2011-2012 Basic and Clinical Science Course, Section 8: by James J. Reidy MD

By James J. Reidy MD

Discusses the constitution and serve as of the cornea and exterior eye and stories appropriate exam options. Covers infectious and ocular floor illnesses, issues and surgical procedure of the ocular floor, immune-mediated and neoplastic problems, congenital anomalies and degenerations. A lately up-to-date bankruptcy at the genetics of corneal dystrophies displays the recent IC3D category. Discusses poisonous and irritating accidents and corneal transplantation. includes many new colour pictures. lately revised 2010 2011.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 8: External Disease and Cornea (Basic & Clinical Science Course)

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ZS5~ zas ~ OD Figure 2·28 Keratography of a norm al co rnea wi th regular asti gmatism. The white circl e indicates the pupil . 2@102. (Courtesy of John E. Sutphin. J 44 • External Disease and Cornea requires caution on the part of the ophthalmologist and is now considered to be a contraindication to LASIK and possibly surface ablation. Forme fruste keratoconus or early pellucid marginal degeneration may show a peripheral steepening or "crab claw" configuration (Fig 2-29). Furthermore, topographic corneal abnormalities may preclude the use of advanced IOL technologies such as toric, multi focal, or pseudoaccommodative IOLs.

_ _ ......... _......... - - =- ~,;,. 121'1_'''''_ " ''''' .. '". uU _ _ ... "'_-::: :::: . ..... - .. -". '''- os Figure 2-19 Orbscan scanning-si lt top ography of a keratoconus patient. ) Figure 2-20 Anterior segment OCT image in a phakic eye. 73 mm, and there is moderate narrowing of the anterior chamber angle. (Reproduced with permission from Goins KM Wagoner MO. Imaging the anterior segment. Foca l Points Cl inical Modu les for Ophtha lmologists. ) Goins KM , Wagoner MD. Imagi ng th e anterior segment.

This method can be used to detect most clinically relevant cases of reduced corneal sensation . The handheld esthesiometer (Coche-Bonnet) is a contact device that gives quantitative information about corneal sensation. This device contains a thin, flexible, retractable nylon filament. The patient's cornea is touched with the filament, which is extended to the full length of 6 cm. S-cm steps until it becomes rigid enough to allow the patient to feel its contact. This length is then recorded. EstheSiometry readings may vary with user technique, but in general a lower number, or shorter filament, indicates reduced corneal sensation.

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