2011-2012 Basic and Clinical Science Course, Section 8: by James J. Reidy MD

By James J. Reidy MD

Discusses the constitution and serve as of the cornea and exterior eye and studies appropriate exam options. Covers infectious and ocular floor ailments, issues and surgical procedure of the ocular floor, immune-mediated and neoplastic issues, congenital anomalies and degenerations. A lately up to date bankruptcy at the genetics of corneal dystrophies displays the hot IC3D category. Discusses poisonous and tense accidents and corneal transplantation. comprises many new colour photos. lately revised 2010 2011.

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Extra info for 2011-2012 Basic and Clinical Science Course, Section 8: External Disease and Cornea (Basic & Clinical Science Course)

Example text

Ke ratosco py images can be digitall y captured and analyzed by com puters. Placido disk- based computeri zed topographers have been the type most commonly available. These units assume the angle of incidence to be nearly perpendicula r and the radius of curvature to be the distance from the surface to the intersection wi th the li ne of sight or visual axis of the patient (axial distance) (Fig 2-25). However, the ass umption that the visual axis is coincident to the cornea l apex may lead to some misinterpretations, such as the overdiag nosis of keratoconus.

Areas of increased translucency (scleromalacia) are detected by direct observation and by transillumination. Corneal Pachometr A corneal pachometer measures corneal thickness, a sensitive indicator of endothelial physiology that correlates well with fu nctional measurements such as aqueous fluorophotometry. The normal cornea has an average central thickness of about 540 fim. ote that in the Ocular Hypertension Treatment Stud y, the average corneal thickness was higher, at 573 ± 39 fim , but it was acknowledged that these numbers were probably higher than those of the general population.

Dry eye represents a disturbance of the la crimal functional unit (LFU), an integrated system comprising the lacrimal glands, ocular surface (cornea, conjunctiva, and meibomian glands), and eyelids, as well as the sensory and motor nerves that connect them (Fig 3-1 ). The LFU regulates the major components of the tear film and responds to environmental, endocrinologic, and cortical in fl uences. Its overall functions are to preserve tear-film integrity: lubricating, ant imicrobial, and nutritional roles ocular surface health: maintaining corneal transpare ncy and surface stem cell population quality of image projected onto the retina Tear-film stability is threate ned when the interactions among stabilizing tear-film constituents are compromised by decreased tear secretion, delayed clearance, and altered tear composition.

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