"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".

Curbside Consultation in Glaucoma: 49 Clinical Questions has been updated into a Second Edition! The Second Edition contains new questions and is completely updated! Curbside Consultation in Glaucoma, Second Edition contains new questions and brief, practical, evidence-based answers to the most frequently asked questions that are posed during a "curbside consultation" between surgical colleagues. Dr. Steven J. Gedde and associate editors Dr. Dale K. Heuer, Dr. Richard A. Lewis, and Dr. Joseph Panarelli have assembled the top glaucoma consultants from the United States and abroad to offer expert advice, preferences, and opinions on tough clinical questions commonly associated with glaucoma in this updated reference. The unique Q&A format provides quick access to current information related to glaucoma in the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and illustrate surgical pearls. Some of the questions that are answered inside the Second Edition include: What imaging technology is best for diagnosing glaucoma? For detecting progression? What new methods are available to measure intraocular pressure? Are any devices available for continuous monitoring of intraocular pressure? Do anti-VEGF agents produce intraocular pressure elevation? How should I set a target intraocular pressure? How should I manage a patient who is progressing at low levels of intraocular pressure? Does cataract extraction produce significant and sustained intraocular pressure reduction? When should I perform a combined procedure versus cataract surgery alone? What are MIGS? When should I use them? Curbside Consultation in Glaucoma: 49 Clinical Questions, Second Edition provides information basic enough for residents while also incorporating expert pearls that even high-volume glaucoma specialists will appreciate. General practitioners, residents, fellows, and optometrists alike will benefit from the user-friendly, casual format and the expert advice contained within.

This book highlights the unique aspects of oncologic ophthalmology as a medical and surgical discipline practiced at a comprehensive cancer center. Multi-disciplinary management of ocular, orbital and adnexal cancers are highlighted using simple and tried-and-true algorithms. In addition, ocular problems caused as a direct result of cancer treatment are reviewed using illustrative photographs and case presentations. The content is provided by full-time ophthalmology faculty and fellows at M. D. Anderson Cancer Center. Experts in complementary disciplines such as ophthalmic pathology, dermatopathology, radiation oncology, radiology, and other surgical subspecialties have brought their unique perspective to each chapter.

The book is abundant with clinical photographs as well as interesting case presentations that will help the clinician correctly diagnose cancers of the orbit, eye, and adnexal structures, initiate appropriate management, as well as recognize and treat common ocular complications of cancer therapy.

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.

An International Symposium on Low Vision was sponsored by the Centre for Sight Enhancement of the School of Optometry, University of Waterloo in June 1986, bringing low vision researchers and clinicians together from a number of countries. The unique feature of the conference is the multi-disciplinary approach towards low vision care. A total of 44 papers were presented in the three day period by speakers of note from the fields of optometry, ophthalmology, psychophysics, special education, nursing and vision rehabilitation. The papers deal with issues in diagnostic science, low vision assessment and rehabilitation. The proceedings volume is ideal for clinicians and vision scientists to update their understanding of low vision research and clinical practice.

During the past several decades, a significant international research effort has been directed towards understanding the composition and regulation of the preocular tear film. This effort has been motivated by the recognition that the tear film plays a critical role in maintaining corneal and conjunctival integrity, protecting against microbial challenge and preserving visual acuity. In addition, research has been stimulated by the knowledge that alteration or deficiency of the tear film, which occurs in numerous individuals throughout the world, may lead to desiccation of the ocular surface, ulceration and perforation of the cornea, an increased incidence of infectious disease, and potentionally pronounced visual disability and blindness.

Recent developments in the field of retinal detachment surgery have called for a substantial revision of the previous edition of this text. The most significant advances have focused around the increased use of pars plana vitrectomy and of various intraocular gases. The illustrations have also been improved, including more colour material, and the references have been revised and supplemented where indicated. The basic format of the first edition has, nevertheless, been adhered to: namely, a concise textbook on retinal detachment surgery which will enable the reader to attain a sequential approach to the examination and treatment of patients with retinal detachment. The clear presentation will benefit those in training as well as the more experienced general ophthalmologist who normally does not specialize in vitreo-retinal surgery, but who has to cope with retinal detachment surgical problems.

From the 98 presentations of the XIIth Symposium on Colour Vision Deficiencies, 61 were selected after peer review and revision by the authors. In addition to these contributions this volume contains a cumulative index to all authors in the IRGCVD proceedings since the first one in 1968, including the present volume. The contents include contributions on basic questions of anatomical and electrophysiological organisation of the neural pathways underlying colour vision; and on ways in which disturbances of these pathways can produce acquired colour vision deficiencies. Further contributions deal with genetics and congenital red--green colour deficiencies and colour vision testing. The resulting publication contains much of interest to basic vision scientists as well as to specialists in colour vision deficiencies.

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.

This book deals with the cellular biology, biochemistry and physiology of photoreceptors and their interactions with the second-order neurons, bipolar and horizontal cells. The focus is upon the contributions made by these neurons to vision. Thus the basic neurobiology of the outer retina is related to the visual process, and visual defects that could arise from abnormalities in this part of the retina are highlighted in the first 16 chapters. Since all vertebrate retinas have the same basic structure and physiological plan, examples are given from a variety of species, with an emphasis upon mammals, extending to human vision. The last four chapters approach the problem from the other end. This part of the book covers a range of clinical conditions involving visual abnormalities that are due to cellular defects in the outer retina. Although the contents of this book do not represent the proceedings of a conference, the concept arose at an international symposium on 'Recent Advances in Retinal Research' which was held at the International Marine Centre in Oristano, Sardinia. We hope that the book will give a coherent, up to date review of the neurobiology and clinical aspects of the outer retina and encourage further integration of these areas. Retinal neurobiology has been an intense field of investigation for several decades. More recently, it has seen significant advances with the application of modern techniques of cell and molecular biology.

During the last few years, an explosion of infonnation has come from human genetics and molecular and cell biological studies as to the genetic basis for a number of fonns of inherited retinal degenerations. These disorders have plagued mankind for millennia because they take from otherwise healthy individuals the precious gift of sight. The fundamental advances in recent years have identified a number of genes involved in the groups of diseases which hopefully will lead to discoveries that may, in the not too distant future, allow the prevention and possible cure of some of these blinding eye disorders. To foster a forum for discussions of studies on degenerative retinal disorders, we convened a symposium on retinal degenerations in 1984, at the VIth International Congress of Eye Research Meeting, held in Alicante, Spain. Because of the success of this meeting and the subsequent publication, we have since organized a series of biennial satellite meetings on retinal degenerations for the ISER congresses held in Nagoya, Japan (1986), San Francisco (1988) and Helsinki (1990). Each of these satellite symposium on retinal degenerations was accompanied by a published proceedings volume. This volume is the fifth in this series and contains the proceedings of the Sardinia Symposium on Retinal Degeneration held September 15-20, 1992, as a satellite meeting of the 10th International Congress of Eye Research.

Since 1984, we have organized satellite symposia on retinal degenerations that are held in conjunction with the biennial International Congress of Eye Research. The timing and location of our Retinal Degeneration Symposia have allowed scientists and clinicians from around the world to convene and present their exciting new findings. The symposia have been arranged to allow ample time for discussions and one-on-one interactions in a relaxed atmosphere, where international friendships and collaborations could be established. The IXth International Symposium on Retinal Degeneration was held on October 9-14, 2000 in Durango, Colorado and was attended by over 100 scientists from six continents. This book contains many of their presentations. Several events of note occurred at this meeting. First, thanks to the generous support of the Foundation Fighting Blindness, we were able to sponsor the travel of 11 young scientists from six countries. Most of them have contributed chapters to this volume. The response to the travel program was so overwhelming that we will make it regular feature of our meeting. This will allow other bright, young investigators to be introduced to the world experts who study retinal degenerations. Second, about 40% of the scientists who attended this meeting were there for the first time. We believe that this indicates a growing interest in retinal degeneration research and ensures that new talent will be attracted to this important area of investigation. The symposium received support from several organizations.

Recent Developments in Graves' Ophthalmopathy offers an overview of the pathogenesis, assessment and management of patients with thyroid-associated eye disease. Each chapter is written by an expert and truly represents the current state of the art on the particular topic. This book can therefore almost be considered a textbook on this enigmatic disorder. Recent Developments in Graves' Ophthalmopathy is designed for all those interested in this disease, including basic scientists, clinical endocrinologists, ophthalmologists, radiotherapists, and orbital surgeons. The book gives a comprehensive overview of all aspects of Graves' ophthalmopathy. Subjects covered include the pathology of Graves' eye disease and the controversial views on its autoimmune pathogenesis; assessment of the eye changes using reliable measurements; medical management of Graves' eye disease with an overview of the many treatment options available to the clinician, including orbital radiotherapy and other immunosuppressive treatments; management of the thyroid disease; and finally, the techniques for performing various surgical procedures, which are explained and illustrated.

These Proceedings of the Fourth International Congress on the Cornea continue a tradition of summarizing the state-of-the art basic and clinical research in cornea and ex- ternal diseases since the first Congress was held in 1964. Reflecting the emerging impor- tance of refractive surgery, two of the twelve sessions of the Congress were devoted to refractive surgery; this is reflected in an emphasis in these Proceedings. In addition, an en- tire session was devoted to the molecular and cellular biology of the cornea with impor- tant new information on the role of growth factors and cytokine modulation of corneal wound healing. Within these Proceedings an international group of expert researchers and practitioners provide the latest insights into the tear film and ocular surface, corneal trans- plantation and eyebanking, the corneal stroma and endothelium, contact lenses, microbial and nonmicrobial keratitis, keratoconus, and world corneal health. Notable subjects covered include the latest understanding of the barrier function of the ocular surface epithelium, corneal hydration control, the molecular mechanisms con- trolling gene expression in corneal wound healing, stromal~pithelial interactions in the cornea, the immunology of blepharitis, the effect of contact lenses on the conjunctiva, morphologic and functional evaluation of the human corneal endothelium, long-term fol- low-up of penetrating keratoplasty in keratoconus, the Tampa trephine penetrating kerato- plasty, and the refractive results of the Nidek EC-5000 excimer laser.

Numerous studies have pointed to the key role of complement in the pathogenesis of retinal disease, particularly age-related macular degeneration (AMD). Reports about new gene associations and links to other physiological pathways are emerging almost on a weekly base. Several promising clinical candidates covering a wide area of potential treatment applications are in the pipelines of both industrial and academic groups. This indicates an increasing interest in complement as a therapeutic target. In view of these exciting discoveries, scientists from around the world convened at the First Aegean Conferences Conference on Inflammation and Retinal Disease: Complement Biology and Pathology (June 10-17, 2007) in Crete, Greece, to discuss recent advances in this rapidly-evolving field. This volume represents a collection of topics on the functions of complement in eye diseases, pathophysiology, protein structures, and complement therapeutics discussed during the conference. Our sincere thanks to the contributing authors for the time and effort they have devoted to writing what I consider exceptionally informative chapters in a book that will have a significant impact on the complement field. We would also like to express my thanks to Rodanthi Lambris for her assistance in collating the chapters and preparing the documents for publication and I gratefully acknowledge the generous help provided by Dimitrios Lambris in managing the organization of this meeting. Finally, I also thank Andrea Macaluso of Springer Publishers for her supervision in this book's production. John D. Lambris Anthony P.

Ophthalmic researchers and clinicians alike increasingly are recognizing the importance of the vitreous body in the physiology, biochemistry, and pathology of the inner eye. The Vitreous and Vitreoretinal Interface, with contributions by vitreoretinal surgeons and laboratory eye researchers, presents the most up-to-date clinically relevant data. This book provides evidence of the vitreous body's significant role in preserving retinal homeostasis, as well as the close connection between vitreous traction and such conditions as retinal inflammation, retinal vascular occlusions, macular edema, proliferative diabetic retinopathy, and giant retinal tears. The particular vitreal changes that occur in aphakia, myopia, retinitis pigmentosa, and idiopathic giant retinal breaks, as well as recent advances in open-sky vitreous surgery and in the search for useful vitreous substitutes are discussed.

After a decade or longer, approximately one-third of individuals with either type 1 or type 2 diabetes commence a downhill course in which decreasing renal function and failing vision define a Renal-Retinal Syndrome, dominating all aspects of life and presaging early death. Only a generation ago, survival after onset of end-stage renal disease (ESRD) in diabetes was limited because rehabilitation was preempted by blindness, limb amputation, stroke, and heart disease. By 1998, however, team management has improved the outlook, with preserved sight and return to work and home responsibilities, usually for a decade or longer, following kidney transplantation and laser photocoagulation. Recognition of the critical requirement for blood pressure regulation and metabolic control are central themes in management. In this unique book, the accomplishments of ophthalmologists, nephrologists, diabetologists, transplant surgeons, and basic scientists are blended into a strategic approach that may be readily applied by all those caring for diabetic patients. Each of twenty-one presentations suitable for primary care physicians, as well as for subspecialists concerned with macrovascular and microvascular complications of diabetes, is placed in perspective by an introductory editorial analysis. Promising near-term innovative therapies, including insertion of genetically engineered beta cells or polymer-coated islets of Langerhans, interdiction of kinins that promote retinal angiogenesis, and prevention of synthesis of advanced glycosylated endproducts (AGEs), are presented in detail. While comprehensive care of diabetic patients reflects multiple incremental advances that in sum afford major benefit, this text envisions further remarkable changes likely to suppress and possibly entirely prevent the Diabetic Renal-Retinal Syndrome.

Basic and Clinical Applications of Vision Sciences contains the edited papers presented at the Enoch Vision Science Symposium, April 27-30 1996, which was organized in honor of the pioneer in vision science, Dr Jay M Enoch. Dr Enoch served for twelve years as Dean, School of Optometry, University of California, Berkeley. The book is organized along the lines of Dr. Enoch's contributions to vision science, but is not limited to these topics. Of special note, the reader will find papers on important new developments in photoreceptor, ophthalmic and visual optics, retinal imaging, ophthalmic physiology and pathophysiology, visual psychophysics and visual techniques. The papers are grouped into the following sections: photoreceptor optics; ophthalmic and visual optics; binocular vision, developmental vision, eye movements and physiology; ophthalmic dysfunction; visual psychophysics and clinical applications; history of vision science. GBP/LISTGBP

This comprehensive report on sight correction through laser surgery provides the practitioner with solid background information from top industry researchers. Carefully illustrated, it details the latest techniques and clinical results in wavefront technology for laser surgery, which is now defining a new standard of practice. This second edition has been significantly expanded to include in-depth descriptions of important new advances as well as glimpses of what the future holds. The book will be indispensable to all wishing to expand their knowledge of customized refractive surgery with an understanding of the underpinning technology.

This volume is devoted to the recent advances in diagnostic ultrasound in ophthalmology. It provides an overview of the progress in clinical applications of the technique. There are chapters that focus on the optic nerve and extraocular muscles, orbital and periorbital lesions, intraocular tumors and intraocular disorders. In addition there are chapters that deal with the anterior segment, instrumentation, biometry and Doppler methods. The contributions prepared by a group of international experts in the field should be of interest to all those involved in ophthalmic echography.

The eleventh Symposium of the International Research Group on Colour Vision Deficiencies (IRGCVD) was held 20-23 June 1991 in Sydney, Aus tralia, ably hosted by local organizer Stephen Dain. A total of 35 talks and 10 posters were presented. Papers based on 37 of these presentations are included here, in Colour Vision Deficiencies XI. The scientific program featured sessions on three special topics, with each topic highlighted by an invited speaker. The opening session on the Genetics of congenital colour vision deficiencies began with a superb invited lecture by Charles Weitz about his pioneering work on the molecular genetics of tritanopia. The session on the second special topic, Spatial aspects of colour vision, began with the launching of a new IRGCVD tradition, as 1991 Verriest Memorial Award recipient Harry Sperling presented the first Ver riest Memorial Lecture on his recent studies of spatial discrimination of heterochromatic stimuli. Dr. Sperling reported new evidence that certain asymmetries in red-green opponent colour vision can be explained by the spatial organization of colour-opponent retinal neurons. In the third special session, on Occupational aspects of colour vision, Barry Cole took the audi ence on a fascinating tour of the historical development of colour vision standards in his invited lecture entitled 'Does defective colour vision really matter?'. In addition to the three special topics, many interesting presentations were given in topical sessions on Variations in normal colour vision, Acquired colour vision deficiencies and Colour vision tests and testing methods.

Are you looking for concise, practical answers to questions that are often left unanswered by traditional references on refractive surgery? Are you seeking brief, evidence-based advice for the daily examination of patients? This book provides quick and direct answers to the thorny questions most commonly posed during a "curbside consultation" between experienced clinicians. Drs. Bonnie An Henderson and Sonia H. Yoo have designed this unique reference in which refractive specialists offer expert advice, preferences, and opinions on tough clinical questions commonly encountered by ophthalmologists, residents, and other health care professionals. The unique Q&A format provides quick access to current information related to refractive and lens-based surgery with the simplicity of a conversation between two colleagues. Images, diagrams, and references are included to enhance the text and to illustrate clinical diagnoses and treatment plans. Based on clinical scenarios that a refractive surgeon might encounter in real life, Curbside Consultation in Refractive and Lens-Based Surgery provides information basic enough for residents while also incorporating expert pearls that even high-volume ophthalmologists will appreciate. General ophthalmologists and residents alike will enjoy the user-friendly and casual format. Some of the questions that are answered: * How do I manage epithelial ingrowth after LASIK? What if it recurs? * Should I perform PRK in patients with forme fruste keratoconus? * How do I manage patients with dry eyes after LASIK surgery? * How do I determine my surgically induced astigmatism? * Is a monocular implantation of a multifocal IOL tolerated? * How do you manage an unhappy multifocal patient who is experiencing halos and glare?

With over 20 years of experience, Dr. Kenneth A. Lane has designed "Developing Ocular Motor and Visual Perceptual Skills: An Activity Workbook" to help occupational therapists, optometrists, and other professionals develop the ocular motor and visual perceptual skills of learning disabled children.

To establish a framework for understanding, each chapter begins with the scientific theories used to develop the activity forms. Insightful suggestions are included on how to solidify the program's success.

The easy-to-follow activity forms are then presented, along with numerous illustrations that help develop ocular motor and visual perceptual skills. The forms are divided into as many as five levels of difficulty so both children and teenagers can benefit from each activity.

"Developing Ocular Motor and Visual Perceptual Skills" contains daily lesson plans and practical tips on how to successfully start an activities program. Other helpful features include a glossary of terms and a reference list of individuals and organizations that work with learning disabled children to develop these skills.

The first of its kind, "Developing Ocular Motor and Visual Perceptual Skills" utilizes a learning approach by linking the theories with the remediation activities to help learning disabled children improve their perceptual and fine motor skills. All professionals looking to assess and enhance a variety of fine motor and visual perception deficiencies will welcome this workbook into their practices.
Topics include:

• Complexity of reading
• Ocular motor
• Gross motor
• Visual-motor perception
• Visual memory
• Laterality
• Reversals

This comprehensive volume discusses approaches for a systematic selection of delivery systems for various classes of therapeutic agents including small molecule, protein, and nucleic acid drugs. Specific topics covered in this book include: * Solution, suspension, gel, nanoparticle, microparticle, and implant dosage forms* Refillable and microneedle devices* Intravitreal, suprachoroidal, intrascleral, transscleral, systemic, and topical routes of delivery* Physical methods including iontophoresis for drug delivery* Rational selection of routes of administration and delivery systems* Noninvasive and continuous drug monitoring * Regulatory path to drug product development* Clinical endpoints for drug product development* Emerging and existing drugs and drug targets Drug Product Development for the Back of the Eye is authored by renowned ocular drug delivery experts, representing academic, clinical, and industrial organizations and serves as indispensable resource for ophthalmic researchers, drug formulation scientists, drug delivery and drug disposition scientists, as well as clinicians involved in designing and developing novel therapeutics for the back of the eye diseases.This book is also relevant for students in various disciplines including ophthalmology, pharmaceutical sciences, drug delivery, and biomedical engineering. * Refillable and microneedle devices* Intravitreal, suprachoroidal, intrascleral, transscleral, systemic, and topical routes of delivery* Physical methods including iontophoresis for drug delivery* Rational selection of routes of administration and delivery systems* Noninvasive and continuous drug monitoring * Regulatory path to drug product development* Clinical endpoints for drug product development* Emerging and existing drugs and drug targets Drug Product Development for the Back of the Eye is authored by renowned ocular drug delivery experts, representing academic, clinical, and industrial organizations and serves as indispensable resource for ophthalmic researchers, drug formulation scientists, drug delivery and drug disposition scientists, as well as clinicians involved in designing and developing novel therapeutics for the back of the eye diseases. This book is also relevant for students in various disciplines including ophthalmology, pharmaceutical sciences, drug delivery, and biomedical engineering.* Refillable and microneedle devices* Intravitreal, suprachoroidal, intrascleral, transscleral, systemic, and topical routes of delivery* Physical methods including iontophoresis for drug delivery* Rational selection of routes of administration and delivery systems* Noninvasive and continuous drug monitoring * Regulatory path to drug product development* Clinical endpoints for drug product development* Emerging and existing drugs and drug targets Drug Product Development for the Back of the Eye is authored by renowned ocular drug delivery experts, representing academic, clinical, and industrial organizations and serves as indispensable resource for ophthalmic researchers, drug formulation scientists, drug delivery and drug disposition scientists, as well as clinicians involved in designing and developing novel therapeutics for the back of the eye diseases. This book is also relevant for students in various disciplines including ophthalmology, pharmaceutical sciences, drug delivery, and biomedical engineering.