Ординатура / Офтальмология / Английские материалы / Fundamentals of Clinical Ophthalmology Cornea_Coster_2002

Abiotrophia species 61 abnormalities of cornea acquired 93–101 congenital 19–20, 21 developmental 19

abrasions, corneal 79, 109–10 treatment 170

acanthamoeba keratitis 62–4, 76–7 treatment 168

acetate esters 141 acetates 145

acetyl cysteine 115, 142, 145 acid burns 114 acycloguanosine 106, 137

adenoviral keratoconjunctivitis 70 treatment 168

age-related peripheral corneal atrophy 100 alkali burns 113–14, 114

allergic conjunctivitis 39–40, 40, 78–9 treatment 169

allograft rejection 70, 128–9, 130, 134 prevention 143

amethocaine 145 aminoglycosides 59, 142 amiodarone, drug deposition 72 amniotic membrane 115

amniotic membrane transplantation, procedure summary* 148

amoebic keratitis, treatment 142 amoeboid ulcers 104 amourosis 94, 94

amphotericin 145

anaemia, aplastic anaemia 141 anaesthetics 138, 145 anatomy, adult cornea 20–1 angle closure glaucoma 37

angle damage/recession 109, 111 aniline, amides and derivatives 139 anisometropia 136

anterior blepharitis 13, 14

anterior chamber cleavage syndrome 20 anterior membrane dystrophy 120–1, 120 anti-amoebic agents 142

antibacterial agents 141–2, 145 antifungal agents 62, 142, 145 antigens 128–9

anti-inflammatory agents 140–1, 143, 145 antimicrobial prophylaxis, incisional wounds 113 antimitotic agents 145

antiprotozoal agents 145

aplastic anaemia 141 arcus senilis 30 Arlts line 13 astigmatism

after corneal transplantation 97, 98, 134–5, 136 after corneal wound 118

incisional wounds causing 112 irregular 14, 118, 136

in Terrien’s dystrophy 99–100 treatment 118

atopy 93–4, 94, 97 atrophy 30

essential (progressive) iris atrophy 125 atropine 115, 140, 145

Avellino dystrophy 122 Axenfeld’s anomaly 20

Axenfeld–Reiger’s anomaly 126, 127 azathioprine 143, 143–4

blockers 115

bacterial infections, effect of topical steroids 146 bacterial keratitis, treatment 58, 59, 169

band keratopathy 29, 33, 38

calcified, removal of, procedure summary* 164 Behçet’s disease 40

benoxinate 139

benzoic acid amides/esters 139 benzylkonium chloride 137, 145 betamethasone 141, 145

biopsy, conjunctival, procedure summary* 150 biopsy, corneal 58–9

procedure summary* 153 blepharitis 13, 14, 52, 71 blepharoconjunctivitis 102–3

treatment 177 blepharokeratoconjunctivitis 70 blunt trauma 109–11 botulinum 51

botulinum toxin-A induced ptosis, procedure summary* 149

Bowen’s disease 90

Bowman’s membrane 21, 22, 22, 94, 104 calcification see band keratopathy

Brolene 64, 142

bullous keratopathy 117, 129, 130 bupivacaine 139

burns see chemical injuries

calcification see band keratopathy calcium see band keratopathy

canaliculitis, herpetic 105–6 carbonic anhydrase inhibitors 115 carcinoma

carcinoma in situ 31, 32, 90 epithelial 31, 32

see also intraepithelial carcinoma; squamous carcinoma

cataracts

in Fuchs’ dystrophy 122, 123, 124

removal at time of corneal transplantation 132 cephalosporins 59, 142

cephalothin 59, 59, 142, 145 Chandler’s syndrome 125 chemical injuries 113–15

acid burns 114

alkali burns 113–14, 114 causing ulceration 42

lavage, procedure summary* 160 from oxidising agents 114–15 rehabilitation after 115 transplant failure rate 115 treatment 115, 169

chlamydial infection 40

chlamydial keratoconjunctivitis 70, 71 chloramphenicol 110, 112, 141, 145 chlorococaine 139

chloroquine derivatives, drug deposition 72 ciliary flush 38

ciprofloxacin 59, 59, 145 climate, affecting ocular surface 2 climatic droplet keratopathy 2 cocaine 139

Cogan–Reece syndrome 125 Cogan’s syndrome 87 collagen 22–3, 23

congenital abnormalities of cornea 19–20, 21 conjunctival biopsy, procedure summary* 150 conjunctival flaps 51–2 see also Gunderson’s

conjunctival flap; pedicled conjunctival flap conjunctival graft see pterygium excision and

conjunctival graft

conjunctival intraepithelial neoplasia see intraepithelial neoplasia

conjunctival reactions to corneal disorders 11–13 conjunctival subepithelial fibrosis 13

follicular 11–12 infiltrative 12–13 papillary 12

conjunctival subepithelial fibrosis 13 conjunctivitis 39–40

allergic 39–40, 40, 78–9, 169

in contact lenses wearers 35, 40, 79 follicular 12, 71, 102, 103 papillary 75, 78, 79, 175

vernal 44

see also keratoconjunctivitis contact lenses

contaminated storage conditions 75 failure 95, 96–7

INDEX

fitting 96–7, 99, 100 as foreign bodies 74–5 hard 17

sensitivity reaction to 75 contact lens wear

acanthamoeba keratitis 76 affecting conjunctiva 74–5 complications 74–82

diagnosis 75–6, 76 infections 74 inflammatory 74, 75, 76–9

non-inflammatory 75–6, 79–82, 81 and conjunctivitis 35, 40

hypoxia 28

ocular inflammation 35

ocular surface ecosystem and 74–5 and tear flow 75

contrast sensitivity 6–7

contusion, corneal, without abrasion 110–11 copper deposits 29, 33

corneal hydrops 94–5

corneal intraepithelial neoplasia (CIN) see intraepithelial neoplasia

corneal plana 21

corneal privilege 27, 128, 128–9 corneal transplantation 128–36

allograft rejection 128–9, 130, 134 prevention 143

astigmatism after 97, 98, 134–5, 136 biology 128–9

cataract removal 132 complications 132–5, 156

damage to underlying structures 132 dystrophies 124

graft failure 130–1, 130, 134 haemorrhage 132

history 128

indications 129, 129, 156

in infants, procedure summary* 157 infection after 135

for keratoconus 97, 97–8

with lens extraction and intraocular lens insertion, procedure summary* 158

postoperative care 135–6, 156 preoperative assessment 129–31 procedure summary* 156 risk-benefit analysis 130–1 shortage of donor corneas 128 surgical principles/aims 131

surgical technique/variations 131–2, 133–4 suture complications 132

see also penetrating corneal transplantation corneoscleral support ring 132, 134 corticosteroids

as anti-inflammatory agents 140–1 in corneal allograft rejection 134 and infection 140, 146

inhibition of leucocyte migration 140 introduction of 140

INDEX

corticosteroids continued

and raised intraocular pressure 140–1, 146 side-effects 146

toxicity 141

in treatment of herpetic keratitis 106 in treatment of microbial keratitis 60 cryotherapy, in squamous carcinoma 91 curvature of cornea, measurement 15, 95

cyclopentolate 140, 145 cycloplegics 139–40, 145 cyclosporin 54, 129, 143, 143–4 L-cysteine 115

cytotoxicity 104

dacroadenitis 85

degenerative disorders of the cornea 32–3 dellen formation 117

dendritic cells 22 dendritic keratitis 61, 103

effect of topical steroids 146 swab debridement in 106

dendritic keratopathy 65–7 causes 66

treatment 106 dendritic ulceration

herpetic 36, 48–9, 65, 103 treatment 172

non-herpetic 49–50

denervation, causing corneal ulceration 37, 42 deposits, corneal 29–30 see also band keratopathy dermoids 88–9

treatment 175

Descemet’s membrane 9, 21, 23, 23 detachment 117

rupture in keratoconus 28, 94 development of the cornea

congenital abnormalities 19–20, 21 developmental abnormalities 19 embryology 19

homeobox gene PAX6 19 normal cornea at birth 19 dexamethasone 141, 145, 145

diagnosis of corneal disorders 3–6 examination 3, 4, 7–8, 14–18 history taking 4

hypothesis generating and testing 4–5, 5 knowledge required 6

pattern recognition 5–6 steps in diagnostic process 4 see also individual disorders

differentiation promoters 145 disciform keratitis 28, 39, 84

stromal 105 diseases of the cornea

causing blindness 1 clinical features 6–18

eyelid conditions associated with 13–14 major patterns 34

symptoms and signs 6–11, 18

systemic immunosuppression 143, 143–4 see also diagnosis; and individual disorders

documentation of corneal signs 18 Down’s syndrome 94, 94

drugs and drug therapy 137–46

absorption across the cornea 137, 138, 145 cross-reactions 137

diagnostic preparations 138–40 eye drops v ointment 137–8

inflammatory disorders of cornea 144–6 routes of administration 137

systemic anti-inflammatory therapy 143 therapeutic agents 140–2

see also treatment; and individual drugs and drug types

dyes 138–9, 145 dysplasia

corneal lines 68 epithelial 30, 31, 32

dystichiasis 13

dystrophies, corneal 119–27 causing ulceration 42 classification 119, 120 diagnosis 119 endothelial 120, 122–4 features 120

histological examination 119 posterior 120

stromal 120, 121–2 superficial 120, 120–1 symptoms 119 treatment 124–5

see also specific dystrophies

ectasia, corneal 14, 30, 93–101 Ehlers–Danlos syndrome 94, 94 embryology 19

embryotoxon, posterior 20 endophthalmitis 142

endothelial dystrophies 120, 122–4 endothelial keratitis 39

endothelial polymegathism 80–1, 81 endothelium 21, 23–4

cell loss 24, 28, 113, 117 posttraumatic decompensation 113 repair 24, 26, 28, 113, 129

epikeratoplasty 97 episcleritis 39

treatment 170 epithelial closure 51

epithelial downgrowth, postsurgical 118 epithelial keratitis 39

epithelial sliding 44 epitheliopathy 79

acute 77, 79

causing corneal ulceration 42 toxic 77, 79, 116

epithelium, corneal 21, 22, 41 carcinoma 31, 32

chronic defects 50–2 delayed healing 51

differentiation of cells 31–2, 32 disorders of 30–2

healing defects 49, 65–6 loss 8–9, 24, 42, 116 microcysts 80, 81 oedema 81

protective function 24, 41, 65 repair 26–7

Epstein–Barr virus interstitial keratitis 85 erosion

acute recurrent, treatment 168 persistent and recurrent, treatment 176 punctate epithelial 69–70

recurrent erosion dystrophy 120, 120, 125

recurrent erosion syndrome 48 essential (progressive) iris atrophy 125 etidocaine 139

examination of cornea 3, 4, 7–8, 14–18

excimer laser phototherapeutic keratoplasty (PTK) 124–5

eye drops 137–8

eyelid conditions associated with corneal disease 13–14

eye wall inflammation 38

Fabry’s disease 72 Fas ligand 128

filamentary keratitis 116, 142 treatment 170

filaments, corneal 67 Fleischer lines 69, 94 floppy eyelid syndrome 94 flucytosine 62

fluorescein 8, 49–50, 65, 138–9, 145 fluoromethalone 141, 145 fluroquinolones 59, 142

follicles 11–12

follicular conjunctivitis 12, 71, 102, 103 foreign bodies, corneal 111–12

treatment 170

Fuchs’ dystrophy 119, 120, 122–4 cataracts in 122, 123, 124

confused with ICE syndrome 126, 127 corneal transplantation 124, 129

graft failure 124 treatment 123–4 wound healing 124

functions of the cornea see optical functions; protective functions

fungal infections, effect of topical steroids 146

fungal keratitis 61–2 antifungal agents 62

filamentous organism, treatment 171 yeast, treatment 171

Fusarium solani 61

INDEX

gentamicin 59, 59, 142, 145

geographic ulceration, herpetic 36, 49, 50, 103–4 treatment 106, 172

glandular fever 85 glaucoma

angle closure glaucoma 37 posttraumatic 111 secondary 26

glycosaminoglycans 22–3, 31 Gram stain 56, 57–8

procedure summary* 159

granular dystrophy 120, 121–2, 123, 124 granuloma, conjunctival/limbal 92

treatment 171

Gunderson’s conjunctival flap, procedure summary*

151 guttatae 122

haemorrhage 111, 132

herpes simplex virus infection 37, 38, 50 causing ulceration 42, 48–9, 53 dendritic keratitis due to 66

effect of topical steroids 146 primary ocular 102–3, 177

superficial punctate keratopathy in 70, 71 herpes simplex virus keratitis 102–7

pathways to visual loss 102 stromal 83–5

herpes zoster ophthalmicus 36, 39, 44, 50, 65 herpetic canaliculitis 105–6

herpetic dendritic ulceration, treatment 172 herpetic geographic ulceration, treatment 172 herpetic keratitis, treatment 106

herpetic stromal keratitis 104–5 treatment 172

herpetic uveitis 105 treatment 173

histocompatibility antigens 128–9 histology, adult cornea 21–4 homatropine 140, 145

homeobox gene PAX6, in eye development 19 Hudson–Stahle lines 69, 94

hydrocortisone 141, 144–5, 145 hypercalcaemia 33 hyperlipidaemia 29 hyperplasia, epithelial 30, 30 hypertrophy 30

hyphaema 109, 111 hypopyon 25, 85 hypoxia 28

idoxuridine 106, 137 IgA disease, linear 40 imidazoles 142

immune system, corneal privilege 27, 128, 128–9 immunosuppression 131, 143, 143–4

incisional wounds 112–13 infection

as ophthalmic emergency 26, 46

INDEX

infection continued

resulting from contact lens wear 74

and use of topical corticosteroids 140, 146

see also herpes simplex virus infection; and under ulceration, corneal

infectious crystalline keratopathy 60–1, 135 treatment 173

infectious mononucleosis syndrome (glandular fever) 85

inflammation

as complication of contact lens wear 74, 75, 76–9 of eye wall 38

intraocular 37–8 limbal 44

stromal 42, 46, 51

systemic inflammatory diseases 38, 40

see also inflammation, corneal; inflammation, ocular

inflammation, corneal acute 10, 25 chronic 10, 26

corneal inflammatory score 144, 144 corticosteroid effect on 140 inflammatory rebound 146 management 144–6

medication dose schedules 145–6 systemic anti-inflammatory therapy 143

topical medication, anti-inflammatory potency 144–5

inflammation, ocular 35 assessment strategy 40 and contact lenses 35 diagnosis 35–40 infection and 37

integrins 31

interstitial keratitis 38–9, 44, 83–7 causes 83–7, 84

clinical features 83 diagnosis 84 diffuse 84, 86 disciform 84

effect of topical steroids 146 multifocal 85

suppurative (necrotising) stromal 85 treatment 173, 174

intraepithelial carcinoma 90, 90 corneal lines 68

intraepithelial dysplasia 90 intraepithelial intraepithelioma 90 intraepithelial neoplasia 90–1

treatment 174 intraepithelioma 90

intraocular lens insertion see under corneal transplantation

intraocular pressure (IOP), raised, as side effect of steroids 140–1, 146

ionising radiation injuries 109 IOP see intraocular pressure

iridocorneal endothelial (ICE) syndrome 125–7

clinical features 126, 126 conditions confused with 126 diagnosis 127

pathology 126–7 treatment 127 iridogoniodysgenesis 20 iron deposits 29, 69, 94 irradiation injuries 108–9

keratin sulphate 22 keratitis 38–9

amoebic 142 endothelial 39 epithelial 39

filamentary 116, 142, 170 herpetic, treatment 106 herpetic stromal 104–5, 172 nummular 70, 83

rubella keratitis 67 sterile infiltrative 77, 79 stromal 83–5, 104–5, 172 superficial punctate 103

superior limbic, postsurgical 116 suppurative 79, 85

ulcerative 47–8, 58–9

see also dendritic keratitis; disciform keratitis; interstitial keratitis; microbial keratitis

keratoconjunctivitis 40 adenoviral 70, 168

superior limbic 40, 67, 116, 178 keratoconus 30, 93, 93–8

clinical features 93, 94–5 contact lens fitting 96–7 corneal transplants 97, 97–8 Descemet’s membrane in 28 diagnostic measurements 95, 96 incidence/prevalence 93

as indication for corneal transplant 129 ocular associations 93

posterior 20 surgery 95, 96, 97

systemic conditions associated with 93–4,

94

treatment 95–6, 174 keratoconus forme fruste 95 keratocytes 23 keratoglobus 93, 93, 98 keratometry 14–15, 15, 95 keratomycosis 142 keratopathy

bullous 117, 129, 130 climatic droplet keratopathy 2

infectious crystalline keratopathy 60–1, 135,

173

linear keratopathy 66, 68–9 lipid 11, 26

microcystic 81

vortex keratopathy 66, 71–2

see also band keratopathy; dendritic keratopathy; punctate keratopathy; superficial keratopathy; superficial punctate keratopathy

ketaconazole 62, 142 Khodadoust line 134

lamellar transplantation 97 laser therapy

excimer laser phototherapeutic keratoplasty (PTK) 124–5

LASIK (laser in situ keratomileusis) 109–10 lattice dystrophy 120, 121–2, 123, 124 Leber’s congenital amourosis 94, 94

lens extraction see under corneal transplantation lignocaine (lidocaine) 139, 145

limbal dermoid 88–9 treatment 175

limbal dysplasia 80, 81 limbal inflammation 44 limbal transplantation 115

procedure summary* 161

lipid deposition/keratopathy 11, 26 local anaesthetics 139

lysis, stromal 9, 26

macroulceration 44, 50, 63

macular dystrophy 120, 121–2, 123, 124 map dot dystrophy 120, 120

“mare’s tail” lines 68 Marfan’s syndrome 94, 94

measurements of corneal shape/size 14–17, 95 Meesman’s dystrophy 120

megalocornea 21 mepivacaine 139

meta-aminobenzoic acid esters 139 metaherpetic ulceration 42, 105

treatment 175

metaplasia, epithelial 30, 30–1, 32

methyl ethylmethyl ketone peroxide 114–15 miconazole 62, 142, 145

microbial keratitis 46, 54–64, 79 acanthamoeba keratitis 62–4, 76–7, 168 antibiotic treatment 58, 59, 59–60, 61 bacterial keratitis, treatment 58, 59, 169 cause 54–5

complications of contact lens wear 76–7 corneal biopsy 58–9

corticosteroid treatment 60 culture results 58

fungal keratitis 61–2, 62, 171 Gram stain 56, 57–8, 159 host response 55

infectious crystalline keratopathy 60–1, 135, 173 investigation 56

management 56

material for microbiological assessment 56–7 pathogens causing 55, 56

postsurgical 116–17 predisposing factors 55

INDEX

microcornea 21 microcystic keratopathy 81 microcysts, epithelial 80, 81

micropuncture, corneal, procedure summary* 154 microscopy, specular/confocal 17–18 microulceration 44

mitomycin C 91, 145 mitral valve prolapse 94, 94 molluscum contagiosum 71

monoclonal gammopathy 29 Mooren’s ulceration 54, 100 mucolytics 145

mucus plaques 44, 49–50, 65 Munson’s sign 94 mydriatics 139–40, 145 myopia, in keratoconus 94

natamycin 62, 142, 145 necrotising stromal keratitis 85 neoplasia, epithelial 30, 31

neovascularisation 10–11, 28–9, 81, 81–2, 87 neurocristopathies 19

non-steroidal anti-inflammatory agents 141, 143 nummular keratitis 70, 83

ocular cicatricial pemphigoid 13 ocular surface, climate affecting 1–2 oculoglandular syndrome 85 oedema

corneal 9, 25, 27–9, 79–80 chronic 28

epithelial 81 stromal 81

ofloxacin 59, 59, 145

optical functions of cornea 1, 2 oxidising agents, burns from 114–15 oxyquinolones 142

pain 6

papillary conjunctivitis, due to contact lens wear 75, 78, 79

treatment 175 papillomata 91–2

benign 31

corneal and limbal, treatment 176 para-aminobenzoic acid esters 139 paraquat 114–15

pathogens causing microbial keratitis 55, 56 pathology of cornea 24–34 see also individual disorders pedicled conjunctival flap 51–2

procedure summary* 152

to close corneal perforation, procedure summary*

162

pellucid marginal degeneration 93, 93, 98–9 treatment 176

pemphigoid 2, 13, 40, 44

penetrating corneal transplantation, in keratoconus 97

alternatives 99

INDEX

penetrating corneal transplantation continued management of 97–8

treating dystrophies 124 penicillin G 59, 145

perforation of the cornea see pedicled conjunctival flap; tissue adhesive

peripheral corneal atrophy, age-related 100 peripheral corneal ulceration 44, 52–4

with coexisting ocular inflammation 52–3 without coexisting ocular inflammation 53 Mooren’s ulceration 54, 100

with severe inflammation and destruction 53–4

Peter’s anomaly 19, 20 phenylephrine 116, 137, 140, 145 photophobia 6

pinguecula 2, 32–3, 89–90 treatment 177

plaque keratopathy 66, 67–8 polyarteritis nodosa 39 polyenes 142 polyhexamethyl biguanide 64

polyhexamethylene biguanide 145 polyhexaminemethaminebromide 142 polymegathism, endothelial 80–1, 81 polymorphonucleocytes 140, 146 polyosis 13

posterior blepharitis 13, 14 posterior dystrophies 120 posterior embryotoxon 20 posterior keratoconus 20

posterior polymorphous dystrophy 120, 126, 127 prednisolone 106, 141, 143, 144, 145, 145

in corneal allograft rejection 134 prednisolone acetate 141, 145, 146 prednisolone phosphate 60, 71, 97, 106, 141,

145, 145

privilege see immune system procaine 139

procedure summaries* 147–66 see also individual procedures

proliferative lesions 88–92 propamidine 64 propamidine isothianate 145 proparacaine 139

proparacaine hydrochloride 139 protective functions 1, 2–3, 24, 41, 65 proteoglycans 22, 23

proxymetacaine 145

pseudomonas, effect of topical steroids 146

Pseudomonas aeruginosa 58 pseudopterygia 88 pterygia 2, 32–3, 89

treatment 177

pterygium excision and conjunctival graft, procedure summary* 163

punctate epithelial erosions 69–70

punctate keratopathy 32 see also superficial punctate keratopathy

red eye see inflammation, ocular reflex, corneal 37

Reis–Bückler’s dystrophy 120, 121, 125 Reiter’s disease 40

repair

corneal 26–7, 28

endothelial 24, 26, 28, 113, 129 stromal 26, 27

retinoic acid 142, 145 retinoscopy 15 rheumatoid arthritis 38, 39 Rieger’s anomaly 20

rose bengal 8, 49–50, 65, 138–9, 145 rubella keratitis 67

Salzmann’s nodular dystrophy 10 sand blast injury 110

scarring 10, 41, 43

Schnyder’s central crystalline dystrophy 120 scleritis 39

sclerocornea 21 sclerokeratitis 39 sclerotic scatter 7 scorbic acid 115

scraping, corneal, procedure summary* 155 shield ulcers 36, 40, 44, 142

treatment 177

signs of corneal diseases 6–11 documentation 18

slit lamp examination of cornea 3, 7–8, 9 ulceration 44, 46

spectacle blur 80

squamous cell carcinoma 90–1 corneal lines 68

treatment 91, 178 squamous metaplasia 142

squamous papilloma, treatment 178 Staphylococcus aureus 57–8, 60

stem cell insufficiency, causing corneal ulceration 42 sterile infiltrative keratitis 77, 79

steroids see corticosteroids Stevens–Johnson syndrome 2, 13, 40, 44 Stocker lines 69

streptococci, nutrient variant streptococci see Abiotrophia species

stroma 21, 22, 22–3 repair 26, 27 scarring 10, 41, 43

stromal disease, treatment 106 stromal dystrophies 120, 121–2 stromal inflammation 42, 46, 51 stromal keratitis 83–5, 104–5, 172 stromal lysis 9, 26

stromal oedema 81

superficial dystrophies 120–1, 120 superficial keratopathy 9, 65–73

causes 66 patterns of 65, 66

superficial membrane dystrophies 68

superficial punctate keratitis 103 superficial punctate keratopathy 66, 69–71

combined lesions 69 diagnosis 70–1, 72

superior limbic keratitis, postsurgical 116 superior limbic keratoconjunctivitis 40, 67, 116

treatment 178 suppurative keratitis 79, 85 surgery

corneal injury from 116–18 see also corneal transplantation

symptoms of corneal diseases 6 syphilitic interstitial keratitis 83, 86, 87 systemic inflammatory diseases 38, 40 systemic lupus erythematosus 38

tarsorrhaphy, procedure summary* 165 tear deficiency 24

tear film 22, 24, 65, 116

tear flow, contact lenses and 75 Terrien’s dystrophy 93, 99–100

treatment 100, 179

tetanus prophylaxis, incisional wounds 112–13 tetracaine 139

thermokeratoplasty 14, 97

thickness of cornea, measurement 14, 15 thiomersol (thimerosol) 145

allergy 78–9, 79

Thygeson’s punctate keratitis, treatment 179 Thygeson’s superficial punctate keratopathy

70, 71

tissue adhesive, corneal perforation, procedure summary* 166

tobramycin 59, 145

toxic epitheliopathy 79, 116 trachoma 13, 40, 44 transparency, of cornea 3, 15, 23

transplantation see amniotic membrane transplantation; corneal transplantation; lamellar transplantation; limbal transplantation

trauma, corneal 108–18 angle damage 109, 111 assessment 108

blunt trauma 109–11 causing corneal ulceration 42

posttraumatic endothelial decompensation 113

see also individual injuries

treatment 167–79 see also drugs and drug therapy; and under individual disorders

trifluorothymidine 106 trophozoites 62 tropicamide 140, 145 tyrosinaemia type II 49, 65

INDEX

ulceration, corneal 8–9, 24, 36–7, 41–64 amoeboid ulcers 104

assessment 43–5, 46 causes 41, 41–3, 43 chronic 48

classification of ulcers 45 dendritic 36, 48–50, 65, 103, 172

treatment 172 examination 44–5, 46 healing 43

history 43–4, 46 infection 46–7

causing ulceration 42

as complication of ulceration 43 linear ulcers 44

macroulceration 44, 50, 63 metaherpetic ulceration 42, 105, 175 microbiological investigation 47, 48 microulceration 44

morphology 36 overtreatment 51 postoperative 116

recurrent erosion syndrome 48 sequelae 41, 43

shield ulcers 36, 40, 44, 142, 177 signs and their implications 46

see also geographic ulceration; microbial keratitis; peripheral corneal ulceration

ulcerative keratitis 47–8, 58–9 ultraviolet radiation injuries 108–9 Uritz–Savellia pupil 132

uveitis 37–8 herpetic 105

treatment 173

vaccinial infection 70 vancomycin 59, 145

varicella-zoster dendritic keratopathy 49–50 varicella-zoster interstitial keratitis 85–6 vascularisation 25 see also neovascularisation vernal conjunctivitis 44

vernal keratoconjunctivitis, treatment 179 videokeratography 14–15, 15–17, 95, 99 virus replication 104

visual loss 6, 6–7 Vogt’s striae 94

von Hippel’s internal corneal ulcer 20 vortex keratopathy 66, 71–2

warpage, of cornea 80, 81 Wegener’s granulomatosis 39, 54 Wilson’s disease 29, 33

wound dehiscence 117, 118