Declaration
Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors, editors, contributors and the publishers have, as far as it is possible, taken care to ensure that the information given in this text is accurate and up-to-date. However, readers are strongly advised to confirm that the information, especially with regard to drug dose/usage, complies with current legislation and standards of practice.
PK Mukherjee MS
Former Professor and Head Upgraded Department of Ophthalmology Pandit Jawaharlal Nehru Memorial Medical College
Raipur, Chhattisgarh, India
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Essentials of Neuro-ophthalmology
© 2010, Jaypee Brothers Medical Publishers (P) Ltd
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: 2010
9788184489828
Typeset at JPBMP typesetting unit
Printed at
Preface
The fascinating subject of neuro-ophthalmology is an enigma that frightens the undergraduates and the postgraduates are initially at ease with cases of neuro-ophthalmology and the general ophthalmologists find them too demanding hence are happy to handover them to neurophysicians or neurosurgeons at the earliest.
Neuro-ophthalmology is not an individual entity, it is very much ophthalmology. It has ramifications in other specialties like neuromedicine, neurosurgery, neuroimaging, oncology and otorhinology.
The riddle of neuro-ophthalmology is not difficult to crack provided the cases are examined by a fixed protocol, avoiding ordering investigations at random. The puzzles of neuro-ophthalmology are easier to solve if the clues in the form of history, clinical examination, etc. are given adequate attention to.
The number of books in neuro-ophthalmology are not too many. Most of those available are huge treatise which are almost classics by themselves. These books create awe in the beginners. The remaining books are too abridged to comprehend. The present book is a veritable “Neuro-ophthalmology Made Easy” meant for both undergraduates and postgraduates.
Management of a neuro-ophthalmic disorder is not always within the domain of ophthalmologists who should be aware of the significance of referring the case to consultants in other specialties. They should be able to decide when and to whom a case should be referred to.
The present book does not deal with systemic management in details, whenever needed only passing references have been given. The systemic management is better left to neurophysicians or neurosurgeons. The surgical procedures too have been left out. They may be read from specific books. Neuroimaging is proving to be a great boon in neuro-ophthalmic disorders. The students are advised to understand finer points of neuroimaging from books exclusively dealing with the subject.
Acknowledgments
It was virtually impossible for me to write the book without the help from my friends, colleagues and family members.
On the top of the list of my peers, who extended unending help are the members of upgraded Department of Ophthalmology, Pandit Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India. They include Professor SL Adile, the present Director Medical Education, Government of Chhattisgarh, Professor and Head of the Department, Dr AK Chandrakar, Professor Dr ML Garg and Dr Nidhi Pandey, Associate Professor of Ophthalmology, all of whom have kept me supplied with unending stream of books and journals. Dr Santosh Patel has been generous enough to provide me maximum number of clinical pictures, who deserves special mention and thanks.
My niece, Dr Nupur Chakravarty, Professor of Ophthalmology, YD Patil Medical College, Mumbai, Dr OP Billore of Rotary Eye Hospital, Navsari, Dr Hetal Yagnik, Dr Sharad Sivasane and Dr Dishant Shant of the same institute as well, have sent me interesting photographs from their collection. Their contribution is acknowledged with gratitude. I am thankful to Dr Anand Saxena for the colored fundus photographs and fundus fluorescein angiography (FFA) used in the book.
I thank Dr Barun K Nayak, Editor of Indian Journal of Ophthalmology, to use some of the photographs published in the journal.
Dr Manik Chatterjee, Associate Professor of Anatomy, Pandit Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India was always available to solve my curiosity about intricacies of neuroanatomy. He was polite enough to point out the fallacies in my drawings. I am thankful to him.
I am highly obliged to Padamsri Professor AT Dabke PhD, former Director of Medical Education and Professor of Pediatric for permitting to use his personal library unfettered.
The book may not have seen the light of the day without the help from members of my family. My sons-in-law, Satayadeep Sahukar and Dr Abeer Bandyapadhya, took special interest in locating various references on Internet, drawing the diagrams and arranging them. I am thankful to my daughters, Dr Protibha Mukherjee Sahukar and Dr Preeti Bandyopadhya, for their unending help and suggestions from time to time in their respective specialties.
The real inspiration has been my wife, Protima, who awakened me often from the slumber in which I slipped occasionally.
Sri Maneesh Dandekar of Hypersoft Computers has taken great troubles in deciphering my handwritten manuscript and type them many a times. Sri Bhim Sona of Hypersoft also deserves appreciation for drawings used in the book.
Finally, I extend my thanks to Sri Jitendar P Vij (Chairman and Managing Director), Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India and members of his team for their constant interest in publishing my humble contribution towards continued medical education.