
Contents
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Examining eyes 1
Examining eyes 1
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History History
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Symptoms: Symptoms:
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Divide the eye into a car to examine it Divide the eye into a car to examine it
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Windscreen components Windscreen components
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Front seat components Front seat components
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Anterior chamber: Anterior chamber:
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Lens: Lens:
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Backseat components Backseat components
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Boot components Boot components
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Retina, vitreous, and choroid: Retina, vitreous, and choroid:
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Further reading Further reading
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Examining eyes 2 Examining eyes 2
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Acuity Acuity
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Visual field Visual field
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Extraocular movements Extraocular movements
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Ophthalmoscopy Ophthalmoscopy
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Slit lamp examination Slit lamp examination
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Some key things to remember
Some key things to remember
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The external eye The external eye
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Styes Styes
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Blepharitis Blepharitis
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Treatment: Treatment:
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Pinguecula Pinguecula
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Typical patient: Typical patient:
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Associations: Associations:
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Entropion Entropion
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Ectropion Ectropion
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Associations: Associations:
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Upper lid malposition Upper lid malposition
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Lagophthalmos Lagophthalmos
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Xanthelasma Xanthelasma
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Blepharospasm Blepharospasm
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Presentation Presentation
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Causes: Causes:
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Treatment Treatment
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Drugs—Botulinum neurotoxin: Drugs—Botulinum neurotoxin:
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Other options: Other options:
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Supportive treatment: Supportive treatment:
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Further reading Further reading
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Tears and lacrimation Tears and lacrimation
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Components of tears Components of tears
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Dry eyes (keratoconjunctivitis sicca) Dry eyes (keratoconjunctivitis sicca)
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Further reading Further reading
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Ophthalmic shingles
Ophthalmic shingles
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Shingles Shingles
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Risk factors: Risk factors:
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Presentation: Presentation:
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Predictors of ocular involvement: Predictors of ocular involvement:
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Assesment: Assesment:
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Ramsay Hunt syndrome Ramsay Hunt syndrome
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Carotico-cavernous fistula Carotico-cavernous fistula
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Causes: Causes:
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Further reading Further reading
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Orbital swellings Orbital swellings
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Orbital cellulitis Orbital cellulitis
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Typical patient: Typical patient:
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Associated complications: Associated complications:
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℞: ℞:
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Preseptal (periorbital) cellulitis Preseptal (periorbital) cellulitis
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℞: ℞:
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Eye movements and squint Eye movements and squint
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Convergent squint (esotropia) Convergent squint (esotropia)
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Divergent squint (exotropia) Divergent squint (exotropia)
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Non-paralytic squints Non-paralytic squints
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Diagnosis Diagnosis
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Management Management
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Optical: Optical:
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Orthoptic: Orthoptic:
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Paralytic squint Paralytic squint
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Third nerve palsy (oculomotor) Third nerve palsy (oculomotor)
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Causes: Causes:
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Fourth nerve palsy (trochlear) Fourth nerve palsy (trochlear)
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Causes: Causes:
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Sixth nerve palsy (abducens) Sixth nerve palsy (abducens)
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Causes: Causes:
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Medial rectus: Medial rectus:
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Lateral rectus: Lateral rectus:
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Best results are achieved in childhood strabismus by: Best results are achieved in childhood strabismus by:
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Further reading Further reading
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Pupils Pupils
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Pupil reflexes Pupil reflexes
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Afferent defects Afferent defects
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Causes: Causes:
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Swinging flashlight test: Swinging flashlight test:
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Efferent defects Efferent defects
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Causes: Causes:
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Other causes of a fixed dilated pupil Other causes of a fixed dilated pupil
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Tonic (Adie) pupil Tonic (Adie) pupil
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Typical patient: Typical patient:
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Holmes–Adie syndrome: Holmes–Adie syndrome:
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Horner’s syndrome Horner’s syndrome
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Argyll Robertson pupil Argyll Robertson pupil
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Irises Irises
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Further reading Further reading
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Refraction Refraction
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Myopia (short sight) Myopia (short sight)
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Causes: Causes:
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Pathological myopia: Pathological myopia:
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Management: Management:
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Astigmatism Astigmatism
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Hypermetropia (long sight) Hypermetropia (long sight)
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Presbyopia Presbyopia
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Further reading Further reading
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Visual field defects
Visual field defects
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Optic nerve Optic nerve
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Optic chiasma Optic chiasma
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Optic tracts Optic tracts
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Optic radiation Optic radiation
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Visual cortex Visual cortex
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Tests Tests
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Finger confrontation: Finger confrontation:
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Hat-pin confrontation: Hat-pin confrontation:
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Diagnosing the lesion’s site Diagnosing the lesion’s site
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Causes of visual cortex field defects: Causes of visual cortex field defects:
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The red eye
The red eye
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Subconjunctival haemorrhage Subconjunctival haemorrhage
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Inflammation of the sclera Inflammation of the sclera
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Clinical distinction between scleritis and episcleritis.
Clinical distinction between scleritis and episcleritis.
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Episcleritis Episcleritis
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℞: ℞:
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Scleritis Scleritis
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℞: ℞:
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Further reading Further reading
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The red eye: immediate referral
The red eye: immediate referral
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Uveitis Uveitis
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Anterior uveitis Anterior uveitis
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℞: ℞:
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Acute closed-angle glaucoma Acute closed-angle glaucoma
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Presentation: Presentation:
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℞: ℞:
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Further reading Further reading
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More red eyes: cornea and conjunctiva
More red eyes: cornea and conjunctiva
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Conjunctivitis Conjunctivitis
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Non-infectious causes: Non-infectious causes:
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Infectious causes: Infectious causes:
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Investigations: Investigations:
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Treatment: Treatment:
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Keratitis Keratitis
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Corneal abrasion Corneal abrasion
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Corneal ulcers Corneal ulcers
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℞: ℞:
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Management of corneal ulcers: Management of corneal ulcers:
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Further reading Further reading
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Sudden painless loss of vision 1
Sudden painless loss of vision 1
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Optic neuropathies Optic neuropathies
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Anterior ischaemic optic neuropathy (AION) Anterior ischaemic optic neuropathy (AION)
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Giant cell (temporal) arteritis (GCA) Giant cell (temporal) arteritis (GCA)
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Non-arteritic AION Non-arteritic AION
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Optic neuritis Optic neuritis
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Subacute loss of vision (fig 5.31): Subacute loss of vision (fig 5.31):
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℞: ℞:
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Further reading Further reading
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Sudden painless loss of vision 2
Sudden painless loss of vision 2
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Retinal vein occlusion (RVO) Retinal vein occlusion (RVO)
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Causes/associations: Causes/associations:
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Central retinal vein occlusion (CRVO) Central retinal vein occlusion (CRVO)
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Branch retinal vein occlusion Branch retinal vein occlusion
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Management: Management:
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Vitreous haemorrhage (VH) Vitreous haemorrhage (VH)
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Check: Check:
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Other causes of sudden loss of monocular vision: Other causes of sudden loss of monocular vision:
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Further reading Further reading
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Gradual loss of vision
Gradual loss of vision
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Age-related macular degeneration (ARMD) Age-related macular degeneration (ARMD)
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Pathogenesis: Pathogenesis:
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Symptoms: Symptoms:
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Optic atrophy Optic atrophy
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Other causes: Other causes:
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Choroiditis (choroidoretinitis) Choroiditis (choroidoretinitis)
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In young teenagers, In young teenagers,
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Further reading Further reading
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Blindness and partial sight
Blindness and partial sight
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Registration Registration
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Criteria for partial sighted registration: Criteria for partial sighted registration:
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Severe visual impairment (blind) registration: Severe visual impairment (blind) registration:
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Special educational facilities Special educational facilities
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Living with blindness and partial sight Living with blindness and partial sight
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Further reading Further reading
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Chronic simple (open-angle) glaucoma
Chronic simple (open-angle) glaucoma
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Diagnosis Diagnosis
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Screen if at high risk Screen if at high risk
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Follow-up: Follow-up:
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Drug treatment Drug treatment
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Surgery: Surgery:
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Optic disc cupping Optic disc cupping
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Pathogenesis Pathogenesis
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Further reading Further reading
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Cataract
Cataract
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Risk factors Risk factors
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Ophthalmoscopic classification Ophthalmoscopic classification
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Presentation Presentation
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Surgery Surgery
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Post-op complications: Post-op complications:
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Prevention/photoprotection
Prevention/photoprotection
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Further reading Further reading
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The retina
The retina
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Optic disc. Optic disc.
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Retinal detachment (RD, fig 5.38) Retinal detachment (RD, fig 5.38)
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Types: Types:
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Differential diagnosis: Differential diagnosis:
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Mangement: Mangement:
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Retinitis pigmentosa Retinitis pigmentosa
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Common symptoms associated with the retina Common symptoms associated with the retina
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Floaters Floaters
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Common causes: Common causes:
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Management: Management:
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Flashing lights (photopsia) Flashing lights (photopsia)
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Posterior vitreous detachment (PVD) Posterior vitreous detachment (PVD)
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Further reading Further reading
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The macula The macula
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A macular hole A macular hole
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Prevalance: Prevalance:
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Pathogenesis: Pathogenesis:
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Presentation: Presentation:
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Tests Tests
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Treatment Treatment
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Surgery: Surgery:
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Dispelling the myths Dispelling the myths
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Further reading Further reading
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The eye in systemic disease
The eye in systemic disease
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Vascular retinopathy Vascular retinopathy
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Metabolic disease Metabolic disease
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Granulomatous disorders Granulomatous disorders
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Collagen and vasculitic diseases Collagen and vasculitic diseases
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Keratoconjunctivitis sicca/Sjögren’s syndrome Keratoconjunctivitis sicca/Sjögren’s syndrome
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HIV/AIDS HIV/AIDS
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Other causes of retinopathy (haemorrhages, microaneurysms, hard exudates) Other causes of retinopathy (haemorrhages, microaneurysms, hard exudates)
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Further reading Further reading
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The eye in diabetes mellitus (DM)
The eye in diabetes mellitus (DM)
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Structural changes Structural changes
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Pathogenesis Pathogenesis
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Classification Classification
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Proliferative diabetic retinopathy (PDR): Proliferative diabetic retinopathy (PDR):
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Maculopathy: Maculopathy:
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Presymptomatic screening
Presymptomatic screening
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Management Management
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CNS effects CNS effects
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Further reading Further reading
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Swelling of the optic disc
Swelling of the optic disc
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The optic disc The optic disc
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Papilloedema Papilloedema
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Investigations: Investigations:
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Pseudopapilloedema Pseudopapilloedema
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Diabetic papillopathy Diabetic papillopathy
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Optic nerve head drusen Optic nerve head drusen
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NB: NB:
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Is the optic disc swollen? Is the optic disc swollen?
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Further reading Further reading
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Drugs and the eye Drugs and the eye
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Common topical eye drops used in ophthalmology Common topical eye drops used in ophthalmology
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Antibiotics: Antibiotics:
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Mydriatics: Mydriatics:
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Miotics: Miotics:
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Local anaesthetics: Local anaesthetics:
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Steroids and NSAID drops: Steroids and NSAID drops:
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Systemic drugs that cause ophthalmological issues Systemic drugs that cause ophthalmological issues
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Dry eyes: Dry eyes:
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Corneal deposits: Corneal deposits:
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Lens opacities: Lens opacities:
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Glaucoma: Glaucoma:
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Pailloedema: Pailloedema:
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Retinopathy: Retinopathy:
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Tropical eye disease Tropical eye disease
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Xerophthalmia Xerophthalmia
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keratomalacia keratomalacia
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Trachoma Trachoma
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Management: Management:
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Onchocerciasis (river blindness) Onchocerciasis (river blindness)
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℞: ℞:
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Further reading Further reading
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Allergic eye disease Allergic eye disease
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Seasonal allergic conjunctivitis (SAC) Seasonal allergic conjunctivitis (SAC)
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℞: ℞:
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Perennial allergic conjunctivitis (PAC) Perennial allergic conjunctivitis (PAC)
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Management: Management:
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Vernal keratoconjuctivitis (VKC) Vernal keratoconjuctivitis (VKC)
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℞: ℞:
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Atopic keratoconjunctivitis (AKC) Atopic keratoconjunctivitis (AKC)
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Giant papillary conjunctivitis Giant papillary conjunctivitis
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Management: Management:
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Differential diagnoses Differential diagnoses
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Contact lenses Contact lenses
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Functions of a contact lens Functions of a contact lens
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Indications Indications
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Types of lens Types of lens
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Complications Complications
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CLARE: CLARE:
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Sensitivities: Sensitivities:
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Infection: Infection:
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Further reading Further reading
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Refractive procedures Refractive procedures
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Photorefractive keratotomy (PRK) Photorefractive keratotomy (PRK)
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LASIK (laser-assisted in situ keratomileusis) LASIK (laser-assisted in situ keratomileusis)
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LASEK (laser epithelial keratomileusis) LASEK (laser epithelial keratomileusis)
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Lens surgery Lens surgery
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Other procedures Other procedures
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Further reading Further reading
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Looking into the future Looking into the future
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Google smart lens Google smart lens
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The bionic eye The bionic eye
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Cite
Abstract
This chapter explores ophthalmology, including examining eyes, aids to ophthalmoscopy, testing visual acuity, the external eye, tears and lacrimation, orbital swellings and zoster, retinoblastoma, eye movements and squint, pupils and irises, refraction; myopia; astigmatism, visual field defects, the red eye, management of corneal ulcers, sudden painless loss of vision, gradual loss of vision, chronic simple glaucoma, cataract, the retina, the eye in diabetes mellitus, the eye in systemic disease, tropical eye disease, eye trauma, blindness and partial sight, drugs and the eye, contact lenses, blepharospasm, allergic eye disease, floaters, flashes, and haloes, and refractive procedures.
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