst Thyroid Eye Disease Optic Nerve Sheath Meningioma Myositis Optic Nerve Glioma Adenoid Cystic Carcinoma Orbital Mucocele Key References References 12.4 Blepharoptosis Key Features Introduction Foundation: A Simplified Classification of Ptosis Anatomy and Function Classification Based on Levator Function Common Ptosis Acquired Involutional Ptosis Simple Congenital Ptosis Differential Diagnosis Common Ptosis Unusual Congenital Ptosis Marcus Gunn Jaw-Winking Syndrome Blepharophimosis Syndrome Unusual Acquired Ptosis Neurogenic Ptosis Myasthenia Gravis Third Cranial Nerve Palsy Horner’s Syndrome Myogenic Ptosis Chronic Progressive External Ophthalmoplegias Oculopharyngeal Dystrophy Myotonic Dystrophy Posttraumatic Ptosis Clinical Evaluation and Preoperative Considerations History and Examination Adults Children Formulating a Treatment Plan General Considerations Surgical Correction of Ptosis Anesthesia Levator Aponeurosis Advancement Frontalis Suspension Complications Undercorrection Overcorrection Changes in Astigmatism Outcome Key References References 12.5 Entropion Key Features Introduction Preoperative Evaluation and Diagnostic Approach The Capsulopalpebral Fascia The Tarsus and Canthal Ligament Enophthalmos Orbicularis Muscle The Posterior Lamella Other Factors Differential Diagnosis Epiblepharon Trichiasis Congenital Entropion Alternatives to Surgery Quickert–Rathbun Sutures Botulinum Toxin Anesthesia General Technique Specific Techniques Retractor Reattachment Lateral Tarsal Strip Procedure Transverse Tarsotomy Hard Palate Mucosal Graft Complications Overcorrection Hematoma Eyelid Retraction Exposure Keratopathy Ptosis Outcome Key References References 12.6 Ectropion Key Features Associated Features Introduction Preoperative Evaluation and Diagnostic Approach Eyelid Laxity Evaluation Medial Canthal Tendon Laxity Lateral Canthal Tendon Laxity Lacrimal Puncta Evaluation Anterior Lamellae Inspection Orbicularis Oculi Muscle Tone Eyelid Masses Lower Eyelid Retractor Dehiscence Differential Diagnosis Involutional Ectropion Cicatricial Ectropion Paralytic Ectropion Mechanical Ectropion Congenital Ectropion Alternatives to Surgery Anesthesia General Techniques Specific Techniques Involutional Ectropion Lateral Tarsal Strip Procedure Medial Spindle Procedure With Rotational Suture Lower Eyelid Retractor Advancement Full-Thickness Pentagonal Block Resection Cicatricial Ectropion Local Skin Flaps (Z-Plasty) Full-Thickness Skin Graft Paralytic Ectropion Medial Canthoplasty Lateral Tarsorrhaphy Complications Outcome Key References References 12.7 Benign Eyelid Lesions Key Features Associated Features Introduction Epithelial Tumors Squamous Papilloma Cutaneous Horn Seborrheic Keratosis Inverted Follicular Keratosis Keratoacanthoma Actinic Keratosis Epidermal Inclusion Cyst Pilar Cyst Epidermoid and Dermoid Cysts Adnexal Tumors Benign Lesions of Sebaceous Origin Milia Sebaceous Adenoma Benign Lesions of Eccrine Origin Eccrine Hidrocystoma Syringoma Chondroid Syringoma Benign Lesions of Apocrine Origin Apocrine Hidrocystoma Cylindroma Benign Lesions of Hair Follicle Origin Trichoepithelioma Trichofolliculoma Trichilemmoma Pilomatrixoma Vascular Tumors Capillary Hemangioma Lymphangioma Nevus Flammeus Pyogenic Granuloma Tumors of Neural Origin Neurofibroma Xanthomatous Lesions Xanthelasma Juvenile Xanthogranuloma Pigmented Lesions of Melanocytic Origin Freckles Lentigo Simplex Solar Lentigo Melanocytic Nevi Congenital Melanocytic Nevus Nevus of Ota Blue Nevus Inflammatory Lesions Chalazion Hordeolum Infectious Lesions Molluscum Contagiosum Verruca Vulgaris Conclusion Outcomes Key References References 12.8 Eyelid Malignancies Key Features Associated Features Introduction Basal Cell Carcinoma Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Differential Diagnosis Systemic Associations Pathology Treatment Surgery Radiation Therapy Cryotherapy Chemotherapy and Photodynamic Therapy Course and Outcome Squamous Cell Carcinoma Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Pathology Treatment Course and Outcome Sebaceous Gland Carcinoma Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Pathology Treatment Course and Outcome Malignant Melanoma Epidemiology and Pathogenesis Ocular Manifestations Diagnosis Systemic Associations Pathology Treatment Course and Outcome Key References References 12.9 Evaluation and Management of Periorbital Soft Tissue Trauma Key Features Introduction Preoperative Evaluation and Diagnostic Approach Systemic Stabilization Medical History Examination Ancillary Testing Documentation Infection Prophylaxis Timing of Repair Anesthesia Treatment General Concepts Common Patterns of Eyelid Injury Partial-Thickness Eyelid Injuries and Abrasions Deep Partial-Thickness and Full-Thickness Eyelid Lacerations Eyelid Margin Lacerations Eyelid Injuries With Tissue Loss Tissue Loss of 0% to 25% Tissue Loss of 25% to 60% Full-Thickness Eyelid Injuries With Greater Than 60% Tissue Loss Lower Eyelid Upper Eyelid Postoperative Care Late Repair of Eyelid Injuries Dog Bites Lacrimal Injury Eyelid Burns Conclusions Key References References 12.10 Orbital Diseases Key Features Introduction Clinical Evaluation Metastatic Tumors Introduction Metastatic Carcinoma Key Points Orbital Imaging Treatment and Prognosis Lacrimal Gland Lesions Introduction Pleomorphic Adenoma (Benign Mixed Cell Tumor) Key Points Orbital Imaging Pathology Treatment and Prognosis Adenoid Cystic Carcinoma Key Points Orbital Imaging Pathology Treatment and Prognosis Mesenchymal Tumors Introduction Fibrous Histiocytoma Key Points Orbital Imaging Pathology Treatment and Prognosis Rhabdomyosarcoma Key Points Orbital Imaging Pathology Staging Treatment and Prognosis Neurogenic Tumors Introduction Plexiform Neurofibroma Key Points Orbital Imaging Pathology Treatment and Prognosis Schwannoma (Neurilemmoma) Key Points Orbital Imaging Pathology Treatment and Prognosis Malignant Peripheral Nerve Sheath Tumor (Malignant Schwannoma) Key Points Orbital Imaging Pathology Treatment and Prognosis Neuroblastoma Key Points Orbital Imaging Pathology Treatment and Prognosis Optic Nerve Glioma (Pilocytic Astrocytoma of Childhood) Key Points Orbital Imaging Pathology Treatment and Prognosis Optic Nerve Sheath Meningioma Key Points Orbital Imaging Pathology Treatment and Prognosis Lymphoproliferative Diseases Introduction Benign Reactive Lymphoid Hyperplasia Key Points Orbital Imaging Pathology Treatment and Prognosis Atypical Lymphoid Hyperplasia Key Points Orbital Imaging and Echography Pathology Treatment and Prognosis Malignant Orbital Lymphoma (Lymphosarcoma) Key Points Orbital Imaging Pathology Treatment and Prognosis Histiocytic Tumors Introduction Eosinophilic Granuloma (Histiocytosis X) Key Points Orbital Imaging Pathology Treatment and Prognosis Inflammations and Infections Thyroid Eye Disease Cystic Lesions Introduction Dermoid Cyst Key Points Superficial Lesions Orbital Imaging Pathology Treatment and Prognosis Deep Lesions Orbital Imaging Pathology Treatment and Prognosis Mucocele Key Points Orbital Imaging Pathology Treatment and Prognosis Microphthalmos With Cyst Key Points Orbital Imaging Pathology Treatment and Prognosis Vascular Neoplastic and Structural Lesions Introduction Capillary Hemangioma (Hemangioendothelioma) Key Points Superficial Lesions Treatment and Prognosis Deep Lesions Orbital Imaging Pathology Treatment and Prognosis Cavernous Hemangioma Key Points Orbital Imaging Pathology Treatment and Prognosis Lymphangioma Key Points Superficial Lesions Deep Lesions Orbital Imaging Pathology Treatment and Prognosis Arteriovenous Fistula Key Points Low-Flow Type High-Flow Type Primary Shunts Secondary Shunts Orbital Imaging Treatment and Prognosis Varices Key Points Orbital Imaging Pathology Treatment and Prognosis Secondary Tumors Introduction Basal Cell Carcinoma Key Points Orbital Imaging Pathology Treatment and Prognosis Malignant Melanoma Key Points Orbital Imaging Pathology Treatment and Prognosis Key References References 12.11 Enucleation, Evisceration, and Exenteration Key Features Introduction Preoperative Evaluation and Diagnostic Approach Indications for Surgery Preoperative Counseling Anesthesia Specific Techniques Enucleation Enucleation With Simple Sphere Implant Enucleation With Porous Implant Evisceration Overview Surgical Technique Exenteration Overview Surgical Technique Postoperative Management Complications Evisceration Enucleation Exenteration Key References References 12.12 The Lacrimal Drainage System Key Features Associated Features Introduction Anatomy and Physiology Evaluation of Epiphora Clinical History Physical Examination Eyelids Lacrimal Passages Nose Clinical Diagnostic Tests Tear Tests Dye Tests Excretory Tests Lacrimal Syringing Jones Fluorescein Dye Test Endoscopy Diagnostic Imaging Nuclear Lacrimal Scan Dacryocystography Computed Tomography Obstructions of the Lacrimal Sac and Duct Congenital Obstruction Acquired Obstruction Nonspecific Acquired Obstruction Specific Acquired Obstruction Dacryocystitis Treatment of Lacrimal Sac and Duct Obstruction Congenital Nasolacrimal Obstruction Acquired Nasolacrimal Obstruction Dacryocystorhinostomy Endonasal Dacryocystorhinostomy Tumors of the Lacrimal Sac Diseases of the Canaliculi Punctal Stenosis Useful Lacrimal Tips Key References References 12.13 Thyroid Eye Disease Key Features Introduction Epidemiology, Risk Factors, and Associated Conditions Pathogenesis Clinical Presentation: Disease Severity and Activity Diagnosis Evaluation of Disease Severity and Activity Quality of Life Basic Management Medical Therapy Orbital Radiotherapy Surgical Therapy Management Plan Using the VISA Classification Key References References 12.14 Orbital Infection and Inflammation Key Features Introduction General Assessment Orbital Infection Orbital Cellulitis Bacterial Dacryoadenitis Orbital Tuberculosis Orbital Viral Infection Orbital Fungal Infection Rhino-Orbital-Cerebral Mucormycosis Orbital Aspergillus Infection Orbital Parasitical Infection Noninfectious Orbital Inflammation Granulomatous Orbital Inflammation Sarcoidosis Xanthogranulomatous Disease IgG4-Related Disease Orbital Vasculitic Disease Granulomatosis With Polyangiitis Sjögren’s Syndrome Idiopathic Orbital Inflammation Idiopathic Orbital Myositis Idiopathic Dacryoadenitis Tolosa–Hunt Syndrome (Orbital Apex IOI) Key References References 12.15 Cosmetic Blepharoplasty and Browplasty Key Features Introduction Anatomical Considerations Eyelids Upper Eyelid Lower Eyelid Brows Blepharoplasty Preoperative Evaluation and Diagnostic Approach History and Psychological Evaluation Physical Examination Anesthesia General Techniques Specific Techniques Upper Lid Blepharoplasty Lower Lid Blepharoplasty Skin Approach Transconjunctival Approach Other Surgical Techniques Postoperative Care Complications Orbital Hemorrhage and Blindness Infections Ptosis Lagophthalmos, Lower Lid Retraction, Ectropion, and Lateral Canthal Deformities Other Complications Outcome Brow Malposition Preoperative Evaluation and Diagnostic Approach Anesthesia General Techniques Specific Techniques The Bicoronal Forehead Lift The Midfrontal Brow Lift The Direct Brow Lift Endoscopic Brow Lift Transblepharoplasty Brow Fixation Complications Excessive Cutaneous Scar and Alopecia Paresthesia and Hematoma Overcorrection and Undercorrection Outcome Key References References 12.16 Aesthetic Fillers and Botulinum Toxin for Wrinkle Reduction Key Features Introduction Approach to Periorbital Rejuvenation Botulinum Toxin Fillers Anatomical Considerations The Brow and Temple Rhytides in the Upper Face Shaping the Brow Temple and Forehead Contouring The Eye Widening the Palpebral Aperture Lid Ptosis, Malposition, and Asymmetry Orbital Augmentation Infraorbital Hollow Adjunctive Therapies Precautions Chlorhexidine Vascular Compromise Conclusion Key References References
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