229A Exophthalmometer.Fig 229B CT scan of orbital lymphoma, exhibiting proptosis.Fig 230 Phthisis bulbi: a shrunken globe.Fig 231 CT scan of an orbital blow‐out fracture (↓).Fig 232 A blow‐out fracture may cause entrapment of the inferior rectus musc...Fig 233 Test for hypesthesia using two paper clips to compare the sensitivit...Fig 234 CT scan of traumatic orbital fracture showing lens dislocation.Fig 235 Orbital hemorrhage with overlay of lateral canthal ligament and its ...Fig 236 Retrobulbar injections of anesthesia are used for most ocular surger...
7 Chapter 6Fig 237 Slit lamp microscope.Fig 238 Slit lamp beam.Fig 239 Slit lamp view of anterior segment. C, cornea; A, anterior chamber; ...Fig 240 Cross‐section of cornea.Fig 241 (A) Slit beam cross‐section of a cornea. A, epithelium; B, stroma; C...Fig 242 Corneal abrasion stained with fluorescein.Fig 243 Linear abrasions from trichiasis or particle under lid.Fig 244 A 360° limbal stem cell allograft: sutured or glued to sclera (↑)....Fig 245 Corneal foreign body.Fig 246 Axenfeld loop.Fig 247 Recurrent corneal erosion with localized epithelial edema.Fig 248 Superficial punctate keratitis (SPK) see Table 9, p. 94.Fig 249 SPK stained with fluorescein.Fig 250 Filamentary keratitis presents with strings of epithelium and is oft...Fig 251 Lagophthalmos is a condition in which the lids don’t close completel...Fig 252 SPK from trichiasis.Fig 253 Superficial vascularization, often due to poorly fitting contact len...Fig 254 Sodium hydroxide injury minutes after the event.Fig 255 Sodium hydroxide injury months after the event.Fig 256 Epidemic keratoconjunctivitis with characteristic white, punctate su...Fig 257 Herpes simplex keratitis with tree‐like branching lesions.Fig 258 Herpes simplex with large fluorescein‐stained dendrites. Lesions may...Fig 259 Herpetic inflammation of the stroma could cause permanent scarring w...Fig 260 Herpes dermatitis with multiple small blisters.Fig 261 Marginal corneal ulcer.Fig 262 Central corneal ulcer with secondary hypopyon.Fig 263 Perforated corneal ulcer.Fig 264 Severe corneal edema with epithelial cysts is referred to as bullous...Fig 265 At birth, the normal endothelial cell count is 5,000 cells/mm. It st...Fig 266 Specular microscopy after cataract surgery that damaged the endothel...Fig 267 Edematous folds in the cornea – called stria – usually result from l...Fig 268 Fuchs’ dystrophy with central corneal thickening and haze due to ede...Fig 269 Endothelial cell changes in aging with guttata due to Fuch’s dystrop...Fig 270 Diagram outlining full‐thickness corneal transplant (penetrating ker...Fig 271 Full‐thickness corneal transplant (penetrating keratoplasty).Fig 272 Descemet‐stripping endothelial keratoplasty (DSEK): After removing d...Fig 273 Replacement of endothelium and Descemet’s membrane. (A) Stripping of...Fig 274 OCT showing detached endothelial graft.Fig 275 DSEK graft separation (↑) 3 days after transplant. It was reattached...Fig 276 Successful DSEK surgery with 8.0 mm implant in place (↑).Fig 277 DALK removes most of the stroma up to Descemet’s membrane. A common ...Fig 278 DALK: step 1 is to inject air into the corneal stroma to begin separ...Fig 279 DALK: step 2 is to complete stromal dissection with crescent blade....Fig 280 DALK: step 3 is to remove Descemet’s membrane from donor cornea (↑)....Fig 281 DALK: step 4 is to suture donor graft to recipient bed.Fig 282 The Boston Keratoprosthesis: collar‐button device made of PMMA plast...Fig 283 Eye of a 23‐year‐old patient with congenital endothelial dystrophy. ...Fig 284 Keratoconus with scarring at apex of cone.Fig 285 Munson’s sign: conical cornea indents lid when looking down.Fig 286 Intracorneal ring strengthens and flattens the cornea in keratoconus...Fig 287 Corneal tomography of keratoconus showing thin, steep, eccentrically...Fig 288 Down’s syndrome patient with keratoconus. Corneal edema (hydrops) is...Fig 289 Argyrosis: deposition of silver in conjunctiva, cornea, and lid. Sil...Fig 290 Copper deposited in Descemet’s membrane causing an orange ring at th...Fig 291 Corneal dermoid.Fig 292 Bulbar palpebral and forniceal conjunctiva.Fig 293 Chemosis refers to conjunctival edema.Fig 294 Pterygium.Fig 295 Excision of conjunctival autograft which is usually harvested from t...Fig 296 Autograft is usually sutured (rarely glued) to nasal bulbar conjunct...Fig 297 A pinguecula is a very common benign yellow elevation of the conjunc...Fig 298 Pingueculitis.Fig 299 Subconjunctival hemorrhage.Fig 300 Lymphangiectasia.Fig 301 Conjunctival concretions.Fig 302 Conjunctival verruca (wart) with typical cauliflower appearance.Fig 303 Pemphigoid causes itchy, red blisters on the skin and conjunctivaFig 304 Symblepharon: adhesions of bulbar to palpebral conjunctiva should be...Fig 305 Conjunctivitis is usually due to a bacterial or viral infection. All...Fig 306 Papillae of the palpebral conjunctiva.Fig 307 Follicles of the palpebral conjunctiva.Fig 308 Corneal inflammation from trachoma.Fig 309 Infectious conjunctivitis: Assume conjunctivitis – “pink eye” – of a...Fig 310 Bacterial blepharoconjunctivitis.Fig 311 Conjunctival nevus.Fig 312 Conjunctival melanoma.Fig 313 Melanosis oculi with cutaneous involvement (lower right) has a 4× in...Fig 314 Episcleritis has a 60% occurrence rate.Fig 315 Scleritis.Fig 316 Rheumatoid arthritis causing thin sclera with visible underlying cho...Fig 317 Staphyloma is a weakening of the sclera causing a bulging of the wal...Fig 318 Jaundice (icterus): yellow skin and sclera due to elevated bilirubin...
8 Chapter 7Fig 319 Aqueous flow from ciliary body to Schlemm’s canal.Fig 320 Histology showing Schlemm’s canal (arrows), trabecular meshwork (arr...Fig 321 Uveoscleral outflow of aqueous produced by ciliary processes exits t...Fig 322 Microscopic view of trabecular meshwork that overlies Schlemm’s cana...Fig 323 Goldmann tonometer: The gold standard for measuring eye pressure.Fig 324 Portable tonometers: (A) Schiötz tonometer. (B) Tono‐Pen applanation...Fig 325 Measurement of corneal thickness with ultrasonic pachymeter.Fig 326 Normal trabecular meshwork: grade 4 angle as seen in a goniolens.Fig 327 Peripheral anterior synechiae ↑ are adhesions between the iris and c...Fig 328 The anterior chamber is the space between the iris and cornea. It is...Fig 329 Deep anterior chamber with wide open angle in long myopic eye.Fig 330 Trabecular meshwork seen with a goniolens at the slit lamp (see Fig....Fig 331 (A) Goldmann and (B) Zeiss gonioscope lenses used to examine the ang...Fig 332 Examination of angle with Goldmann lens at slit lamp.Fig 333 Grading angle by progressive widening from 0 to 4.Fig 334 Schematic cross‐section of retina.Fig 335 Lamina cribrosa forms the floor of optic disk. Note perforations for...Fig 336 Drawing of retinal nerve fiber layer with 1.2 million ganglion cell ...Fig 337 “Red‐free” photograph of glaucomatous cupping and loss of retinal ne...Fig 338 Optical coherent tomography (OCT) performed in office showing normal...Fig 339 OCT of glaucoma left eye showing ganglion cell axon layer (nerve fib...Fig 340 Optic cup/disk ratio (A) C/D = 0.25; (B) C/D = 0.40; (C) C/D = 0.70 ...Fig 341 Scanning laser optic disk tomography (OCT) with red color indicating...Fig 342 Three‐dimensional OCT using high‐speed ultra‐high resolution to crea...Fig 343 Color‐coded GDx scanning laser polarimetry showing loss of thicker (...Fig 344 Visual field defects in glaucoma.Fig 345 SLT trabeculoplasty requires a reflecting mirror on the eye to visua...Fig 346 Drawing of SLT trabeculoplasty. Up to 100 shots (causing bubble form...Fig 347 Surgical trabeculectomy showing aqueous flow from ciliary body throu...Fig 348 Dissection of sclera towards the limbus. A window of the sclera is t...Fig 349 A trabeculectomy is a surgically created fistula from anterior chamb...Fig 350 Fundus photo with OCT scan of hypotony maculopathy showing wrinkled ...Fig 351 Very low pressure (hypotony) or posterior scleritis can cause a chor...Fig 352 The rate of trabeculectomy bleb‐related infection is about 1.5% afte...Fig 353 Ahmed glaucoma valve. Tube in anterior chamber drains aqueous to sub...Fig 354 The titanium iStent Trabecular Micro‐Bypass Stent (Glaukos) drains a...Fig 355 Trabectome unroofing Schlemm’s canal.Fig 356 Trabectome removal of trabecular meshwork (↑↑) to expose Schlemm’s c...Fig 357 Photo of trabectome.Fig 358 Kahook Dual Blade enters cornea avoiding conjunctiva.Fig 359 Kahook Dual Blade used to remove 3–4 hours of trabecular meshwork—al...Fig 360 Transscleral cryotherapy is applied for less than 20 seconds to 180°...Fig 361 Endoscopic cyclophotocoagulation for partial destruction of aqueous‐...Fig 362 OCT of closed angle after pupil dilation (see Table 6, p. 53). v...Fig 363 Acute angle‐closure glaucoma with dilated pupil.Fig 364 Angle closure glaucoma: As the eye pressure steadily rises above 35 ...Fig 365 Nd: YAG laser peripheral iridotomy at 2 o’clock.Fig 366 Pigment of dispersion syndrome causing secondary glaucoma.Fig 367 There are a number of types of steroids. Corticosteroids are one typ...Fig 368 Pseudoexfoliation is identified by white flakes on the anterior lens...Fig 369 Hyphema with large iris disinsertion (dialysis) from its root causin...Fig 370 Angle recessed posteriorly following traumatic hyphema. The recessed...Fig 371 Very high pressure, often over 35 mmHg damage the pumping action of ...Fig 372 Congenital glaucoma in an 8‐month‐old, with squinting, an enlarged g...
9 Chapter 8Fig 373 Uvea.Fig 374 The uvea is made up of the iris, ciliary body,