Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatm ent Second Edit ion Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatm ent Second Edit ion Amar Agarw al, MS, FRCS, FRCOphth Professor of Ophthalmology Ram achandra Medical College Private Practice Chennai, India Soosan Jacob, MS, FRCS, DNB, MNAMS Private Practice Chennai, India Th iem e New York • St u t tgar t Thiem e Medical Publishers, Inc 333 Seventh Ave New York, NY 10001 Editorial Director: Michael Wachinger Managing Editor: J Owen Zurhellen IV Editorial Assistant: Dom inik Pucek Vice President, Production and Electronic Publishing: Anne T Vinnicombe Production Editor: Kenneth L Chumbley, Publication Services Vice President, International Marketing and Sales: Cornelia Schulze Chief Financial Officer: Peter van Woerden President: Brian D Scanlan Cover illustration drawn by Karl Wesker Compositor: MPS Content Services Printer: Gopsons Papers Ltd Library of Congress Cataloging -in-Publication Data Color atlas of ophthalm ology : the quick-reference m anual for diagnosis and treatm ent / [edited by] Am ar Agarwal, Soosan Jacob.—2nd ed p ; cm Includes index Prev ed has subtitle: Manhat tan Eye, Ear & Throat Hospital pocket guide ISBN 978-1-60406-211-3 (alk paper) Eye—Diseases—Atlases Eye—Diseases—Handbooks, manuals, etc Ophthalm ology—Atlases Ophthalm ology—Handbooks, m anuals, etc I Agarwal, Am ar II Jacob, Soosan [DNLM: Eye Diseases—diagnosis—Atlases Eye Diseases—diagnosis—Handbooks Eye Diseases—pathology—Atlases Eye Diseases—pathology—Handbooks Eye— pathology—Atlases Eye—pathology—Handbooks Opthalmologic Surgical Procedures— Atlases Ophthalmologic Surgical Procedures—Handbooks WW 17 C7195 2009] RE71.C65 2009 617.70022'3—dc22 2009020093 Copyright © 2010 by Thiem e Medical Publishers, Inc This book, including all part s thereof, is legally protected by copyright Any use, exploitation, or com m ercialization out side the narrow lim its set by copyright legislation without the publisher’s consent is illegal and liable to prosecution This applies in particular to photostat reproduction, copying, m im eographing or duplication of any kind, translating, preparation of m icrofilm s, and electronic data processing and storage Important note : Medical knowledge is ever-changing As new research and clinical experience broaden our knowledge, changes in treatm ent and drug therapy m ay be required The authors and editors of the m aterial herein have consulted sources believed to be reliable in their effort s to provide information that is complete and in accord with the standards accepted at the time of publication However, in view of the possibilit y of hum an error by the authors, editors, or publisher of the work herein or changes in m edical knowledge, neither the authors, editors, nor publisher, nor any other part y who has been involved in the preparation of this work, warrants that the inform ation contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such inform ation Readers are encouraged to confirm the information contained herein with other sources For example, readers are advised to check the product inform ation sheet included in the package of each drug they plan to adm inister to be certain that the inform ation contained in this publication is accurate and that changes have not been m ade in the recom m ended dose or in the contraindications for adm inistration This recom m endation is of particular importance in connection with new or infrequently used drugs Som e of the product names, patents, and registered designs referred to in this book are in fact registered tradem arks or proprietary nam es even though specific reference to this fact is not always m ade in the text Therefore, the appearance of a nam e without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain Printed in India 54321 ISBN 978-1-60406-211-3 Noth ing in th is w orld m oves w ith out Him , an d so also th is book w as on ly w rit ten by Him Th is book is dedicated to a great frien d, Brian S Boxer Wach ler, MD Contents Fo rew o rd ix Preface xi Abo ut the Edito rs xiii Co ntributo rs xv Chapter Ocu lar Traum a Daniele Veritt i, Carlo Sborgia, Francesco Boscia, Giuseppe Sm aldone, and Paolo Lanzetta Chapter Eyelids an d Lacrim al System 33 Christopher I Zoum alan, Andrea Olm os, and Kim berly P Cockerham Chapter Orbit al In fect ion s, In am m at ion , an d Neoplasm s 69 Praveen Saluja, Sw at i Ravani, Soosan Jacob, and Am ar Agarw al Chapter Extern al Diseases 100 Guillerm o Sim ón-Castellví, Pablo Gili-Manzanaro, Sarabel Sim ón-Castellví, José María Sim ón-Castellví, Crist ina Sim ón-Castellví, and José María Sim ón-Tor Chapter Corn ea 141 W Barry Lee and Ivan R Schw ab Chapter In t raocu lar In am m at ion 194 Soosan Jacob, Dhivya Ashok Kum ar, Athiya Agarw al, and Am ar Agarw al Chapter Len s an d Cataract 218 Athiya Agarw al, Soosan Jacob, and Am ar Agarw al Chapter Glaucom a 244 Soosan Jacob and Am ar Agarw al Chapter Medical Ret in a 260 Mandeep Lam ba, Soosan Jacob, and Am ar Agarw al Chapter 10 Su rgical Ret in a 288 Clem ent K Chan and Dariusz G Tarasew icz Chapter 11 Ocular Neoplasm s 322 Soosan Jacob, Santosh Hanovar, and Am ar Agarw al Chapter 12 St rabism u s 339 Federico G Velez, Noa Ela-Dalm an, and Arthur L Rosenbaum Chapter 13 Neuro- Op h th alm ology 359 Soosan Jacob and Am ar Agarw al vii viii Content s Chapter 14 Oph th alm ic Ph arm acology 405 Jam es M Hill, Lori Vidal Denham , Blake A Booth, Duncan A Friedm an, Je ery A Hobden, Andrea T Murina, Marie D Acierno, Jean T Jacob, Herbert E Kaufm an, and Donald R Bergsm a Chapter 15 Ocu lar Man ifest at ion s of System ic Disease 430 Soosan Jacob and Am ar Agarw al Chapter 16 Con tact Len ses 447 Kenneth M Daniels Chapter 17 Oph th alm ic In st r um en t s an d Diagn ost ic Tests 486 Sam uel Boyd and Am ar Agarw al Chapter 18 Oph th alm ic O ce Procedures 507 Sam uel Boyd Chapter 19 Refract ive Su rger y 518 David R Hardten, Natalia Kram arevsk y, Louis E Probst, and Richard L Lindst rom Index 539 Forew ord For som e au th ors of oph th alm ology, w rit ing or edit ing 50 book ch apters is a sizeable accom plish m en t over a lifet im e, let alon e a decade Th is is n ot t ru e for Professor Agar w al Sin ce 1998, Am ar Agar w al h as edited on average m ore th an fou r books a year, w h ich is an u npreceden ted an d virt u ally u n im agin able yearly n u m ber for any on e person His books sp an topics from diagn ost ics an d im aging (su ch as aberrom et r y, angiography, topography, dr y eyes, and neuro-ophthalm ology) to therapeutics and surger y (including contact len ses, lasers, LASIK, strabism us, oculoplastics, cataracts, phako, an d m ore), an d m any h ave been bestsellers He h as au th ored several com prehensive handbooks and textbooks of oph th alm ology, an d Color Atlas of Ophthalm ology stan ds out as on e of h is best In it s 19 su bspecialt y ch apters, th is secon d edit ion illust rates over 500 diagn ost ics an d th erapeut ic dit ion s Th e com preh en sive an d system at ic form at h elp s th e reader fin d an d view th e facts abou t any dit ion in oph th alm ology in st an tly, m aking it an essen t ial resou rce for both th e st u den t an d th e pract it ion er in th e field Anyon e w h o kn ow s Professor Agar w al can tell you th at h e is a sum m ate in n ovator an d teach er As a professor of oph th alm ology an d in tern at ion ally ren ow n ed lect urer, h is exp erien ce an d dedicat ion to teach ing speak for th em selves Over th e years, I h ave p ar t icip ated in several Am erican Academ y of Oph th alm ology an d Am erican Societ y of Cataract an d Refract ive Su rger y cou rses w ith Professor Agar w al an d h ave learn ed a great deal about m icroin cision cataract su rger y an d th e m an agem en t of ch allenging LASIK cases from th em Person ally, I look for w ard to review ing an d referring to th e ten t of th is book on a regu lar basis I recom m en d th at you so as w ell! Ronald R Krueger, MD, MSE Medical Director, Depar t m en t of Refract ive Su rger y Cole Eye In st it ute Clevelan d Clin ic Clevelan d, Oh io ix 542 Index Congen ital an om aly(ies), corn eal, 157–158 Congen ital h ereditar y corneal dyst rop hy, 192 Conju n ct iva am yloid degen erat ion , 120 edem a, 138 See also Ch em osis foreign body, 5f lacerat ion , 4–5, 5f lip oid/lip id d egen erat ion , 120–121, 121f m elan om a, 132–133, 132f m et ap lasia, in ectrop ion , 137, 137f m et astases to, 133 n eop lasm s differen t ial d iagn osis, 118, 120 w ith secon dar y h em orrh age, pigm en ted lesion s, 129–133 reten t ion cyst , 121–122, 121f differen t ial d iagn osis, 118 salm on p atch in , 79, 79f Conju n ct ivit is, 101–111 acu te bacterial, 105–106, 106f acu te h em orrh agic, 101, 103–104, 103f aden oviral, 101–103, 102f differen t ial d iagn osis, 112 adu lt in clu sion , 106, 107t–108t, 109 differen t ial d iagn osis, 112 allergic, d ifferen t ial diagn osis, 45 atop ic, differen t ial diagn osis, 111 bacterial, associated w ith eyelid edem a, 105, 106f ch lam ydial (in clu sion ), 106, 107t–108t, 109 differen t ial d iagn osis, 112 ch ron ic, 109–110 w ith bleph arit is, 100 differen t ial d iagn osis, 62, 63 differen t ial d iagn osis, 3, 66, 101, 114, 124, 125 gian t papillar y, 110–111, 111f differen t ial d iagn osis, 45 gon ococcal, 105–106 m u cop u ru len t , in Steven s-Joh n son syn drom e, 113 n eon atal, ch lam ydial, 106 pseu dom em bran ou s, in Steven s-Joh n son syn drom e, 113 recu rren t , 109–110 toxic, differen tial diagn osis, 192 vern al, 110–111, 111f differen t ial d iagn osis, 111, 192 viral, 101, 104 associated w ith eyelid edem a, 69, 72 Con n ect ive t issu e disease (CTD), perip h eral u lcerat ive kerat it is in , 182 Con stan t exot rop ia, 344, 344f Con t act derm at it is, d ifferen tial d iagn osis, 69, 72 Con t act len ses clean ing solu tion s, an d kerat it is, 147, 149 corn eal scarring cau sed by, differen t ial diagn osis, 171 for dr y eye, 115 gian t p ap illar y conju n ct ivit is of, 110–111 over w ear, keratit is cau sed by, 154 differen t ial d iagn osis, 152 an d recu rren t corn eal erosion , 156 u se, differen t ial diagn osis, 192 Con t recou p inju r y(ies), 11, 19 Convergen ce in su fficien cy, 343 Corn ea abrasion s, 7–8, 7f differen t ial d iagn osis, 9, 10, 105 recu rren t , 109–110 cen t ral clou dy dystrop hy of Fran ỗois, 165, 165f differen t ial d iagn osis, 175 cen t ral cr ystallin e dyst rop hy of Sch nyder, 164, 164f differen t ial d iagn osis, 175 ch em ical bu rn See Ch em ical bu rn s congen it al an om alies, 157–158 conju n ct ivalization , 136, 136f degen erat ion , 173–180 polym orp h ic am yloid , 178, 179f Salzm an n n od u lar, 177–178, 177f sph eroidal, 178 den drite in EBV in fect ion , 145 in HSV kerat it is, 141f in HZV in fect ion , 144f dep osits in , 173–180 dyst rophy See Corn eal dyst rop hy(ies) ectat ic disorders, 170–173 edem a after cataract ext ract ion , 236–237 in congen ital h ered itar y en doth elial dyst rop hy, 170, 170f Fuchs en dothelial dyst rophy an d, 167, 168f in p osterior p olym orph ous dyst rophy, 169, 169f en larged n er ves in , 191 differen t ial d iagn osis, 163 en largem en t , in congen ital glau com a, 134–135 erosion s, trau m at ic, differen tial d iagn osis, 159, 160 farin ata, d ifferen t ial d iagn osis, 178 Fleck dyst rophy, 164–165 differen t ial d iagn osis, 166 foreign body, 8–9, 8f differen t ial d iagn osis, Fu ch s en dothelial dyst rop hy, 167, 168f differen t ial d iagn osis, 167, 169, 191, 192 graft reject ion , 188, 188f gu t tae, 167, 168f differen t ial d iagn osis, 160, 178 hydrops in keratocon u s, 171 in keratoglobu s, 171, 172f in fect ion s, 141–150 in flam m at ion , 150–153 differen t ial d iagn osis, 192 inju r y, an d recu rren t corneal erosion , 156 keloid, 175–176, 176f lacerat ion , 9–10, 9f lip oid/lip id d egen erat ion , 120–121, 121f n eovascu larizat ion , in Steven s-Joh n son syn drom e, 113 perforat ion differen t ial d iagn osis, in Steven s-Joh n son syn drom e, 113 recu rren t erosion , 156 scarring cen t ral, 164 in HSV kerat it is, 141f in terst it ial kerat it is an d , 150, 151f in Steven s-Joh n son syn drom e, 113 su rface d isord ers, 150–153 th in n ing See also Keratocon u s; Pellu cid m argin al d egen erat ion (corn ea) perip h eral, 180–185 u lcer, from Acantham oeba, 147, 148f bacterial, 146–147, 146f differen t ial d iagn osis, 7, 143 fu ngal, 149, 149f h erpet ic, d ifferen t ial diagn osis, 192 h erpet ic den d rit ic, 104f im m u n e-m ediated , 146, 147, 153 in fect iou s, differen t ial diagn osis, 153 m argin al in HSV in fect ion , 142 st aphylococcal, 177, 182 Index 543 sterile, 146 n eurot ropic in HSV in fect ion , 142, 143 in HZV in fect ion , 144f in Steven s-Joh nson syn d rom e, 113 t rach om a, 107f viral, differen t ial diagn osis, 146 Corn ea gu t tata, 167 Corn eal dyst rophy(ies), 158–170 an terior, 158–161 cen t ral clou dy dystrop hy of Fran ỗois, 165, 165f d ifferen t ial d iagn osis, 175 cen t ral cr ystallin e dyst rop hy of Sch nyder, 164, 164f d ifferen t ial d iagn osis, 175 congen it al h eredit ar y, differen t ial diagn osis, 192 congen it al h eredit ar y en d oth elial, 170, 170f d ifferen t ial d iagn osis, 166, 169 Fleck, 164–165 d ifferen t ial d iagn osis, 166 Fu ch s en doth elial, 167, 168f d ifferen t ial d iagn osis, 167, 169, 191, 192 granular, 161, 162f d ifferen t ial d iagn osis, 161, 163 lat t ice, 162–163, 162f d ifferen t ial d iagn osis, 178 p osterior, 167–170 p osterior polym orph ou s, 169, 169f d ifferen t ial d iagn osis, 166, 170, 191, 258 p re-Descem et , 165–166 st rom al, 161–166 congen it al h eredit ar y, 166 differen t ial d iagn osis, 170 d ifferen t ial d iagn osis, 164 p osterior am orp h ou s, 166 Corn eal elastosis, 178 Corn eal in t raep ith elial n eop lasia, differen t ial diagn osis, 159 Corn eal su rger y, 185–191 Corn eal vert icillata, 180, 181f Corynebacterium diphtheriae, conjun ct ivit is cau sed by, 105 d ifferen t ial d iagn osis, 112 Cou p injur y(ies), 11 Cow en sign, 76t Coxsackievirus A24, conju n ct ivit is cau sed by, 102, 103 Cranial n er ve(s) III See Third-n er ve palsy IV See Fou rth -n er ve p alsy VI See Sixth -n er ve p alsy CRAO See Cen t ral ret in al arter y occlu sion Crocodile sh agreen , differen t ial diagn osis, 175 Crocodile tears, 353 Croh n’s disease (CD), ocu lar involvem en t in, 195 Crouzon disease, an d lens sublu xat ion , 13 CRVO See Cen t ral ret in al vein occlu sion Cr yoth erapy, for ret in al det ach m en t, 302 Cr ystallin e retin opathy, d ifferen tial d iagn osis, 280 CSCR See Cen t ral serou s ch orioret in op athy CSR See Cen t ral serous ret in opathy CTR See Capsular ten sion ring Cushing syn drom e, an d cen t ral serous ch orioret in opathy, 273 Cutan eous h orn , differen t ial diagn osis, 53, 54 Cu tis laxa, blue sclera in, 134 Cyclit is, ch ron ic, 200 Cylin drom a, differen t ial diagn osis, 58 Cyst(s) ciliary body, 325 conjun ct ival lym ph at ic, 121, 121f in parasit ic in festat ion , 121, 122 p ost t rau m atic in clu sion , 121 d erm oid See Derm oid cyst(s) d uctal, 57–59 foveal, 275 of iris, 323 of Moll, 57, 58f p ars p lan a, 290 sebaceou s, 57, 58f of Zeis, 57–59 Cyst in osis, differen t ial diagn osis, 160 Cystoid m acular edem a, 274–276, 275f after cataract su rger y, 238–239, 239f, 274, 275f causes, 274 differen t ial d iagn osis, 263, 274, 275 m an agem en t, 275–276 path ogen esis, 274 postcat aract surger y, 238–239, 239f, 274, 275f presen tat ion , 275 Cytom egaloviru s (CMV) congen it al in fect ion , 208 in im m u n osu pp ressed p at ien t , 208, 209f in clu sion ch orioret init is, d ifferen t ial diagn osis, 201 ret in itis caused by, 208, 208f D Dacr yoaden it is, 78, 97 Dacr yocyst itis, 66–67, 67f ch ron ic, differen t ial diagn osis, 65 differen t ial d iagn osis, 47, 68, 110 Dalyr ym p le sign , 76t Degen erat ive m yopia, 272, 272f Derm atobu llou s d isord ers, differen t ial diagn osis, 112 Derm atoch alasis, 42–43, 42f differen t ial d iagn osis, 45, 47 Derm oid cyst(s), 50, 80–81, 82f–83f deep, 80–81, 82f–83f differen t ial d iagn osis, 84, 90, 93, 94, 118, 192 ru pt u red , differen t ial d iagn osis, 87 su perficial, 80–81, 82f Descem et m em bran e breaks, keratoconu s an d, 171 ru pt u re, 134 tears, differen t ial diagnosis, 192 Descem et st ripp ing en doth elial keratoplast y, 187, 187f Diabetes m ellit u s See also Maculopathy, diabet ic an d n eu rot ropic keratopathy, 155 Diabet ic ret in opathy, 261–264 differen t ial d iagn osis, 261, 263, 264, 269, 286 m an agem en t, 263–264, 263f n onp roliferat ive, 261, 262f differen t ial d iagn osis, 263 presen tat ion , 261 proliferat ive, 261, 262f differen t ial d iagn osis, 263 w ith preret in al h em orrh age, 262f–263f an d vit reou s h em orrh age, 270 Diath erm y, for ret in al det ach m en t , 301 Diffu se corn eoscleral kerat it is, 190 Dilated vessels, 125–126, 126f in St u rge-Weber syn drom e, 126–127, 127f Dim m er kerat it is, 101 Dissociated st rabism u s com p lex, 346–347, 347f Distich iasis, 64, 65f differen t ial d iagn osis, 35, 110 pem p h igoid an d, 112 Distract ion test , 33 544 Index Divergen ce excess, 343 Doh lm an keratoprosth esis, 188, 189f Dow n syn drom e Brush field sp ot s in , 325 corn eal involvem en t in , d ifferen tial diagn osis, 192 an d keratocon u s, 171 Drug(s), an d hyp h em a, 15 Drug abu se, differen t ial d iagn osis, 263 Drug-in d u ced degen erat ion s, differen t ial diagn osis, 281 Drug-ind uced ret in op athy, differen t ial diagn osis, 282 Dru sen fam ilial, differen t ial diagn osis, 279, 280 opt ic n er ve h ead , an d ret in itis p igm en tosa, 285 Dr y eye causes, 114 differen t ial d iagn osis, 101 Dr y-eye syn d rom e, 114–116, 114f an d filam en tar y kerat it is, 154 DSEK See Descem et st ripping en dothelial keratoplast y Du an e syn drom e, 351–353, 352f bilateral, 352, 352f system ic association s, 353 t ypes, 352f, 353 Du ral sin u s arterioven ou s fist u la, differen t ial diagn osis, 128 Dysthyroid orbitopathy, 74–77, 74f–75f differen tial d iagn osis, 93, 128 m an agem ent , 76–77 E Eales disease differen tial d iagn osis, 286 an d vit reou s h em orrh age, 270 EBMD See Epith elial basem en t m em bran e dyst rophy Eccrin e hydrocystom a, 57, 58f differen tial d iagn osis, 57 Eclip se ret in op athy, 287 Ectop ia len t is, 251 congen it al, an d len s su blu xat ion , 13 differen tial d iagn osis, 13 Ect rop ion , 33–35, 34f in bleph aroph im osis syn drom e, 48, 48f cicat ricial, 33–35, 34f congen ital, 33, 35 conju n ct ival m etaplasia in , 137, 137f differen tial d iagn osis, 45 involut ion al, 33, 34f m ech anical, 33 paralyt ic, 33–35, 34f Eczem a, differen t ial d iagn osis, 47 Edem a See also Angioedem a; Cystoid m acu lar edem a Cogan m icrocyst ic, 158–159, 159f conju n ct ival, 138 See also Ch em osis corn eal after cataract ext ract ion , 236–237 in congenit al heredit ar y en doth elial dyst rophy, 170, 170f Fu ch s en doth elial dyst rophy an d, 167, 168f in posterior polym orph ou s dyst rop hy, 169, 169f eyelid, 47, 47f in acu te bacterial conju n ct ivit is, 105, 106f allergy an d, 47, 69, 72 in thyroid eye disease, 47, 47f in viral conju n ctivit is, 69, 72 m acular clin ically sign ifican t , 261, 262f diabet ic, 283 d ifferen tial d iagn osis, 283 orbit al, 27 ret in al, post t rau m at ic, 21–22 su bconju n ct ival See Ch em osis Eh lers-Dan los syn d rom e an d angioid st reaks, 270 blue sclera in , 134 an d d egen erat ive m yop ia, 272 an d len s su blu xat ion , 13 Eikenella can aliculit is, 66f Elsch n ig spot s, 260–261 Em boli, in bran ch ret in al arter y occlu sion , 265–266 En ceph alocele, 84 En closed oral bay, 289, 289f En dop h th alm it is, 213–216 after cataract surger y, 240–242, 241f Candida, 215 differen t ial d iagn osis, 326, 335, 336, 337 en dogen ou s, 215–216 postop erat ive, 214–215, 214f, 240–242, 241f post t rau m at ic, 12f sequ elae, differen t ial diagn osis, 136 traum at ic, 213–214 En doth elial keratop last y, 187, 187f En doth eliitis, in HSV in fect ion , 142 En op h th alm os, ru pt u red globe an d, 16 Enterobacter, corn eal u lcer caused by, 146 En teroviru s grou p 70, conju n ct ivit is cau sed by, 102, 103 En t rop ion , 35, 36f cicatricial, 35, 36f congen it al, 35 differen t ial d iagn osis, 48, 49, 64 involu t ion al, 35, 36f spasm odic, 109, 110f EOB See En closed oral bay Epiblep h aron , 48–49, 49f d ifferen tial d iagn osis, 35, 49, 64 Epican th al fold s, syn drom es associated w ith , 49 Epican th u s, 49–50, 50f Epican th u s inversu s, 49 in blep h aroph im osis syn drom e, 48, 48f Epican th u s p alp ebralis, 49 Epican th u s su p erciliaris, 49 Epican th u s tarsalis, 49, 50f Epid erm olysis bu llosa, 112 Epin eph rin e, top ical, an d cystoid m acu lar edem a, 274 Epip h ora, in congen ital glau com a, 134–135 Epiret in al m em bran e d ifferen tial d iagn osis, 23, 321 id iopath ic, 320–321, 320f p rim ar y, 320 secon dar y, 320 Episcleral ven ou s pressu re, elevated, 252–253 Episclerit is, 123–124, 123f–124f differen t ial d iagn osis, 3, 125 n odular, 123, 124f in Steven s-Joh n son syn drom e, 113 Ep ith elial basem en t m em bran e dyst rop hy, 158–159, 159f differen t ial d iagn osis, 160, 161 Ep ith eliom a, 112 Ep stein -Barr viru s (EBV), in fect ion corn eal, 145, 145f, 150, 152 differen t ial d iagn osis, 101, 152 ERM See Ep iretin al m em bran e Er ysip elas, 69, 72 Er yth em a m u lt iform e differen t ial d iagn osis, 112, 136 an d sym bleph aron , 116 Er yth em a m u lt iform e m ajor, 113 Index 545 Er yth em a m u lt iform e m in or, 113 Er yth roderm a, congen ital ich thyosiform , 112 Esot rop ia accom m odat ive, 341–342, 341f refract ive, 341f, 342 in fan t ile, 340–341, 340f Ew ing sarcom a, m etast atic, 94 Exoph th alm os post t rau m at ic, 31–32, 31f pu lsat ing, 127–128 causes, 31 post t rau m at ic, 31–32, 31f ru pt u red globe an d , 16 in thyroid eye d isease, 73t Exot rop ia secu t ive, 344 st an t , 344, 344f in fan t ile, 344 in term it ten t , 342–343, 343f secon dar y, 344 sen sor y, 344 Exp osu re kerat itis, 183 Exposu re keratopathy, 153–154 Ext raocu lar m u scle(s) See also speci c m uscle congen it al fibrosis, 357–358, 357f Eyelid (s) bacterial in fect ion , 69 colobom a, 50–51, 50f deform it ies, in Steven s-Joh n son syn drom e, 113 dist ract ion test , 33 edem a, 47, 47f in acu te bacterial conjun ct ivit is, 105, 106f allergic, 47, 69, 72 in thyroid eye d isease, 47, 47f in viral conjun ct ivit is, 69, 72 inw ard rotat ion See En t ropion lacerat ion , 1–2, 1f, 3f ou t w ard rotat ion (eversion ) See Ectrop ion papillom a, 51, 51f ret raction , 43, 43f t um ors, 51–57, 59–64 u pp er abn orm ally low p osit ion See Ptosis cicat ricial ch anges, 43 scarring, 43 F Fabr y disease, corn eal vert icillata in , 180, 181f Fam ilial aden om atou s p olyp osis, 332 Fam ilial exu dat ive vit reoret in op athy, 335, 336, 337 Ferr y lin e, 179 FF See Fun dus flavim aculat us Fibrin collaret tes, 100, 100f Filam en tar y keratit is, 154–155, 154f Fleck dyst rop hy (corn eal), 164–165 differen t ial d iagn osis, 166 Fleisch er ring, 179, 179f keratocon u s an d , 171 Fleu ret tes, 334 Flexn er-Win terstein er roset tes, 334 Flop py eyelid syn drom e, 44–45, 44f an d keratocon u s, 171 Foreign body conju n ct ival, 5f, 129, 130 corn eal, 7, 8–9, 8f differen t ial d iagn osis, 7, 9, 129, 130, 133, 323 in t raocu lar, 9, 23–25, 24f, 217, 323 int raorbit al, 28–29, 29f an d recu rren t corn eal erosion , 156 Fourth -n er ve palsy, 349–350, 349f–350f Foveal cysts, 275 Foveom acu lar ret in it is, 287 Fract ure(s), orbit al, 26–28 isolated, 30 Francesch et t i syn drom e, 51 Front alis-sling procedure, for ptosis, 38 Fu ch s en dothelial dyst rop hy, 167, 168f differen t ial d iagn osis, 167, 169, 191, 192 Fuchs h eteroch rom at ic iridocyclit is, 197 Fuchs h eteroch rom ic iridocyclit is, 197 Fuchs spot , 272 Fuchs superficial m argin al kerat it is, 184 Fun dus albipun ctat us, 280, 280f differen t ial d iagn osis, 279 Fun dus flavim aculat us, 278–279, 279f differen t ial d iagn osis, 279 m an agem en t, 279 presen tat ion , 278, 279f Fungal in fect ion differen t ial d iagn osis, 192 en dogen ou s en dophth alm it is caused by, 215 postop erat ive en doph th alm it is caused by, 214 trau m at ic en doph thalm it is caused by, 213 Fungal kerat it is, 149–150, 149f differen t ial d iagn osis, 9, 143, 146, 147 Furrow degen erat ion , 185 differen t ial d iagn osis, 183, 184 Fusarium keratit is, 149, 150 G Gardn er syn drom e, 332 Gast roesoph ageal reflu x disease, and cen t ral serou s chorioret in opathy, 273 Gastroin test in al m align an cy, orbit al m et astases, 94 Gen t am icin , in t raocu lar inject ion , 267 Gh ost vessels, 150, 151f differen t ial d iagn osis, 163 Gian t cell arterit is, 268–269 Gifford sign , 76t Glau com a acu te, acu te angle, angle-closu re, 254–257 acu te, 254–255, 254f, 255f ch ron ic, 256, 256f w ith pupillar y block, 254 w ithout pupillar y block, 254 angle recession , 13 congen it al, 127, 134 differen t ial d iagn osis, 68, 166, 170, 192, 326 gh ost-cell, vit reou s h em orrh age an d , 18–19 len s-in du ced, 250–251 len s p art icle, 250 m align an t , 258–259 differen t ial d iagn osis, 326 n eovascular, 256–257 n orm al-ten sion (low -ten sion ), 246–248, 246f–247f op en -angle an d d egen erat ive m yop ia, 272 prim ar y, 244, 245f an d ret in it is pigm en tosa, 285 secon dar y, 248, 249f ph acoan ap hylact ic, 251 ph acolyt ic, 251 ph acom orp h ic, 12, 251 pigm en tar y, an d degen erat ive m yopia, 272 in p osterior p olym orph ou s dyst rophy, 169 post t rau m at ic, 12 in sarcoidosis, 198 uveit ic, 251–252, 252f, 253f differen t ial d iagn osis, 15 in uveit is-glau com a-hyp h em a syn drom e, 196 uveit is related to, 196 546 Index Globe, rupt u red, 16–17, 17f differen t ial d iagn osis, 30 Golden h ar syn d rom e, 51, 353 Goldzieh er sign , 76t Grapevin es, in adu lt toxop lasm osis, 201 Graves’ disease, 74–77 in filt rat ive (severe), 74 n on in filt rat ive (m ild), 74 op h th alm ic m an ifest at ion s, 76t Graves oph th alm op athy, 355–356, 355f See also Thyroid eye disease; Thyroidrelated op h th alm op athy Grid laser, for diabet ic ret in op athy, 263, 263f Griffith sign , 76t Grön blad-St ran dberg synd rom e, an d angioid st reaks, 270 Guillain -Barré syn drom e, Miller-Fish er varian t , eyelid ret ract ion in , 43 Gyrate at rop hy differen t ial d iagn osis, 272, 285, 286 gen et ics, 286 m an agem en t, 286 presen tat ion , 286 H Haab st riae, 134–135 Haem ophilus in uen zae conju n ct ivit is, 105 Ham artom a, com bin ed, of ret in al p igm en t ep ith eliu m an d ret in a, 333, 333f differen t ial d iagn osis, 327, 328, 330, 331, 333 Han d an om alies, 353 Hassall-Hen le bodies, 167 Hearing loss, 353 Helm in th in fect ion , 150 Hem angiom a See also Cap illar y h em angiom a; Cavern ous h em angiom a ch oroidal, 327, 328, 329 exophyt ic ret in al, 329 racem ose, 335, 336, 337 Hem op h ilia, an d hyp h em a, 15 Hem orrh age opt ic n er ve sh eath , 26 orbital, 26 ret robu lbar, 29–30, 30f ru pt u red globe an d , 16 su bconju n ct ival, 3–4, 4f su bret in al, 327, 328, 330, 331 vit reou s See Vitreou s h em orrh age Hem osiderosis bu lbi, vit reou s h em orrh age an d, 19 Hep atolen t icu lar degen erat ion , 180 Herp es sim p lex ch orioret in it is, 201 keratit is, 150, 151f, 167, 192 keratoconju n ctivit is, 104–105, 104f Herp es sim p lex viru s acu te ret in al n ecrosis syn drom e cau sed by, 209 infect ion corn eal, 141–143, 141f differen t ial d iagn osis, 142, 147 in it ial, 141 recu rren ce, 142 differen t ial d iagn osis, 101, 143, 191 an d in terstit ial kerat it is, 150, 151f an d recu rren t corn eal erosion , 156 skin lesion s in , 104f an d n eurot ropic keratop athy, 155 Herp es zoster See also Varicella-zoster viru s infect ion , 101, 191 corn eal, 143–145, 144f, 150 differen t ial d iagn osis, 147 kerat it is, 192 an d n eurot ropic keratop athy, 143, 144f, 155 Herp es zoster op h th alm icu s, 143–145, 144f an d trich iasis, 64 Herring’s law, 43 High accom m odat ive esot ropia, 341f, 342 Histoplasm osis ocu lar differen t ial d iagn osis, 21, 201, 272 presu m ed, 202–203, 202f vit reou s h em orrh age in , 18 Histospot s, 202f differen t ial d iagn osis, 279, 280 Hollen h orst p laqu es, 265 Holt-Oram syn d rom e, 353 Hom er Wrigh t roset tes, 334 Hom ocyst in u ria, 135 an d len s su blu xat ion , 13, 14 Hord eolu m , 46–47, 46f bleph arit is an d, 100 differen t ial d iagn osis, 46, 47, 66 extern al, 46–47, 46f in tern al, 46–47 Hu dson -Stäh li lin e, 179 Hu rler syn drom e, 267 Hyalin e Pillat scleral plaque, 140, 140f Hydroch loric acid bu rn , 5–7 Hydroxych loroquin e, corn eal ver ticillat a cau sed by, 180 Hyperbaric oxygen , for cent ral ret inal ar ter y occlu sion , 268 Hyperlipoprotein em ia, 173, 175 Hyperlysinem ia, and len s sublu xat ion , 13 Hyperten sion, 267 an d angioid st reaks, 270 an d cen t ral serou s ch orioret in opathy, 273 an d hyp h em a, 15 an d m acroan eu r ysm , 269 Hyp erten sive ret in opathy, 260–261, 260f differen t ial d iagn osis, 263, 264, 286 Hyperthyroidism , 355–356 See also Graves’ disease; Graves oph th alm opathy Hyphem a differen t ial d iagn osis, 13 grad ing system , 15, 15f post t rau m at ic, 10f sp on tan eou s, cau ses, 15 traum at ic, 14–16, 15f in uveit is-glau com a-hyp h em a syn drom e, 196 Hypoparathyroidism , 192 Hypopyon, in fu ngal in fect ion , 149, 149f Hypotony, after cataract su rger y, 237–238 I Ich thyosis, 33 differen t ial d iagn osis, 166, 191 In born errors of m etabolism , corn eal involvem en t in , 192 In clusion conjun ct ivitis, 192 In dom eth acin , corneal vert icillata caused by, 180 In fan t ile esot ropia, 340–341, 340f In fan t ile exot ropia, 344 In fect ion(s) bacterial, eyelid, 69 an d conju n ct ivalizat ion of corn ea, 136 corn eal, 141–150 differen t ial d iagn osis, 84, 192 orbital, 69–99 In fect ious keratit is, 182, 183 In fect ious m onon ucleosis, 145 w ith eye involvem en t , differen t ial diagn osis, 101 In ferior obliqu e m u scle, palsy, isolated, 348 In ferior oblique overact ion , 345–346, 346f In flam m at ion ch ron ic, an d len s su blu xat ion , 13 corn eal, 150–153 Index 547 differen t ial d iagn osis, 192 d ifferen t ial d iagn osis, 135 in traocu lar, 194–217 lacrim al glan d, 97 orbital, 71–80 differen t ial d iagn osis, 73t an d sym bleph aron , 116 In flam m ator y bow el d isease (IBD), ocu lar involvem en t in , 195 In sect bite, differen t ial diagn osis, 69, 72 In term it ten t exot ropia, 342–343, 343f basic t ype, 343 convergen ce insu fficien cy, 343 d ivergen ce excess, 343 In tern al lim it ing m em bran e, rem oval, “ap ple peeling” tech n iqu e, 318, 319f In terst it ial kerat it is, 150–151, 151f In t raarterial fibrin olysis, for cen t ral ret in al arter y occlu sion , 268 In traocu lar len s d islocated, tem p orar y h apt ic extern alizat ion , 233–234, 234f foldable, im p lan t at ion , 227, 229f glued , 229–233, 230f–233f opacificat ion , 242–243, 242f torn , 236, 236f In traocu lar p ressu re, elevated , after cataract su rger y, 238 IOL See In t raocu lar len s Irid ocorn eal en doth elial syn drom e, 258 d ifferen t ial d iagn osis, 169, 323 Irid ocyclit is Fuch s h eteroch rom ic, 197 h erpet ic, 104–105 Irid od ialysis, p ost t rau m at ic, 12f Irid od on esis, 13 Iris at rop hy in HSV kerat it is, 141f progressive, 258 cavern ou s h em angiom a, an d hyp h em a, 15 cyst , 323 freckle, d ifferen t ial diagn osis, 322 juvenile xan thogran ulom a an d, 323–324 leukem ic n odu les, 324 m elanom a, 323 differen t ial d iagn osis, 322 m et astat ic lesion s, differen t ial diagnosis, 324 n evus, 322 p igm en t epith elial cyst , 322–323 t u m ors an d n odu les, 322–325 Iris bom bé, in sarcoidosis, 198 Iris sph in cter tear, 11, 11f Irit is d ifferen t ial d iagn osis, in Steven s-Joh n son syn drom e, 113 syphilit ic, 198 t raum at ic, 10–11, 10f Irit is n odosa, in syph ilis, 198 Irit is papu losa, in syph ilis, 198 Irit is roseat a, in syp h ilis, 198 Iron dep osit s, 179 conju n ct ival, differen t ial diagn osis, 129, 130 Iron lin es, 179–180, 179f Ir vin e-Gass syn drom e, 274, 275 Isch em ic opt ic n eu ropathy, differen t ial d iagn osis, 261, 267 J Jacob-Agar w al sling surger y, 37f, 38–41, 39f–41f Jellin ek sign , 76t Juven ile ret in osch isis an d cystoid m acu lar edem a, 274 d ifferen t ial d iagn osis, 275 Juven ile rh eum atoid arthrit is ocu lar involvem en t in , 196–197 pau ciar t icu lar on set , 197 polyar t icu lar on set , 197 system ic on set , 197 t ype 1, 197 t ype 2, 197 uveit is in , 196–197 Juven ile xan th ogran ulom a, 135, 216t, 217 differen t ial d iagn osis, 323 an d hyp h em a, 15 iris lesion s, 323–324 K Kap osi sarcom a, w ith secon dar y h em orrh age, Kap p a angle, 339, 339f, 340 Kasabach -Merrit t syndrom e, 84 Kayser-Fleischer ring, 24, 180 Kearn s-Sayre syn drom e, an d ret in it is p igm en tosa, 285 Keloid, corn eal, 175–176, 176f d ifferen tial d iagn osis, 177 Kerat it is Acantham oeba, 147–149, 148f d ifferen tial d iagn osis, 146, 149, 192 Aspergillus, 149, 150 bacterial, 9, 143, 147, 149 Candida, 149, 149f t act len s clean ing solu t ion s an d , 147, 149 t act len s over w ear, 152, 154 d en drit ic in t raepithelial d ifferen t ial d iagn osis, 142 in HSV in fect ion , 141, 141f, 142 d iffu se corn eoscleral, 190 d im m er, 101 d isciform , h erp et ic, 104–105 exp osu re, 183 filam en tar y, 154–155, 154f Fu ch s su p erficial m argin al, 184 fu ngal, 149–150, 149f d ifferen t ial d iagn osis, 9, 143, 146, 147 Fusarium , 149, 150 h erpes sim plex, 150, 151f, 167, 192 h erpes zoster, 192 h erpet ic d en d rit ic, 141, 141f, 142 in t raep ith elial, 141f, 142 st rom al, 141f, 142 im m u n e st rom al, in HSV in fect ion , 141, 141f, 142–143 in fect iou s, 182, 183 in terst it ial, 150–151, 151f h erpet ic, 104–105 n ecrotizing st rom al in HSV in fect ion , 142 in HZV in fect ion , 144f n eurot ropic, in HSV in fect ion , 142, 143 n um m ular, 143, 145 Paecilom yces, 149, 150 p un ctate, in viral in fect ion , 141–142, 143, 145 st ap hylococcal m argin al, 146 st riate, after cat aract ext ract ion , 237f st rom al d ifferen tial d iagn osis, 142, 145 in EBV in fect ion , 145, 145f su p erficial pu n ct ate, w ith ch em ical bu rn , su perior lim bic, 45 Thygeson superficial pun ctate, 152, 152f u lcerat ive d ifferen tial d iagn osis, 6, 182, 184 p erip h eral, 182–184, 183f, 184 u lt raviolet (UV), viral, 149, 150 548 Index Keratoacan th om a, 53–54, 53f differen t ial d iagn osis, 59, 62, 64 Keratoconju n ct ivit is atop ic, 110 differen t ial d iagn osis, 45, 112, 153 ep idem ic, 101–103 differen t ial d iagn osis, 105, 152 ep idem ic h em orrh agic, 103–104, 103f h erp es sim p lex, 104–105, 104f ph lycten u lar, 192 su perior lim bic, 122–123, 122f differen t ial d iagn osis, 63, 192 an d filam en tar y kerat it is, 154 vern al, 110, 146 sh ield u lcer in , 152–153, 153f Keratoconju n ct ivit is sicca, 192 Keratocon u s, 170–171, 171f differen t ial d iagn osis, 172, 191 an d ret in it is pigm en tosa, 285 Keratoglobu s, 171–172, 172f Keratopathy ban d, 176–177, 177f bullous ap h akic, 167, 169, 192 differen t ial d iagn osis, 167, 169, 192 pseu dop h akic, 167, 169, 192 calcific ban d, 176–177, 177f exposure, 153–154 n europaralyt ic, 153–154 n eurot ropic, 143, 144f, 155–156, 155f in HZV in fect ion , 143, 144f, 155 prim ar y lipid , 175, 175f Keratoplast y Descem et st rip p ing en d oth elial, 187, 187f graft reject ion in , 188, 188f, 192 lam ellar, 186f, 187 pen et rat ing, 185, 186f graft reject ion in , 188, 188f Keratop rosth esis, 188, 189f Kh odadou st lin e, 188, 188f Kidn ey, m align an cy of, orbital m etast ases, 94 Klipp el-Feil syn drom e, 353 Kn ies’ sign , 76t Koch er sign , 76t L Lacerat ion (s) can alicu lar, 2, 3f conju n ct ival, 4–5, 5f corn eal, 9–10, 9f eyelid, 1–2, 1f, 3f Lacrim al glan d(s) accessor y, 121 aden oid cyst ic carcin om a, 98, 99f en largem en t , 97–99 in flam m at ion , 97 t um ors, 97–98 ben ign m ixed, 97–98, 97f Lacrim al sac t u m or, 68 Lacrim al system disord ers, 65–68 traum a, 2, 3f Lagop h th alm ia, 154 Lam ellar keratop last y, 186f, 187 Lateral rect us m u scle palsy, 350–351, 351f Lat tice corn eal dyst rop hy, 162–163, 162f differen t ial d iagn osis, 178 Lat tice degen erat ion , 292–293 Leber congen ital hereditar y opt ic n eu rop athy, an d keratocon u s, 171 Leiom yom a differen t ial d iagn osis, 323, 325 uveal, 324 Len s dislocat ion , 13–14 asym ptom at ic, 14 w ith broken capsule an d in flam m at ion , 14 in to vit reou s, 14 su blu xat ion , 13–14, 14f asym ptom at ic, 14 w ith cataract , 14 w ith h igh un correct able ast igm at ism , 14 w ith m on ocular diplopia, 14 Len t igo m align a, 63f, 64 Lep rosy differen t ial d iagn osis, 150, 191, 192 an d n eu rot ropic keratop athy, 155 Leu kem ia differen t ial d iagn osis, 78, 94, 323 an d hyp h em a, 15 in t raocu lar, 216, 216t iris n odu les in , 324 orbital involvem en t in , 96f Leu kocorn ea, 192–193 Levator m u scle fu n ct ion , m easu rem en t , 36 palsy, isolated, 348 Lim bal follicles, 118 Lim bal girdle of Vogt , 174, 174f Lipid degen erat ion of corn ea an d conjun ctiva, 120–121, 121f Lipid s, seru m , abn orm alit ies See also Hyperlipoprotein em ia an d m acroan eu r ysm , 269 Lipoprotein em ia, 164 Lisch n odules differen t ial d iagn osis, 322 in n eu rofibrom atosis, 325 Low e syn d rom e, 135, 175 corn eal involvem en t in , 192 Low ey sign , 76t Lym e d isease, an d in terst it ial kerat it is, 150, 151 Lym ph angiom a, 85–87, 85t, 86f differen t ial d iagn osis, 84, 93 Lym ph ogran u lom a ven ereu m (LGV), 106 Lym ph oid hyp erp lasia, 133 Lym ph om a(s) differen t ial d iagn osis, 59, 90 in t raocu lar, 216, 216t orbital, 79–80, 79f M Macroaneur ysm , 269–270 differen t ial d iagn osis, 263 Macular degen erat ion age-related See Age-related m acular degen erat ion differen t ial d iagn osis, 280 juven ile, 278 Macu lar dyst rop hy, 163, 163f differen t ial d iagn osis, 161 vitelliform , 280–281 Macular edem a clin ically sign ifican t , 261, 262f diabet ic, 283 differen t ial d iagn osis, 283 Macular h em orrhage, 267 Macular h ole, 267, 296, 317–318, 317f, 318f differen t ial d iagn osis, 274, 318 idiopath ic, 23 m an agem en t by obser vat ion , 318 su rgical, 318, 319f st ages, Gass classificat ion, 318 traum at ic, 22–23, 23f Macular ret in al vein occlusion, 265f Maculopathy age-related See Age-related m acu lopathy diabet ic, 261, 262f an d cystoid m acu lar edem a, 274 Index 549 differen t ial d iagn osis, 263, 269 Madarosis w ith bleph arit is, 100 w ith m align an cy, 59 Maffu cci syn drom e, 84 Malign an t m elan om a See Melan om a Man dibu lofacial dysostosis See Fran cesch et t i syn d rom e Man n is lin e, 179 Map-d ot-fingerprin t corn eal dyst rop hy, 158–159, 159f Marcu s- Gu n n jaw -w in king syn drom e, 38 Marfan syn d rom e, 135 blue sclera in , 134 and d egen erat ive m yop ia, 272 an d keratocon u s, 171 and len s su blu xat ion , 13, 14 Margin to lid reflex, 36 Masqu erade syn d rom es, 216–217, 216t Medial rect us m uscle palsy, isolated , 348, 348f Medu lloep ith eliom a of ciliar y ep ith eliu m , 326 d ifferen tial d iagn osis, 323, 325, 326 Meesm an n dyst rop hy, 160, 160f d ifferen tial d iagn osis, 159, 161 Megalocorn ea, 157 Meibom ian glan d dysfu n ct ion , p em p h igoid an d , 112 Meibom it is, w ith blep h arit is, 100 Melan ocytom a(s), 338, 338f choroidal, 332 Melan ocytosis ocu lar, 129–130, 129f, 324–325 differen tial d iagn osis, 322 ocu lod erm al, 130, 130f differen tial d iagn osis, 129 Melan om a am elan otic ch oroidal, 329 differen tial d iagn osis, 324, 329 choroidal, 132, 327–329, 328f am elan ot ic, 329 differen tial d iagn osis, 216, 327–333, 338 m an agem en t , 329 presen tat ion , 327–329, 328f vit reou s h em orrh age in , 18 ciliar y body, 325–326 differen tial d iagn osis, 322 vit reou s h em orrh age in , 18 conju n ct ival, 132–133, 132f differen tial d iagn osis, 131 cutan eou s, 63–64, 63f ret in op athy secon dar y to, 217 d ifferen tial d iagn osis, 52, 56, 59, 129, 130 d ilated episcleral sen t in el vessels in , 125 of iris, 323 n odular, 64 orbital m etast ases, 94 p ingu ecu la an d , 118f sup erficial spreading, 64 su r veillan ce, w ith m elan ocytosis, 325 Melan osis conju n ct ival ben ign ep ith elial, 131–132, 131f d ifferen tial d iagn osis, 133 p rim ar y acqu ired differen tial d iagn osis, 129, 130 m align an t poten t ial, 132 Melan osis bu lbi, 140 Men ingiom a, 81 Men kes syn drom e, blu e sclera in , 134 Meridion al com p lex, 289 Meridion al folds, 289, 289f Metabolic d isease, 135 Metallosis bu lbi, 23 Metastat ic d isease ch oroidal, 329–330, 329f d ifferen tial d iagn osis, 327–331 ciliar y body, 325 conju n ct ival, 133 d ifferen tial d iagn osis, 80, 324 of iris, 324 orbital, 94, 96f MEW DS See Mult iple evan escen t w h ite dot syn d rom e Microan eu r ysm s, 261 Microcorn ea, 157 Microhyp h em a, 14–16 t raum at ic, 10 Microp an n u s, 192 Microp h akon it, 218f, 219 Microp h th alm os, 50 d ifferen tial d iagn osis, 157, 158 Migrain e, 295 Möbiu s sign , 76t Mollu scu m tagiosu m , 54, 54f d ifferen tial d iagn osis, 51, 192 Mon ocu lar elevat ion deficien cy, 354–355, 354f Mooren u lcer, 180–182, 182f d ifferen tial d iagn osis, 183 MRD See Margin to lid reflex Mu cocele, 93–94, 95f d ifferen tial d iagn osis, 65, 68, 81 eth m oidal, 65, 68 Mu colip idosis, corn eal involvem en t in , 192 Mu cop olysacch arid osis, corn eal involvem en t in , 166, 170, 192 Mu corm ycosis, 128 Mu lt iple en d ocrin e n eoplasia, t yp e IIb, 191 Mu lt ip le evan escen t w h ite d ot syn drom e, 203–204, 203f–204f Mum ps, corn eal involvem en t in, 150 Myasth en ia gravis, 356–357, 356f Myopia degen erat ive, 272, 272f ocu lar associat ion s, 272 system ic associat ion s, 272 h igh , 272, 272f “blu e sclera” in , 134 differen t ial d iagn osis, 21, 286 an d len s su blu xat ion , 13 an d t rau m at ic ret in al detach m en t , 21 an d ret in al d etach m en t , 296 an d ret in it is pigm en tosa, 285 Myopic sh ift , in in fan ts, vit reou s h em orrh age an d, 19 Myosit is, 78 Myoton ic dyst rop hy, 281, 285 Myoton ic ret inop athy, 282 N Nanoph th alm os, 157 Naproxen , corn eal vert icillata caused by, 180 Nasolacrim al duct obst ruct ion, 67–68, 67f Neoplasm (s), 322–338 See also Tum or(s) conju n ct ival, w ith secon dar y h em orrh age, Neovascu larizat ion ch oroidal an d cystoid m acu lar edem a, 274 differen t ial d iagn osis, 21, 275 corn eal, in Steven s-Joh n son syn d rom e, 113 in diabet ic ret in op athy, 261 differen t ial d iagn osis, 263 in ocu lar isch em ic syn drom e, 268, 269f Neovascu lar m em bran es, su bret in al, 21 Ner ve fiber layer, m yelin ated, 266 Neu rilem m om a, 81 Neu roblastom a differen t ial d iagn osis, 84 m et astat ic, 87, 94 550 Index Neu rofibrom a, 58–59, 59f plexiform , 86 Neu rofibrom atosis, 135 differen t ial d iagn osis, 191 Lisch n odules in , 325 Neu roparalyt ic keratop athy, 153–154 Neu roret in it is differen t ial d iagn osis, 263 syp h ilit ic, 198 Neu rot ropic keratopathy, 143, 144f, 155–156, 155f Nevu s (pl., n evi), 54–56, 55f ch oroidal, 326–327, 327f differen t ial d iagn osis, 328, 330, 331, 332 com p ou n d, 54–56, 55f, 131, 132 differen t ial d iagn osis, 52, 59, 64, 129, 130, 133, 323 int raderm al, 54–56, 55f of iris, 322 jun ct ional, 54–56, 55f, 131, 132 m align an t , sign s, 132, 133 m align an t poten t ial, 131, 132 st raw berr y, 81 Nevu s flam m eu s, 84 Nevu s of Ot a, 56, 56f, 324–325 differen t ial d iagn osis, 129 Nicolas-Favre disease, 106 Nicot inic acid, an d cystoid m acular edem a, 274 Nigh t blin dn ess, congen it al st at ion ar y, 280 differen t ial d iagn osis, 285 Nit ric acid burn, 5–7 Nod u le(s), of iris, 322–325 Nonproliferat ive diabet ic ret in op athy See Diabet ic ret inopathy, n onproliferat ive Non steroidal an t i-in flam m ator y drugs (NSAIDs), an d su bconju n ct ival h em orrh age, 3–4 NPDR See Diabet ic ret in op athy, n onp roliferat ive O OAG See Glau com a, open -angle Ocu lar isch em ic syn drom e, 268–269, 269f differen t ial d iagn osis, 263, 264, 269 Ocu lar m assage, 268 Ocu lar vein varicosit ies, 125–126 Ocu loau ricu lovertebral dysp lasia See Golden h ar syndrom e Oculocerebroren al syndrom e, 135, 175 Oculogen it al syndrom e, 107t–108t OIP See Orbital in flam m ator y pseudot u m or On chocerciasis, 150 Open-angle glaucom a See Glaucom a, open angle Oph th alm ic arter y occlusion , 266–268 Opt ic disk capillar y h em angiom a, 334, 335f m elanocytom a, 338, 338f Opt ic n er ve avu lsion , 26 gliom a, 81, 86 t ran sect ion , 26 Opt ic n er ve sheath, h em orrh age, 26 Opt ic n europathy, trau m at ic, 25–26, 25f Ora serrata, 296 Orbit foreign body in , 28–29, 29f fract u res, 26–28 in fect ion s, 69–71 in flam m at ion , 71–78 differen tial d iagn osis, 73t n eoplasm s, 79–94 t raum a, 26–32 Orbital balloon , tem p orar y, 303 Orbital em physem a, 26 Orbital h em orrh age, 26 Orbital in flam m ator y pseu dot u m or, 77–78, 78f, 97 Orbital varices, 85t, 93 Osteitis deform an s, an d angioid st reaks, 270 Osteogen esis im p erfect a blue sclera in , 133–134, 134f d ifferen tial d iagn osis, 191 Osteom a ch oroidal, 327–332, 331f d ifferen tial d iagn osis, 94, 327–331 Osteom yelit is, of p aran asal sin u ses, 69, 72 P Paecilom yces kerat it is, 149, 150 Paget disease, an d angioid st reaks, 270, 271 Palpebral fissure, 36 in blep h aroph im osis syn drom e, 48, 48f Pan n us, 191–192, 192f d ifferen tial d iagn osis, 118 Pan uveitis, 269 Papillae, 110 Papilledem a, 264, 335, 336, 337 Papillit is, 264, 335, 336, 337 Papillom a d ifferen tial d iagn osis, 54, 133 eyelid, 51, 51f p ostsurgical, 119f Paracentesis, an terior ch am ber, 268 Parafoveal telangiectasia d ifferen tial d iagn osis, 263, 269, 283 id iopath ic, 282–283, 283f m an agem ent , 283 p resen tat ion, 282 Paran eoplast ic syn drom e, 217 Parasit ic in fest at ion , conjun ct ival cysts in , 121, 122 Parat rachom a, 106, 107t Parin aud syn drom e, eyelid ret ract ion in, 43 Pars plan a, 296 breaks, 296 Pars plan a cyst , 290 Pars plan a pearls, 290 Pars plan it is, 200 d ifferen tial d iagn osis, 326 Par t ially accom m odat ive esot ropia, 342 Patau syn drom e, corn eal involvem en t in , 192 Pat tern dyst rophy d ifferen tial d iagn osis, 279, 280, 281 gen et ics, 281 m an agem ent , 281 p resen tat ion , 281 Pat tern st rabism us, 344–345, 345f A pat tern , 344–345, 345f V p at tern , 344–345, 345f Pavingstone degen erat ion , 290–291, 291f d ifferen tial d iagn osis, 286 PDR See Diabet ic ret in opathy, proliferative Pellagra, 192 Pellu cid m argin al degenerat ion (cornea), 172–173, 173f at yp ical, 184 d ifferen tial d iagn osis, 171, 184 Pem ph igoid cicat ricial, 63, 192 d ifferen tial d iagn osis, 63, 110, 113, 192 ocu lar, an d d ist ich iasis, 64 ocu lar cicat ricial, 111–113, 112f an d sym bleph aron , 116 Pem ph igus, ocular, 191 Penet rat ing keratoplast y, 185, 186f graft reject ion in, 188, 188f Perioptic n eurit is, 78 Persisten t hyperplastic prim ar y vit reous, 326 Peters an om aly, 135, 190 PEX See Pseudoexfoliat ion syn drom e Index 551 Ph acoan aphylact ic uveit is, 12 Ph acod on esis, 13 Ph aco m ach in e an d n ection of air p u m p to in fu sion bot tle, 226f prin ciples, 223, 223f su rge p h en om en on m ech an ism of, 224f preven tion , 225f Ph acom atoses, 135 Ph ar yngoconju n ct ival fever, 101–103 Ph en oth iazin es, corn eal vert icillata cau sed by, 180 Ph en oth iazin e toxicit y, 285 Ph lycten u lar keratoconju n ct ivitis, 192 Ph lycten u le, 118 Ph lycten u losis, 177 Ph otocoagu lat ion an d recu rren t corn eal erosion , 156 for ret in al detach m en t , 302 Ph otoph obia, in congen ital glau com a, 134–135 Ph ototoxic inju r y, 275 PHPV See Persisten t hyp erplast ic p rim ar y vit reou s Ph th isis bu lbi, 136, 191 Picorn aviru s conju n ct ivit is, 101, 103–104, 103f Pigm en t at ion s, conju n ct ival, 131–132, 131f causes, 131 Pigm en ted dep osits, 129, 130, 133 Pillat scleral p laqu e, 140, 140f Pingu ecu la, 117–118, 117f, 118f differen t ial d iagn osis, 120 Plasm in ogen act ivator in h ibitor 1, an d cen t ral serous ch orioret in op athy, 274 Pleom orp h ic aden om a, lacrim al glan d , 97–98, 97f Pn eum at ic ret in opexy, 303 Poch in sign , 76t POHS See Presum ed ocular h istoplasm osis syn drom e Polyarterit is nodosa, sclerit is in , 124 Polym orph ic am yloid degen erat ion , 178, 179f Por t-w in e stain, 126, 127f Posn er-Sch lossm an syn drom e, 196 Posterior am orp h ou s st rom al dyst rop hy, 166 Posterior em br yotoxon , 157, 158 Posterior sclerit is, 78, 124, 125 differen t ial d iagn osis, 329 Posterior vit reous detach m ent , and vit reous h em orrh age, 270 Pot assium hydroxide burn s, 5–7 Pre-Descem et dystrophy, 165–166 Pregn an cy, an d cen t ral serou s ch orioretin op athy, 273 Preser vatives, top ical, an d n eu rot ropic keratopathy, 155 Presu m ed ocu lar h istop lasm osis syn drom e, 202–203, 202f Prim ar y lip id keratopathy, 175, 175f Progeria, blu e sclera in , 134 Proliferat ive d iabet ic ret in op athy See Diabet ic ret in op athy, p roliferat ive Proliferat ive ret in op athy, vit reou s h em orrh age an d, 18, 19 Propionibacterium acnes, p ostop erat ive en doph th alm it is cau sed by, 214, 241 Proptosis in Graves oph th alm opathy, 355, 355f in thyroid eye d isease, 43, 43f, 355, 355f Prost aglan din (s), top ical, 64 Prost ate can cer, orbital m etastases, 94 Proteus, corn eal u lcer caused by, 146 Pseu d oesot ropia, 49, 339f Pseu d oexfoliat ion syn drom e, 249–250, 250f differen t ial d iagn osis, 280 Pseu d ogeron toxin , 173 Pseudom onas aeruginosa, corn eal u lcer cau sed by, 146 Pseu d oph akia, an d retin al detach m en t , 297 Pseu d opter ygiu m , 120 Pseu doptosis, 38 w ith m on ocu lar elevat ion deficien cy, 354–355, 354f Pseu dostrabism u s, 339–340, 339f Pseu d ot rach om a, 112 Pseu d ot u m or, orbital, 73t differen t ial d iagn osis, 76, 80, 86, 87, 93, 94, 128 in flam m ator y, 77–78, 78f, 97 Pseu d ovascu larit y, 333 Pseu doxan th om a elast icu m an d angioid st reaks, 270, 271 d ifferen t ial d iagn osis, 21 Psoriatic arth rit is, ocu lar involvem en t in , 195 Psych op h arm acological m ed ication s, an d cen t ral serous ch orioret in opathy, 273 Pter ygium (pl., pter ygia), 118–120, 119f d ifferen t ial d iagn osis, 118, 133 Ptosis, 36–41 ap on eu rot ic, 37f, 38 m an agem en t, 38 bilateral, 37f in bleph arop h im osis syn drom e, 48, 48f congen it al, 36, 37f m an agem en t, 38 t ralateral, w ith ip silateral lid ret ract ion , 43 d erm atoch alasis an d, 42–43, 42f m echanical, 38, 59, 59f w ith m on ocu lar elevat ion deficien cy, 354–355, 354f m yogen ic, 38 n eurogenic, 38 overcorrect ion , 43 p resen tat ion , 36–38 Pu p illar y block, w ith len s su blu xat ion , 14 Pup illar y sp h in cter, p alsy, isolated, 348 PVD See Posterior vit reous det ach m en t Pykn odysostosis, blu e sclera in , 134 Pyocele, 93 Pyogen ic gran u lom a, 45f Q Qu in in e toxicit y, 267 R Racial pigm en tat ion, 325 Radiat ion exposure, 112, 113 Radiat ion ret in opathy, 286–287 d ifferen t ial d iagn osis, 261, 263, 264, 286 p resen tat ion , 286 Radiat ion th erapy an d conju n ct ivalizat ion of corn ea, 136, 136f an d n eu rot rop ic keratopathy, 155 RCE See Recurren t corn eal erosion React ive lym ph oid hyp erplasia, 80 Recu rren t corn eal erosion , 156 Red eye causes, 3, 126 d ifferen t ial d iagn osis, 126 Refractive accom m odat ive esot ropia, 341f, 342 Refsu m disease d ifferen t ial d iagn osis, 191 an d ret in it is pigm en tosa, 285 Reis-Bü cklers dyst rop hy, 160–161, 161f d ifferen t ial d iagn osis, 159 an d recu rren t corn eal erosion , 156 552 Index Reiter syn d rom e, ocu lar involvem en t in , 194–195 ReNu w ith Moist u reLoc, 149 Ret icu lar d egen erat ive ret in osch isis, 294–295 Ret in a t u sion , 266 cystoid degen erat ion , 288–289 ret icu lar, 288 t yp ical, 288–289 degen erat ion s, 288–291 develop m en t al an om alies, 288–291 edem a, p ost t rau m atic, 21–22 en closed oral bay, 289, 289f equ ator, 296 exophyt ic capillar y h em angiom a, differen t ial d iagn osis, 329 flecked, 280, 280f See also Fu n du s flavim aculat us; Stargardt disease h em orrh ages, post t rau m at ic, 21–22 m ed ical, 260–287 m eridion al com p lex, 289 m eridion al fold s, 289, 289f n ecrosis acu te, d ifferen t ial diagn osis, 21 post t rau m at ic, 21–22 su rgical, 288–321 tears, post t raum at ic, 21–22 t um ors, 333–337 Ret in al breaks acu te p resen tat ion , 298 id en t ificat ion , 300–301, 300f localizat ion , 300–301, 300f, 305–306, 306f op ercu lated , 297f, 298 t ypes, 297–298, 297f Ret in al cap illar y h em angiom a, diabet ic, 269 Ret in al det ach m en t , 296–305 acu te p resen tat ion , 298 after cataract su rger y, 239–240, 240f ap h akic, 239–240, 240f causes, 21 cen t rifugal forces an d, 296 differen t ial d iagn osis, 19, 274, 295, 298–299 exu dat ive ch aracterist ics, 299t differen t ial d iagn osis, 285, 298, 299t localized serou s See Cen t ral serou s ch orioret in op athy m an agem en t, 300–305 ou t p at ien t tech n iqu es, 303–305, 303f, 304f, 305f su rgical failu re, 303 path ology, color-coded diagram , 306, 307f post trau m at ic, 21–22, 22f rh egm atogen ou s, 239–240, 296 ch aracterist ics, 299t differen tial d iagn osis, 298, 299t epidem iology, 296 m an agem ent , 300–301, 301f presen tat ion , 296–298 risk factors for, 296–297 t ract ion al ch aracterist ics, 299t differen tial d iagn osis, 298, 299t in proliferat ive ret in opathy, 261, 263f Ret in al dialysis, 297f, 298 an d ret in al detach m en t , 21, 22f Ret in al pigm en t degen erat ion , secon dar y, in syph ilis, 198 Ret in al pigm en t ep ith eliu m congen it al hypert rop hy, 332, 332f differen tial d iagn osis, 327, 328, 330, 331, 332 h em orrh agic det ach m en t , differen t ial diagn osis, 329 hyperplasia, differen tial diagn osis, 327, 328, 330, 331, 332 in farct ion s, 260–261 p osth em orrh age h em osid erin dep osits, d ifferen tial d iagn osis, 332 t u m ors, 332–333 Ret in al tears, 296–305 flap , 297, 297f h orsesh oe, 297, 297f Ret in al telangiectasis an d cystoid m acu lar edem a, 274 differen t ial d iagn osis, 275 Ret in al t u fts, 293–294 cyst ic, 293 n on cyst ic, 293–294 zon ular t raction , 294 Ret in al vein occlu sion , an d cystoid m acu lar edem a, 274 Ret in it is acu te, d ifferen t ial diagn osis, 264 cytom egaloviru s, 208, 208f differen t ial d iagn osis, 266 Ret in it is p igm en tosa, 284–285, 284f an d cystoid m acu lar edem a, 274 differen t ial d iagn osis, 285 m an agem en t, 285 ocu lar associat ion s, 285 presen tat ion , 284–285 system ic associat ion s, 285 Ret in it is pu n ct a albescen s, 279, 280 Ret in oblastom a, 216t, 333–334 associated m align an cies, 334 differen t ial d iagn osis, 201, 216, 323, 324, 326, 333, 335, 336, 337 ep idem iology, 333 gen et ics, 333–334 m an agem en t , 334 presen t at ion , 334 vit reou s h em orrh age w ith , 18 Retin op athy cen t ral serou s, 263 t um or-associated, 217 Retin op athy of p rem at u rit y, an d degen erat ive m yop ia, 272 Retin op exy, pn eu m at ic, 305 Retin osch isis differen t ial d iagn osis, 298–299, 299f ret icu lar degen erat ive, 294–295 sen ile, 294–295 Rh abd om yosarcom a, 87–89, 88f–89f differen t ial d iagn osis, 59, 78, 94 Rh egm atogen ou s ret in al det ach m en t , 239–240, 296 ch aracterist ics, 299t differen t ial d iagn osis, 298, 299t ep idem iology, 296 m an agem en t , 300–301, 301f presen t at ion , 296–298 risk factors for, 296–297 Rh eu m atoid arth rit is ep iscleritis in , 123 perip h eral u lcerat ive kerat it is in , 182–184, 183f sclerit is in , 124 Rh exis in m at u re cat aract , 222–223, 223f–226f in sen ile cataract , 226–227, 226f–229f Rieger an om aly syn drom e, 135 Riesm an sign , 76t Rosacea differen t ial d iagn osis, 182, 183 ocu lar, 100–101, 100f RPE See Ret in al p igm en t ep ith eliu m RP inversu s, differen t ial diagn osis, 279, 280 RRD See Rh egm atogen ou s ret in al det ach m en t Index 553 Rubella, 135 congen it al, 285 Rubella ret in opathy, 281, 282 Rubeola, corn eal involvem en t in , 150 Rubeosis iridis an d hyp h em a, 15 vit reou s h em orrh age an d, 18 S Salzm an n n od u lar degen erat ion , 177–178, 177f Sarcoid at ypical lym p h oid in filt rate, 57 differen t ial d iagn osis, 57, 323 Sarcoidosis, 97 cardiovascular involvem en t in , 199 differen t ial d iagn osis, 80, 112, 150, 263 ocu lar involvem en t in , 198–199 pu lm on ar y involvem en t in , 199 vit reou s h em orrh age w ith , 18 Satellite lesion , in adu lt toxop lasm osis, 201 Scarring ch orioret in al, 332 corn eal cen t ral, 164 in HSV kerat it is, 141f from infect ion, 177 in terst it ial kerat it is an d , 150, 151f in Steven s-Joh n son syn d rom e, 113 st rom al, 192 of lid m argin an d dist ich iasis, 64 an d trich iasis, 64 u pp er eyelid, 43 Sch nyder corn eal dyst rophy See Cen t ral cr ystallin e dystrophy of Sch nyder Sch w an n om a, 90 Sch w ar t z-Jam p el syn drom e, 217 Scleral bu ckling en circling, 302, 302t proced u re, 305–316 color-coded d iagram , 306, 307f drain age of su bret in al flu id, 314–315, 314f, 315f exoplan t m aterial, 308–310, 309f localizat ion of ret in al breaks, 305–306, 306f parallax associated w ith view ing, 308, 308f sh aft ing du ring localizat ion , 308, 309f su t u re p lacem en t for silicon e exp lan t , calculat ing distance of, 310f, 311–312, 311f–313f su t u re t ying, an terior sh ift ing, 314, 314f su t u ring tech n iqu e, 310, 310f for ret inal detachm en t , 302 segm en t al, 302, 302t Scleral ectasia, 140 Sclerit is, 124–125, 125f an terior, 124 differen t ial d iagn osis, 124, 329 n ecrot izing, 124 posterior, 78, 124, 125, 329 Sclerocorn ea, 158 differen t ial d iagn osis, 157, 192 Sclerom alacia, 140 Search ligh t in fog, in adu lt toxop lasm osis, 201 Sebaceou s cell carcin om a, 62–63, 62f differen t ial d iagn osis, 46, 101, 133 Sebaceou s hydrocystom a, 57, 58f Seborrh eic blep h arit is, 100 Seborrh eic keratosis, 52, 52f differen t ial d iagn osis, 53, 54, 64 Sen ile ret in osch isis, 294–295 differen t ial d iagn osis, 21 Sen ile tapetoch oroidal degen erat ion , 291 Sen sor y exot rop ia, 344 Serp igin ou s ch oroidit is, 205–206, 206f Serrat ia corn eal u lcer, 146 Seton im plan t at ion , 252, 253f Sh afer sign , 297 Sh aken baby syn drom e, 18 Sh ield ulcer, 146, 152–153, 153f Sh ingles, 143 Sickle cell an em ia, an d angioid st reaks, 270, 271 Sickle cell ret in op athy, 283–284 differen t ial d iagn osis, 263, 286, 335, 336, 337 m an agem en t , 284 presen t at ion , 283 proliferat ive, an d vit reou s h em orrh age, 270 Siderosis, 23–24 Siegrist st reaks, 261 Silden afil cit rate, an d cen t ral serou s ch orioret in opathy, 273 Sin u sit is, an d m u cocele, 93–94, 95f Sixth-n er ve palsy, 350–351, 351f Sjögren syn drom e, differen t ial diagn osis, 112 Skin t ag See Acroch ordon Sling surger y conven t ion al, 37f Jacob-Agar w al, 37f, 38–41, 39f–41f Sn ap -back test , 33 Sn ellen sign , 76t Sodiu m hydroxid e bu rn s, 5–7 Solar ret in it is, 287 Solar ret in opathy, 287 Sp h eroidal corn eal d egen erat ion , 178 Sp h ingolip idoses, 267 SPK See Superficial pun ct ate kerat it is Squ am ou s cell carcin om a, 61–62, 61f conju n ct ival, 137 cyst ic, 61f differen t ial d iagn osis, 51–54, 59, 64, 113, 133, 137 n odu lar, 62 plaqu elike, 62 u lcerat ing, 62 St ap hylococcal hyp ersen sit ivit y, 152 St ap hylococcal m argin al u lcer, 177, 182 Staphylococcus coagu lase-n egat ive, p ostoperat ive en doph th alm it is cau sed by, 241 corn eal u lcer cau sed by, 146, 177, 182 trau m at ic en doph thalm it is caused by, 213 Staphylococcus aureus blep h arit is cau sed by, 106 h ordeolu m cau sed by, 46–47, 46f postop erat ive en doph th alm it is caused by, 214, 241 trau m at ic en doph thalm it is caused by, 213 Staphylococcus epiderm idis, postoperat ive en doph th alm it is cau sed by, 214 St ap hylom a(s) an terior, an terior segm en t t ran sp lan tat ion for, 189–191, 190f congen it al, 272 posterior, w ith degen erat ive m yop ia, 272 scleral, 134–135, 135f differen t ial d iagn osis, 140 St argardt disease, 278–279, 279f differen t ial d iagn osis, 279, 280 m an agem en t, 279 presen tat ion , 278, 279f Stellw ag sign , 76t Steroid s exogen ou s, an d cen tral serous ch orioretin opathy, 273, 274 injection s, 267 an d su bconju n ct ival h em orrh age, 554 Index Steven s-Joh n son syn drom e, 113 differen t ial d iagn osis, 136, 192 an d dist ich iasis, 64 an d sym bleph aron , 116 an d trich iasis, 64 St ickler syn d rom e, an d degen erat ive m yop ia, 272 Stocker lin e, 179 St rabism u s, 339–358 pat tern , 344–345, 345f St raw berr y n evu s, 81 St reptococcus corn eal ulcer caused by, 146 grou p B, n eon at al en dogen ou s en doph th alm it is cau sed by, 215 postoperat ive end oph th alm it is cau sed by, 214, 241 traum at ic en doph th alm it is caused by, 213 St reptococcus pyogenes conju n ct ivit is, 105 St riate kerat itis, after cataract extract ion , 237f St riate m elan okeratosis, corn eal vert icillata in , 180, 181f St ring of p earls app earan ce, 215 St u rge-Weber syn d rom e, 135, 330 differen t ial d iagn osis, 325 dilated episcleral vessels in , 126–127, 127f Su bconju n ct ival h em orrh age, 3–4, 4f Su bretin al h em orrh age, 327, 328, 330, 331 Su ker sign , 76t Su lfite oxidase deficien cy, an d len s su blu xat ion , 13 Su lfu ric acid bu rn , 5–7 Su lfu rou s acid bu rn , 5–7 Su p erficial p u n ctate keratitis, w ith ch em ical burn , Su p erior lid crease, 36 Su p erior lim bic keratoconju n ctivit is, 122–123, 122f differen t ial d iagn osis, 63, 192 an d filam en tar y kerat it is, 154 Su p erior obliqu e p alsy acqu ired, 349 bilateral, 349–350, 350f congen it al, 349 u nilateral, 349f, 350 Su perior rect u s m uscle palsy, isolated, 348 Su pranu clear p alsy, 354f Sym bleph aron , 116–117, 116f in Steven s-Joh n son syn d rom e, 113 Sym pathet ic oph th alm ia, 213 Syph ilis acqu ired an d in terstit ial kerat it is, 150, 151 an d len s su blu xat ion , 13 ocu lar involvem en t in , 198 congen it al an d in terstit ial kerat it is, 150, 151, 151f ocu lar involvem en t in , 198 differen t ial d iagn osis, 285 vit reou s h em orrh age in , 18 Syringom a, 57–58 System ic lupus er yth em atosus an d cen t ral serous ch orioret in op athy, 273 perip h eral u lcerat ive keratit is in , 183f sclerit is in , 124 T Taches de bougie, 199 Tapetoch oroidal degen erat ion , sen ile, 291 Tay-Sach s disease, 267 Tear deficien cy an d filam en tar y kerat it is, 154 in Steven s-Joh n son syn d rom e, 113 Tears, art ificial, 114–115 Telecan thus, in bleph aroph im osis syndrom e, 48, 48f Tem porar y orbital balloon, 303 Tenon it is, 78 Terrien m arginal degen erat ion , 119f, 184–185, 184f differen t ial d iagn osis, 172, 183, 185 Th erm al bu rn (s), 6, 112, 192 Th ird-n er ve p alsy, 347–349 com p lete, 348, 348f congen it al, 349 differen t ial d iagn osis, 349 in ferior, 348, 348f m an agem en t, 349 pu p illar y involvem en t, 348, 349 secon dar y, 349 su perior bran ch , 348, 348f Th rom bosis, cavern ou s sin u s, 71–73 differen t ial d iagn osis, 69, 76, 78, 93, 128 presen tat ion , 71 Thygeson su perficial pu n ct ate kerat it is, 152, 152f Thyroid eye disease, 74–77, 74f–75f differen t ial d iagn osis, 78, 93, 128 dilated vessels in , 126 exoph th alm os in , 73t eyelid edem a in , 47, 47f eyelid ret ract ion in, 43, 43f m an agem en t, 76–77 proptosis in , 43, 43f Thyroid-related op h th alm opathy, 74–77, 74f– 75f See also Graves oph th alm opathy; Thyroid eye disease differen t ial d iagn osis, 78, 93 in filt rat ive (severe), 74 m an agem en t , 76–77 n on in filt rat ive (m ild), 74 Wern er classificat ion , 74 Tilosis, w ith blep h arit is, 100 Tolosa-Hun t syn drom e, 77, 128 Toxic epiderm al n ecrolysis, 112, 113 Toxocariasis, 201 Toxoplasm osis adu lt , 201 congen it al, 200 ocu lar involvem en t in , 200–202 Trach om a Chlam ydia, 106–109, 107f, 107t–108t differen t ial d iagn osis, 110, 112, 192 an d sym bleph aron , 116 an d dist ich iasis, 64 an d trich iasis, 64 Trau m a, 1–32 an terior segm en t , 1–17 an d bacterial corn eal u lcer, 146 carot id cavern ou s fist u la caused by, 31–32, 31f, 90, 93 cat aract cau sed by, 11–13, 12f cerebral, in p ed iatric pat ien t , 201 corn eal involvem en t in , 192 differen t ial d iagn osis, 69, 72, 324 en doph th alm it is cau sed by, 213–214 an d fu ngal kerat itis, 149 lacrim al system , 2, 3f an d len s su blu xat ion , 13 opt ic n er ve, 25–26, 25f orbital, 26–32 pen et rat ing, 21 perforat ing, 16–17, 17f posterior segm en t , 17–26 an d ret in al d etach m en t , 297 an d sym bleph aron , 116 to t rigem in al ner ve, and n eurot ropic keratopathy, 155 an d vit reou s h em orrh age, 270 Trich iasis, 64, 65f w ith bleph arit is, 100 differen t ial d iagn osis, 35, 110 Index 555 pem p h igoid an d, 112 in Steven s-Joh n son syn d rom e, 113 Trisom y 13, 135 Trisom y 15, 135 Trisom y 21, 49 See also Dow n syn drom e Tuberculosis ch orioretin it is in , 201 an d in terstit ial kerat it is, 150, 151 ocu lar involvem en t in , 199, 199t Tum or(s) an d bilateral superior obliqu e palsy, 349 ch oroidal, 326–332 differen t ial d iagn osis, 274 ciliar y body, 323, 325–326 eyelid, 51–57, 59–64 fu n dal, p igm en ted , 333 in t raocu lar an d cystoid m acu lar edem a, 274 an d vit reou s h em orrh age, 270 of iris, 322–325 lacrim al glan d, 97–98 orbital, 69–99 differen t ial d iagn osis, 128 ret in al, 333–337 an d ret in al d etach m en t , 298f ret in al p igm en t epith eliu m , 332–333 Turn er syndrom e, 135 Type A p erson alit y, and cen t ral serou s ch orioretin op athy, 273 U Ulcer corn eal from Acantham oeba, 147, 148f bacterial, 146–147, 146f differen t ial d iagn osis, 7, 143, 146, 153, 192 fu ngal, 149, 149f h erp et ic, 192 den d rit ic, 104f im m u n e-m ediated , 146, 147, 153 in fect iou s, 153 m argin al in HSV in fect ion , 142 st aphylococcal, 177, 182 sterile, 146 n eu rot ropic in HSV in fect ion , 142, 143 in HZV in fect ion , 144f in Steven s-Joh n son syn d rom e, 113 trach om a, 107f viral, 146 den drit ic differen t ial d iagn osis, h erp et ic, 104f h erp et ic den d rit ic, 104f differen t ial d iagn osis, Ulcerat ive colit is, ocu lar involvem en t in , 195 Ulcerat ive kerat it is differen t ial d iagn osis, 6, 182, 184 perip h eral, 182–184, 183f Ultraviolet (UV) kerat it is, Ush er syn drom e, an d ret in it is p igm en tosa, 285 Uveal effu sion syn drom e, 325 Uveit is acu te an terior n ongran u lom atou s, 194–197 in an kylosing sp ondylit is, 194 an terior, 10 in Beh ỗet syn drom e, 212213, 212f ch ron ic n ongran u lom atou s, 196–197 congen it al syp h ilit ic, 198 an d cystoid m acu lar edem a, 274, 276 differen t ial d iagn osis, 124, 125, 324 disord ers m asqu erading as, 216–217, 216t glau com a-related, 196 gran ulom atous, 198–199 HLA-B27-associated , 194–195 in in flam m ator y bow el disease, 195 in term ed iate, 200 in juven ile rh eu m atoid ar th rit is, 196–197 p h acoan ap hylact ic, 12 p h acolyt ic, 196 p osterior, 200–209 in psoriat ic ar th rit is, 195 in Reiter syn drom e, 194–195 in sarcoidosis, 198–199 t u bercu lou s, 199, 199t in uveit is-glau com a-hyp h em a synd rom e, 196 vit reous h em orrh age w ith, 18 Uveit is-glau com a-hyp h em a syn d rom e, 196 V Valsalva ret in opathy, 263 Varicella-zoster virus See also Herpes zoster acu te ret in al n ecrosis syn d rom e cau sed by, 209 in fect ion , 105 Vascular lesion s, orbit al, 85t, 90 See also Cap illar y h em angiom a; Cavern ou s h em angiom a; Lym ph angiom a; Orbital varices Vasculit is d ifferen tial d iagn osis, 269 ret in al, an d cystoid m acu lar edem a, 274 Verruca, 58 VH See Vit reous h em orrhage Viral in fect ion , corn eal, 146 Viral kerat it is, 149, 150 Vision loss, w ith ret in al breaks/ret in al d etach m en t , 297 Vitam in A d eficien cy, 285 Vitam in B deficien cy, 192 Vitelliform m acu lar dyst rop hy, 280–281 Vit iligin ou s ch orioret in it is, 206–207.207f Vit rectom y for ep iret in al m em bran e, 321 25-gauge t ransconjun ct ival, 305, 305f p n eu m at ic, 305 p rim ar y, 303 an d recu rren t corn eal erosion , 156 Vit reom acu lar t ract ion syn drom e, an d cystoid m acular edem a, 274 Vit reoret in al adh eren ce, focal, an d t rau m at ic ret in al detachm en t , 21 Vit reou s d etach m en t , p osterior, 295–296 d ifferen tial d iagn osis, 295 an d retin it is pigm en tosa, 285 Vit reou s h em orrh age, 270 am blyop ia an d, 19 cau ses, 270 diabet ic ret in op athy an d, 270 differen t ial d iagn osis, 18, 270, 295 Eales disease an d , 270 an d exu dat ive age-related m acu lar degen erat ion , 270 an d gh ost-cell glau com a, 18–19 an d h em osiderosis bu lbi, 19 in h istoplasm osis, 18 m an agem en t, 270 in m elan om a, 18 posterior vit reou s detach m en t an d , 270 post t rau m at ic, 17–19, 18f, 270 presen tat ion , 270 an d p roliferat ive ret in opathy, 18, 19 proliferat ive sickle cell ret in op athy an d, 270 w ith ret in al breaks/ret in al detach m ent , 297 w ith ret in oblastom a, 18 sp on tan eou s, 18 in syp h ilis, 18 556 Index Vit reou s h em orrh age (cont inued) traum at ic, 17–19, 18f, 270 in ch ild abu se, 18 Vit rit is in ad ult toxoplasm osis, 201 differen t ial d iagn osis, 295 Vogt-Koyan agi-Harada syn drom e, 210, 210f, 211f Vogt lim bal gird le, 174, 174f Vogt st riae, keratocon u s an d, 171 Von Grafe sign , 76t von Hipp el-Lin dau disease, 334 Vossius ring, 11 Wegen er gran u lom atosis, sclerit is in , 124 Weill-March esan i syn drom e, 135 an d len s su blu xat ion , 13 Weiss ring, 295 Wet sn ow, in adu lt toxop lasm osis, 201 W h ite dot syn drom e, 203–204 Wilder sign , 76t Wou nd leak, after cat aract su rger y, 237– 238 W Warfarin , an d su bconjunct ival hem orrh age, Z ZTTs See Ret in al t uft s, zon ular t raction X Xan th elasm a, 57, 58 .. .Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatm ent Second Edit ion Color Atlas of Ophthalmology The Quick-Reference Manual... au th ored several com prehensive handbooks and textbooks of oph th alm ology, an d Color Atlas of Ophthalm ology stan ds out as on e of h is best In it s 19 su bspecialt y ch apters, th is secon... Associate Professor Depart m en t of Oph th alm ology Un iversit y of Min n esot a Min n esot a Eye Con sult an t s Min n eap olis, MN Jam es M Hill, PhD Assistan t Professor Depart m en t of Microbiology,