The Sankara Nethralaya Atlas of Ophthalmic Ultrasound and Ultrasound Biomicroscopy Muna Bhende, B Shantha, Harshali Kamat, Vikas Khetan, Tandava Krishna
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1THE SANKARA NETHRALAYA Atlas of OPHTHALMIC ULTRASOUND AND ULTRASOUND BIOMICROSCOPY2
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THE SANKARA NETHRALAYA Atlas of OPHTHALMIC ULTRASOUND AND ULTRASOUND BIOMICROSCOPY
SECOND EDITION
Muna Bhende Senior Consultant Vitreoretinal Service Harshali Kamat Fellow, Vitreoretinal Surgery B Shantha Deputy Director and Senior Consultant, Glaucoma Service Vikas Khetan Consultant, Vitreoretinal Service Tandava Krishna Fellow, Vitreoretinal Surgery Parveen Sen Senior Consultant Vitreoretinal Service Suchitra Pradeep Consultant, Uvea Service Sankara Nethralaya 18, College Road Chennai, Tamil Nadu, India
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The Sankara Nethralaya Atlas of Ophthalmic Ultrasound and Ultrasound Biomicroscopy
First Edition: 2006
Second Edition: 2013
9789350905357
Printed at
5Foreword to the First Edition
Although ophthalmic ultrasound is now widely accepted as an important tool for the diagnosis and management of many ocular and orbital disorders, most academic centers do not have formal training programs to teach the skills necessary for performing precise and accurate ultrasound examinations. Unless an individual can spend several months or more at one of the few centers in the world that have an expert echographer, most ophthalmic ultrasound is self taught by attending lectures, reading articles, and studying one of the few textbooks available in this field. A welcome addition to the collection of teaching materials currently available for ophthalmic ultrasound is The Sankara Nethralaya Atlas of Ophthalmic Ultrasound.
This group, consisting of mainly vitreoretinal surgeons who are also experienced echographers, has put together a concise, yet comprehensive text that is extremely well illustrated and very readable. Excellent examples of almost every ocular and orbital disorder, one might expect to encounter in the clinical practice of ophthalmic echography, are represented in this atlas. The reader's understanding of the ultrasound illustrations is enhanced with color fundus photographs and external photos, as well as CT scans and MRI scans of the orbit. One of the text's outstanding features is the use of “nuggets” in most of the chapters; charts which provide pearls of information that are important for the differentiation and diagnosis of particular conditions.
The authors are to be congratulated for carefully assembling this wealth of information in such a practical and straightforward manner. It demonstrates their thoughtful insight into the field of ophthalmic ultrasound as well as their skills as educators. This atlas will undoubtedly be an invaluable resource for new practitioners and will be of great interest to those already familiar with ultrasound of the eye and orbit.
Ronald L Green md
Professor
Doheny Eye Institute
Department of Ophthalmology
University of Southern California Keck School of Medicine
Los Angeles, California
USA6
7Preface to the Second Edition
The first edition of The Sankara Nethralaya Atlas of Ophthalmic Ultrasound was intended to be both a teaching and practical reference tool for the ophthalmologist. Though more sophisticated imaging techniques in certain areas of ophthalmology have evolved over the past years, ultrasonography is still a useful tool that can be done in a clinic by the ophthalmologist. While updating some of the chapters of the first edition with more images and examples of representative cases, we have retained the original outline and pattern.
In this second edition The Sankara Nethralaya Atlas of Ophthalmic Ultrasound and Ultrasound Biomicroscopy, we have now included an entirely new section on ultrasound biomicroscopy that has widened the scope of this atlas to include anterior segment imaging as well. With text being kept to a minimum, the salient clinical and ultrasound features have been described with practical tips for technique, interpretation, and implications on management. Where possible, we have provided corresponding color photographs, pathology images as well as other diagnostic reports, such as CT and MRI. The combined experience of ophthalmologists from almost all the ophthalmic subspecialties has resulted in a large collection of cases both common and rare, where ultrasound imaging has been a valuable diagnostic aid.
We hope that this new, revised edition will prove to be useful to students, practising ophthalmologists, and radiologists who perform ophthalmic ultrasound.
Muna Bhende8
9Preface to the First Edition
Ultrasonography is an important investigative tool in ophthalmology, in particular for vitreous surgery, oncology, and orbital diseases. The ultrasonography department at Sankara Nethralaya consists of ophthalmologists, most of whom are trained vitreoretinal surgeons. The department performs about 40 procedures every day and has been doing so far almost two decades. This atlas is a compilation of the numerous classic and unusual cases that have been seen here, along with a brief outline of the salient clinical and ultrasound features. The nuggets at the end of the chapters are intended to serve as a quick reference in difficult situations. We are honored that an authority on the subject, Prof Ronald L Green, who has coauthored a classic textbook on Ophthalmic Ultrasound, has written the foreword for this atlas. This atlas is meant as both a basic text as well as a reference tool for both students of ophthalmology and practising ophthalmologists.
Muna Bhende10
11Acknowledgments
As we have continued most of the material from the first edition, we acknowledge the original contributors once again as without their help the foundation would have needed to be re-laid. Our mentor and chief Dr SS Badrinath continues to guide and inspire us in our endeavors. Dr Lingam Gopal and Dr Tarun Sharma, both stalwarts in vitreoretinal surgery, have provided encouragement, wise counsel and guidance through every stage of the preparation of the atlas.
The vitreoretinal department both consultants and fellows, has contributed in a huge way toward the material in this atlas.
The incorporation of the new section on ultrasound biomicroscopy has meant active involvement of more subspecialities notably glaucoma, uvea oncology, and optometry.
As always, we rely heavily on our support staff from photography, biomedical engineering, IT, and medical records as well as our secretarial staff. Their contribution to the creation of this atlas is invaluable.
To our patients—many of whom patiently underwent repeat evaluations in order to obtain the best images for the atlas—your contribution will go a long way in making this atlas a purposeful one.
Thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr Tarun Duneja (Director - Publishing), Ms Sunita Katla (Publishing Manager), Ms Chetna Malhotra Vohra (Sr Manager, Business Development), Mr DC Gupta (Sr Editor), Ms Seema Dogra (Cover Designer), Mr Jayanandan (Bengaluru Branch), Ms Samina Khan (PA to Director), Mr Rajesh Sharma (Production Coordinator), Sandeep Tomar (Graphic D esigner), and Arvind Kumar (DTP Operator) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India who made this atlas a reality.
The list of individuals acknowledged below is by no means exhaustive and the authors apologize, if they have left out anyone inadvertently.
VR Consultants
Dr Pramod Bhende
Dr Dhanashree Ratra
Dr Pratik Ranjan Sen
Dr Ekta Rishi
Dr Pukhraj Rishi
Dr Chetan Rao
Dr Kasinathan
Dr Pradeep S
Dr Vinata Rajendran
Dr G Suganeswari
Dr Aditya Verma
Dr Kumar Saurabh
Dr Rupak Roy
Dr Sudipta Das
Uvea Department
Dr J Biswas
Dr Mamta Agarwal
Dr Partho Prathim Majumder
Glaucoma Department
Dr L Vijaya
Dr Aditya Neog
Dr Manish Pandey
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VR Fellows
Dr Aditi Gupta
Dr Lakshmi Kunyal
Dr Bindu Appukuttan
Dr Shruti Thiagarajah
Dr Gaurav Mathur
Dr Mohd Kazi
Optometry
Ms Yamuna Devi L
Ms Shenbagam N
Ms Archana Babu
Neuroophthalmology
Dr Vijay Ananth
Oculoplasty
Dr Bipasha Mukherjee
Radiology
Dr Veena Noronha
Ocular Pathology
Dr Krishnakumar
Ms Vanitha
Secretarial Staff
Ms Anuradha
Ms Bindu
Ms Kalaivani
Photography department
Mr Krishna MS
Mr K Chidambaram
Mr CS Hariharan
Mr T Ravishankar
Mr M Thilak
Mr Shankar K
Biomedical Engineering
Mr P Krishnamurthy
Mr P Vinoth Kumar
Medical Records and IT teams