This book, besides reviewing basic and clinical aspects of Behcet's disease, covers the latest findings, including genetic studies and treatment with biologics for the disease. Although the cause of Behcet's disease is still unknown, it is well known that genetic factors, such as HLA-B51, are involved in its development. Recently, novel susceptibility loci including IL10, IL23R-IL12RB2, and endoplasmic reticulum aminopeptidase 1 have been identified, providing new insights into the pathogenesis of the disease. In addition to basic research, the beneficial efficacy of anti-TNF-alpha monoclonal antibodies has also been suggested for not only uveitis associated with the disease but also other subtypes of the disease such as entero-, vasculo-, and neuro- Behcet's disease. Behcet's Disease: From Genetics to Therapies provides essential information both for basic researchers working in the fields of immunology, inflammation, and genetics, and for clinical physicians who are interested in Behcet's disease, such as ophthalmologists, rheumatologists, dermatologists, gastroenterologists, neurologists, and vascular surgeons.

This handbook is an overview of the diagnosis, treatment and long-term management of diabetic retinopathy, within the context of overall long-term diabetes disease management. Diabetes-related eye damage (diabetic retinopathy) is one of the most common complications of diabetes, affecting approximately 30-40% of people with diabetes. The situation is so severe that in countries such as the US and UK, diabetic retinopathy is currently the leading cause of blindness in people age 20 to 74 years old. Fortunately, there are several existing and emerging treatments on the horizon and with adequate control of the underlying diabetes, this condition can be successfully managed.

This book presents a unique approach not found in any other text for those looking to improve the clinical results of refractive surgery by gaining a better understanding of corneal biomechanics and the instrumentation related to it. Written by leading experts in the field, this book provides authoritative coverage of the interactions of the cornea and the bioinstrumentation, such as corneal topography, pachymetry, aberrometers, tonometry and optical coherence tomography. Organized in an easy-to-read manner, Corneal Biomechanics and Refractive Surgery is designed for refractive surgeons and general ophthalmologists alike and describes the biomechanical role of the corneal tissue and how each part is affected in refractive surgery. Additionally, showing what the bioinstrumentation can measure, how models can improve understanding of the interaction between biomechanics, bioinstrumentation, and refractive surgery, and how these models and bioinstrumentation together can improve the refractive results, are also discussed.

The only book on the market to cover the psychophysics, anatomy, physiology, and clinical deficits of the developing visual system in an accessible format and length. The visual system is the most commonly studied aspect of the nervous system and is the primary model for the study of both normal development and the effects of environment and sensory deprivation on development. This third edition highlights new research and features a large number of illustrations, many in color. It can be used as a supplementary text in neuroscience and ophthalmology courses. This book is a great resource for both novice and advanced researchers in the field of vision.

Primary Sjoegren's syndrome is a rheumatic disease affecting around 0.1-0.2% of the adult female population and can result in significant disability without adequate therapy. Diagnosis is often delayed and suggested therapies may not be optimal, and a multidisciplinary approach that includes rheumatologists, ophthalmologists, oral medicine physicians, and others is important to patient management. This volume summarises current understanding of the pathogenesis of the disease, including advances in the genetics of Sjoegren's syndrome. Chapters cover disease mechanisms, clinical diagnosis and assessment, secondary Sjoegren's syndrome, the role of laboratory investigations, and imaging. A therapy-based section covers topical oral and ocular therapies, and the role of steroids and biologics are also addressed. Sjoegren's Syndrome is a practical concise pocketbook featuring key points and illustrations showing important mechanisms of disease and pathways of care. The book will be of interest to trainees in rheumatology, ophthalmology, and oral medicine/surgery; specialist practitioners and therapists involved in the care of patients with Sjoegren's syndrome; and primary care physicians, dentists, and other specialists such as ENT physicians.

This second Uveitis volume provides the ophthalmologist with the most current understanding of the pathogenesis of the most frequent immune-mediated disorders of the eye and a practical approach to these diseases. It fills the gap between textbooks and original research publications and focuses on clinical aspects of inflammatory eye diseases. It covers a broad spectrum, including diseases affecting the conjunctiva, sclera and cornea, as well as intraocular inflammation, and it includes basic research aspects, such as immune mechanisms and genetics. The book is easy to read with highly structured core messages and summaries for the clinician.

Ocular toxicity is routinely assessed in toxicology studies conducted for regulatory purposes. Ocular anatomy and physiology and the assessment of ocular toxicity itself can be challenging to scientists involved in the safety assessment of pharmaceuticals, pesticides and other agents. Anatomical and physiological differences between species can impact the nature of ocular effects observed following intended or unintended exposure of ocular tissues to xenobiotics. Ocular Toxicity in Laboratory Animals provides a concise reference addressing ocular anatomy and physiology across species that will enhance the design and interpretation of toxicology studies conducted for regulatory purposes. The book provides an overview of routine and advanced techniques that are used to assess ocular toxicity including slit lamp biomicroscopy, indirect ophthalmoscopy, electrophysiology and imaging methods for the anterior and posterior segments of the eye. Additionally, the book defines the regulatory expectations for pharmaceuticals intended to treat ocular diseases and for other non-pharmaceutical regulated chemicals. With contributions from experts in the field, Ocular Toxicity in Laboratory Animals is an authoritative, accessible guide for toxicologists and other scientists involved in conducting toxicology studies for regulatory purposes and/or reviewing data from such studies.

Muller cells may be used in the future for novel therapeutic strategies to protect neurons against apoptosis (for example, somatic gene therapy), or to differentiate retinal neurons from Muller/stem cells. Meanwhile, a proper understanding of the gliotic responses of Muller cells in the diseased retina, and of their protective vs. detrimental effects, is essential for the development of efficient therapeutic strategies that use and stimulate the neuron-supportive/-protective - and prevent the destructive - mechanisms of gliosis.

In this exceptionally important new work, a panel of distinguished authors discusses all the latest developments in the study of ocular transporters. Focusing on the molecular characteristics, localization, and substrate specificities in various compartments of the eye, this volume discusses how transporters regulate the clarity of the cornea and lens, the movements of fluids across the ciliary epithelium and nutrients across the retinal pigment epithelium.

Retinal Degenerations is the result of the International Symposium on Retinal degeneration which has become perhaps the most important research meeting in the field. THe topics in this volume explore the etiology, cellular mechanisms, epidemiology, genetics, models and potential therapeutic measures for the blinding diseases of retinitis pigmentosa and age-related macular degeneration.

Indispensable for continuous education and advanced training All editors with international reputation and contributing authors with great expertise in their topic Well-structured text and design, quick and easy to read Bridges the gap between primary literature and daily practice Every 2nd year each subject is covered with timely information about new developments in the specialised field

We are excited to bring together recent research on the molecular biology of Axenfeld-Rieger syndrome (ARS) disorders. In the following chapters we will review and provide direct evidence for the molecular basis of this group of heterogeneous disorders, which include Rieger syndrome and Rieger anomaly. While ARS patients were initially diagnosed in the early 1930s the genetic basis for ARS was unknown until the recent identification of chromo- somal loci associated with this genetic disorder. In the mid-1990s Drs. Jeffrey C. Murray and Elena V. Semina identified PITX2 through positional cloning tech- niques as a gene associated with ARS. These researchers were able to iden- tify point mutations in PITX2 that were linked with ARS patients. ARS patients presented clinically with several developmental anomalies that fur- ther provided clues about the function of the PITX2 homeobox tran- scription factor. The phenotypic variability of ARS patients indicates that PITX2 can participate with many other faaors to control normal development processes. The hallmarks of ARS developmental anomalies are eye, tooth and umbilical defects. However, abnormal pituitary, heart, and craniofacial development are also detected. Thus, ARS patients provided the first link of PITX2 involvement in the development of these organs and structures. Some of these anomalies are recapitulated in epigenetic and genetic mouse, chick, zebrafish and frog studies which will be reviewed in the following chapters.

The first of its kind to cover the cutting edge technique of glued IOLs in eyes with deficient capsules, A Video Textbook of Glued IOLs combines the practical explanation of written text with the dynamic demonstration of a surgical video website. With this unique combination, the narrated videos are able to demonstrate all the challenging surgical situations, while the textbook will provide more in-depth step-by-step details for each technique. Dr. Amar Agarwal and his contributors are some of the leading pioneers of the glued IOL technique and provide expert advice on all aspects, including complications, predictions of problems, and methods of management. A Video Textbook of Glued IOLs also includes the history of the technique, methods, modifications, combinations, results, and complications, making it the first textbook to collect all the details on glued IOLs and compile them together with over 40 narrated video tutorials into one comprehensive resource. A Video Textbook of Glued IOLs offers state-of-the-art instruction from the innovators of the technique themselves and its step-by-step approach makes it simple to understand and easy to reproduce for anterior segment surgeons, junior ophthalmologists, specialists, and post-graduates alike. Some videos include: Subluxated cataract extraction Decentered IOL in the sulcus IOL in the anterior chamber Dislocated IOL in the retina Co-morbid scenarios like microcornea, aniridia, trauma and Coloboma

The purpose of this important new book is to provide basic scientists working in the field of glaucoma with a current understanding of the clinical aspects of glaucoma. The authors comprehensively review the most current knowledge available in the field and provide a basis in which researchers can effectively study the glaucomas. The multidisciplinary book will be of great value as its contents will aid the reader in prevention of blindness from glaucoma.

Visual Prosthetics provides an in-depth analysis of the principles of operation, current state, anticipated developments, and functional aspects of visual prosthetics restoring sight to visually impaired individuals. This volume uniquely describes the human visual system in health and disease in a pedagogical and didactic manner, fitting to professionals and researchers with a bioengineering background. Readers will find a balanced overview of electrical, molecular chemical and synthetic chromophore stimulation, in addition to the biophysics and psychological aspects of vision restoration. Unlike competitive texts, this introduction also includes the need and methods for functional evaluation and rehabilitation. Professionals in the field of biomedical engineering and graduate and postgraduate researchers will find Visual Prosthetics a valuable reference.

Recent missions on board the International Space Station have revealed previously unreported physiological consequences of long duration space flight, particularly in eyesight, and in this Brief Dr. Seedhouse reviews the existing theories on what causes this degeneration and how long it will last. Notably, 60% of long-duration crews have reported subjective degradation in vision, a clear indication that further study is necessary before astronauts embark on even longer-term space missions. Decreased near-visual acuity was reported in 46% of ISS/Mir crewmembers, resulting in a change of up to 2 dioptres in their refractive correction. It is possible that ophthalmic changes have been present since the first days of spaceflight, but had been attributed to other causes; this approach to the issue as well as other hypotheses are all presented in full to give a broad foundation of the existing knowledge on the topic. The changes have occurred at various times during a mission with varying degrees of visual degradation. Some cases resolved on return to Earth, but several crewmembers have not regained pre-flight visual acuity, indicating the damage may be permanent. One explanation of the syndrome has been attributed to hyperopic shift due to aging, but onboard analysis techniques, including visual acuity assessments, retinal imagery, and ultrasound examination of the eye, has led to the acceptance of a wider syndrome. In addition to vision changes, studies have reported flattening of the globe, swelling of the optic disc (papilledema), choroidal folds in the retina, swelling of the optic nerve sheath, and visual field defects. It is widely hypothesized that this spectrum of symptoms may be explained by an elevation of intracranial pressure (ICP). Establishing the provenance of this medical problem, monitoring its occurrence and resolving the symptoms for future long term space missions is a key challenge for space medicine. With this book, readers have an entry point for understanding the full scope of the problem and its possible origins.

The global medical and scientific communities need to standardize methodologies and agree on minimum criteria to permit inter-study comparisons. This book develops such standards, presenting a series of recommendations that represent the first codification of the manner in which studies should be executed.

Important questions about myopia are being posed by researchers across a broad spectrum of disciplines from psychology to molecular biology, from corneal surgery to retinal physiology, and from genetics to experimental optics. In bringing together information on pathology, epidemiology, experimentation, and treatment, this volume covers all aspects of myopia research and is an essential source for optometrists and ophthalmologists, as well as those interested in ocular growth or myopia.

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional texts and references in oculoplastics? Are you seeking brief, evidence-based advice for common clinical dilemmas or complications? Curbside Consultation in Oculoplastics: 49 Clinical Questions provides quick and direct answers to the thorny questions most commonly posed during a "curbside consultation" between experienced clinicians. Dr. Robert C. Kersten and Dr. Timothy J. McCulley, have designed this unique reference in which oculoplastic specialists offer expert advice, preferences, and opinions on tough clinical questions commonly associated with oculoplastics. The unique Q&A format provides quick access to current information related to oculoplastics with the simplicity of a conversation between two colleagues. Images, diagrams, and references are included to enhance the text and to illustrate common clinical dilemmas. Curbside Consultation in Oculoplastics: 49 Clinical Questions provides information basic enough for residents while also incorporating expert pearls that even high-volume ophthalmologists will appreciate. Residents, fellows, and practicing physicians alike will benefit from the user-friendly and casual format and the expert advice contained within. Some of the questions that are answered:What do I do when a patient on anti-coagulants needs surgery? When does an eyelid lesion need to be biopsied? What are the general treatment guidelines for Graves' ophthalmopathy? How should I treat bacterial orbital cellulitis? How do you distinguish an orbital infection from sterile inflammation? When should I be concerned about systemic disease in a patient with blepharoptosis? What are the oculoplastic uses of botulinum toxin? How do I know when to order an MRI or a CT?

Permanent surgical treatment for presbyopia remains the hereto unconquered "last frontier" in anterior segment surgery. Over the years, continuing innovations like Phaco, Radial Keratotomy, LASIK, and premium intraocular lenses have pushed toward this ultimate goal, but now anterior segment surgery is closer than ever with the advent of modern laser-assisted presbyopic lens implantation. Let Refractive Lens Exchange: A Surgical Treatment for Presbyopia, the first book of its kind, be your guide to this fifth wave of innovation in the surgical treatment of presbyopia. Dr. Ming X. Wang, MD, PhD, joined by Associate Editor Dr. Tracy S. Swartz, OD, MS, FAAO and more than 30 expert contributors, compiled this remarkable book. Never before has there been a book dedicated to all aspects of refractive lens exchange as a permanent treatment for presbyopia, both medically and surgically. Highlights of Refractive Lens Exchange include: Overview of all surgical treatments for presbyopia Dysfunctional lens syndrome and pathophysiology Patient education and preoperative assessment Marketing refractive lens exchange as a surgical treatment for presbyopia New technologies in assessing dysfunctional lens syndrome New technologies in mapping cornea and lens for refractive lens exchange Retinal issues related to refractive lens exchange Presbyopic lens types, indications, and contraindications for refractive lens exchange Lens- and cornea-based astigmatism correction Intraocular calculations for post refractive surgery eyes for refractive lens exchange Intraoperative wavefront technology 3D high-definition microsurgical visualization and positioning technology Femtosecond laser application in refractive lens exchange Postoperative care and complication management YAG capsulotomy after refractive lens exchange: indications and alternatives Postoperative care and complication management Keratorefractive enhancement Designed for newcomers as well as seasoned eyecare professionals, Refractive Lens Exchange: A Surgical Treatment for Presbyopia is the first book to guide ophthalmic surgeons, optometrists, and technicians through this exciting new field that is emerging as a safe and effective primary surgical treatment for presbyopia.

Studies on Retinal and Choroidal Disorders examines the role that oxidative and nitrosative stress plays in the complex physiology and pathophysiology of the retina and choroid. Both the basic science researcher and the clinical practitioner can use this book as a guide to the current understanding of retinal and choroidal cellular mechanisms involved in aging and disease. Beginning with a review of oxidative stress and inflammation in the pathoetiology of AMD and a review of the complement system in the retina, the book then takes a detailed look at oxidative stress in lipid metabolism and oxidized lipoproteins in the retina. It examines the anti-apoptotic activity of -crystallins in the presence of glutathione, oxidative stress in the mitochondria and endoplasmic reticulum, the role of iron in retinal disease, the mechanisms of pathological VEGF expression, NAPDH oxidase mechanisms, and Hepatocyte Growth Factor in oxidative stress in the retina. A detailed look at the Ccl2-/-/Cx3cr1-/- mouse model of AMD follows. Then a detailed examination of the systemic changes in AMD is followed by a discussion of cerium oxide nanoparticle reduction of oxidative stress. Two chapters discuss progenitor cells in the cause and treatment of retinal diseases including AMD and diabetic retinopathy. Natural compounds in the prevention and treatment of retinal diseases are exhaustively presented, followed by a chapter on serotonin 5-HT1A receptor agonists in oxidative stress of the retina. The current anti-VEGF treatment strategies of neovascular AMD are then given. The volume continues with a detailed look at nitric oxide and inducible nitric oxide synthase in retinal vascular disease, an explanation of an in vivo technique of studying the effect of lipid hydroperoxides on circulating leucocytes in the retina, an excellent review of oxidative stress in retinopathy of prematurity, and a look at VEGF induced oxidative stress in the retinal ganglion cell. The book ends with a detail examination of the role of carotenoids in retinal health and disease. These 31 chapters summarize what is known about oxidative stress in retinal and choroidal disorders. All those involved with degenerative diseases of the eye will find Studies on Retinal and Choroidal Disorders to be illuminating and comprehensive.

There has been considerable increase in the knowledge concern ing tear secretion, the ocular surface, and pathophysiologic con ditions leading to the dry eye. Much of this new knowledge is not widely appreciated. Although there have been proceedings of symposia published, there is no currently available book of suf ficient scope, yet reasonable length, which ties together aspects of this newly acquired knowledge. This textbook is designed to give the ophthalmic practitioner a comprehensive, yet concise, guide line concerning the diagnosis and treatment of the dry eye. We have been able to bring together leading researchers to accom plish the same. We wish to express our special thanks to the company Dr. Mann Pharma of Berlin without whose generous sponsorship we could not have completed our task. The sponsor ship, in bringing together the authors in planning, preparation, and realization of this text, is gratefully acknowledged. Washington/Ulm, March 1992 M. A. Lemp R. Marquardt Contents Introduction 1 Chapter 1 History of the Dry Eye J. Murube . . . . . 3 1 lntroduction 3 2 The Concept of the Dry Eye 5 3 The History of the Causes of the Dry Eye 6 4 The History of the Diagnosis of the Dry Eye 11 5 The History of the Treatment of the Dry Eye 15 6 The Social Response to the Dry Eye 19 References . . . . . . . . . . . . . . . . 19 Chapter 2 Functional Morphology of the Conjunctiva J. W. Rohen and E. Lutjen-Drecoll. With 20 Figures and 3 Tables . . . . . . . . . 35 1 Conjunctiva . . . . . . . .

The management of vascular and tumorous lesions of the parasellar region still remains one of the most demanding tasks in neurosurgery. It is only a short time ago that the major concepts of the anatomy of the so-called cavernous sinus were described in detail. Surgical interventions in this region are very complex, they are time-consuming and require an extensive back ground of experience in surgery of the cranial base. Pioneer anatomical studies of the parasellar region done by Taptas, and the daring direct operative approach introduced by Parkinson pro moted the development of modern neuroradiological intervention proce dures, which were initiated by Serbinenko and further refined by Debrun, Vifiuela and others. The technique of the detachable balloon catheter stimulated surgeons to proceed with the direct operative approach to lesions of the parasellar region. Today, it is hard to imagine a successful man agement of vascular pathologies of this region without a complementary use of the two techniques."

This conference was instigated by a combination of factors: The nature of the problem, the wide spread occupational epidemiology reported on eye symptoms and eye fatigue in the workplace, and the organizers' awareness of the complexity of the scientific and clinical bases of knowledge that might be usefully applied. The introduction of new methods into system neurobiology provides new insights into how we receive and process information from the external world, and act upon it. New, non-invasive methods have opened the way to direct observation of the human brain in action. Due particularly to the interaction between the visual and oculomotor requirements involved, several clinical and scientific fields intersect when these issues are considered. To provide clear vision the accommodative and pupillary mechanisms are used. To maintain binocularity, the ver gence oculomotor system, sensitive to fatigue, must attain congruence with accommodative levels. This accommodation-vergence linkage was a focus of our symposium."