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Chapter 1 EXTERNAL EXAMINATION OF EYES AND ADNEXA1

Eyelids and Palpebral Fissures1

Lashes and Eyebrows2

Position of the Eyeballs2

Motility of the Eyeballs3

Lacrimal Apparatus4

Conjunctiva4

The Cornea7

Iris and Pupil9

Intra-ocular Pressure9

Examination of Infant and Small Child10

Chapter 2 EXAMINATION OF THE EYE BY OPHTHALMOSCOPY11

The Ophthalmoscope11

Examination of the Ocular Media12

Examination of the Fundus14

Normal Fundus15

Normal Variations18

Chapter 3 EXAMINATION OF THE EYE BY OTHER OBJECTIVE METHODS19

Slit Lamp Microscopy19

Cornea21

Anterior Chamber23

Iris24

Lens24

Vitreous25

Transillumination25

Measurement of Intra-ocular Pressure26

Testing Corneal Sensitivity28

Examination of Pupil28

Chapter 4 FUNCTIONAL EXAMINATION OF THE EYE30

Determination of Visual Acuity31

Testing Accommodation or Focusing Power35

Investigation of Visual Fields35

Methods of Testing Visual Field37

Distribution of Nerve Fibers40

Types of Pathologic Field Defects46

Tests for Color Sense53

Dark Adaptation53

Psychosomatic Disturbances of Visual Function54

Emotional Disturbances54

Malingering55

References55

Chapter 5 DISTURBANCES OF OCULAR MOTILITY57

Anatomy and Physiology of the Individual Muscles58

Movements of the Globe60

Action of the Individual Muscles61

Voluntary Control of the Ocular Movements64

Reflex Control of the Ocular Movements69

Static Reflexes72

Static-Kinetic Reflexes72

Nystagmus73

Proprioceptive Sense of the Ocular Muscles75

Visual Fixation Reflex75

Fusion80

Orthophoria and Heterophoria84

Strabismus or Squint89

Concomitant Strabismus89

Types90

Paralytic Strabismus93

Supranuclear Paralyses94

Paralysis of Individual Ocular Muscles98

Paralysis of the Third Nerve：The Ophthalmoplegias103

References107

Chapter 6 OPTICAL DEFECTS OF THE EYE109

Physiologic Optics109

Refraction by the Eye112

Accommodation113

Presbyopia115

Ametropia116

Hyperopia117

Myopia119

Astigmatism123

Methods of Refraction124

Prescription of Glasses124

References126

Chapter 7 THE ORBIT127

Anatomy127

Congenital Malformations130

Circulatory Disturbances131

Orbital Inflammation134

Exophthalmos135

Exophthalmos of Graves＇ Disease138

Orbital Tumors147

Primary Tumors in the Orbit147

Tumors from Adjacent Structures149

Metastatic Tumors149

Pseudotumors；Chronic Orbital Myositis149

Enophthalmos150

Orbital Injuries150

References151

Chapter 8 THE EYELIDS152

Anatomy152

Alterations in the Form of the Lids156

Alterations in the Size and Form of the Fissures158

Changes in Position of the Lids158

Entropion158

Ectropion161

Diseases of the Skin of the Lids162

Alterations in the Circulation of Blood and Lymph162

Emphysema of the Lids165

Inflammatory Diseases of the Skin165

Hypertrophic，Abiotrophic and Degenerative Processes170

Changes in Pigmentation of the Lids171

Diseases of the Glands of the Lids172

Diseases of the Sebaceous Glands172

Diseases of the Sweat Glands173

Diseases of the Lid Margin173

Marginal Blepharitis173

Hordeolum175

Diseases of the Cilia176

Diseases of the Tarsus and Its Glands177

Alterations in Movements of the Lids179

Tumors of the Lid183

Congenital Tumors183

Acquired Tumors184

Injuries of the Eyelids186

Ecchymosis186

Wounds of the Eyelids186

Burns188

References189

Chapter 9 THE LACRIMAL APPARATUS190

Anatomy190

Diseases of the Lacrimal Gland191

Inflammation191

Tumors193

Diseases of the Lacrimal Ducts193

References195

Chapter 10 THE CONJUNCTIVA196

Anatomy196

Anomalies of the Circulation198

Conjunctivitis200

Bacteriology of the Conjunctiva202

Clinical Appearance of Certain Types of Acute Conjunctivitis204

Gonococcal Conjunctivitis204

Acute Catarrhal Conjunctivitis208

Trachoma210

Angular Conjunctivitis214

Conjunctival Glandular Form of Tularemia214

Allergic Forms of Conjunctivitis214

New Growths of the Conjunctiva216

Injuries of the Conjunctiva：Traumatic Conjunctivitis217

References219

Chapter 11 THE CORNEA220

Anatomy and Physiology220

Congenital Anomalies222

General Pathologic Considerations of Corneal Diseases223

Foreign Bodies on the Cornea223

Wounds of the Cornea225

Vascularization of the Cornea226

Edema of the Cornea227

Birth Injuries227

Inflammation of the Cornea：Keratitis228

Superficial Keratitis229

Deep Keratitis243

Degenerative Processes of the Cornea247

References250

Chapter 12 THE SCLERA251

Anatomy251

Pigmentation251

Ectasia and Staphyloma252

Inflammation：Scleritis and Episcleritis252

References253

Chapter 13 IRIS，CILIARY BODY，PUPIL254

Anatomy of the Iris and Ciliary Body254

Inflammation of the Iris and Ciliary Body256

Diagnosis of Specific Types of Iridocyclitis262

Tumors of the Iris267

Sympathetic Ophthalmia267

The Pupil269

Anatomy and Physiology of the Muscles270

Examination of the Pupil272

Disturbances in Pupillary Reaction275

References280

Chapter 14 THE CHOROID AND VITREOUS BODY281

Anatomy281

Congenital Anomalies of the Choroid284

Inflammation of the Choroid285

Acute Choroiditis286

Special Types of Choroiditis287

Treatment of Choroiditis290

Tumors of the Choroid291

References292

Chapter 15 THE CRYSTALLINE LENS294

Embryology294

Anatomy297

Cataract300

Causes of Opacification of Lens Fibers302

Theories of Cataract Formation in Man304

Symptoms of Cataract306

Types of Cataract306

Differential Diagnosis318

Treatment319

Dislocation of the Lens320

Arachnodactylia (Marfan＇s Syndrome)322

References322

Chapter 16 GLAUCOMA323

Normal Intra-ocular Pressure323

Various Types of Glaucoma323

References330

Chapter 17 THE RETINA332

Anatomy and Physiology332

Circulatory Disturbances in the Retina335

Obstruction of the Retinal Vessels338

Obstruction of the Arterial Circulation338

Obstruction of the Central Retinal Vein340

Arteriosclerosis342

General Characteristics of Sclerosis342

Types of Sclerosis345

Hypertension348

The Hypertensive Retinopathies348

Types of Hypertensive Retinopathy350

Arteriosclerotic Retinopathy351

Renal Retinopathy351

Hypertensive Retinopathy (Benign and Malignant)354

Late Toxemia of Pregnancy355

Diabetic Retinopathy356

Evaluation of Hypertensive Disease by the Ophthalmoscopic Picture359

Treatment of the Hypertensive Retinopathies360

Retinal Changes in Diseases of the Blood360

Atrophy and Degeneration of the Retina362

Detachment of the Retina370

Tumors of the Retina：Retinoblastoma374

References377

Chapter 18 THE OPTIC NERVE379

Anatomy and Physiology379

Inflammatory Changes：Optic Neuritis385

Clinical Features385

Etiology of Optic Neuritis388

Papilledema or Choked Disc393

Optic Atrophy399

Tumors of the Optic Nerve and Sheaths402

Toxic Amblyopias402

References405

Chapter 19 OCULAR DISORDERS DUE TO DISEASES OF THE CENTRAL NERVOUS SYSTEM406

Diseases of the Meninges406

Diseases of the Brain413

Disorders of the Cerebral Circulation413

Arterial Blood Supply413

Venous Circulation421

Cerebrospinal Fluid421

Inflammatory Diseases of the Brain422

Brain Abscess422

Viral Infections423

Demyelinating Diseases424

Congenital and Degenerative Disorders425

Cerebromacular Degeneration425

The Phakomatoses425

Hepatolenticular Degeneration427

Brain Tumors427

Focal Symptoms428

Eye Manifestations of Head Injuries436

References438

Chapter 20 OCULAR MANIFESTATIONS OF GENERAL DISEASES440

Infectious Diseases440

The Bacillary Diseases440

The Coccal Diseases446

Contagious Diseases of Childhood447

Diseases of Doubtful Etiology450

Fungus Infections451

Diseases of Metabolism452

Diseases of the Urinary Tract454

Protozoan and Metazoan Diseases454

Viral Diseases457

Rickettsial Diseases458

Spirochetal Diseases459

The Arthritides462

Diseases of the Heart and Blood Vessels463

Diseases of the Blood465

References467

Chapter 21 ORIENTATION ON SURGICAL OPERATIONS ON THE EYE AND ADNEXA470

Extraction of Cataracts470

Glaucoma471

Operations on the Conjunctiva473

Operations on the Lids and Socket478

Operations for Removal of the Globe480

Operations on the Muscles of the Eye486

Operations on the Tear Apparatus487

Operation for Detachment of the Retina487

Chapter 22 THERAPEUTIC AGENTS USED IN OPHTHALMOLOGY489

Collyria or Eye Washes489

Local Anesthetics490

Mydriatics and Cycloplegics490

Miotics491

Ointments491

References491

INDEX493