Comprehensive Ophthalmology AK Khurana, Bhawna Khurana, Aruj K Khurana
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1Comprehensive Ophthalmology2
SIXTH EDITION
3Comprehensive OPHTHALMOLOGY
AK Khurana ms faico cto (London) Senior Professor and Head Regional Institute of Ophthalmology Postgraduate Institute of Medical Sciences Rohtak, India Aruj K Khurana dnb (Sankara Nethralaya, Chennai) fico Department of ophthalmology Himalayan institute of medical sciences Jolly Grant, Dehradun (UK), India Bhawna Khurana ms dnb fico Department of ophthalmology All India institute of medical sciences (AIIMS) Rishikesh (UK), India
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© 2015, AK Khurana
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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Comprehensive Ophthalmology
First Edition: 1996
Sixth Edition: 2015
9789351526575
Printed at
Dedicated
To my parents and teachers for their blessings5
To my students for their encouragement
To my children for their patience
To my wife for her understanding 6
7Preface
Journey of Comprehensive Ophthalmology, beginning from January 1996, has been satisfying, as it has succeeded in serving the needs of the students at large. Thoroughly revised and updated sixth edition of the book retains its well accepted style of presenting the text. However, to make it more user-friendly its layout has been re-organized into six sections as against two sections in the fifth edition.
Section 1: Anatomy and Physiology of Eye includes two chapters. First chapter is devoted to essential aspects of Anatomy and Development of the Eye, and second chapter covers Physiological aspects of various ocular structures including Physiology of Vision in a concise manner.
Section II: Optics and Refraction. Out of two chapters of this section one is devoted to Elementary and Physiological Optics and the other describes Errors of Refraction and Accommodation in depth.
Section III: Diseases of Eye. This section covers important diseases of various structure components of the eyeball, ocular adnexa and visual pathway in fourteen chapters.
Section IV: Ocular Therapeutics. This section comprises two chapters one each on Ocular Pharmacology, and Lasers and Cryotherapy in Ophthalmology.
Section V: Systemic and Community Ophthalmology includes two chapters one on each topic.
Section VI: Practical Ophthalmology. This section includes chapters on Clinical Methods in Ophthalmology and different other aspects essential to the practical examinations such as Ophthalmic Cases, Darkroom Procedures, and Ophthalmic Instruments.
Review of Ophthalmology. This companion to the textbook provides an in depth revision of the subject at a glance and an opportunity for self-assessment, and thus makes it the book of choice for preparing for various postgraduate entrance examinations.
Salient Features of the Book
Sixth Edition of the book has been possible as a result of active criticism, suggestions and generous help of many teachers and students. Surely, I owe sincere thanks to them all. Those who need special mention are Prof. R.C. Nagpal, Prof. Harsh Bahadur and Prof. Renu Dhasmana from HIMS, Jolly Grant, Dehradun; Prof. G.S. Bajwa, DMC, Ludhiana; Prof. R.N. Bhatnagar, Gian Sagar Medical College, Rajpura; Prof. P.S. Sandhu, Faridkot; Prof. S.S. Shergill, Amritsar; Prof. Dharamveer, Patiala; Prof. S.M. Bhati and Prof. Nitin Batra from CMC, Ludhiana; Prof. V.P. Gupta, UCMS, New Delhi; Prof. K.P. Chaudhary, GMC, Shimla; Prof. Atul Kumar, and Prof. Tanuj Dada from Dr. R.P. Centre for Ophthalmic Sciences, AIIMS, New Delhi; Prof. Vishnu Gupta and Prof. B.P. Guliani from VMMC, New Delhi; Prof. Amod Gupta, Prof. Jagat Ram and Prof. M.R. Dogra from PGIMER, Chandigarh and Dr. Mahipal S. Sachdev, Medical Director, Centre for Sight, New Delhi.
8I acknowledge the special help rendered by Prof. S. Sood from GMC, Chandigarh by contributing fundus photographs and OCT pictures; Dr. Santosh Honavar from CFS, Hyderabad for some figures of orbital tumours and Dr. Shweta Goel for her sincere help in updating this edition. I am grateful to Dr. C.S. Dhull, Director, PGIMS and Dr. S.S. Sangwan, Vice-Chancellor, University of Health Sciences, Rohtak for providing an academic atmosphere conducive to such a venture. I acknowledge with humble thanks, the respect, affection and cooperation of faculty members of Regional Institute of Ophthalmology (RIO), PGIMS, Rohtak namely Dr. S.V. Singh, Dr. J.P. Chugh, Dr. V.K. Dhull, Dr. R.S. Chauhan, Dr. Manisha Rathi, Dr. Neebha Anand, Dr. Manisha Nada, Dr. Urmil Chawla, Dr. Ashok Rathi, Dr. Sumit Sachdeva, Dr. Sumeet Khanduja, Dr. Reena Gupta and Dr. Jitender Phogat.
The love and moral support, in addition to the editorial help, rendered by my daughter Dr. Arushi, University of Connecticut, USA, and my wife Dr. Indu Khurana, Senior Professor, Physiology made my task untiring.
The enthusiastic cooperation received from Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director–Publishing), Ms. Sunita Katla (Publishing Manager), Mr. Rajesh Sharma (Author Coordinator), and Mr. Sumit Kumar (Graphic Designer), Ms. Seema Dogra (Cover Designer), Ms. Geeta Srivastava and Geeta Barik (Proof Readers) and Mr. Kapil Dev Sharma (DTP Operator) of Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, needs special acknowledgement.
Sincere efforts have been made to verify the correctness of the text. However, in spite of best efforts, ventures of this kind are not likely to be free from human errors, some inaccuracies, ambiguities and typographic mistakes. Users are therefore requested to send their feedback and suggestions. The importance of such views in improving the future editions of the book cannot be overemphasized. Feedbacks received will be highly appreciated and duly acknowledged.
A K Khurana