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.

The macular carotenoids play key roles in eye health and retinal disease. Age-related macular degeneration (AMD), the most common cause of acquired blindness in much of the world, is associated with low levels of macular pigment. Macular pigment is also essential for enhancing visual performance by reducing glare disability and improving photostress recovery. Carotenoids and Retinal Disease presents an up-to-date, thorough volume devoted to the chemistry, pathobiology, visual science, and medical and public health significance of the macular carotenoids. With contributions from an international group of leading experts, this book covers a range of topics, from macular anatomy to clinical trials. It begins with a chapter tracing the discovery of macular pigment through the more recent functional recognition of carotenoids. The text covers AMD risk factors, epidemiology, pathogenesis, and classifications. It reviews evidence from epidemiological studies of relationships between AMD and the carotenoids lutein, zeaxanthin, and meso-zeaxanthin, as well as evidence from clinical trials on the effects of macular carotenoid supplementation in subjects with AMD and normal subjects. The book explores the use of molecular genetics in studying macular pigment and AMD pathogenesis; bioavailability of macular pigment; functions of lutein, zeaxanthin, and meso-zeaxanthin; and the identification of macular carotenoid binding proteins involved in pigment uptake and transport. It also covers xanthophyll-membrane interactions, and the macular carotenoids in human serum and their capacity to protect against AMD. Further, the implications of light distribution on the retina for AMD are discussed. Advancing our understanding of how the macular carotenoids enhance vision and prevent vision loss, this book provides a valuable reference for researchers and clinicians involved in the treatment and prevention of retinal disease.

Fresh insights into the pathogenic mechanisms by which hyperglycemia induces tissue and organ injurt are the basis for rapidly evolving promising therapies in diabetes. Especially promising as targets for intervention are products of oxidative stress, including kinins and growth factors. Improving results of renal replacement regimes now incorporating pancreatic islet transplants are able to delay and prevent end-organ damage in diabetic individuals. The evolving story of the taming of diabetes is of direct concern to nephrologists, endocrinologists, ophthalmologists, primary care physicians and medical students.

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 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.

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.

Posterior Capsular Rupture: A Practical Guide to Prevention and Management addresses a nightmare of every cataract surgeon: a posterior capsular rupture. The book details each aspect of the process, from prevention of a posterior capsular rupture to management and IOL placement. Dr. Amar Agarwal and his contributors, leading international ophthalmic surgeons, discuss the latest techniques in easy-to-understand text and format and include more than 250 high-quality photographs that enhance reader comprehension. Posterior Capsular Rupture: A Practical Guide to Prevention and Management presents a variety of complicated cases and complications such as posterior polar cataracts, IOL scaffold & glued IOL, sutured IOLs, management of dislocated IOLs, and corneal damage & posterior capsule rupture, to name a few. & Additionally, a video website accompanies Posterior Capsular Rupture: A Practical Guide to Prevention and Management and allows readers to gain a better understanding of the subject. As a bonus, readers will be able to submit questions and receive clinical answers from Dr. Agarwal through the video website. Practising ophthalmologists, residents, and post-graduate students alike will benefit from this book's clear portrayal of this difficult medical issue.

With a revolution in the surgical management of mild to moderate glaucoma, new procedures allow for the use of microinvasive techniques that avoid disruption of the conjunctiva and formation of a bleb. These approaches range from laser therapies targeting the outflow system of the eye to the implantation of miniature devices in Schlemm's canal or the suprachoroidal space. The emergence of this new branch of glaucoma surgery, often coupled with micro-incisional cataract surgery, requires the practicing surgeon to learn about anatomical nuances to ensure success. MIGS: Advances in Glaucoma Surgery will aid the novice resident as well as the seasoned ophthalmic surgeon facing these new issues in glaucoma treatment. The book addresses preoperative patient selection advice, intraoperative pearls for success, and post operative management skills, which are some of the important aspects of the process towards the adoption of MIGS. Why you will want to read MIGS: Advances in Glaucoma Surgery: * Forward thinking contributions from seasoned MIGS experts who have intimate knowledge of the devices benefits and potential pitfalls in their use * Basic knowledge is provided that will allow each surgeon to tailor their treatment plan while leveling the learning curve * Assists in indentifying patients with a milder form of the disease and higher target pressures who may benefit from the MIGS devices MIGS: Advances in Glaucoma Surgery is the first book of its kind to cover the range of devices in this arena using expert contributors and offering real world pearls for practice that can be used in the operating room. Practicing cataract and glaucoma physicians, residents, and fellows will benefit from this timely resource as the thought process for how to treat glaucoma has advanced.

The hereditary retinopathy, retinitis pigmentosa (RP), which affects 1 in 3,500 people worldwide, is the most common cause of registered visual handicap among those of the working age in developed countries. RP is a highly variable disorder where patients may develop symptomatic visual loss in early childhood, while others may remain asymptomatic until mid-adulthood. Most cases of RP segregate in autosomal dominant, recessive or X-linked recessive modes, with approximately 41 genes being implicated in disease pathology to date (RetNet). The extensive genetic heterogeneity associated with autosomal dominant RP (adRP) is an undisputed hindrance to the development of genetically based therapeutics.

Every 4 years, neuroradiologists from around the world meet at an international congress in order to discuss the state of their art.

Part of the Oxford American Ophthamology Library, this book provides clear and detailed guidelines on the diagnosis and treatment of glaucoma. Coverage spans the entire spectrum of glaucoma, including descriptions of traditional and newly emerging modalities available for glaucoma diagnosis and management. Chapters discuss current imaging technology for glaucoma diagnosis and monitoring, providing practical tips using case examples. Management is also thoroughly addressed, from the treatment of primary open angle glaucoma to management of complex secondary glaucoma. Evidence-based management of glaucoma in different stages of the disease is also discussed with highlights of the multicenter glaucoma clinical trials.

While chopping techniques are particularly advantageous for complicated cataracts, they must be integrated with other devices and strategies. Phaco Chop, the best-selling cataract surgery book, has been revised and updated into a Second Edition to reflect the many advances over the past few years. More than half of the 30 total chapters are new. These detail strategies for complicated cases and introduce femtosecond laser nuclear fragmentation techniques. Dr. David F. Chang is widely acknowledged as one of the best cataract surgical teachers. His video instruction courses for phaco chop and complicated cataracts have consistently ranked among the best attended and top rated at the American Academy of Ophthalmology and American Society of Cataract and Refractive Surgeons meetings for over a decade. The Four Main Sections inside the Second Edition: * Phaco Chop Techniques * Phacodynamics of Chopping * Femtosecond Laser Nuclear Pre-Chopping * Complicated Cases and Complications - Strategies and Management Section One is a detailed guide for learning phaco chop. The faculty from Dr. Chang's popular phaco chop course outlines their pearls based upon extensive experience teaching residents and transitioning surgeons. Section Two provides the general principles of instrumentation and configuring machine parameters. Separate chapters specifically address optimizing the Infiniti, Signature, and Stellaris platforms for chopping. Section Three introduces femtosecond laser nuclear pre chopping with separate chapters on the LenSx, LensAR, and Optimedica platforms. Section Four covers small pupils and IFIS, rock hard and white mature cataracts, weak zonules, and extremely long and short eyes with an emphasis on managing posterior capsule rupture, advanced IOL fixation strategies, and avoiding and managing capsulorrhexis complications. Bonus Video Material! Phaco Chop and Advanced Phaco Techniques, Second Edition includes instructional video that complements and supplements the content of the book. With your book purchase, you will receive a DVD that contains 26 surgical videos in high definition 3D format. With the enclosed 3D glasses-learning intraocular surgical techniques is taken to a new level. Additionally, you will receive access to a website that includes additional companion surgical videos narrated by Dr. Chang in 2D format-watch, listen, view repeatedly, and learn the techniques! The narrated videos produced by Dr. Chang illustrate advanced surgical techniques and technologies. Together with over 400 high-resolution operative photographs, this paired format overcomes the limitations of learning new and advanced surgical techniques from written text alone. With its comprehensive and integrated emphasis on advanced surgical techniques, optimizing phaco technology, and complication management, Phaco Chop and Advanced Phaco Techniques: Strategies for Complicated Cataracts, Second Edition will appeal to residents and transitioning surgeons as well as high volume surgeons interested in honing their most advanced phaco skills.

The sellar region and paranasal sinuses constitute the anatomical sections of the skull base in which pathological entities warrant interdisciplinary management. Processes originating in the paranasal sinuses can reach and involve the skull base in and around the sella, sometimes not respecting the natural dural boundary. On the other hand, lesions involving the sellar block, such as pituitary adenomas and meningiomas, can also extend downwards into the paranasal sinuses. The orbit and cavernous sinus may be subject to involvement and infiltration by both paranasal and sellar pathology. The advancement and new achievements of modern diagnostic procedures, such as high-resolution CT, three-dimensional reconstruc tion, MRI, and MRI angiography, as well as the detailed selective angiographic protocols and endovascular techniques, have increased the possibilities for surgical management of this type of pathology with extra- and intracranial involvement. Long-standing and intense inter disciplinary work has led to sophisticated operative approaches which for benign tumors allow total excision with preservation of structures and function, and for some malignant lesions permit an en bloc resec tion via a combined intracranial-extracranial approach. This volume reflects the work and scientific exchange which took place during the IV International Congress of the Skull Base Study Group, held in Hanover. Leading authorities in the basic sciences including anatomy joined with diagnosticians, clinicians, and surgeons from different fields to evaluate the state of the art of this topic in skull base surgery."

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.

"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."

Intracranial injury, caused by a transorbital penetrating object, is a neglected topic in neurosurgery. With few exceptions, only occasional publications, often containing merely case histories, are present in the literature. Through a perusal of the world literature - for the first time - the author has collected and combined all available and relevant information, trying to give a thorough description of this rare, but extremely dangerous injury. This book is a major and definitive contribution to neurosurgery, but is also of importance to ophthalmology, neurology, traumatology, neuro-radiology and pediatrics.

With Surface Ablation: Techniques for Optimum Results, refractive surgeons will learn efficient pre- and post-op routines that optimize chair time and lead to improved safety and excellent results for patients. Inside Surface Ablation: Techniques for Optimum Results by Dr. Ellen Anderson Penno is joined by 9 contributors who offer a practical approach with clinically useful tips including patient counseling and post-operative care that will improve patient satisfaction. This up-to-date book is an excellent resource for patient assessment of candidacy for refractive surgery or in post- operative co-management. In addition to chapters with information on patient selection, surgical techniques, post-op care, and prevention and management of complications, Surface Ablation: Techniques for Optimum Results includes several articles, contributed by leaders in the refractive surgery field, covering a variety of topics including surface ablation in keratoconus patients, corneal cross-linking, and ectasia. Surface Ablation: Techniques for Optimum Results is a clinically- oriented resource for residents and new refractive surgeons as well as the many seasoned refractive surgeons, general ophthalmologists following the increasing trend of transitioning away from LASIK towards surface ablation for many of their patients.

Cataract Surgery in Complicated Cases offers the latest techniques in treating complicated cases as faced by today's surgeons performing cataract surgery. Dr. Lucio Buratto; Dr. Stephen Brint; and Dr. Luigi Caretti provide step-by-step approach to facilitate how to assess the patient, perform the technique, and manager the most challenging cataract surgery complicated cases facing both beginning and experienced surgeons. Cataract Surgery in Complicated Cases covers a wide variety of topics including cataract in high myopia, floppy iris syndrome, traumatic cataract, phacoemulsification with a small pupil, and IOL explanation and replacement. Supplemented by more than 250 colour illustrations, diagrams, a glossary, and references, all surgeons, from beginner to expert will want this unique resource by their side.

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

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.

Retinal and choroidal vasculatures are easily affected by various systemic diseases, and changes in the retina can easily be observed with various procedures such as direct and indirect ophthalmoscopy, scanning laser ophthalmoscopy, fluorescein fundus angiography, and indocyanin green fundus angiography. Vascular changes are the major, most prominent, and most important fundus changes. The above-mentioned procedures can reveal vascular changes clearly, but mainly reveal changes in the superficial layer of the retina. In addition, these procedures cannot show the three-dimensional architecture of the retina. Usually we can barely obtain the view of that three dimensional architecture. At the same time, pathological findings are well described, but most of them are based on histological and cytological methods. Thus, three-dimensional description of pathology is rare. Vascular corrosion cast scanning electron microscopy can provide a very useful three-dimensional view of the microvasculature and can demonstrate the fine structural architecture of the capillary network. However, the application of this method to the retinal and choroidal vasculature is very difficult, especially in small eyes. We succeeded in making good corrosion casts of retinal and choroidal vessels in the rat. Using this method during the past 10 years we have examined the retinal and choroidal vascular architecture of rats with various systemic diseases such as aging, hypertension, diabetes mellitus, and arteriosclerosis."

The nature, control, and disorders of eye movements are topics which draw together scientists from many diverse fields. On October 29-30, 1976, a Symposium on Eye Movements was held at The University of Texas Health Science Center at San Antonio. The Symposium constituted the Southern Sectional Meeting of the Association for Research in Vision and Ophthalmology. The Program Coordinators, Drs. Frank Bajandas and Barbara Brooks invited an outstanding group of participants to give presentations on a variety of aspects of this subject. This volume contains all of the invited presentations delivered at that meeting. It does not include the excellent free papers, nor the enthusiastic and fruitful discussions that the participants and the audience enjoyed as well. The editorial work for this book was performed by Dr. Brooks and Dr. Bajandas with great care and efficiency. They have made special efforts together with the Publisher, Plenum Press, to bring this information to you in the shortest possible time, so as to retain the currency of its contents. This effort would not have been even considered without the tireless and always dependable assistance of Mrs. Catherine Arocha and Mrs. Louise Whelan. We are also indebted to the ~exas State Commission for the Blind for its help in defraying the expenses ever attendant at significant symposia. George W. Weinstein, M.D.

Researchers in recent decades have elucidated signal transduction in the retina and the function of the visual cortex. The highly flexible nature of neural circuits in the visual cortex especially during the critical period has been an interesting subject for studying neural plasticity and development. Recent advances in the visual neurosciences of the vertebrate retina and the visual cortex were discussed during the 12th Keio International Symposium for Life Science and Medicine, meeting jointly with Vision Forum 2002. Contributions to the symposium collected in this volume reflect the convergence of physiological, cell biological, molecular, mathematical, and clinical approaches. The book covers topics ranging from phototransduction to visual information processing in the primary visual cortex, and includes clinical studies on hereditary night blindness, creating a valuable source of information for researchers and clinicians in the visual neurosciences.