Textbook of Visual Science and Clinical Optometry Bikas Bhattacharyya
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1Textbook of Visual Science and Clinical Optometry
2Textbook of Visual Science and Clinical Optometry
Bikas Bhattacharyya MBBS (Honours), MS, DO Consultant Eye and Laser Surgeon Apollo Gleneagles Hospitals, Kolkata Sambhu Nath Pandit Hospital, Kolkata Wockhardt Medical Centre Kolkata, West Bengal, India Foreword Debashish Bhattacharya
3
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
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Textbook of Visual Science and Clinical Optometry
© 2009, Jaypee Brothers Medical Publishers
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 author and the publisher.
First Edition: 2009
9788184485998
Typeset at JPBMP typesetting unit
Printed at
4To
My parents Prativa Bhattacharya and Late Biresh Chandra Bhattacharya
along with My parents-in-law Geeta Roychowdhury and Late Satyabrata Roychowdhury
5Foreword
Textbook of Visual Science and Clinical Optometry is a wonderful knowledge book for the ophthalmic practitioners, optometrists and students of ophthalmology.
This book explains the anatomy and physiology of the eye in a very well-formatted concise manner. It enlightens the optical defects and its correction in a most lucid and methodical way. In the glamour of ophthalmic innovations, the fundamental optics and refraction of the eye have become a forgotten territory.
I thank Dr Bikas Bhattacharyya for bringing out this book in such a “transparent and structured format”. Bikas, 2 years junior to me in Medical Education in the same University, is always remembered for his unusual inclination to minute details and documentation. This book is reflection of his qualities.
I am sure we will learn a lot of skills from this book and use it for more efficient eye care. This will be the most fitting tribute to the hard work that he has put into writing this book.
Dr Debashish Bhattacharya
Chairman
Disha Eye Hospital and Research Centre (P) Ltd
Barrackpore, West Bengal, India
6Preface
Textbook of Visual Science and Clinical Optometry is designed to cater to the needs of eye care team which includes ophthalmologists, ophthalmology residents, optometry students and ophthalmic technicians.
The book includes 18 chapters which are divided into 6 sections and each chapter is supplemented by numerous illustrations. Every attempt is made to make this book as clinically relevant as possible.
to deal with the normal human eye and its optical principle. deals with the different types of refractive errors and its correction. stresses on the various optical lenses, frames, measurements and contact lenses. Knowledge on these topics () is usually not covered in books on ophthalmology. The last section is unique in a way as it covers three special chapters on ophthalmic instrumentation techniques, low visual aids and paediatric eye examination, which is invaluable to all those involved in eye care.
I hope that my humble efforts would prove successful in helping the beginners in ophthalmology. I have tried to make the topics as comprehensive and simplified as possible. However, certain inaccuracies may arise for which I apologise sincerely.
Any suggestions and comments on the book would be greatly appreciated.
Bikas Bhattacharyya
7Acknowledgements
During my residency training and subsequent practising years, I felt the need of a comprehensive book covering all aspects of practical ophthalmic examinations and clinical optics.
I would like to thank M/s Appasamy Associates, Chennai, India for giving me the relevant photographs for publication.
I would also like to express my gratitude to Mr Sirajul Mullick, Department of Optometry Science (DOS) for the invaluable assistance he has extended to me during preparation of the chapters related to clinical optometry.
I would like to convey my gratitude to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi and all the technical staff.
I would also like to thank all my colleagues in different institutions for their continued encouragement.
Finally, I would like to thank my wife and children for their continued support and their patience for tolerating my preoccupation with the book.
12Abbreviations AC
Anterior chamber
AC/A
Accommodative convergence / Accommodation ratio
add
Addition for near vision
ARC
Abnormal retinal correspondence
ARMD
Age-related macular degeneration
BE
Both eyes
BIO
Binocular indirect ophthalmoscopy
BOZD
Back optic zone diameter
BOZR
Back optic zone radius
BRAO
Branch retinal artery occlusion
BRVO
Branch retinal vein occlusion
BVP
Back vertex power
CB
Ciliary body
cd
Candela
C/D
Cup disc ratio
CF
Counting fingers
CL
Contact lens
CLARE
Contact lens acute red eye
CME
Cystoid macular oedema
CNV
Choroidal neovascularisation
cpd
Cycle per degree
CRAO
Central retinal arterial occlusion
CRVO
Central retinal vein occlusion
CR-39
Columbia Resin 39
Ct
Carat
CVS
Computer vision syndrome
D
Diopter
DBL
Distance between lenses
DBR
Distance between rims
Dk
Oxygen permeability
13
Dk/t
Oxygen transmissibility
ECCE
Extracapsular cataract extraction
EOG
Electrooculogram
ERG
Electroretinogram
ERP
Early receptor potential
EUA
Examination under anaesthesia
EW
Extended wear contact lens
FAZ
Foveolar avascular zone
FM100
Farnsworth-Munsell 100 Hue test
ftcs
Footcandles
FVP
Front vertex power
GAG
Glycosaminoglycans
GPC
Giant papillary conjunctivitis
HEMA
Hydroxyethyl methacrylate
HM
Hand movements
ICCE
Intracapsular cataract extraction
IO
Inferior oblique
IOL
Intraocular lens
IOP
Intraocular pressure
IPD
Interpupillary distance
IR
Infrared, inferior rectus
J
Jaeger type notation
KCS
Keratoconjunctivitis sicca
KP
Keratic precipitates
LE
Left eye
LPS
Levator palpebrae superioris
LR
Lateral rectus
LVA
Low vision aid
M
Magnification
MAR
Minimum angle of resolution
MR
Medial rectus
N
N system of notation
n
Index of refraction
nm
Nanometer
OD
Oculus dexter, i.e. right eye
OKN
Optokinetic nystagmus
OS
Oculus sinister, i.e. left eye
14
OU
Oculus uterque, i.e., both eyes
PAL
Progressive addition lens
PAM
Potential acuity meter
PAS
Peripheral anterior synechiae
PD
Pupillary distance
PL
Perception of light
PMMA
Polymethyl methacrylate
POAG
Primary open-angle glaucoma
PVD
Posterior vitreous detachment
PXF
Pseudoexfoliation
RAPD
Relative afferent pupillary defect
RE
Right eye
RGP
Rigid gas permeable contact lens
RPE
Retinal pigment epithelium
SO
Superior oblique
SR
Superior rectus
TD
Total diameter
TM
Trabecular meshwork
UV
Ultraviolet
V
Abbé's number/constringence/V-value, vision
VA
Visual acuity
VEP
Visual evoked potential
VER
Visual evoked response
VKC
Vernal keratoconjunctivitis
a
Angle alpha
D
Prism diopter
k
Angle kappa
I
Angle lambda; wavelength
¥
Infinity