Lecture Notes on Ophthalmology PDF
If you are a student, just starting ophthalmology, you are probably already stretched by a busy curriculum. Suddenly you are asked to absorb an unfamiliar anatomy, new diseases and a fresh terminology. Lecture Notes aims to make this a palatable process. Fortunately the discipline has many attractive features.Technologically, optical and digital techniques give diagnostic access to the minute structures of the eye. Specular microscopy can image the corneal endothelial cells which regulate corneal hydration and transparency; digital fluorescein angiography allows the retinal capillary bed to be explored in ischaemic retinal disease; optical coherence tomography allows the layers of the retina to be dissected and confocal microscopy provides a threedimensional view of the optic nervehead. The shape of the cornea can be plotted digitally and, outside the globe, orbital structures and the visual pathway can be viewed by neuroimaging. Therapeutically, lasers are used to treat an extraordinary range of disorders, for instance, to break the cycle of events which cause angle closure glaucoma, to bring down pressure in chronic glaucoma, to open up an opaque lens capsule following cataract surgery, and to seal retinal holes. Sight-threatening diabetic retinopathy can be treated effectively by retinal photocoagulation, which ablates ischaemic retina and removes the angiogenic stimulus to vasoproliferation.
The opportunities afforded by these techniques are matched by significant technological innovations in microsurgery, responsible for dramatic advances in cataract and vitreoretinal surgery. Cataracts are now removed by phacoemulsification, using an oscillating, ultrasonic probe and optical function restored by insertion of a lens which unfolds within the eye. Vitreoretinal surgery employs inert gases to flatten the detached retina and endoscopic probes, which allow manipulations in the vitreous space and the dissection of microscopic membranes from the retinal surface.