Gifford's Textbook of Ophthalmology Fourth EditionPDF电子书下载

Chapter 1 EXTERNAL EXAMINATION OF EYES AND ADNEXA 1

Eyelids and Palpebral Fissures 1

Lashes and Eyebrows 2

Position of the Eyeballs 2

Motility of the Eyeballs 3

Lacrimal Apparatus 4

Conjunctiva 4

The Cornea 7

Iris and Pupil 9

Intra-ocular Pressure 9

Examination of Infant and Small Child 10

Chapter 2 EXAMINATION OF THE EYE BY OPHTHALMOSCOPY 11

The Ophthalmoscope 11

Examination of the Ocular Media 12

Examination of the Fundus 14

Normal Fundus 15

Normal Variations 18

Chapter 3 EXAMINATION OF THE EYE BY OTHER OBJECTIVE METHODS 19

Slit Lamp Microscopy 19

Cornea 21

Anterior Chamber 23

Iris 24

Lens 24

Vitreous 25

Transillumination 25

Measurement of Intra-ocular Pressure 26

Testing Corneal Sensitivity 28

Examination of Pupil 28

Chapter 4 FUNCTIONAL EXAMINATION OF THE EYE 30

Determination of Visual Acuity 31

Testing Accommodation or Focusing Power 35

Investigation of Visual Fields 35

Methods of Testing Visual Field 37

Distribution of Nerve Fibers 40

Types of Pathologic Field Defects 46

Tests for Color Sense 53

Dark Adaptation 53

Psychosomatic Disturbances of Visual Function 54

Emotional Disturbances 54

Malingering 55

References 55

Chapter 5 DISTURBANCES OF OCULAR MOTILITY 57

Anatomy and Physiology of the Individual Muscles 58

Movements of the Globe 60

Action of the Individual Muscles 61

Voluntary Control of the Ocular Movements 64

Reflex Control of the Ocular Movements 69

Static Reflexes 72

Static-Kinetic Reflexes 72

Nystagmus 73

Proprioceptive Sense of the Ocular Muscles 75

Visual Fixation Reflex 75

Fusion 80

Orthophoria and Heterophoria 84

Strabismus or Squint 89

Concomitant Strabismus 89

Types 90

Paralytic Strabismus 93

Supranuclear Paralyses 94

Paralysis of Individual Ocular Muscles 98

Paralysis of the Third Nerve：The Ophthalmoplegias 103

References 107

Chapter 6 OPTICAL DEFECTS OF THE EYE 109

Physiologic Optics 109

Refraction by the Eye 112

Accommodation 113

Presbyopia 115

Ametropia 116

Hyperopia 117

Myopia 119

Astigmatism 123

Methods of Refraction 124

Prescription of Glasses 124

References 126

Chapter 7 THE ORBIT 127

Anatomy 127

Congenital Malformations 130

Circulatory Disturbances 131

Orbital Inflammation 134

Exophthalmos 135

Exophthalmos of Graves＇ Disease 138

Orbital Tumors 147

Primary Tumors in the Orbit 147

Tumors from Adjacent Structures 149

Metastatic Tumors 149

Pseudotumors；Chronic Orbital Myositis 149

Enophthalmos 150

Orbital Injuries 150

References 151

Chapter 8 THE EYELIDS 152

Anatomy 152

Alterations in the Form of the Lids 156

Alterations in the Size and Form of the Fissures 158

Changes in Position of the Lids 158

Entropion 158

Ectropion 161

Diseases of the Skin of the Lids 162

Alterations in the Circulation of Blood and Lymph 162

Emphysema of the Lids 165

Inflammatory Diseases of the Skin 165

Hypertrophic，Abiotrophic and Degenerative Processes 170

Changes in Pigmentation of the Lids 171

Diseases of the Glands of the Lids 172

Diseases of the Sebaceous Glands 172

Diseases of the Sweat Glands 173

Diseases of the Lid Margin 173

Marginal Blepharitis 173

Hordeolum 175

Diseases of the Cilia 176

Diseases of the Tarsus and Its Glands 177

Alterations in Movements of the Lids 179

Tumors of the Lid 183

Congenital Tumors 183

Acquired Tumors 184

Injuries of the Eyelids 186

Ecchymosis 186

Wounds of the Eyelids 186

Burns 188

References 189

Chapter 9 THE LACRIMAL APPARATUS 190

Anatomy 190

Diseases of the Lacrimal Gland 191

Inflammation 191

Tumors 193

Diseases of the Lacrimal Ducts 193

References 195

Chapter 10 THE CONJUNCTIVA 196

Anatomy 196

Anomalies of the Circulation 198

Conjunctivitis 200

Bacteriology of the Conjunctiva 202

Clinical Appearance of Certain Types of Acute Conjunctivitis 204

Gonococcal Conjunctivitis 204

Acute Catarrhal Conjunctivitis 208

Trachoma 210

Angular Conjunctivitis 214

Conjunctival Glandular Form of Tularemia 214

Allergic Forms of Conjunctivitis 214

New Growths of the Conjunctiva 216

Injuries of the Conjunctiva：Traumatic Conjunctivitis 217

References 219

Chapter 11 THE CORNEA 220

Anatomy and Physiology 220

Congenital Anomalies 222

General Pathologic Considerations of Corneal Diseases 223

Foreign Bodies on the Cornea 223

Wounds of the Cornea 225

Vascularization of the Cornea 226

Edema of the Cornea 227

Birth Injuries 227

Inflammation of the Cornea：Keratitis 228

Superficial Keratitis 229

Deep Keratitis 243

Degenerative Processes of the Cornea 247

References 250

Chapter 12 THE SCLERA 251

Anatomy 251

Pigmentation 251

Ectasia and Staphyloma 252

Inflammation：Scleritis and Episcleritis 252

References 253

Chapter 13 IRIS，CILIARY BODY，PUPIL 254

Anatomy of the Iris and Ciliary Body 254

Inflammation of the Iris and Ciliary Body 256

Diagnosis of Specific Types of Iridocyclitis 262

Tumors of the Iris 267

Sympathetic Ophthalmia 267

The Pupil 269

Anatomy and Physiology of the Muscles 270

Examination of the Pupil 272

Disturbances in Pupillary Reaction 275

References 280

Chapter 14 THE CHOROID AND VITREOUS BODY 281

Anatomy 281

Congenital Anomalies of the Choroid 284

Inflammation of the Choroid 285

Acute Choroiditis 286

Special Types of Choroiditis 287

Treatment of Choroiditis 290

Tumors of the Choroid 291

References 292

Chapter 15 THE CRYSTALLINE LENS 294

Embryology 294

Anatomy 297

Cataract 300

Causes of Opacification of Lens Fibers 302

Theories of Cataract Formation in Man 304

Symptoms of Cataract 306

Types of Cataract 306

Differential Diagnosis 318

Treatment 319

Dislocation of the Lens 320

Arachnodactylia (Marfan＇s Syndrome) 322

References 322

Chapter 16 GLAUCOMA 323

Normal Intra-ocular Pressure 323

Various Types of Glaucoma 323

References 330

Chapter 17 THE RETINA 332

Anatomy and Physiology 332

Circulatory Disturbances in the Retina 335

Obstruction of the Retinal Vessels 338

Obstruction of the Arterial Circulation 338

Obstruction of the Central Retinal Vein 340

Arteriosclerosis 342

General Characteristics of Sclerosis 342

Types of Sclerosis 345

Hypertension 348

The Hypertensive Retinopathies 348

Types of Hypertensive Retinopathy 350

Arteriosclerotic Retinopathy 351

Renal Retinopathy 351

Hypertensive Retinopathy (Benign and Malignant) 354

Late Toxemia of Pregnancy 355

Diabetic Retinopathy 356

Evaluation of Hypertensive Disease by the Ophthalmoscopic Picture 359

Treatment of the Hypertensive Retinopathies 360

Retinal Changes in Diseases of the Blood 360

Atrophy and Degeneration of the Retina 362

Detachment of the Retina 370

Tumors of the Retina：Retinoblastoma 374

References 377

Chapter 18 THE OPTIC NERVE 379

Anatomy and Physiology 379

Inflammatory Changes：Optic Neuritis 385

Clinical Features 385

Etiology of Optic Neuritis 388

Papilledema or Choked Disc 393

Optic Atrophy 399

Tumors of the Optic Nerve and Sheaths 402

Toxic Amblyopias 402

References 405

Chapter 19 OCULAR DISORDERS DUE TO DISEASES OF THE CENTRAL NERVOUS SYSTEM 406

Diseases of the Meninges 406

Diseases of the Brain 413

Disorders of the Cerebral Circulation 413

Arterial Blood Supply 413

Venous Circulation 421

Cerebrospinal Fluid 421

Inflammatory Diseases of the Brain 422

Brain Abscess 422

Viral Infections 423

Demyelinating Diseases 424

Congenital and Degenerative Disorders 425

Cerebromacular Degeneration 425

The Phakomatoses 425

Hepatolenticular Degeneration 427

Brain Tumors 427

Focal Symptoms 428

Eye Manifestations of Head Injuries 436

References 438

Chapter 20 OCULAR MANIFESTATIONS OF GENERAL DISEASES 440

Infectious Diseases 440

The Bacillary Diseases 440

The Coccal Diseases 446

Contagious Diseases of Childhood 447

Diseases of Doubtful Etiology 450

Fungus Infections 451

Diseases of Metabolism 452

Diseases of the Urinary Tract 454

Protozoan and Metazoan Diseases 454

Viral Diseases 457

Rickettsial Diseases 458

Spirochetal Diseases 459

The Arthritides 462

Diseases of the Heart and Blood Vessels 463

Diseases of the Blood 465

References 467

Chapter 21 ORIENTATION ON SURGICAL OPERATIONS ON THE EYE AND ADNEXA 470

Extraction of Cataracts 470

Glaucoma 471

Operations on the Conjunctiva 473

Operations on the Lids and Socket 478

Operations for Removal of the Globe 480

Operations on the Muscles of the Eye 486

Operations on the Tear Apparatus 487

Operation for Detachment of the Retina 487

Chapter 22 THERAPEUTIC AGENTS USED IN OPHTHALMOLOGY 489

Collyria or Eye Washes 489

Local Anesthetics 490

Mydriatics and Cycloplegics 490

Miotics 491

Ointments 491

References 491

INDEX 493