The 13th biennial Symposium of the International Research Group on Colour Vision Deficiencies was held from 27 July to 30 July, 1995, in the splendidjin de siecle Theatre Saint Louis, in Pau, France. A total of 80 papers and posters were presented during the four days, of which 56 have been selected for inclusion in this volume. Each has been reviewed by two of the Editors. Additionally, in numerous cases in which specialized knowledge was called for the Editors asked for external help; their assistance is acknowledged below. While Pau now exists largely on agriculture and, more recently, oil extraction and refining, a century ago it was a winter resort that rivalled Cannes and Nice; indeed, Baedeker judged the air of Pau to be preferable for those of a nervous disposition. Pau and the surrounding Beam district are rich in history and have close ties to the Basque region, both of which were exploited brilliantly by the local organizers, Doctors Jean and Veronique Lied, to introduce the partici pants to the gastronomy and traditions of the region. The Committee of the IRGCVD owe a great debt of gratitude to the external reviewers, Oscar Estevez, Karl Gegenfurtner, Gunilla Haegerstrom-Portnoy, RL. Hilz, John Krauskopf, Anne Kurtenbach, Barry B. Lee, Adam Reeves, Marilyn Schneck, L.T. Sharpe, Eugene Switkes, Wayne Verdon, and B.A.

The ciliopathies are a group of rare diseases that often affect multiple systems within the body, and are caused by defects in the function or structure of cilia. When cilia go wrong, there are profound consequences; these are discussed in detail for the first time in Ciliopathies: a reference for clinicians. The book provides a clinical overview and reference to this newly emergent group of disorders ranging from Alstroem syndrome to putative ciliopathic disorders. Each chapter provides an in-depth discussion on a specific disorder, including the latest scientific research together with a description of its features, and practical guidelines on diagnosis. The authors also examine the evidence for dysfunction of cilia in cancer and more common disorders. Ciliopathies: a reference for clinicians will appeal to those involved in the care of patients with ciliopathies, including specialists in the fields of nephrology, diabetes, cardiology, and ophthalmology, and non-clinical researchers interested in cilia biology.

to the Second Edition here have been significant changes in pediatric Chapter 56 by Maya Eibschitz-Tsimhoni, MD, is a T ophthalmology and strabismus since the first wonderful contribution to the literature, as it reviews edition. Great effort has gone into incorporat 235 important ocular disorders that have systemic ing recent advances into this second edition. Each manifestations, and it includes a detailed glossary of chapter in the book has been revised, and over half of terms. them have been completely rewritten. In addition to As with the first edition, our goal is to present a updating and revising the entire book, we have added comprehensive textbook of pediatric ophthalmology three new chapters: Chapter 7 on electrophysiology and strabismus written in a clear, reader-friendly style. and the eye, Chapter 1 7 on strabismus surgery, and Our hope is that the readerwill find the second edi Chapter 56 on congenital syndromes with ocular man tion of Pediatric Ophthalmology and Strabismus to ifestations. Chapter 17 is the definitive work on pedi be scientifically informative, clinically useful, and en atric ocular electrophysiology, bar none, and was fin joyable to read. ished just weeks before the untimely death of its author, Dr. Tony Kriss (see tribute in Chapter 17).

This timely publication fills a large gap in the ophthalmic literature which has so far lacked a monograph on the clinically very important subject of macular edema. The book presents the most up-to-date scientific concepts concerning the etiology and pathogenesis of blood retinal barrier breakdown such as tight junction associated protein dysfunction, and changes in fluid transport properties of the retinal pigment epithelium. The bulk of the book is clinically oriented and addresses novel imaging and diagnostic techniques for the detection of macular edema as well as the clinical context of a panoply of ocular diseases which induce macular edema, such as diabetes, other vasculopathies, uveitis, and many others. New light is shed on the association between highly active antiretroviral therapy and the induction of macular edema in HIV-positive patients. Novel drug treatment regimens with steroids and carbonic anhydrase inhibitors as well as new ways of applying laser and surgical therapies are also discussed in detail, and practical treatment guidelines are given. This book will be helpful for vitreoretinal specialists as well as for the practising ophthalmologist confronted with patients suffering from macular edema.

Cataract Surgery: Introduction and Preparation offer the latest information and examines the most popular instruments used, the preoperative examination, and the operating technique for cataract surgery. Dr. Lucio Buratto, Dr. Stephen Brint, and Dr. Laura Sacchi provide a step-by-step approach to facilitate assessing the patient, performing the technique, and managing cataract surgery in the most optimal way possible. Cataract Surgery: Introduction and Preparation will lead beginning surgeons down the exciting path of cataract surgery as they increase their knowledge of phacoemulsification and the femtolaser by learning all the details associated with the procedures. Cataract Surgery: Introduction and Preparation covers a wide variety of topics, including presurgery examination, incisions, capsulorhexis, hydrodissection, prevention of endophthalmitis, and ophthalmic viscosurgical devices for modern cataract surgery. Supplemented by more than 200 color illustrations, diagrams, a glossary, and references, all surgeons from beginner to expert will want this unique resource by their side.

Dr. Zoltan Z. Nagy performed the first femtosecond laser-assisted cataract surgery in a human eye in 2008. As one of the most authoritative sources on the topic, Femtosecond Laser-Assisted Cataract Surgery: Facts and Results presents the history of the development and use of femtosecond laser-assisted cataract surgery summarizes the results of five years of pioneering techniques by Dr. Nagy and his team, including personal reflections and thoughts, as well as a series of classic papers. Femtosecond Laser-Assisted Cataract Surgery consists of two main sections. The first section discusses and reviews the new results for the reader from the research. The second section comprises original articles on the topic of femtosecond laser cataract surgery that is essential to ophthalmologists. Additional features include: * A review of the current state-of-the-art usages of femtosecond laser-assisted cataract surgery * Examine existing technologies that compete with femtosecond laser-assisted cataract surgery and compare outcomes * Discuss key secrets to successful surgical techniques using femtosecond laser-assisted cataract surgery * How to address and manage common complications associated with femtosecond laser-assisted cataract surgery Femtosecond Laser-Assisted Cataract Surgery presents these clinical results with cataract and corneal application, and highlights basic research with the strength of the anterior capsule and will assist ophthalmologists and residents alike gain a better understanding of the femtosecond laser cataract surgery process.

"To explain all nature is too difficult a task for anyone man or even for anyone age. Tis much better to do a little with certainty, and leave the rest for others that come after you, than to explain all things ... " Sir Isaac Newton (1642-1727) This book describes and discusses some new aspects of col or vision in primates which have emerged from a series of experiments conducted over the past 8 years both on single ganglion cells in monkey retina and on the visually evoked cortical potential in man: corresponding psychophysical mechanisms of human perception will be considered as well. An attempt will be made to better understand the basic mechanisms of color vision using a more comprehensive approach which takes into account new mechanisms found in single cells and relates them to those found valid for the entire visual system. The processing of color signals was followed up from the retina to the visual cortex and to the percepq.tal centers, as far as the available techniques permitted."

Management of retinal venous occlusions (RVO) has changed dramatically in recent years. With an increase in medical information, technological advances, and clinical trials, ophthalmologists need a concise, updated reference. Management of Retinal Vein Occlusion: Current Concepts fills this current need in the market. In Management of Retinal Vein Occlusion, Dr. Seenu Hariprasad is joined by multiple section editors to provide this easy-to-read and nicely formatted resource, which is divided into organized sections: Background: The epidemiology, risk factors, and classification of RVO History: Seven large clinical trials involving RVO and the pros and cons of earlier treatment modalities Anti-VEGF Therapies: The rationale and outcomes of large clinical trials Corticosteroid Therapies: The rational and outcomes of various steroid treatment modalities Imaging: Case presentations and emerging technology that highlights the relationship between peripheral ischemia and macular edema Difficult cases: Combination therapies, management of recalcitrant cases, and surgical approaches for cases that do not respond to standard management Future of RVO: A summary overview of the subject and future directions With an unparalleled list of contributors that are leaders in the retina field, Management of Retinal Vein Occlusion goes beyond the conclusions of clinical trials and delves deeper into practical recommendations for patient management in daily practice. With abundant illustrations, fundus photographs, concise tables, and summary boxes that enhance the written text, Management of Retinal Vein Occlusion: Current Concepts is a valuable resource.

Held in Amsterdam, The Netherlands, September 3-4, 1981

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional pediatric ophthalmology references? Are you seeking brief, evidence-based advice for complicated cases or controversial decisions? Curbside Consultation in Pediatric Ophthalmology: 49 Clinical Questions provides quick answers to the tricky questions most commonly posed during a "curbside consultation" between pediatricians. Dr. Rudolph Wagner has designed this unique reference which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with pediatric ophthalmology. The unique Q&A format provides quick access to current information related to pediatric ophthalmology with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references allow readers to browse large amounts of information in an expedited fashion. Some of the questions that are answered: * How do I make the diagnosis of amblyopia? * How can I differentiate a true strabismus from a pseudo- strabismus? * How do I diagnose and treat corneal abrasions? Does patching remain an important component of therapy? * What is naso-lacrimal duct obstruction? How is it managed? When should I refer these children? * How can I determine if a "red eye" is caused by a bacterial infection, viral infection or an allergic reaction? How are they managed? Curbside Consultation in Pediatric Ophthalmology: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume pediatricians will appreciate. Pediatricians, nurse practitioners, emergency room physicians, physician assistants and family practitioners will benefit from the user-friendly, casual format and the expert advice contained within.

Silicone oil was introduced into ophthalmic surgery by Paul Cibis in the early 1960's in an attempt to treat giant retinal tears and cases where retinal detachment had failed to respond to conventional scleral buckling tech niques. His understanding of the nature of vitreous pathology and how it related to complex retinal detachment laid the foundation for modern vit reoretinal surgery. Cibis's success with these problems together with his rationale for sepa rating membranes from the retina led others to try their hand at learning his techniques. At the same time much criticism was levelled at the concept of injecting what was regarded as a foreign material into the eye, as well as to the whole idea of operating within the vitreous cavity. Some of this was personal, some due to a lack of understanding of the underlying pathology and some due to disappointment following surgical failure us ing the new methods. Early results were certainly encouraging but it was not until the advent of pars plana vitrectomy that it became possible to develop more refined methods in combination with the use silicone oil so that much better results could be obtained.

Cataract Surgery: Introduction and Preparation offers the latest information and examines the most popular instruments used, the preoperative examination, and the operating technique for cataract surgery. The authors provide a step-by-step approach to facilitate assessing the patient, performing the technique, and managing cataract surgery in the most optimal way possible. Cataract Surgery will lead beginning surgeons down the exciting path of cataract surgery as they increase their knowledge of phacoemulsification and the femtolaser by learning all the details associated with the procedures. It covers a wide variety of topics, including presurgery examination, incisions, capsulorhexis, hydrodissection, prevention of endophthalmitis, and ophthalmic viscosurgical devices for modern cataract surgery. Supplemented by more than 200 colour illustrations, diagrams, a glossary, and references, all surgeons from beginner to expert will want this unique resource by their side.

Cataract Surgery With Phaco and Femtophaco Techniques offers a unique insight into the evolution of phacoemulsification machines and the development of new ways to supply energy, as well as new devices that improve fluidics therefore increasing the safety of the phaco and femtophaco surgical procedures. Dr. Lucio Buratto, Dr. Stephen Brint, and Dr. Rosalia Sorce provide a step-by-step approach to everything the surgeon must learn about the physical principles that regulate the fluidics and energy to understand the machine's working during the surgical procedure. Cataract Surgery With Phaco and Femtophaco Techniques covers a wide variety of topics, including anterior chamber phacoemulsification, endocapsular techniques, irrigation and aspiration, fluidics and pumps, and principles of femtosecond cataract surgery. Supplemented by more than 300 color illustrations, diagrams, a glossary, and references, all surgeons from beginner to expert will want this unique resource by their side.

Proceedings of the 5th Biannual International Meeting on Angiogenesis: From the Molecular to Integrative Pharmacology, held July 1-7, 1999, in Crete, Greece. Angiogenesis, as a vastly complex biological process, has challenged researchers from all basic scientific disciplines, including pharmacology, biochemistry, physiology, embryology and anatomy. The significance of this phenomenon for the study of disease states has also interested clinicians from a number of specialist fields. This multidisciplinary work reflects the growth of awareness of concepts such as angiogenesis based therapy, the enormous therapeutic and commercial potential of which has attracted major research and investment in recent years. This volume, which aims to bridge the gap between basic and clinical methodology and understanding, presents the most up-to-date developments in this field.

This Volume of the Documenta Ophthalmoligica Proceeding Series presents the scientific papers read during the 13th Congress of SIDUO, the International Society for Ultrasonic Diagnosis in Ophthalmology, held in Vienna in the Summer of 1990. It was the second time that SIDUO had selected Vienna as a site for its biennial congresses in the 28 years of its existence. Previously, the 3rd SIDUO Meeting had taken place as part of the 1st World Congress for Ultrasonic Diagnosis in Medicine organized by Karl C. Ossoinig in 1969. Ossoinig, the pioneer of Standardized Echography opened the scientific sessions of SIDUO 13 with the First Jules Fran~ois Memorial Lecture on the Optic Nerve reviewing the modern examination techniques for precise measurements of the orbital optic nerve and its various sheaths and for an accurate diagnosis and differential diagnosis of diseases affecting the optic nerve, highlighting the new field of prophylactic recognition of early optic nerve compression (e. g. , in Graves' orbitopathy) and the important confirmation of CON in the presence of other conditions affecting the optic nerve functions. The first scientific session then dealt with a variety of interesting conditions of the optic nerve and of the extraocular muscles ranging from inflammatory diseases such as optic neuritis and orbital myositis to congenital anomalies, from glaucomatous changes to IIH, and from normal anatomical (dynamic) findings to malignant tumors such as lymphomas and leucemic meningeosis.

The Sclera is the definitive text on the diagnosis and treatment of scleral diseases, with in-depth chapters on non-infectious scleritis, infectious sclertitis, non-inflammatory diseases of the sclera, and systemic implications of scleral disease. Basic physiology, anatomy, and biochemistry are addressed as well. Written for the ophthalmologist, the revised and updated new edition of The Sclera contains the most current information available on newer characterizations of the composition of the sclera, immune derangements of it, and success in medical and surgical treatment of the inflammatory diseases of the sclera.

We in ophthalmology are fortunate to be able to measure quantitatively many aspects of ocular morphology and visual function. These measurements are either objective (e. g. electroretinography, tonometry, electromyography, visually evoked responses, etc.) or subjective and psychophysical (e. g. visual acuity, visual fields, color vision, etc.). One aspect of corneal physiology and pathology which has so far escaped careful and reliable measurements is corneal sensitivity. Previous attempts have been rather crude and can be compared to measuring intraocular pressure by digital compression. Professor Draeger has for the last decade and a half directed his attention to the question of esthesiometry of the cornea. He has a gift for constructing and devising new ingenious ocular instruments. His handheld tonometer is a splendid example. He has now applied the principle of this instrument to the new electronic optical esthesiometer. In many publications he has reported on his first results using this modern technique to study corneal physiology and evaluate certain pathologic conditions. In this monograph Professor Draeger has collected all of his material and reports on his long experience. The usefulness of this instrument is just beginning to be appreciated. It is obvious that this new measuring device will help us in the fitting of contact lenses, evaluating herpes simplex infections of the cornea, follow the postoperative course of patients with a penetrating keratoplasty, etc.

This volume of Documenta Ophthalmologica Proceedings Series collects the scientific papers presented at the 2nd International Symposium on Retinal Pigment Epithelium and the 4th Meeting of the European Macula Group held in Genoa, May 29-June 1, 1996. The Symposium on Retinal Pigment Epithelium was promoted by the University Eye Clinic of Genoa as the natural continuation of the first Symposium held with great success in Genoa in 1988. The previous Meetings of the European Macula Group were held in Coimbra (1988), Crete (1989) and Athens (1994). I was greatly pleased and honoured to host the fourth congress of this distinguished Society and I am grateful to Gabriel Coscas, Jose Cunha-Vaz and George Theodossiadis, found ers of the Society, for selecting Genoa on this occasion. The two meetings integrated well in an unicuum and brought together an exceptional number of outstanding retinal specialists coming from all over the world. All the aspects of the current research concerning retinal pigment epithelial and macular diseases were covered. Several interesting presentations regarded new techniques of retinal and choroidal imaging. A full session was dedicated to the latest advances in culture and transplantation of retinal pigment epithelial cells. Age-related macular degeneration was a major subject for discussion, including new approaches to treatment. This topic was high lighted by a mini-symposium on drusen, including a series of superb lectures on classification, clinicopathological studies, indocyanine green imaging, and laser treatment for prevention of choroidal neovascularization.

Roots of the theory and practice of ocular pharmacology may be traced to the ancient Mesopotamian code of Hammurabi and then to several papyri reflecting the clinical interests of the Egyptians. The evolution of its art and science was irregularly paced until the nineteenth century when Kohler, in 1884, proved the anesthetic effect of cocaine on the cornea, and when Fraser, Laquer, Schmiedeberg, Meyer, and others studied the pharmacology of the autonomic nervous system by way of observations of the pupil. Advances in the past few decades have been nothing short of explosive. How can the student, physician, or basic research scientist stay in touch with these electrifying studies? To help with the answer to this question, the authors set as their goal the development of increased understanding so that the student, research scientist, and ophthalmologist can cope with the latest discoveries. The authors want to narrow what appears to be an ever-increasing gap between basic science and ophthalmology. The basic aspects of pharmacology have been presented in light of the natural physiology. In this regard, while distinctions among endogenous mechanisms, drug effects, and the pathogenesis of disease are to be separately recognized, appreciation must be given to the concept that both the desirable and unwanted manifestations or functions caused by either disease or drugs must very often represent a quantitative change in normal metabolic pathways.

Glaucoma simplex or open angle glaucoma is a slow, progressive illness with an insidious course which can lead to blindness. According to our con temporary state of knowledge, the illness begins with a decreased outflow of aqueous humor. This leads, sometimes after a period of decreased aqueous humor production due to a feedback mechanism, to an increase in intra ocular pressure (lOP). An elevated lOP can eventually lead to optic nerve damage, which manifests itself morphologically as glaucomatous papillary excavation and functionally in the development of a visual field defect. The classic triad of elevated lOP, papillary excavation and visual field defect, on which the diagnosis of glaucoma was also based in earlier times, is then pre sent. To this can now only be added that tonography usually shows a de crease in aqueous humor outflow and that gonioscopy must reveal an open angle. On the basis of statistical findings, Goldmann has calculated that there may be an interval of as long as 18 years between the initial increase in lOP and the development of visual field defects. This point of view (which has been confirmed in practice) that the onset of the illness can be demon strated by measurement of the lOP has introduced a new element into the discussion around glaucoma, namely, the concept of ocular hypertension. This implies simply that there is an (statistically) elevated intraocular pres sure, even though the optic nerve may not (yet) be damaged.

The phenomenon known as Leao's spreading depression is investigated in this collection of ten original articles. New ideas about the fundamental mechanisms, which focus on the involvement of polyunsaturated fatty acids and free radicals, are presented. The relationship of spreading depression with clinical entities such as migraine, epilepsy, ischemic and protein-deficiency conditions of the nervous tissue are discussed as well. Studies dealing with the application of non-invasive techniques to monitor the disease are included.

Pediatric Oculoplastic Surgery is the definitive text for ocular disorders and how they apply specifically to children. Addressing everything from genetic considerations, embryology and anatomy, anesthesia, dermatologic considerations, benign and malignant tumors, fetal wound healing, establishing propoer diagnosis, timing for surgical interventions and surgical procedures. This volume is an essential addition to the library of every pediatric ophthalmologist and reconstructive surgeon. The distinguished contributors have combined their surgical knowledge and experience with over 1,100 color photographs and custom illustrations to present comprehensive and readily usable information on the identification and treatment of a wide range of ocular disorders.

Contents Introduction .......................................... . 1 The Primate Eye ...................................... . 2 Embryology of Retina and Choroid ....................... . 4 Microscopic Anatomy .................................. . 4 Retina ............................................ . 4 Choroid ........................................... . 8 Material and Methods .................................. . 10 Fine Structure of the Retina 14 RetinaI Pigment Epithelium ............................. . 16 Photoreceptor Cells ................................... . 30 Outer Plexiform Layer and Horizontal Cells .................. . 64 Bipolar, Radial Clial, and Amacrine Cells .................... . 76 Canglion Cells and InternaI Limiting Membrane ............... . 98 Spatial Density of RetinaI Cells .......................... . 112 Fine Structure of the Choroid ........................... . 116 Choroidocapillaris and Its Fiber System ..................... . 118 Arteries, Veins, and Lymphatic Spaces ...................... . 134 Choroidal Nerves .................................... . 142 Cells of Choroidal Connective Tissue ....................... . 148 References ........................................... . 153 Index ................................................ . 157 vii This volume describes the morphology of the primate re tina as seen with the electron microscope. As it is an atlas, the electron micrographs are its most In trad lietian important part. The text accompanies the figures, highlighting selected topics either to explain structures or to point out structure-function relation ships. A scholarly review of the whole spectrum of research on the re tina and choroid is not feasible in a single volume. Thus, whenever available, review artides or monographs, rather than original work, are cited for reference."

The eye has fascinated scientists from the earliest days of biological in vestigation. The diversity of its parts and the precision of their interaction make it a favorite model system for a variety of developmental studies. The eye is a particularly valuable experimental system not only because its tissues provide examples of fundamental processes, but also because it is a prominent and easily accessible structure at very early embryonic ages. In order to provide an open forum for investigators working on all aspects of ocular development, a series of symposia on ocular and visual devel opment was initiated in 1973. A major objective of the symposia has been to foster communication between the basic research worker and the clinical community. It is our feeling that much can be learned on both sides from this interaction. The idea for an informal meeting allowing maximum ex change of ideas originated with Dr. Leon Candeub, who supplied the nec essary driving force that made the series a reality. Each symposium has concentrated on a different aspect of ocular development. Speakers have been selected to approach related topics from different perspectives."

In its long series of annual reports, the Belgian Society of Ophthal- mology has a tradition of bringing into focus the recent advances in ophthalmology. But it seems surprising that one has to go back to 1940 to find a major report on the corneal diseases, when R. Rub- brecht wrote an "Aperr;u de la pathologie et de la therapeutique generale des maladies de la cornee". However, this omission is only apparent. In fact, many reports, since then, have contributed to our knowledge of the advances in corneal research. The corneal dimensions were documented in "La biometrie ocu- laire clinique (Y. Delmarcelle et aI., 1976)", the fine structure of the cornea in "L'ultrastructure de tissues oculaires (L. Missotten, 1964)", and many aspects of its metabolism in "Les verres de contact (P. Cochet et ai, 1967)" and "Les complications oculaires des erreurs congenitales du metabolism (J.P. Groux et O. Kallay, 1971)" . Bacterial keratitis was a main topic in "La therapeutique par les antibiotiques autres que la Penicillamine en Ophtalmologie (1. Michiels, 1952). Fungal corneal infections were described in detail in "Les mycoses oculaires" (J . Fran90is et M. Elewaut-Rysselaere, 1968)" and the toxic effects of drugs were dealt with in "Les effets nocifs des medications generales sur I'appareil visuel (J. Michiels et coil. 1972)".