Neuro-ophthalmology Ashok Garg, Emanuel Rosen, Arturo Perez Arteaga, Jawahar Lal Goyal
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1INSTANT CLINICAL DIAGNOSIS IN OPHTHALMOLOGY: NEURO-OPHTHALMOLOGY
2INSTANT CLINICAL DIAGNOSIS IN OPHTHALMOLOGY: NEURO-OPHTHALMOLOGY
Series Editors Ashok Garg MS PhD FIAO (Bel) FRSM FAIMS ADM FICA International and National Gold Medalist Chairman and Medical Director Garg Eye Institute and Research Centre 235-Model Town, Dabra Chowk Hisar-125 005, India Emanuel Rosen MD Medical Director Rosen Eye Associates Harbour City, Salford Quays M50 3 BH United Kingdom Editors Arturo Perez Arteaga MD Medical Director Centro Oftalmologico Tlalnepantla Dr Perez-Arteaga Vallarta No. 42 Tlalnepantla, Centro Estado de Mexico 54000, Mexico Jawahar Lal Goyal MD DNB Professor of Ophthalmology Guru Nanak Eye Centre Maulana Azad Medical College (MAMC) New Delhi 110 002 India Foreword Marcel PM Ten Tusscher
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Instant Clinical Diagnosis in Ophthalmology—Neuro-ophthalmology
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2009
9788184486636
Typeset at JPBMP typesetting unit
Printed at Ajanta Press
4To
—Ashok Garg
—Emanuel Rosen
—Arturo Perez Arteaga
—Jawahar Lal Goyal
5Contributors 8Foreword
About half of the afferent fibers carrying information about the external world enter the human brain via the visual system. This shows the remarkable importance of the perception of sight. We all know the comparison between the eye and a camera, suggesting that the eye feeds the brain with detailed pictures of the external world. Immanuel Kant, however, already knew that we cannot know for certain what actually is out there. Our senses react to stimuli that come from the outside world, but we only have knowledge of how they appear to us after processing by our senses and brain.
Kant distinguishes between the world of noumena, which is the world of things—as they are, and the world of phenomena, which is the world of things—as it appears to us. What the eye forwards to the brain, indeed are mere aspects and hints of impressions that make our vivid visual experience all the more amazing. The brain interprets many rough parallel representations of the world in such a way that it apparently can provide us with the information we seem to need. The visual system is one of the best studied areas of the human brain and every year thousands of newspapers concerning the visual system and Neuro-ophthalmology are published. Besides the progress in knowledge of sensory information processing, the increasing knowledge of the control of eye movements also contributes to the understanding of how the brain works. This progress in Neuroscience has been matched by a comparable increase in research and understanding of pathological conditions. Furthermore, understanding the systems itself and its diseases, Neuro-ophthalmological disorders often are an important clue to the localization of a disease process. Therefore, Neuro-ophthalmology covers an enormously broad range of physiology and pathology of the brain and the eye.
The present book on Neuro-ophthalmology contains 5 sections which subsequently deal with anatomy and physiology, clinical investigations, pathology of the sensory visual pathways, eye movement disorders, non-organic diseases and the autonomic nervous system. All these aspects are covered by several experts in the field of Neuro-ophthalmology. Dr Ashok Garg from India has teamed up with several experts from all over the world to realize this ambitious project.9
The resulting book edited by Dr Ashok Garg, Dr Emanuel Rosen, Dr Arturo Perez Arteaga and Dr Jawahar Lal Goyal will help the clinicians diagnose many often challenging and hard to diagnose disorders.
I am sure it will be of interest to ophthalmologists, neurologists and residents in training and I do hope that more and more clinicians are stimulated to be interested in Neuro-ophthalmology and that this book will trigger their curiosity in the subject.
Marcel PM Ten Tusscher md phd
Consultant, Laurentius Hospital Roermond
The Netherlands Consultant in Neuro Ophthalmology
University Hospital Antwerp, Belgium
Professor in Neuro Ophthalmology
University Hospital Antwerp
Wilrijkstraat 10
2650 Edegem, Belgium
Tel. +31-475382606
Fax +31-475382659
10Preface
In modern day, busy and fast life ophthalmologists are glued to their clinical and surgical practice and have little time to read large volume books. The need of the hour is to have pocket size ready reckoner enriched with complete and uptodate information of the diseases in a most comprehensive manner. At present, very few quality Ready Reference books are available at an International level.
After detailed research and according to the need of ophthalmologists, we have developed a series of 10 Volume Ready Reference Books termed as Instant Clinical Diagnosis in Ophthalmology. This series covers Oculoplastic and Reconstructive Surgery, Retina, Lens, Glaucoma, Refractive Surgery, Pediatric Ophthalmology, Strabismus, Anterior Segment Diseases, Cornea and Neuro-ophthalmology. This present series has been designed to provide uptodate information of concerned disease in a comprehensive and lucid manner along with high quality clinical photographs in an easy-to-read format. International Masters of concerned subject have contributed chapters in this series covering pathophysiology, clinical signs and symptoms, investigations, differential diagnosis, treatment and prognosis in a simiplified manner.
The present volume provides complete insight into clinical neuro-ophthal-mology, the knowledge of which is essential for every ophthalmologist in their day-to-day practice. This book gives complete information about diagnosis and management of neuro-ophthalmological conditions in a comprehensive manner and covers anatomical, physiological and neurological aspects of various clinical neuro-ophthalmological diseases. It shall serve as ready reference for ophthalmologists worldwide.
We are highly thankful to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, especially Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing) and all staff members for their dedication and hard efforts put in the preparation of high quality series of Instant Clinical Books.
We hope this 10 volume set of ready reference pocket size books shall provide complete and useful clinical information to ophthalmologists all around the world and shall help them to accurately and precisely diagnose, treat and manage their clinical cases confidently to the satisfaction and expectations of their valued patients. We also hope this Ready Reckoner shall serve as useful companion on every clinician's desk.
Editors