Ординатура / Офтальмология / Учебные материалы / Clinical Diagnosis and Management of ocular trauma
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Clinical Diagnosis and Management of
OCULAR TRAUMA
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Clinical Diagnosis and Management of
OCULAR TRAUMA
Editors
Ashok Garg MS PhD FIAO (Bel) FRSM FAIMS ADM FICA |
Jose M Ruiz-Moreno MD PhD |
International and National Gold Medalist |
Professor of Ophthalmology |
Chairman and Medical Director |
Albacete Medical School, University of |
Garg Eye Institute and Research Centre |
Castilla La Mancha |
235-Model Town, Dabra Chowk |
Avendia de Almansa, 14 02006, ALBACETE |
Hisar-125005, India |
Spain |
B Shukla MS PhD MAMS FICS |
T Mark Johnson MD FRCS |
Director of Research |
Consultant Vitreo Retinal Surgeon |
RJN Institute of Ophthalmology |
National Retina Institute |
Chandra Bhawan, 1, Jhansi Road |
Suite 101, 5530 Wisconsin Ave |
Gwalior-474002, India |
Chevy Chase 20815, USA |
Jerome Jean Bovet MD |
Keiki R Mehta MS DO FRSH FIOS |
Consultant Ophthalmic Surgeon FMH |
Chairman and Medical Director |
Clinique de L’oeil |
Mehta International Eye Institute and |
15, Avenue Du Bois-de-law-Chapelle |
Colaba Eye Hospital |
CH-1213, Onex, Switzerland |
Seaside, 147, Shahid Bhagat Singh Road, |
Mahipal S Sachdev MD |
Mumbai-400005 |
India |
|
Chairman and Medical Director |
Bojan Pajic MD |
Centre for Sight, B-5/24, Safdarjung Enclave |
|
New Delhi-110029, India |
Chief of the Cornea and Refractive |
CS Dhull MS PhD FIAO |
Surgery Department |
Klinik Pallas Louis Giroud- |
|
Professor and Head |
Str. 20 4600, Olten |
Regional Eye Institute of Ophthalmology |
Switzerland |
Pt. BD PGIMS, Rohtak-124001, India |
|
Belquiz A Nassaralla MD PhD
Consultant Ophthalmic Surgeon
Department of Cornea and Refractive Surgery
Goiania Eye Institute, Goiania
GO, Brazil
Cyres K Mehta MS FSVH FAGE
Director and Consultant
Mehta International Eye Institute and Colaba Eye Hospital
Seaside, 147, Sahid Bhagat Singh Road, Mumbai-400005, India
Foreword
Bruce Wallace
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Clinical Diagnosis and Management of Ocular Trauma
© 2009, Editors
All rights reserved. No part of this publication and DVD ROM 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.
This book has been published in good faith that the material provided by Contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors 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: 2009
ISBN 978-81-8448-470-0
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
Dedicated to
-My Respected Param Pujya Guru Sant Gurmeet Ram Rahim Singh Ji for his blessings and motivation.
-My Respected Parents, teachers, my wife Dr Aruna Garg, son Abhishek and daughter Anshul for their constant support and patience during all these days of hard work.
-My dear friend Dr Amar Agarwal, a renowned International Ophthalmologist for his constant support, guidance and expertise.
Ashok Garg
My family (Magali, my wife and Jorge, Guillermo and Magali my children) for the time, comprehension and patience that they have had with me during all these years of hard work.
Jose M Ruiz-Moreno
Sir Stewart Duke-Elder, my ideal and inspiration for ophthalmology.
B Shukla
My wife Joanne and my son Connor for providing me with their love, wisdom and support throughout the years.
T Mark Johnson
-Yveric, Luc and Fanny Laure.
-Silvio Korol, who was not only a teacher but also an intellectual guide and a friend.
Jerome Jean Bovet
Zena the light of my life.
Keiki R Mehta
My family without whose help it would not have been possible to do book.
Mahipal S Sachdev
To my son Valentin Aleksandar.
Bojan Pajic
My dear wife Dr Indira Dhull and my children Tushar and Chirag.
CS Dhull
To my parents Lucia and Justino, for their blessings and motivation. To my husband Joao, a great partner at home and at work. To my children Arthur, Joao Neto and Anna Paula, who have been giving me constant support and love.
Belquiz A Nassaralla
-My parents for everything.
-To Vini my Best friend.
Cyres K Mehta
Contributors
Ajay Aurora MS
Divector
Retina-Clinic
Dr. Chaudhary Eye Centre and
Laser Vision, 4802 Bharat Ram Road
24, Daryaganj,
New Delhi
India
Amar Agarwal MS FRCS FRC Ophth
Consultant
Dr. Agarwal’s Eye Hospital
19, Cathedral Road
Chennai-600086,
India
Amol Mhatre MS
Aditya Jyot Eye Hospital Pvt. Ltd
Plot No. 153, Road No.9
Major Parmeshwaran Road
Opp. SIWS College, Gate No.3
Wadala, Mumbai-400031
India
Arturo Perez-Arteaga MD
Medical Director
Centro Oftalmologico Tlalnepantla Dr Perez - Arteaga Vallarta No. 42 Tlalnepantla, Centro,
Estado de Mexico 54000, Mexico
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-125005
India
Ashok Sharma MS
Director
Dr. Ashok Sharma’s Corneal Centre
SCO 833-834 (2nd Floor)
Sector 22-A,
Chandigarh-160022
India
Athiya Agarwal MD DO FRSH
Consultant
Dr. Agarwal’s Eye Hospital
19, Cathedral Road
Chennai-600086, India
Belquiz A Nassaralla MD PhD
Consultant Ophthalmic Surgeon
Department of Cornea and
Refractive Surgery
Goiania Eye Institute, Goiania
GO, Brazil
B Shukla MS PhD MAMS FICS
Director of Research
RJN Institute of Ophthalmology
Chandra Bhawan, 1, Jhansi Road
Gwalior-474002, India
Binoo Nayer DOMS
Consultant Ophthalmologist
Hindu Rao Hospital
New Delhi, India
Bojan Pajic MD
Chief of the Cornea and Refractive
Surgery Department
Klinik Pallas Louis Giroud-
Str.20 4600, Olten
Switzerland
Boris Malyugin MD Phd
Chief of Department of Cataract and Implant Surgery
Dy. Director General
S. Fyodorov Eye Microsurgery Complex State Institution, 127486 Moscow Beskudnikovsky blvd 59A Russia
Brigitte Pajic-Eggspuhler MD
AugenZentrumPajic (AZP)
Research Institute
Titlisstrasse 44, 5734
Reinach, Switzerland
CS Dhull MS PhD FIAO
Professor and Head
Regional Eye Institute of
Ophthalmology
Pt. BD PGIMS, Rohtak-124001
India
Chandresh Baid MS
Dr. Agarwal’s Eye Hospital
19, Cathedral Road
Chennai-600086, India
Chitra Ramamurthy MS
Director
The Eye Foundation
DB Road, Coimbatore-641002
India
Cristina Masini MD
Institute of Ophthalmology
University of Modena and Reggio Emilia via del Pozzo 71-41100, Modena
Italy
Cyres K Mehta MS FSVH FAGE
Director and Consultant
Mehta International Eye Institute and
Colaba Eye Hospital
Seaside, 147, Sahid Bhagat Singh
Road, Mumbai-400005
India
Daljit Singh MS DSC
Director
Dr Daljit Singh’s Eye Hospital
57-Joshi Colony
Amritsar-143001, India
David F Chang MD
Clinical Professor of Ophthalmology
University of California
762, Altos Oaks Drive, Suite-1
Los Altos, CA 94024,
USA
Dhivya A MS
Dr. Agarwal’s Eye Hospital
19, Cathedral Road
Chennai-600086,
India
Douglas W Morck MD
Department of Ophthalmology
The Eye Care Centre
2550, Willow St., Section G
Vancouver, BC V5Z3N9
Canada
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Clinical Diagnosis and Management of Ocular Trauma |
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D Ramamurthy MS |
GK Das MD |
Jerome Jean Bovet MD |
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Medical Director |
Professor of Ophthalmology |
Consultant Ophthalmic Surgeon FMH |
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The Eye Foundation |
UCMS and GTB Hospital |
Clinique de L’oeil |
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D.B. Road |
Shahdara, New Delhi |
15, Avenue Du Bois-de-law-Chapelle |
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Coimbatore-641002 |
India |
CH-1213, Onex, Switzerland |
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India |
Harmit Kaur MS |
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João J Nassaralla Jr MD PhD |
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D Shukla MS MAMS |
Daljit Singh Eye Hospital |
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Rua L no 53 # 12o andar, Setro Oeste |
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Consultant |
57, Joshi Colony |
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Goiania, Goias |
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Vitreo Retina Unit |
Amritsar-143001 |
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Brazil, ZC : 74.120-050 |
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Aravind Eye Care System |
India |
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Madurai (Tamil Nadu) |
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John D Sheppard MD MMSc |
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India |
Henry D Perry MD FACS |
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Associate Professor of Ophthalmology |
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Chief of Corneal Services |
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Earl Crouch MD |
Microbiology and Immunology |
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Nassau University Medical Center |
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Clinical Director, Thomas R. Lee |
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Eastern Virginia Medical School |
East Meadow, New York |
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Centre for Ocular Pharmacology |
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880, Kemphsville Road |
2000 North Village Ave |
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Eastern Virginia Medical School |
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Suite 2500, Norflock, Virginia-23502 |
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Rockville Centre, NY 11570 |
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Norfolk, Virginia 23501 |
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USA |
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USA |
USA |
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Eric D Crouch MD |
Hsi-Kung Kuo MD |
Jose M Ruiz-Moreno MD PhD |
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Assistant Professor of Pediatric |
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Department of Ophthamology |
Professor of Ophthalmology |
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Ophthalmology |
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Chang Gung Memorial Hospital |
Albacete Medical School, University of |
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Eastern Virginia Medical School |
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Kaohsiung Medical Center |
Castilla La Mancha |
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880, Kemphsville Road |
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123, Ta-PEi Road, Niao-Sung |
Avendia de Almansa, 14 02006, |
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Suite 2500, Norflock, Virginia-23502 |
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ALBACETE |
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Hsien, Kaohsiung, Hsien, 883 |
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USA |
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Spain |
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Taiwan, ROC |
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Eric D Donnenfeld MD FACS |
Ian Bell MD |
Kanupriya Mhatre MS |
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Ophthalmic Consultants of Long Island |
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Aditya Jyot Eye Hospital Pvt. Ltd |
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Suit 402 |
Consultant Ophthalmologist |
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Plot No. 153, Road No.9 |
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2000 North Village Ave. |
NY Eye Institute, New York |
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Major Parmeshwaran Road |
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Rockville Centre, NY 11570 |
USA |
Opp. SIWS College, Gate No.3 |
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USA |
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Wadala, Mumbai-400031 |
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Essam El Toukhy MD FRCOPH |
Indu R Singh MS |
India |
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Daljit Singh Eye Hospital |
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Assistant Professor of Ophthalmology |
Karol Stasiak MS |
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57, Joshi Colony |
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Cairo University |
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Amritsar-143001 |
Department of Pediatric |
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Debuty Director, National Eye Center, |
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Ophthalmology, Hertza 9, 04-603 |
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India |
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Egypt |
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Warsaw, Poland |
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Gaurav Luthra MS |
Jaroslaw Kulinski MD |
Keiki R Mehta MS DO FRSH FIOS |
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Director, Drishti Eye Centre |
Department of Pediatric |
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Chairman and Medical Director |
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Dehradun, Uttrakhand |
Ophthalmology, Hertza 9, 04-603 |
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Mehta International Eye Institute and |
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India |
Warsaw |
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Colaba Eye Hospital |
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Poland |
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Gian Maria Cavallini MD |
Seaside, 147, Shahid Bhagat Singh |
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Road, |
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Director |
Jasna Ljubic MD |
Mumbai-400005 |
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Institute of Ophthalmology |
General Hospital |
India |
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University of Modena and Reggio Emilia |
Department of Physical Medicine & |
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via del Pozzo 71-41100, Modena |
Kiranjit Singh MS |
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Rehabilitation, 16000 Leskovac |
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Italy |
Serbia |
Daljit Singh Eye Hospital |
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57, Joshi Colony |
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Gina Chavez MD |
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Javier A Montero MD |
Amritsar-143001 |
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Director |
India |
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Pio del Rio Hortega University |
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Department of Ophthalmology |
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Hospital, Ophthalmology Unit |
KK Bhalla MS |
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The Eye Care Centre |
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C/Rondilla de Sta Teresa 9, Valladolid |
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2550, Willow St., Section G |
Daljit Singh Eye Hospital |
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47010, |
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Vancouver, BC V5Z3N9 |
57, Joshi Colony |
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Canada |
Spain |
Amritsar-143001, India |
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Clinical Diagnosis and Management of Ocular Trauma |
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Leonardo Toledo Netto MD |
P Dutta MS |
Ritika Sachdev MS |
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Medical Director |
Director |
Sr. Resident |
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Olho.com Eye Clinic |
Dutta Eye Clinic, Gwalior |
Dr. RP Centre for Ophthalmic Sciences |
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Department of Cornea and Cataract |
India |
AIIMS, Ansari Nagar |
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Surgery, Aparecida de Goiania |
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New Delhi-110029, India |
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GO, Brazil |
Pei-Chang Wu MD |
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Luca Campi MD |
Department of Ophthalmology |
Rupal H Trivedi MD MSCR |
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Chang Gung Memorial Hospita- |
MUSC - Storm Eye Institute |
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Institute of Ophthalmology |
Kaohsiung Medical Center |
167 Ashley Ave |
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University of Modena and Reggio Emilia |
123, Ta-PEi Road, Niao-Sung |
Charleston, SC 29425, USA |
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via del Pozzo 71-41100, Modena |
Hsien, Kaohsiung, Hsein, 883 |
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Italy |
Taiwan, ROC |
Rupesh V Agrawal MD |
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M Edward Wilson MD |
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Consultant |
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Quresh B Maskati MD |
Comprehensive Ophthalmology |
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Professor of Ophthalmology |
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Maskati Eye Clinic |
Uveitis and Ocular Trauma |
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Department of Ophthalmology |
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Mumbai, India |
LV Prasad Eye Institute |
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Storm Eye Institute |
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Kallam Anjil Reddy Campus |
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Miles Center for Pediatric |
Rajni Sharma MD |
Banjara Hills, Hyderabad-500034 |
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Ophthalmology |
Ex-Senior Resident |
India |
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Medical University of South Carolina |
Department of Pediatrics |
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Charleston, SC 29425 |
S Natarajan MS |
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AIIMS, Ansari Nagar |
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USA |
New Delhi-110029, India |
Chairman and Medical Director |
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Mahipal S Sachdev MD |
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Aditya Jyot Eye Hospital Pvt. Ltd |
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Rajpal Vohra MD |
Plot No. 153, Road No.9 |
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Chairman and Medical Director |
Professor of Ophthalmology |
Major Parmeshwaran Road |
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Centre for Sight, B-5/24, Safdarjung |
Dr Rajendra Prasad for Ophthalmology |
Opp. SIWS College, Gate No.3 |
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Enclave |
All India Institute of Medical Sciences |
Wadala, Mumbai-400031 |
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New Delhi-110029, India |
New Delhi, India |
India |
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Marek E Prost MD |
Rania Abdel Salam MD |
Satish Desai MS |
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Professor of Ophthalmology and |
Lecturer of Ophthalmology |
Consultant Ophthalmologist |
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Cairo University, |
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Director Center for Pediatric |
Shri Ganapati Netralaya |
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National Eye Center, Egypt |
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Ophthalmology Hertza 9, 04-603 |
Jalna (India) |
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Warsaw, Poland |
Ranjit Singh MS |
Saumil Sheth MS |
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Matteo Piovella MD |
Director |
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Aditya Jyot Eye Hospital Pvt. Ltd |
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Daljit Singh Eye Hospital |
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Director |
Plot No. 153, Road No. 9 |
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57, Joshi Colony |
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CMA Centro Microchirurgia |
Major Parmeshwaran Road |
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Amritsar-143001, India |
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Ambulatoriale |
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Opp. SIWS College, Gate No. 3 |
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Via Donizetti 24-20052 |
Ritesh Gupta MD |
Wadala, Mumbai-400031 |
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Monza, Italy |
Senior Resident |
India |
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Vitreo-Retina, |
Shui Lee MD FRCS |
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Neeraj Sanduja MD |
Trauma and ROP Service |
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Central Square Unit |
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Director |
Dr. RP Centre for Ophthalmic Sciences |
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AIIMS, New Delhi-110029, India |
255-4231 Hazelbridge |
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Delhi Retina Centre, |
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Way Richmond |
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4802 Bharat Ram Road |
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Rene Cano-Hidalgo MD |
BC, V6X-3L7 |
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24, Daryaganj, New Delhi |
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Chairman |
Canada |
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India |
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Institute of Ophthalmology |
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Simon P Holland MB FRCSC FRCOph |
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NR Biswas MD DM |
Conde De Valenciana |
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Vitreous and Retina Department |
Clinical Professor |
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Professor of Ocular Pharmacology |
Professor of Ophthamology |
Department of Ophthalmology |
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Dr. RP Center for Ophthalmic Sciences |
National Institute of Mexico (UNAM) |
The Eye Care Centre |
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AIIMS, Ansari Nagar |
Mexico |
2550, Willow St., Section G |
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New Delhi, India |
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Vancouver, BC V5Z3N9 |
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Richard Mathias MD |
Canada |
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P Bhasin MS |
Department of Ophthalmology |
Simone Pelloni MD |
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Director |
The Eye Care Centre |
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Institute of Ophthalmology |
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RJN Ophthalmic Institute |
2550, Willow St, Section G |
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University of Modena and Reggio Emilia |
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Gwalior |
Vancouver, BC V5Z3N9 |
via del Pozzo 71-41100, Modena |
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India |
Canada |
Italy |
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Clinical Diagnosis and Management of Ocular Trauma |
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Soosan Jacob MS |
Syed Asghar Hussain MS |
Viney Gupta MD |
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Dr. Agarwal’s Eye Hospital |
Aditya Jyot Eye Hospital Pvt. Ltd |
Assistant Professor of Ophthamology |
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19, Cathedral Road |
Plot No. 153, Road No.9 |
Dr RP Center for Ophthalmic Sciences |
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Chennai-600086, |
Major Parmeshwaran Road |
AIIMS, Ansari Nagar |
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India |
Opp. SIWS College, Gate No.3 |
New Delhi-110029, India |
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Sumit Sachdeva MS |
Wadala, Mumbai-400031 |
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India |
Yog Raj Sharma MD |
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Assistant Professor of Ophthalmology |
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Professor of Ophthalmology |
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RIO, PGIMS |
T Mark Johnson MD FRCS |
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Dr. R.P. Center for Ophthalmic Sciences |
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Rohtak, India |
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Consultant Vitreo Retinal Surgeon |
AIIMS, Ansari Nagar |
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National Retina Institute |
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Sunil Vasani MS |
New Delhi -110029, India |
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Suite 101, 5530 Wisconsin Ave |
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“Eye-r-Us” Clinic |
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Chevy Chase 20815, USA |
Yumi G Ohashi B.Sc |
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Gowalia tank, Mumbai-400036 |
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India |
Tracy L Lee MD |
Department of Ophthalmology |
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The Eye Care Centre |
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Sunita Agarwal MS DO PSVH |
Department of Ophthalmology |
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2550, Willow St., Section G |
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The Eye Care Centre |
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Dr. Agarwal’s Eye Hospital |
Vancouver, BC V5Z3N9, Canada |
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2550, Willow St., Section G |
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19, Cathedral Road |
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Vancouver, BC V5Z3N9, Canada |
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Chennai-600086, India |
Yuri Flores MD |
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Supriya Dabir MS |
Vandana Jain MD |
Consultant |
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Aditya Jyot Eye Hospital Pvt. Ltd |
Aditya Jyot Eye Hospital Pvt. Ltd |
Vitreoretina Surgeon |
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Plot No. 153, Road No.9 |
Plot No. 153, Road No. 9 |
Centro Oftalmologico Tlalnepantla |
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Major Parmeshwaran Road |
Major Parmeshwaran Road |
Dr. Perez - Arteaga Vallarta no.42 |
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Opp. SIWS College, Gate No.3 |
Opp. SIWS College, Gate No. 3 |
Tlalnepantla, Centro, |
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Wadala, Mumbai-400031 |
Wadala, Mumbai-400031 |
Estado de Mexico 54000, |
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India |
India |
Mexico |
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Foreword
I was called to examine a man in the hospital emergency room who had been injured in a motor vehicle accident. I was told the patient had an eye that was “red and swollen”. There was urgency in the voice of the consulting doctor, so I hurried to the hospital to examine this patient. After I arrived, I found the patient to have no evidence of a sight threatening problem. But, this man had definite signs of a skull fracture, open fracture of the right femur and probable rib fractures. And I was the first specialist called to see this patient.
This experience reminded me of how serious ocular trauma can be to patients, their families and even our medical colleagues outside of Ophthalmology. The impact of an accident that could lead to loss of visual function is frightening.
Fortunately, the evaluation and treatment of ocular injuries has improved significantly. Newer imaging systems and other diagnostic equipment provide better methods for detecting the extent of damage to the eye and adnexa. Advancements in microsurgical technology give us new equipment needed to repair a wide variety of ocular injuries.
This important textbook, edited by Professor Garg, offers a step by step update to modern evaluation and treatment of ocular and adnexal trauma. Since all injury cases are unpredictable by nature, having a reliable reference to access information on the latest in diagnostic and surgical repair is valuable to all medical care professionals involved in the care of patients who are suddenly afflicted with traumatic eye disease.
Congratulations to Professor Garg and his contributing editors who have provided us with a well organized, thorough and practical guide to handle traumatic ocular conditions.
Prof. Bruce Wallace MD
Medical Director Wallace Eye Surgery 4110 Parliament Drive
Alexandria, LA 71303 (USA) Tel.: 318-448-4488 www.wallaceeyesurgery.com