Glaucoma Ashok Garg, Emanuel Rosen, Tanuj Dada, Ahmed K Khalil
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1INSTANT CLINICAL DIAGNOSIS IN OPHTHALMOLOGY: GLAUCOMA
3INSTANT CLINICAL DIAGNOSIS IN OPHTHALMOLOGY: GLAUCOMA
Series Editors 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) Emanuel Rosen MD Medical Director Rosen Eye Associates Harbour City, Salford Quays M50 3 BH UK Editors Shlomo Melamed MD PhD Professor of Ophthalmology Sackler Medical School Tel-Aviv University Head and Chairman Sam Rothberg Glaucoma Centre Tel HaShomer, Israel Tanuj Dada MD Associate Professor of Clinical Ophthalmology, Dr RP Centre for Ophthalmic Sciences AIIMS, Ansari Nagar New Delhi-110029 India Ahmed K Khalil MD PhD Professor of Ophthalmology, Medical Director Saridar Clinic Tower, Apt 67-C, 92, Tahrir St. Dokki Square, Cairo, Egypt-12411 Foreword Robert N Weinreb
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Instant Clinical Diagnosis in Ophthalmology (Glaucoma)
© 2009, Editors
All rights reserved. No part of this publication 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.
First Edition: 2009
9788184484533
Typeset at JPBMP typesetting unit
Printed at Ajanta Press
5Dedicated to
— Ashok Garg
— Emanuel Rosen
— Shlomo Melamed
— Tanuj Dada
— Ahmad K Khalil
7Contributors 11Foreword
It seems like yesterday that I began a career in glaucoma and first contemplated what might transpire during the ensuing decades. At times, it has seemed that what has been learned through basic research has been inadequate to justify it's time and effort. Also the pace of translational clinical research often has appeared to be so slow, and certainly not fast enough to have a major impact on glaucoma blindness. There still are fundamental issues relating to glaucoma that have to be addressed, including some very basic ones. The absence of a clear definition of glaucoma is the one that most consistently irks me. It is, perhaps, the most basic of issues in glaucoma and is at the core of what we do in the laboratory. More significantly, it is central to how we daily diagnose and manage our glaucoma patients. Plus ca change, plus la meme chose? Or are we on the precipice of paradigm changes for both diagnosis and treatment that will impact significantly the prognosis for retaining vision and quality of life with glaucoma. From my vantage point, I suspect that it is the latter.
Never before have we had better tools to elucidate glaucoma pathophysiology, as well as to better diagnose, better monitor progression, and better treat glaucoma. And never before have we had the desire and commitment to do so. New instruments for imaging the optic disk, retinal nerve fiber layer and anterior segment have emerged that provide objective analyses that clearly are superior to subjective examinations of the past. There also has been the introduction into clinical practice of new medical and surgical therapies, albeit they all still have limitations.
Many of these advances are described in this text, particularly the innovative surgical approaches that promise to revolutionize our care.
Despite having all this new information so nicely packaged and available in this book, it still will be a daunting task for an interested reader to be constantly updating their knowledge and clinical skills. In addition to being grounded in the fundamentals of glaucoma, high quality glaucoma care requires access to timely and informed information. One needs then to critically evaluate the provided information, place it in the context of one's own clinical experience and translate it into clinical practice. Evidence-based medicine, consensus and clinical experience are all complementary for the most thoughtful clinicians.12
I congratulate Dr. Ashok Garg, editors and authors who have contributed to this timely book.
Dr Robert N Weinreb md
Distinguished Professor of Ophthalmology
Director
Hamilton Glaucoma Center
University of California, San Diego
La Jolla, California 92093
United States
Ph.: 001 858 534-8824.
13Preface
In modern day busy and fast life ophthalmologists are glued to their clinical and surgical practice and have little time to read large volume books. The need of hour is to have pocket size ready recokner enriched with complete and up-to- date information of the diseases in a most comprehensive manner. At present very few quality ready reference books are available at an International level.
After detailed research regarding the needs of ophthalmologists we have developed a series of 10 volume ready reference books termed as Instant Clinical Diagnosis in Ophthalmology. This series covers Oculoplastic and Reconstructive Surgery, Retina, Lens, Glaucoma, Refractive Surgery, Pediatric Ophthalmology, Strabismus, Anterior Segment Diseases, Cornea and Neuro-ophthalmology. Present series has been designed to provide up-to-date information of concerned disease in a comprehensive and a lucid manner along with high quality clinical photographs in an easy to read format. International masters of concerned subjects have contributed chapters in this series covering pathophysiology, clinical signs and symptoms, investigations, differential diagnosis, treatment and prognosis in a simplified manner.
This volume deals with important clinical entity, glaucoma, which is one of the major causes of blindness worldwide. This volume consists of latest information on various clinical glaucoma conditions, their diagnosis and management in an easy to ready format for the benefit of readers. A number of leading international glaucoma experts have shared their experiences in form of chapters covering all aspects of glaucoma. We are glad to provide complete and latest information of glaucoma in a comprehensive manner in this book for quick look and as a ready reckoner.
We are highly thankful to our publisher M/s Jaypee Brothers Medical Publishers Pvt. Ltd. especially Shri Jitendar P Vij (CEO), Mr. Tarun Duneja (Director, Publishing) and all staff members for their dedication and hard efforts put in the preparation of high quality series of Instant Clinical books.
We hope this 10 volume set of ready reference pocket size books shall provide complete and useful clinical information to ophthalmologists all around the world and shall help them to accurately and precisely diagnose, treat and manage their clinical cases confidently to the satisfaction and expectations of their valued patients. We also hope this ready reckoner shall serve as useful companion on every clinician desk.
Editors