Editors
Ashok Garg MS, PhD, FIAO (Bel) FRSM FAIMS ADMFICA
International and National Gold Medalist Chairman and Medical Director Garg Eye Institute and Research Centre
235-Model Town, Dabra Chowk, Hisar-125005, India
Jose Maria Ruiz Moreno MD, PhD
Professor of Ophthalmology Albacete Medical School University of Castilla La Mancha Avendia de Almansa, 14 02006,
Albacete, Spain
T Mark Johnson MD, FRCS
Consultant, Vitreo-retinal Surgeon National Retina Institute Suite 101 5530 Wisconsin Ave, Chevy Chase 20815,
USA
Arturo Perez Arteaga MD, PhD
Medical Director Centro Oftalmologico Tlalnepantla Dr. Perez –
Arteaga Vallarta No. 42 Tlalnepantla, Centro, Estado de Mexico 54000, Mexico
João J Nassaralla Jr MD, FRCS
Associate Professor of Ophthalmology University of Brasilia, DF Consultant Ophthalmic Surgeon Department of Retina and Vitreous Goiania Eye Institute Goiania GO,
Brazil
Foreword Mario Enrique Leonardo Duarte Tortoriello
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Jaypee Gold Standard Mini Atlas Series® Ophthalmic Ultrasound
© 2010, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication and Photo CD ROM 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: 2010
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5Dedicated to
- My respected Param Pujya Guru Sant Gurmeet Ram Rahim Singh Ji for his blessings and motivation.
- My respected parents, teachers, my wife Dr. Aruna Garg, son Abhishek and daughter Anshul for their constant support and patience during all these days of hard work.
- My dear friend Dr. Amar Agarwal, a renowned International Ophthalmologist for his constant support, guidance and expertise.
Ashok Garg
My family (Magali, my wife and Jorge, Guillermo and Magali my children) for the time, comprehension and patience that they have had with me during all these years of hard work.
Jose Maria Ruiz Moreno
My wife Joanne and my son Connor for providing me with their love, wisdom and support throughout the years.
T Mark Johnson
I dedicate my work to all the people in the world with ophthalmic diseases, with the best wish that we can improve with this kind of material our quality of care. I also dedicate this opus to Prof. Ashok Garg, because he has trusted in my work many times.
Arturo Perez Arteaga
My wife Belquiz and our children, Joao Neto, Arthur and Anna Paula, for providing me with their love, wisdom and support throughout the years.
7CONTRIBUTORS
- Amar Agarwal ms frcs
- Director
- Dr. Agarwal's Eye Hospital
- 19, Cathedral Road
- Chennai-600086, India
- Anand A Shroff ms
- Shroff Eye Hospital
- 222, SV Road, Bandra (W)
- Mumbai-400050, India
- Aravind R Reddy ms frcs
- The Leeds Teaching Hospitals
- Leeds-LS29NS
- UK
- Ashok Garg ms phd frsm
- Chairman & Medical Director
- Garg Eye Institute and Research Centre
- 235-Model Town
- Dabra Chowk
- Hisar-125005, India
- Arturo Perez Arteaga md
- Ophthalmologist Anterior
- Segment, Surgeon
- Medical Director & Founder
- Centro Oftalmologico
- Tlalnepantla
- Mexico, Vallarta No. 42
- Tlalnepantla
- Centro, Mexico 54000
- Dinesh Garg md
- Professor
- Department of Ophthalmology
- Dayanand Medical College and Hospital
- Ludhiana-141001 (India)
- Hugo Linares md
- National Retina Institute
- Ste 101-5530 Wisconsin
- Ave Chevy Chase
- MD 20815
- USA
- I Howard Fine md facs
- Oregon Eye Surgery Centre
- 1550, Oak Street
- # 5, Eugene, OR - 97401
- USA
- Javier A Montero md phd
- Pio del Rio Hortega
- University
- Hospital, Valladolid
- VISSUM
- Vitreo-Retina Unit
- Alicante, Spain
- João J Nassaralla Jr md
- Consultant Ophthalmic
- Surgeon
- Department of Retina
- Goiania Eye Institute
- Goiania, GO, Brazil
- Jose Maria Ruiz Moreno md
- Professor
- Department of Ophthalmology
- Albacete Medical School
- Castilla La Macha University
- Avendia de Almansa, 14
- 02006, Albacete, Spain
- Kumar J Doctor ms
- Director
- Doctor Eye Institute
- Spenta Mansion
- SV Road, Andheri (W)
- Mumbai-400058, India
- Mario Enrique Leonardo Duarte Tortoriello md
- Director
- Ophthalmic Ultrasonic Department
- Juarez Hospital
- Mexico City
- Mexico
- Mark Packer md
- Oregon Eye Surgery Centre
- 1550, Oak Street
- # 5, Eugene
- OR - 97401
- USA
- Nita Shanbhag ms
- Doctor Eye Institute
- Spenta Mansion
- SV Road
- Andheri (W)
- Mumbai-400058, India
- Pooja Deshmukh ms
- Doctor Eye Institute
- Spenta Mansion
- SV Road, Andheri (W)
- Mumbai-400058, India
- Richard S Hoffman ms
- Oregon Eye Surgery Centre
- 1550, Oak Street
- # 5, Eugene
- OR - 97401
- USA
- Seema Gupta md
- Assistant Professor
- Department of Anatomy
- Dayanand Medical College and Hospital
- Ludhiana-141001 (India)
- Sumita Karandikar ms
- Director
- Doctor Eye Institute
- Spenta Mansion
- SV Road, Andheri (W)
- Mumbai-400058, India
- Sunita Agarwal ms
- Director
- Dr. Agarwal's Eye Hospital
- Bengaluru, India
- T Mark Johnson md frcsc
- Consultant Vitreoretinal Surgeon
- National Retina Institute
- Ste 101-5530 Wisconsin
- Ave Chevy Chase
- MD 20815, USA
An antique proverb says that “One image is better than one thousand words”; nothing more than this truly applies to the echographic study of the eye. After two decades dedicated to the study and performance of the ophthalmic ultrasound, it is an honor and an enormous pleasure for me, to present to you and contribute in this magnificent Jaypee Gold Standard Mini Atlas Series: Ophthalmic Ultrasound.
When performing a historical review of ophthalmic ultrasound, we find that the media opacities were the initial motivation for the application of the ultrasound to the eye structures. Many things have changed since those beginning years. Currently, because of the efforts of many researches, many concepts have evolved since then, involving within many advantages to this particular study. Maybe we can say that the more important are as follows:
- It is a non-invasive study that can be performed to the eye with the lids closed, situation of advantage, in particular with non-cooperative patients (e.g., pediatric).
- It is being useful even in cases without media opacities, helping the clinicians in performing of certain clarifications in the diagnosis (e.g., subretinal space, choroidal effusions and macular edema follow-up).
- It is a magnificent diagnostic tool in the study of structures outside the globe, like orbitary region (e.g., optic nerve, extra-ocular muscles, and soft intraorbitary tissue) and para-orbitary sectors (e.g., lids, lacrymal pathway).
- It has increased its precision for IOL calculation, with new formulae and new immersion techniques.
- It is a complimentary tool to some other investigations, like interferometry, pentacam or optical coherence tomography.
- It has the enormous advantage of “real time studies”, performing video and seeing in live-movement the intraocular structures. This active technique increases the diagnostic possibilities of echography.
This book has explored all these new and antique possibilities of ophthalmic ultrasonography in a smooth and comprehensive way. Renowned ophthalmologists from around the world, are showing us in this mini atlas different pathologies from the point of view of the ocular echography. We can learn from one image; but furthermore, this opus is showing us the current state of this technology and leave us to enter in the field of imagination, about the possibilities that the ophthalmic 13ultrasonography will bring in the future, by itself or in conjunction to some other technologies for the diagnosis, follow-up and biometry of the eye and neighbor structures.
It has been a tremendous honor for me to participate and present to you this magnificent opus. I congratulate chief editor, editors and contributing authors for their remarkable efforts.
Mario Enrique Leonardo Duarte Tortoriello MD
Ophthalmologist, Sub-specialist in Ophthalmic Ultrasound
Chairman of Ophthalmology Department
Hospital Juàrez de Mexico, Secretarìa de Salud
(Secretary of Health), Mexico City
Clinical Professor of Ophthalmology, Medical School,
“Universidad Nacional Autonoma de Mexico”
(National University of Mexico)
Ophthalmic Ultrasound Consultant to “Centro Oftalmològico
Tlalnepantla” Tlalnepantla, Mexico
Office Address: Avenida San Agustin No. 2, Rincon de
Echegaray, Naucalpan, Estado de Mexico, Mexico 53309
Phone: 52-1-5537070647
15PREFACE
Ophthalmic ultrasound is an important diagnostic tool for various ocular and orbital diseases. A-scan biometry is quite significant for anterior segment surgeons for detecting axial length, depth of anterior chamber and IOL power calculation in cataract and lenticular refractive surgery. B-scan ultrasonography is commonly used by posterior segment surgeons in the diagnosis of various ocular pathologies and intraocular and retrobulbar tumors.
Concept of this book is to provide text and echograms details in an easy-to-read mini atlas form to serve as ready reckoner to ophthalmologists in their day-to-day practice. Nineteen chapters of this book provide in-depth analysis of A-scan and B-scan ultrasonography in all major ocular conditions in a comprehensive manner. This book provides correlation between clinical and ultrasound findings in a beautiful manner. International experts on this subject have shared their experiences in this mini atlas book.
At the end we are grateful to our publishers M/s Jaypee Brothers Medical Publishers (P) Ltd. especially Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing) and all staff members who took keen interest in this project and published it expeditiously.
Certainly, this book shall serve as quick look companion to ophthalmologists in their consultation room.
Editors