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.

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

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.

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 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.

Mechanisms of neural plasticity enable the encoding and memorization of information based on sensory inputs and can be harnessed to partially restore function after CNS assault such as stroke or head trauma. In the present book, experts from the field of visual system plasticity describe and evaluate the evidence for neural mechanisms proposed to underlie CNS plasticity in the major divisions of the brain dedicated to visual processing, the retina, sub-cortical structures and cortex. We present studies from a wide variety of disciplines that range from molecular biology to neurophysiology and computer modeling. Leading investigators discuss their own work, and integrate this research with colleagues from other specializations. The book points out future applications for this research including clinical uses and engineering within the biomedical sciences. This book is an exciting and thought provoking read for all levels of science enthusiast interested in the physical basis of learning and cognition.

Minister, Mr. Mayor, Mr. Honourary President, Honoured guests, Ladies and gentlemen, Dear colleagues and friends: On behalf of the Ophthalmological Society of the German Democratic Republic I welcome you to this symposium. I am glad to see so many experts from more than 20 countries of all parts of the world assembled here in Schwerin, who have travelled far and overcome many obstacles in doing so. I wish to extend a special welcome to the Vice-Minister of Health of the GDR, whom we should like to thank for the continuing generous support of the government of the GDR for this event. It is a great pleasure to welcome scientists from socialist countries such as the Soviet union, Poland, Cechoslovakia, Hungary, Bulgaria and Yugoslavia and from non socialist countries such as USA, Canada, Great Britain, The Netherlands, Belgium, France, Federal Republic of Germany, Austria, Sweden, Finland, Denmark, Italy, Spain, Switzerland and far away Japan and Australia. I have the great honour to welcome Prof. FRANQOIS as our Honourary President, our scientific directors Prof. VOLKOV from Leningrad and Prof. BLODI from Iowa City, and Dr. ZIMMERMAN and other members of the Verhoeff Society, and Prof. GAILLOUD and Prof. MEYER-SCHWIcKERATH as prominent representatives of the Club Jules Gonin. We are delighted that you have accepted our invitation.

This book has become an iconic textbook in eye care over many years and multiple editions having originally published in 1986. Considered one of the classic, definitive books for comprehensive anterior segment diagnosis, treatment, and management, this new edition includes a new chapter on pre- and postop management of cataract and refractive surgery and primary care of Glaucoma, which is a major part of primary care optometry today, along with updates on proprietary therapeutic drugs, and technology additions such as amniotic membranes, injectables, and minor in-office procedures. It contains high-quality photos, 6 clinical DX and RX appendices, an index of more than 1800 items, and 74 tables, making this an accessible resource for clinical practitioners. Key Features: * With a combined 130 years of clinical experience and expertise, the optometric authors provide succinct information necessary for diagnosing, treating, and managing all anterior segment, primary glaucoma, and non-surgical ocular conditions. * Includes current and new ocular, and systemic drugs along with pre & postoperative cataract and refractive surgery management protocols useful for clinicians to assist with diagnosis and treatment. * Features a unique presentation format as all the clinical (DX & RX) information is organized in the SOAP (Subjective, Objective, Assessment, Plan) format for quick referencing and practical use by the primary eye care practitioners.

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.

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.

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.

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.

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.

"No attainment is ever final" Vascular disorders of the optic disc and nerve are important not only to the ophthalmologist but also to the neurologist and the internist. To the first specialty group they represent one cause of blindness or severe visual impairment; to the second group the optic disc edema and optic atrophy seen in these disorders can pose serious problems of diagnosis, or give indica tions of the involvement of the cerebral circulation; while to the last group they are frequently indicative of systemic disease, particularly of the cardiovas cular system. Recent advances in our knowledge of the blood supply of the optic nerve head have shed a significant new light on the subject. With the recent advent of fluorescein fundus angiography, an extra dimension has been added to the study of the ocular and optic disc circulations, and we have entered into a new era in the understanding of ocular vascular disorders "in vivo". In the pre-angiography era, postmortem injection studies, although very valuable, did not completely reveal the vascular pattern of the optic disc in the living, in health, and disease. The ophthalmoscope, without doubt, has been valuable in assessing optic disc lesions, but could not give us informa tion on the circulation of the eye and optic disc "in vivo".

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

Progress in the development of surgical implant materials has been hindered by the lack of basic information on the nature of the tissues, organs and systems being repaired or replaced. Materials' properties of living systems, whose study has been conducted largely under the rubric of tissue mechanics, has tended to be more descriptive than quantitative. In the early days of the modern surgical implant era, this deficiency was not critical. However, as implants continue to improve and both longer service life and higher reliability are sought, the inability to predict the behavior of implanted manufactured materials has revealed the relative lack of knowledge of the materials properties of the supporting or host system, either in health or disease. Such a situation is unacceptable in more conventional engineering practice: the success of new designs for aeronautical and marine applications depends exquisitely upon a detailed, disciplined and quantitative knowledge of service environments, including the properties of materials which will be encountered and interacted with. Thus the knowledge of the myriad physical properties of ocean ice makes possible the design and development of icebreakers without the need for trial and error. In contrast, the development period for a new surgical implant, incorporating new materials, may well exceed a decade and even then only short term performance predictions can be made.

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."

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.

Opening Remarks of the President, 2nd ISVO, Professor G.M. Breinin, M.D. The study of visual processes is surely unique as a clinical specialty, in corporating the disciplines of physics, chemistry, physiology, and psycho logy. Diagnosing and correcting disorders of the visual system in these last two decades of the 20th century has brought all of us into close prox imity with computer sciences, laser technology, the marvels of electronic microcircuitry, and the impressive developments in optical materials. Dur ing the course of this meeting we shall be hearing about how these different technologies can interact with one another, and we shall discover that such interaction may produce new diagnostic tools and new optical devices. We shall also learn that the optical qualities of the eye change during life, producing subtle and complex alterations in vision. On behalf of the members and organizing committee of the American Commit tee on Optics and Visual Physiology and our co-sponsoring organization, the Optical Society of America, I welcome you to this second symposium on visual optics. The first symposium took place in Japan in 1978 and, like the pres ent one, was a satellite meeting of the International Congress of Ophthal mology. The third symposium in this series will take place in Italy in 1986 as part of the next session of the International Congress of Ophthalmology.

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."

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?