Fifth Edition
Saul Rajak PhD FRCOphth
Honorary Lecturer, London School of Hygiene and Tropical Medicine,
London, UK
John Sandford-Smith FRCS FRCOphth
Emeritus Consultant Ophthalmologist Leicester Royal Infirmary, Leicester, UK Ophthalmologist, Christian Hospital Quetta, Pakistan Senior Lecturer in Ophthalmology Ahmadu Bello University Hospital,
Kaduna, Nigeria
© 2015 Saul Rajak and John Sandford-Smith
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9781909836228
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_5Preface
Around 250 million people worldwide are either blind or suffer serious visual impairment. Of these, 200 million have avoidable and preventable diseases and almost all live in poor countries. The goal of this book is to provide a practical guide for the healthcare professionals who look after these patients.
There are many excellent ophthalmology textbooks for those in the developed world, but hardly any books written specifically for those training or working in developing nations. Eye Diseases in Hot Climates aims to reach the areas that other books don't reach. It is a comprehensive guide to eye disease and eye care, but focuses on diseases such as cataract, vitamin A deficiency, trachoma and corneal infection, all of which are common, severe and potentially blinding in poor and tropical countries. In doing so the book supports the World Health Organization's VISION 2020 initiative in its goal of eliminating preventable and treatable blindness by 2020.
Much has changed in eye care since the publication of the fourth edition. Some diseases such as leprosy and onchocerciasis are less common thanks to effective treatment campaigns. Other diseases such as macular degeneration and diabetic retinopathy, which used to be a problem only in rich countries, are now widely seen throughout the world. Cataract remains widespread, but access to surgery and the range of treatment options are improving. HIV continues to have dramatic consequences in poor countries.
The Fifth Edition of Eye Diseases in Hot Climates has been comprehensively updated in response to these changes. Each chapter has been thoroughly revised and many new photos, tables and illustrations added. We hope the book continues to be not just the standard textbook for ophthalmic nurses, ophthalmic clinical officers, ophthalmic assistants and medical students in tropical and poor countries, but will also be an invaluable resource for ophthalmologists in any location. As flights get cheaper and the world gets smaller, patients and healthcare workers frequently travel from poorer countries to richer ones, and vice versa. Doctors and nurses working in rich countries need to know about the diseases of poorer countries, many of which have been labelled by the WHO as neglected tropical diseases.
We have written Eye Diseases in Hot Climates in a simple, direct style to help readers who may not use English as their first language. We have tried to make the book engaging and stimulating. Above all we have focussed on providing practical information and advice for those without ophthalmic training who nonetheless treat patients with only a limited range of diagnostic equipment and medications at their disposal.
Saul Rajak
John Sandford-Smith
June 2015
8Dedications
To my wife Juliette and children, Eve and Florence.
SR
To Sheila my wife, who has brought up a family in three different continents and 12 different homes and hardly ever complained.
JSS
9Acknowledgements
We would like to thank the Ulverscroft Foundation, Leicester, for their very generous financial support and encouragement for this and all the previous editions of the book.
Most of the illustrations have been prepared by either the staff of the Medical Illustration Department of Leicester Royal Infirmary (in particular, Georgean Lochead, Parul Desai and Jan Johnson) or by Juliette Rajak.
The clinical photos have come from a wide range of sources and people, to whom we are very grateful. We would particularly like to acknowledge Dr Edward Hughes, Dr Neil Rogers, Dr Margreet Hogeweg, Dr Andy Richards and Drs Michele and Ian Murdoch, for providing so many high quality images.
The International Centre for Eye Health, London, has been a constant source of encouragement and information. We would like to thank in particular Professor Allen Foster, Professor Clare Gilbert and Dr Matthew Burton.
Various friends and colleagues have offered us advice and help on this or previous editions. In particular, Dr Adrian Hopkins, Dr Astrid Leck, Dr Susan Lewallen, Dr Denise and Professor David Mabey, Mr Andy Richards, Dr Keith Waddell, Dr Martin Wiselka and, for indispensable advice on publishing, Michael Manson, Michael Leventhal, Harry and Tessa Rajak. We are very grateful to them all, but in the end we must take responsibility for any errors or mistakes.
It would not have been possible to write this book, or to live in the countries that this book is intended for, without the unfailing and wonderful support of our families. Saul would like to thank Tessa and Harry, Stella and Tony, Dinah, Sam, Rafi and Noa.
The authors thank the following for their generous contribution of figures to this edition:
- Albert Lue Figure 20.7
- Al Sommer Figure 10.9
- Andre Curi Figure 16.17
- Clare Gilbert Figure 10.7
- David Mabey Figure 16.3b
- Ed Hughes Figures 11.4, 11.8b, 11.12, 11.14, 11.15, 11.17, 11.18, 11.19, 11.20, 11.21, 11.24, 11.26, 11.29, 12.25a–b, 13.1, 13.4, 13.7, 13.10, 13.11, 13.12, 13.13, 13.14, 13.17, 13.22, 13.24a–b, 13.25, 13.28, 13.33, 13.34, 13.37, 13.40, 13.41, 13.44, 14.5a–b, 20.8, 20.9, 20.12 and Chapter 11 opening figure
- Frank Green Figure 9.25
- Isabelle Schaeffers Chapter 5 opening figure
- JE Marr Figures 7.13a–b
- Laura Dunn Figure 9.1
- Margreet Hogeweg Figures 17.1, 17.2, 17.3, 17.7a–b, 17.9, 17.11, 17.12 and Chapter 17 opening figure
- Matthew Burton Figures 9.9a–b
- Philippa Matthews Figure 9.1
- Steve Tuft Figures 9.21a–b
Thanks to the organisations and people who kindly allowed us to reproduce their photographs in previous editions:
The World Health Organization, Teaching Aids at Low Cost, Professor Alistair Fielder, Professor
Barrie Jones, Mr J Kanski, Mr E Rosen, Mr J Talbot, Mr M Kerr Muir, Dr E Wright, Andy Richards.