Ординатура / Офтальмология / Учебные материалы / Manual of Eye Emergencies Diagnosis and Management Webb Kanski 2004

Manual of Eye Emergencies

Diagnosis and Management

To Clemency, Douglas, Duncan and James

For Butterworth-Heinemann

Publishing Director: Caroline Makepeace

Development Editor: Kim Benson

Project Manager: Joannah Duncan

Designer: George Ajayi

Disclaimer: Some images in the printed version of this book are not available for inclusion in the eBook.

BUTTERWORTH-HEINEMANN

An imprint of Elsevier Limited

©Reed Educational and Professional Publishing Ltd 1995

©2004, Elsevier Limited. All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: healthpermissions@elsevier.com. You may also complete your request online via the Elsevier Limited homepage (http://www.elsevier.com), by selecting ‘Customer Support’ and then ‘Obtaining Permissions’.

First edition 1995

Second edition 2004

ISBN 0 7506 5219 5

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

Note

Medical knowledge is constantly changing. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the Publisher nor the author assumes any liability for any injury and/or damage to persons or property arising from this publication.

Printed in China

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Contents

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Foreword

This practical and pragmatic book has been written for those who may have little knowledge of ophthalmology, but who are required to diagnose and manage eye patients.

The text concentrates largely on common eye problems, and is designed to lead the clinician towards the likely diagnosis and most appropriate management. The majority of surgical procedures used in ophthalmology are described briefly and some simple techniques are illustrated in detail as a guide for suitably qualified clinician.

With its emphasis on guiding the user towards safe and effective management of common eye conditions, this book is a valuable tool for any professional involved in primary eye care.

Jack Kanski, 2004

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Preface

This book assumes the reader has little knowledge of ophthalmology, and acts as a guide to the most appropriate diagnosis and management of the majority of common eye complaints. Intentionally it does not enter into detailed discussion, but concentrates on the practical initial treatment and referral pathway. Extensive cross-referencing is used to allow fast navigation, and practical charts and pictures can be used directly from this book, to test patients’ visual function, or to help identify their medication. Repetition, where this occurs, is deliberate to allow rapid access to management pathways. Most eye problems are not true emergencies, but are perceived to be so by both patients and practitioners, hence the title of this book.

Lennox A. Webb, 2004

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Chapter 1

Basic Examination

History

An accurate and detailed history often points to the diagnosis and guides your examination.

BASIC EXAMINATION (Fig. 1.1)

The basic examination should cover the following.

Face, Lids and Orbit

External Appearance (Fig. 1.2)

■eczema, trauma, cellulitis, allergic responses, styes, cysts, tumors, proptosis.

Choroid

Cornea

Retina

Eyelid

Iris

Pupil

Fig. 1.1 The eye.