Clinical Ophthalmology: Medical and Surgical Approach Sandeep Saxena
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1Clinical Ophthalmology: MEDICAL AND SURGICAL APPROACH2
3Clinical Ophthalmology: MEDICAL AND SURGICAL APPROACH
Second Edition
Editor Sandeep Saxena MS MAMS Member, National Academy of Medical Sciences, India DAAD Visiting Professor, University of Bonn, Bonn, Germany Visiting Professor, UNC-Chapel Hill, Chapel Hill, USA Fellow, Barnes Retina Institute and Anheuser-Busch Eye Institute, St Louis, USA Fellow, New York-Presbyterian Hospital, New York, USA Professor, Department of Ophthalmology CSM Medical University (Erstwhile, King George's Medical University) Lucknow, Uttar Pradesh,India
4Published by
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Clinical Ophthalmology: Medical and Surgical Approach
© 2010, Sandeep Saxena
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 editor and the publisher.
This book has been published in good faith that the material provided by the contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and the editor will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only.
First Edition: 2003
Second Edition: 2011
9789350250044
Typeset at JPBMP typesetting unit
Printed at
5To
My parents Dr R C Saxena and Mrs Madhu Saxena
&
My family Sangeeta, Shreeya and Aishwarya
6
7Contributors 11Foreword
The pace of change in ophthalmology is rapid and requires us to constantly update our skills and knowledge. We are subspecialized to a degree that demands that we must stay in close communication with our colleagues to be able to follow the advances occurring in the separate subdivisions of our specialty. In this challenging intellectual environment, a text bringing together respected authors from multiple disciplines is particularly welcome, and Dr Saxena has accomplished this task with great success. Twenty-one chapters cover new concepts and technological advances in the diagnosis and management of common ophthalmic disorders. Several chapters deal with advances in lens surgery, and several authorities cover new concepts in retinal disease including macular and submacular surgery. Modern concepts in corneal disease, glaucoma, oculoplastics, ocular oncology, infectious and inflammatory diseases, strabismus, trauma, and optic nerve disorders are each presented by experts in ophthalmology. As ophthalmology has become more complex, we are driven to establish higher standards of scientific proof for our treatments and simultaneously to run our practices with greater efficiency to be able to bring the best of high technology to bear on our patients' problems while being mindful of cost. Thus, I was particularly pleased to see practice management and clinicial trials covered in this text. Dr Saxena is an extraordinarily gifted and energetic physician and academician who, along with his fellow authors, has produced a book, which is an important contribution to contemporary ophthalmic education. Readers will benefit greatly from this accomplishment.
Travis A Meredith md
Sterling A Barrett Distinguished Professor
Chairman, Department of Ophthalmology
University of North Carolina
Chapel Hill, USA
12
13Preface to the Second Edition
Ophthalmology is a continuously advancing field. As new technologies are being introduced at a rapid pace, the ophthalmologist must learn their intricacies as one begins to apply them to the treatment of ocular diseases. The adoption of new technology, in turn, brings with it the need to learn new skills and develop new treatment algorithms. Old concepts change and new ideas are plentiful. Everything is difficult before it becomes easy.
Clinical Ophthalmology: Medical and Surgical Approach is being launched as the second edition of Clinical Practice in Ophthalmology. This text attempts to update the state-of-the-art ophthalmology in a lucid, authoritative and well-illustrated manner. Ten sections encompassing forty-four chapters provide a new insight into the subject.
In this challenging intellectual environment Clinical Ophthalmology: Medical and Surgical Approach brings together a distinguished group of seventy-one experts and provides a comprehensive text combined with integrated visual reference, in the form of black and white and colored figures. The value of this book lays in the quality and expertise of the text chapter contributors. This book is intended for the experienced ophthalmologists, postgraduates as well as those in training. It is hoped that this book will be sufficiently comprehensive to aid the ophthalmologist in making diagnosis of common ophthalmic conditions as well as in performing competent surgeries. This pragmatic book provides an understanding of ophthalmology, important to the everyday practice. I hope this book will find a meaningful and valued place in the libraries of ophthalmologists, today and in future.
Sandeep Saxena
14
15Preface to the First Edition
With the evolution of new diagnostic and therapeutic modalities, the ophthalmologist has become more involved in decision-making for patients. The challenge facing the ophthalmologist lies in maintaining an up-to-date practical knowledge. This thirst for knowledge is typical of those who are fascinated by the subject, but is also true of those who develop a great understanding of the subject.
Clinical Practice in Ophthalmology, a multi-authored text, was conceptualized in New York, USA. The publisher and the contributing authors were contacted on Internet to lay the groundwork. This book summarizes the present knowledge of clinical ophthalmology and practice management. The value of this book lies in the quality and expertise of the authors of the selected subjects. The authors have presented the material to provide the reader with a quick, but comprehensive review of the major ophthalmological issues. This pragmatic book provides an understanding of diseases so important to the everyday practice of ophthalmology. I hope this book will find a meaningful and valued place in the libraries of ophthalmologists, today and in future.
This book would not have been possible without the guidance of my mentors, cooperation of my family and help of Dr SK Bhasker.
Sandeep Saxena