1023
AABC transporters, 97Ab externo Schlemm's canal outflow devices
deep dissection, 801laser goniopuncture, 804microcatheter, 802prolene suture and knots, 803scleral flap, 800–801trabeculodescemet window (TDW), 801–802
Ab interno Schlemm's canal outflow devicestrabectome handpiece
advantage, 807complications and outcome, 806design, 805–806
trabecular micro-bypass, 805Absolute risk reduction (ARR), 30acetazolamide, 44, 452, 483, 494, 514, 572, 577, 605–608, 612, 634,
681–683, 742, 908, 965ACG. See Angle closure glaucomaAdherence
coverage and dosing errors, 651economic impact, 654–655evaluation and medication, 651eye drop administration instillation, 652nonadherence, IOP control relationship, 655vs. outcomes, 651provider–patient relationship
inadequate communication, 653inadequate provider monitoring, 654rapport issues, 653–654
Adjunctive therapyadvantages, 637–638alpha-adrenergic agonists, 630–631beta-blockers, 631
vs.brimonidine, 632–633vs. topical CAIs, 632
brimonidine-P, 638combination agents, 615–616combination medical therapy, 634–636diastolic ocular perfusion pressure, 637fixed combination agents, 634limitations, 937medical management, 638vs. medical therapy, 631–632medications classes, 629monotherapy
benzalkonium chloride (BAK), 629IOP reduction, 629–630PAG therapy, 630selection process, 630
oral CAIs, 634
PGAs, 629pilocarpine, 633topical carbonic anhydrase inhibitors, 631
Advanced Glaucoma Intervention Study (AGIS)intraocular pressure (IOP), 37risk factors, 51
Ahmed valved implants, 813, 816Alphagan, 609Alphagan-P, 592, 609, 610Alpha-lipoic acid, 657Alpha-tocopherol, 658ALT. See Argon laser trabeculoplastyAlzheimer’s disease (AD)
optic nerve cupping, 276sCD44 and POAG, 941–943
Amniotic membrane transplantation (AMT)bleb leak, 863conjunctival tube repairing devices, 864intraoperative conjunctival buttonholes, 862shunt tube covering devices, 864trabeculectomy, 861–862
Analysis of variance (ANOVA), 150Anecortave acetate
anterior juxtascleral depot (AJD), 991intraocular pressure (IOP), 989intravitreal triamcinolone acetate
(IVTA), 991–992vs. tetrahydrocortisol, 989, 990treatment timeline, 989, 990
Angiotensin converting enzyme (ACE), 115Angle closure glaucoma (ACG)
anterior segment imaging, 467–468chronic angle-closure, 470classification, ISGEO
PAC, 461PACG, 462PACS, 461
combined mechanism, 470definitions, 461drug-induced secondary, 482–484epithelial and fibrous downgrowth, 480genetics, 97gonioscopy
compression, 465concentric rings, 466Goldmann three-mirror lens, 464, 465Keoppe lens, 464Posner lens, 465–466Sussman lens, 466synechiae charted, 466Zeiss lens, 465
Index
1024 Index
Angle closure glaucoma (ACG) (Con’t)inflammation, 480–481iridocorneal endothelial (ICE) syndrome, 479–480mechanistic (pathophysiologic) Classification, 462–463methods, 461, 462nanophthalmos, 484–485neovascular glaucoma, 479PAC
acute and sub-acute, 471–475risk factors, 470–471
pathogenesis and pathophysiologyiris bombe, 469mechanisms, 463, 468pupillary block mechanism, 468–469
plateau iris syndrome, 463primary vs. secondary, 464progressive iris atrophy, 479retinal disorders and posterior segment disorders, 481secondary without pupillary block, 478–479secondary with pupillary block
homocystinuria, 476, 478laser iridotomy, 478marfan syndrome, 476penetrating trauma and phacomorphic glaucoma, 475, 476Weill–Marchesani syndrome, 475–476
ultrasound biomicroscope (UBM), 295–298Angle recession, 563, 565ANOVA. See Analysis of varianceAnterior chamber angle
ciliary body band (CBB), 314–315Schwalbe’s line, 315–316scleral spur (SS), 315trabecular meshwork (TM), 315
Anterior chamber intraocular lens (ACIOL) optic implantation, 895Anterior chamber paracentesis, 774Anterior juxtascleral depot (AJD), 991Anterior scleral buckling method, 874–875Anterior segment digital imaging
angle closure, 295–298clinical performance, 298normal angle, 294–295OCT, 294plateau iris, 295posterior iris, 298pupillary block, 295ultrasound biomicroscope (UBM), 293–294
Anterior uveitis, 533–534Apnea–hypopnea index (AHI), 135, 702apraclonidine, 494, 514, 595, 608, 609, 683, 716, 720, 725AQP1, 558Aqueous humor production, 35–36Aqueous misdirection. See Malignant glaucomaAqueous veins
aqueous outflow, 72distribution, 66episcleral vein, 66–67episcleral vein pressure and posture
collapsible veins, 75Starling resistor, 75–76
importancedirect observation, 65gonioscopy, 73peripheral iridectomy, 65
intrascleral mixing of, 66mixing veins, 66–67origin, 66, 69
pulsatile aqueous flowcardiac source, 68, 71causes, 71–72driving force, 68glaucoma abnormalities, 72–73increased stroke volume, 72medications, 74–75origination, 69physiologic pressure effect, 68Schlemm’s canal (SC), 70systole and diastole changes, 71systolic stroke volume determinates, 69TM tissue abnormalities, 73–74trabecular meshwork (TM), 70–71
recognization method, 67stoke volume, 72theories validation methods
collapsible tubes, 70enucleated eyes, 69–70in vivo tissue load, 70TM movement and outflow resistance, 70
visiblity, 66Argon laser trabeculoplasty (ALT), 450–451, 513–514, 755, 873Association of Clinical Research Professionals (ACRP), 978Axenfeld-Rieger syndrome, 97Axon screamometer, 15Azarga, 607, 971Azopt, 607
BBaerveldt implants, 816Bailey–Lovie near reading card, 355Beehler three-point pupil dilator, 899Benzalkonium chloride (BAK), 591–593Betagan, 599Beta-adrenergic antagonists
brands, 599brimonidine, 573, 632–633preservatives, 599systemic side effects
cardiovascular medicine, 678ophthalmic efficacy, 677pharmacology and physiology, 677–678
topical type, 600vs. topical CAIs, 632
Beta-blockers. See Beta-adrenergic antagonistsBetimol, 599, 600Betoptic-S, 599, 600bimatoprost, 27–30, 307, 415, 513, 548, 573, 593, 599–605, 615, 616,
629–635, 685, 897, 966, 970Binocular Esterman testing, 339–340Binomial scale distributions, 152Biomarkers
cytokine molecules, POAG, 935–936extracellular matrix (ECM) components, 933–934stress and agings, POAG, 936
Biomechanics, 70Black-and-white photography, 223Bland–Altman analysis, 153Bleb leak, AMT, 863Bleb needling revision, 386Bradycardia, 679brimonidine, 74, 75, 277, 463, 494, 502, 504, 513, 573, 577, 585, 591,
592, 595, 608–611, 616, 631–638, 648, 674, 683, 684, 716, 720, 725, 744, 772, 970
brinzolamide, 494, 607, 610, 631–633, 638, 681, 970
1025Index
Bupivicaine, 675Busacca nodules, 530, 539
CCalcium channel blockers and optic nerve blood flow
brovincamine, 453CCBs caution and OAG development, 453–454memantine and excitotoxicity, 454nifedipine, 452–453nilvadipine and nimodipine, 453
Canaloplastyaqueous humor
pathways, 796Schlemm’s canal outflow, 796–797subconjunctival filtration, 796suprachoroidal outflow, 797–798
emerging devices, 795Schlemm’s canal devices, 800–807subconjunctival filtration device, 798–800suprachoroidal gold microshunt device, 807–811
Canon laser Doppler flowmeter (CLBF), 124Carbonic anhydrase inhibitors (CAI)
acetazolamide, 605–606dorzolamide, 607methazolamide, 606oral type, 605–606systemic side effects
physiology and pharmacology, 681systemic reactions, 682–683
topical type, 607use, 608
Cardiovascular diseaseantihypertensive medications, 691–693atherosclerosis, 689factors, 689glaucomatous optic neuropathy, 690hypertension and cardiovascular risk
blood pressure classification, 690definition, 690diagnosis, 690JNC-VI and VII report, 690patterns, 690prognostic significance, blood pressure, 690–691
IOP, 689posterior ciliary artery (PCA), 689vascular autoregulatory capacity, 689
Carnitine, 658carteolol HCL, 599Cataract extraction
adjunctive proceduresendocyclophotocoagulation, 910filtration procedures, 910–911goniosynechialysis, 909–910limited pars plana vitrectomy (LPPV), 910
indicationsacute and chronic angle closure, 906adjunctive procedures, 906–907
lens, angle closure, 905technique
capsulorhexis and iris, 909incisions, 908phacoemulsification, 909postoperative management, 909preoperative considerations, 908
Cataract surgery, 512cataract extraction with IOL implantation alone, 895
clear-corneal phacoemulsification, 897evidence-based medicine, 889preoperative considerations
implications, 890–893slit-lamp examination, 889, 890
prostaglandin analogs and pseudophakic cystoid macular edema, 902
selective laser trabeculoplasty (SLT), 897sequential surgery vs. combined surgery, 896–897surgical techniques
combined surgery, 900–901filtering bleb, 901pupil management, 898–900
topical medications, 897Catechins, 662CD44
cell growth and survival, 945–947casein kinase II inhibitors, 946CD44 transmembrane receptor, 945human TM cells, 946, 947phospho-specific western blot analysis, 946RGC-5 cells, 946, 947
cell signalling, 945functions, 939interactions
ATP-binding cassette transporter, 941signal transduction pathways, 940
localization, 941NF-kB and lactate stress, 948trabecular cells, 1012
Center for Medicare and Medicaid Services (CMS), 377–378Central corneal thickness (CCT)
case presentationIOP mesurement, 79racial differences, 79
corneal hysteresis, 87–88correction factors, 87differences
age-related, 80corneal refractive surgery, 80–83diabetes, 83diurnal variations, 83lamina cribrosa, 83racial, 80
drug effects, 87measuring methods
anterior segment optical coherence tomography (AS-OCT), 84optical pachymetry, 83orbscan system, 84ultrasonic pachymetry, 83
ophthalmic assistant role, 305practical aspects, 88
Central retinal vein occlusion (CRVO)elevated IOP, 518neovascular glaucoma risk, 521ocular hypotension, 518retinal disorders and treatments, 481
Certified Low Vision Therapists (CLVT), 377Certified Orientation and Mobility Specialists (COMS), 377Certified Vision Rehabilitation Therapist (CVRT), 377Chandler’s syndrome, 553Cholinergic agents, 610Ciliary body
band (CBB), 314–315endoscopic photocoagulation treatment, 731–732indications and contraindication
1026 Index
Ciliary body (Con’t)endoscopic photocoagulation (ECP), 730transscleral cyclophotocoagulation (TSCPC), 730
intraoperative and postoperative complications, 732IOP reduction, 732–733preparation, 731surgery and postoperative care, 731TSCPC treatment, 731
Circadian IOP variation, 644Citicoline
brain pharmacotherapy, 658–659phospholipids biosynthesis, 659retinal ganglion cells (RGCs), 659
Clinical research organizations (CROs), 978Clinical research trials
new drug application, 977participants
association of clinical research professionals (ACRP), 978clinical research organizations (CROs), 978finding and obtaining of, 979–981primum non nocere principle, 979
phases, 977–978real world, 977–978registration trials, 977
Clonidine, 609, 683CNTGS. See Collaborative Normal Tension Glaucoma StudyCoding and billing reconciliation, 388Coenzyme Q10, 659Cogan-Reese syndrome, 553, 554Collaborative Initial Glaucoma Treatment Study (CIGTS), IOP, 37Collaborative Normal Tension Glaucoma Study (CNTGS)
lowering treatment, 449randomized clinical trials, 36–37
Collagen VIII gene, 558Color Doppler ultrasound imaging, 121–122Combigan, 610, 616, 634, 635, 970, 1018Community setting. See Clinical research trialsCompliance. See AdherenceComputerized optic nerve analysis
computerized scanning imaging, 219–220cup-to-disc ratio, 219white-on-white automated perimetry, 219
Confocal scanning laser Doppler flowmeter (CSLDF), 125–126Confocal scanning laser ophthalmoscopy (CSLO), 209–210,
214–215, 220Confounding, 151Congenital glaucoma, genetics, 96Continuous wave laser systems
postoperative care, 716tissue temperature interpretation, 717treatment and settings, 716
Contralateral eye management, 496Corneal hysteresis, 87–88Corticosteroid-induced ocular hypertension management, 532–533, 535Cosopt, 607, 610, 616, 634, 635, 970, 1018CRVO. See Central retinal vein occlusionCupping
nonglaucomatous optic neuropathyarteritic AION, 271nonarteritic AION, 270–271optic nerve photographs, 272
ONH biomechanicslaminar deformation, 188prelaminar thinning, 188tissue types, 185
optic nerve head, 185
Curcuminbeneficial effect, 659diabetic cataract, 659–660neuroprotective, 659
Current Procedural Terminology (CPT) codes, 384Cyclodestruction, 576Cyclodialysis (CDC)
anatomy and pathogenesis, 871cleft closure, 564diagnosis, 871–872sentinel cleft, 873signs and symptoms, 871treatment
anterior scleral buckling method, 874–875cycloplegia and Argon laser methods, 873direct cycloplexy, 874–875McCannel suture technique, 874surgical methods, 872–874
Cyclophotocoagulation (CPC) techniquecautions, 531endoscopic cyclophotocoagulation, 750–751laser therapy, inflow, 760techniques/features, 750
Cycloplegia medical treatment, 872Cystoid macular edema (CME), 551Cytokine molecules, POAG, 935–936Cytoskeletal active agents
actomyosin complex, 955, 956latrunculia magnifica, 956myosin light chain phosphatase (MLCP), 955trabecular meshwork, 958
DDan shen (Salvia miltiorrhiza), 660Daranide, 606Darkroom infrared gonioscopy (DIG), 467–468Definition, 3Depression, 679–680Descemet’s membrane (DM), 557Descemet’s stripping endothelial keratoplasty (DSEK)
incidence, 885–886intraocular pressure (IOP), 886surgical management
glaucoma drainage devices, 886–887posterior corneal lamellar surgery, 886
DiabetesBaltimore eye survey, 697cardiovascular diseases, 697diagnosis, 696–697diet, exercise and life style, 698–700Los Angeles Latino Eye Study (LALES), 697metabolic abnormalities, 696risk factor, 696
Diamox, 606Diastolic ocular perfusion pressure, 637dichlorphenamide, 606Diffuse neuroretinal rim loss, 204Diffuse RNFL loss, 204DIG. See Darkroom infrared gonioscopyDigital fundus photography, 225–226Direct cycloplexy, 874–875Discam digital camera, 226Disc damage likelihood scale (DDLS), 160Disc hemorrhages (DH)
consequences, 196–197definition, 195
1027Index
local and systemic factors, 197morphologic relationships, 196ocular blood flow, 195pressure reduction, 197–198prevalence, 195–196
Diurnal IOP, 55Diurnal–nocturnal variation and fluctuation, 422–423Docosahexaenoic acid (DHA), 657dorzolamide, 25, 29, 38, 56, 87, 494, 513, 607, 610, 616, 631, 632,
634–638, 692, 965, 970Drainage devices
categories, 813clinical outcomes
keratoplasty, 822–823ocular surface disease, 823pediatric, uveitic and neovascular glaucoma, 821retinal detachment, 823
complicationselevated intraocular pressure, 824hypotony, 823
design features, 816glaucoma tube insertion technique, 575–576indications, 816nonvalved implants, Baerveldt and Molteno types, 816surgical techniques
basic methods, 817–819flow restriction devices, 819Pars plana tube insertion devices, 820
valved implantsAhmed type, 813, 816Eagle Vision type, 816
valve failure, 817–818Driving activity
Advance Glaucoma Intervention Study (AGIS)-scoring system, 340Binocular Esterman testing, 339–340crash rates, 339functional abilities, 340motor vehicle accidents (MVAs), 339vision-threatening diseases, 339
Drug management processdevelopment
adverse clinical response observation, 968clinical pharmacology, 968–970clinical trial initiation, 971–972no-observed-adverse-effect level (NOAEL), 968
discoveryclinical candidate selection, 967disease target discovery, 965lead identification, 965lead optimization, 966preformulation, 966–967safety assessment, 966
efficacy assessment, 645–646marketing
drug discovery and development cycle, 965, 973phase 4 program and postmarketing surveillance, 974
pre-clinical testinginvestigational new drug application, 962–963new drug application, 964
registrationfactors, 973fileability, 972safety and efficacy, 972stages, 963, 972
DuoTrav, 616, 634, 635, 970, 1018Dynamic Contour Tonometry (DCT)
corneal confounding effect, 996corneal refractive surgery, 80–83intraocular pressure (IOP) measurement, 40
Dysrhythmia, 679
EEagle Vision valved implants, 816Early manifest glaucoma trial (EMGT), IOP
randomized clinical trials, 38risk factors, 51
Eccentric fixation training, 372Electronic health record (EHR) systems
initial task force, 343legal aspects
available information, 347–348confidentiality issues, 348documentation and installation time, 346policies and resources, 348printed format, 347recordkeeping changes, 346system downtime, 348training time, 346–347
selectioninternet searches, 343–344record-keeping methods, 344–345records and format, 345upgrades and implementation, 345vendors, 344
Electronic magnifiersinline closed-circuit television (CCTV), 362portable lightweight handheld, 363swing-arm, 363
Electronic prescribing, 389Electroretinography
flash (ERG), 265multifocal (mfERG), 266pattern (PERG), 265–266visual evoked potential, 266
Encapsulated filtering blebs, 814–816Endoscopic cyclophotocoagulation
advantage and disadvantage, 760–761limbal approach and a pars plana entry, 761phacoemulsification surgery, 762
Endoscopic cyclophotocoagulation (ECP), 750–751Endothelins, ocular blood flow, 114Epigallocatechin gallate (EGCG), 662epinephrine, 26, 74, 531, 594, 595, 608, 609, 635, 674, 683, 684, 731,
818, 851, 891, 972Episcleral venous identification, 67Episcleral venous pressure (EVP), 797Epithelial downgrowth
diagnosisaqueous humor aspiration, 879differential diagnosis, 879–880iris surface, 880specular microscopy and fluorophotometry, 879
etiology and pathogenesis, 877–878vs. fibrous ingrowth, 880glaucoma mechanisms, 879incidence, 877pathology, 880signs and symptoms
anterior chamber angle, 879retrocorneal membrane, 878scalloped edge, 878
vs. transplant rejection, 879
1028 Index
Epithelial downgrowth (Con’t)treatment
glaucoma drainage methods, 881surgical methods, 880–881
Esterman visual field test (EVFT), 15Evaluation and Management (EM) codes, 385Evidence-based medicine (EBM)
definition, 23evidence cart, 28evolution, 24–25glaucoma care evolution
golden age and polypharmacy era, 26individualized medicine era, 27postgonioscope and postophthalmoscope era, 26randomized clinical trial era, 26–27
meta-analysis, 27process
application, 29–30basic calculus, 30–31clinical problem formulation, 27–28evidence cart assemble, 28evidence quality evaluation, 28–29suprachoroidal hemorrhages, 31–32
usage reasonslearning, principle and sense of control, 25risk calculators, 25
Excimer laser trabeculostomy (ELT), 755Exfoliative glaucoma (XFG)
appearancebiomicroscope, 509classic slit-lamp, 508electron microscope, 508light microscope, 508ultrastructure, 509
argon laser trabeculoplasty (ALT), 513–514clinical diagnosis
dense deposition, 510, 511typical gonioscopic appearance, 510, 511
definition, terminology and prevalance, 507differential diagnosis
cataract surgery, 512IOP characteristics, 511
evolution, XFS, 510genetics, 96medical therapy
IOP characteristics, 512POAG, 512–513
surgery, 514–515EX-PRESS shunt devices
gonioscopic view, 800sapphire blade, 799schematic diagram, 798vs. trabeculectomy, 800
Extensive conjunctival scarring, 816Eye codes, 385
FFerritin abnormalities, 1012Filtering blebs, surgery complications
early failure, 854–855encapsulated type, 855–856late failure, 855ocular infection, 856–857symptomatic type, 856
Flash (ERG) electroretinogram, 265Flow restriction techniques, 819
Flow-restrictive drainage devices. See Valved implants5-Fluorouracil (5-FU), 777Focal ischemic disc, 199Folic acid
exfoliation syndrome (XFS), 660homocysteine, 660
Fornix-based flap techniqueadvantages and disadvantages, 772creation steps, 772postoperative complications, 768
Fresnel prisms, 367–368Fuchs’ endothelial dystrophy (FED)
angle closure glaucomaanterior chamber, 557bilateral endothelial dystrophy, 557
AQP1, 558collagen VIII gene, 558oxidative stress and apoptosis, 558primary open angle glaucoma, 557
Fuchs’ uveitis syndrome (FUS)etiology and pathogenesis, 541history and clinical features
cataracts, 540–541iris changes, 539subtle heterochromia, 539vitreous debris, 540
managementmedical and surgical therapy, 542prognosis, 541
FUS. See Fuchs’ uveitis syndrome
GGanfort, 616, 631, 634, 635, 970, 1018GDx, 215–216Gene therapy, 985–986Genetics
angle closure glaucoma, 97congenital glaucoma, 96definitions and nomenclature
gene and exons, 91–93inheritance, 91–92mutations and diseases, 92–93polymorphism, 94single nucleotide polymorphisms (SNPs), 94transcription factors, 93–94
early observations, 94exfoliation glaucoma, 96genes and loci associated, 92gene therapy, 97genetic testing, 97–98mesodermal dysgenesis syndromes, 97open angle glaucoma (OAG), types
genetic loci, 95gene variants, 95–96
pharmacogenetics, 98, 985potential phenotypic differences, OAG, 93
Gentle digital pressure, 67Ghost cell glaucoma, 314, 563–564
anterior chamber aspirate, 556cataract surgeries, 555definition, 555diagnosis, 555IOP reduction, 555
Ginkgo biloba extract (GBE)bioactive compound, 660diabetic retinopathy, 661
1029Index
neuroprotective, 660–661protective effects, 660
Ginseng RB1/RG3, 661Glaucoma drainage implants, PK-glaucoma, 883–884L-Glutathione, 661Glycerin, 613Goldmann applanation tonometry (GAT), 39, 55Goldmann equation, 35Goldmann perimetry. See Kinetic perimetryGoldmann-style 3 mirror lens, 404, 405Goldmann visual field testing (III-4e target), 340Gold microshunt suprachoroidal outflow device
fornix-based conjunctival peritomycomplications and medication usage, 810non-toothed forceps, 808–809nylon sutures, 809–810postoperative goniophotograph, 809scleral cutdown, 808toothed forceps, 808
implantation, 807interior view, 808models, 807schematic diagram, 808
Gonioscopyanterior chamber angle
ciliary body band (CBB), 314–315Schwalbe’s line, 315–316scleral spur (SS), 315trabecular meshwork (TM), 315
comparison, 283–285compression, 465concentric rings, 466direct and indirect method, 283–285four-mirror lenses, 288FUS, 539–540Goldmann lens technique, 288Goldmann three-mirror lens, 464, 465grading systems
Scheie system, 289Shaffer system, 289Spaeth system, 289–291
guidelines, 285–287indentation, 288–289Keoppe lens, 462lenses, 404Posner lens, 463–464Posner style goniolens, 314–315Sussman lens, 464synechiae charted, 466view, 287–288Zeiss lens, 465
Goniotomyindications, 573results, 574technique, 573–574
Grape seed proanthocyanidins, 661
HHandheld magnifiers, 361Handheld scanner/reader, 364–365Heidelberg retina tomographs (HRT), 209–210, 214–215Herpes simplex virus (HSV)
managementanti glaucoma medications, 547, 548anti-inflammatory agents, 547oral acyclovir and eye medications, 547
ocular areaconjunctival and stroma disease, 545dendritic/amoeboid ulcer, 545epithelial/stromal keratiti, 545–546intraocular pressure (IOP), 545keratouveitis, 545
pathogenesisenucleated eyes, 546keratouveitic glaucoma, 546trabecular meshwork cells, 546
types, 545Herpes zoster ophthalmicus (HZO)
management, 549–551varicella–zoster virus (VZV), 549
High pressure open angle glaucoma, 1011–1013Hill of vision
Humphrey field analyzer, 230procedure, 229schematic representation, 230sensitivity profile, 230testing
lens induced artifacts, 233rim defects, 234–235
visual field defects, 231Home tonometers, 61Humphrey field analyzer (HFA)
multiple field analysis, 257single field analysis
deficit features, 257gaze tracking, 255information interpretion, 255–257retinal ganglion cell arrangements, 257–258total and pattern deviation probability plots, 254
test frequency, 253–254Humphrey visual field, 81Hyaluronic acid receptor CD44 (sCD44)
Alzheimer’s diseaseectodomain shedding of CD44 and B-amyloid, 941, 942metalloproteinase inhibitors, 942protein kinase C activators, 943putative phosphorylation and influence, 943
antagonists, 947aqueous humor concentration, 943–944cell growth and survival
casein kinase II inhibitors, 946CD44 transmembrane receptor, 945human TM cells, 946, 947phospho-specific western blot analysis, 946RGC-5 cells, 946, 947
cell signaling, 945disease process, 944–945ectodomain shedding, 941internalization, 947–948NF-kB and lactate stress, 948
Hyperosmotic agentsintravenous (IV) mannitol, 612–613oral glycerin, 613side effects, 613–614
Hyphema, 563, 565Hypopyon, 314Hypotensive lipids (HLs)
bimatoprost, 27–30, 307, 415, 513, 548, 573, 593, 599–605, 615, 616, 629–635, 685, 897, 966, 970
chemical structure, 601cystoid macular edema (CME), 604first-line agents, 600–601
1030 Index
Hypotensive lipids (HLs) (Con’t)functional activity, 602–603lash changes, bimatoprost, 604–605latanoprost, 27–30, 51, 56, 75, 414, 513, 548, 573, 585, 591, 593,
599–604, 615, 616, 629–635, 637, 638, 644, 674, 685, 686, 897, 966, 970
Lumigan, 304, 600, 638, 966ocular-related side effects, 604prostaglandin FP receptors, 601–603Rescula, 600, 966systemic side-effects, 603–604Travatan, 304, 414, 592, 600, 966Travatan Z, 592, 600travoprost, 27–29, 56, 87, 415, 513, 573, 591, 593, 599–604, 615,
616, 629–635, 685, 966unoprostone, 600, 601, 685Xalatan, 60, 304, 600, 966
HypothyroidismICD-9 diagnosis, 695mucopolysaccharide deposition, 695open-angle glaucoma, 695–696relationship, 696
Hypotonyglaucoma drainage devices, 823maculopathy (HM)
disc edema and chorioretinal folds, 845–846occurence and diagnosis, 847scleral flap suture, 846
serous choroidal effusions, 867surgery complications
choroidal effusions, 842corneal edema and Descemet’s folds, 842flat anterior chamber, 842–844management, 841treatment, 845–847
IImmunology
glaucoma vs. immune responses, factors, 929neurodegenerative disease
abnormal accumulation, 926–927apoptotic signals, 927excessive glutamate, increased calcium levels, and excitotoxic-
ity, 926intraocular pressure (IOP), 925neurotrophins and growth factors, 926oxidative stress and free radicals, 926
pharmacological neuroprotection, 927potential glaucoma therapy, 928–929retinal ganglion cells (RGCs)
anti-self T cells, 928immune system, 927protective autoimmunity, 928
Implantable pressure transducer, 61–63Improved techniques
adherence, sustained drug delivery implants, 1006anterior segment, optical coherence tomography, 999, 1000aqueous outflow, 1004automated diagnosis, 1003–1004diagnosis
optical disc photographs, 998three-dimensional optical coherence tomography, 998, 999
Doppler OCT, 1001Dynamic Contour Tonometry (DCT), 996intraocular pressure (IOP) measurement, 995iTrack Microcatheter, 1007
ocular disease, (SD-OCT), 1000, 1001ocular response analyzer (ORA), 996stent and shunt devices, 1004–1006surgery, ocular ultrasound system, 1004swept source OCT, 1001telemedicine, 997Trabectome, 1007visual field, 1002
Incisional therapiescanaloplasty
aqueous humor, 796–798emerging devices, 795Schlemm’s canal devices, 800–807subconjunctival filtration device, 798–800suprachoroidal gold microshunt device, 807–811
fibrin glue, 851–852glaucoma drainage devices
categories, 813clinical outcomes, 820–823complications, 823–824design features, 816elevated pressure, 827–828indications, 816–817nonvalved implants, 816surgical techniques, 817–820valved implants, 813, 816
iStentdevelopment, 831–832goniophotograph, 832–833surgical techniques, 832–837
physiologic function restoration, surgery, 831surgery complications
bleb-related ocular infection, 856–857early bleb leak, 851filtering bleb failure, 854–855hyphema, 848–849hypotony and overfiltration, 841late bleb leak, 853–854malignant glaucoma, 849–850postoperative suprachoroidal hemorrhage, 842–844releasable sutures, 848symptomatic blebs, 856types, 841wipe-out phenomenon, 850–851
trabeculectomy surgeryadults, 789–794alternative filtration routes, 765anesthesia, 765–766anterior chamber paracentesis, 774anticoagulants, 769–770antimetabolites, 777–780conjunctival closure, 781–782conjunctival incision, 768, 771corneoscleral flap, 766eye exposure, 766, 768flap suturing techniques, 776–777guarded filtration procedure, 765intraocular pressure (IOP), 767–768peripheral iridectomy (PI), 781postoperative follow-up, 782–786scleral flap, 774–776traction suture, 768
tube shunt surgeryhypertensive phase (HP), 824–826Tube Versus Trabeculectomy Study (TVT), 814–815
Infantile, childhood, and juvenile glaucomas
1031Index
clinical examinationangle appearance, 571–572examination-under-anesthesia (EUA), 572infantile glaucoma, 571iris and pupil, 571medical and family history, 571optic nerve head, 572tonometry, 571
clinical featuresPCG diagnoses, 570signs and symptoms, 570
epidemiology and geneticsanterior segment dysgenesis, 569chromosome locus, 569evaluation, 569–570
nomenclaturedevelopmental glaucoma, 567genetic basis, 567primary and secondary pediatric glaucomas, 568
pathophysiologyangle histopathology, 569PCG, 568Schlemm's canal and trabecular meshwork, 569
treatmentbeta-adrenergic agonist, 573beta-adrenergic antagonists, 573cyclodestruction, 576glaucoma drainage devices, 575–576goniotomy, 573–574oral carbonic anhydrase inhibitors, 572prostaglandin analogues, 573trabeculectomy, 574–575trabeculotomy, 574
Inflammatory disease, elevated IOPmechanisms
affects, 527clinical classification, 527–530
uveitis patientsprinciples, 530–531therapeutic armamentarium, 531–532treatment, 532–535
Inflammatory ocular hypertension syndromes (IOHS) management, 532Inline closed-circuit television (CCTV), 362Insurance coding
office servicesdiagnosis, 386–387office procedures, 385–386patient past visits, 384service level, 385special tests and exam modifiers, 385
postoperative period, 387–388surgical procedures, 387
Interleukin-1 (IL1) autocrine loop disruption, 1012Intermediate uveitis, 534Intraocular pressure (IOP)
Advanced Glaucoma Intervention Study (AGIS), 51aqueous humor production and outflow
ciliary body, 36Goldmann equation, 35
clinical import, 56–57continuous monitoring method
current methods and limitations, 59–60home tonometers, 61implantable pressure transducer, 61–63necessity, 60–61
cyclic oscillations, 54
distribution, 41diurnal role, 54exfoliative glaucoma (XFG), 507early manifest glaucoma trial (EMGT), 51history, glaucoma link, 35influencing factors
cardiac pulse wave, 42circadian and seasonal variation, 41–42fluid intake, 42–43nutrition and recreational substances, 43physical exercise and postural changes, 42respiration and valsalva maneuver, 42
intravitreal triamcinolone (IVTA) effectsdelayed, 672early, 671–672immediate, 672
long-term IOP fluctuation, 51measurement
Dynamic Contour Tonometry (DCT), 40Goldmann applanation tonometry (GAT), 39noncontact air puff and tono-pen tonometry, 40phasing, 12pneumatonometer, 40Schiotz tonometry, 41telemetry and water-drinking test, 12transpalpebral scleral palpation, 40
medication efficacy analysisaqueous suppressants, 56nocturnal measurements, 56
medications influencecorticosteroids, 43drug-induced intraocular hypertension, 43general anesthetics, 44pupillary block, 43–44
nocturnal and diurnal IOP, 55ocular hypertensive patients, 53randomized clinical trials
Advanced Glaucoma Intervention Study (AGIS), 37Collaborative Initial Glaucoma Treatment Study (CIGTS), 37Collaborative Normal Tension Glaucoma Study (CNTGS), 36–37Early Manifest Glaucoma Trial (EMGT), 38Ocular Hypertension Treatment Study (OHTS), 37–38
rapid oscillations, 52risk factor, glaucoma development, 38target IOP, 44tonometry measurements, 54
Intraoperative considerations, 913–914Intravitreal colchicine, 220Intravitreal gas, 918–919Intravitreal triamcinolone (IVTA)
indications, 671intraocular pressure (IOP) elevation
delayed, 672early, 671–672immediate, 671
pharmacokinetics, 671Intravitreal triamcinolone acetate, 991–992Iopidine, 609, 716, 725Iridocorneal endothelial (ICE) syndrome
clinical variations, 553Cogan-Reese syndrome, 554corneal endothelium, 553glaucoma prevalence and surgical intervention, 553
Iridoplastyhistory, 727surgery and postoperative care, 727–728
1032 Index
Iridotomycomplications, 727history, 725postoperative care, 726–727preparation, 725treatment and laser system settings, 725–726
Iris bombe, 528, 529Iris heterochromia, 530Iris hooks, 899Irradiance, 753, 754Ismotic, 612, 613Isosorbide, 44, 472, 494, 612, 613Istalol, 599, 600iStent
development, 831–832goniophotograph, 832–833implantation
applicator tubing, 834sequence, 835with and without cataract surgery, 836
surgical techniquesimplantation, 834–837trabectome trabecular excision, 836–838
iTrack Microcatheter, 1007
KKeoppe lens, 464Keratouveitis, 546, 550Kestenbaum's vision rule, 359Kinetic perimetry
binocular testing, 237–238grayscale and sensitivity, 237polar and Cartesian coordinate systems, 237suprathreshold static type, 237
Koeppe nodules, 539Krukenberg spindle, 499, 500Kurzweil-National Federation of the Blind Reader, 364–365
LLaser assisted in situ keratomileusis (LASIK) effects, 424–425Laser Doppler flowmeter (LDF), 124–125Laser iridoplasty technique
acute angle closure, 742–743clinical assessment
ancillary testing, 744examination, 743–744history, 743
crystalline lens, 741lens extraction, 743malignant or ciliary block, 743pupillary block, 741pathophysiology and mechanism
anatomic levels, 741angle closure, 741–742plateau iris, 741pupil block, 741
phacomorphic glaucoma, 743plateau iris syndrome, 742primary angle closure (PAC) management, 742quantitative imaging techniques, 746technique
coherence tomography image, 745complications, 746contraction burns and laser setup, 745pilocarpine, 744posttreatment, 746
risks, 744–745Urrets-Zavalia syndrome, 746
Laser therapyangle closure mechanism
iridoplasty, 727–728iridotomy, 725–727pupilloplasty and pupillary sphincterotomy, 728–729
bleeders coagulation, 735ciliary body
complications, 732endoscopic photocoagulation treatment, 731–732history, 730–731indications and contraindication, 730IOP reduction, 732–733preparation, 731surgery and postoperative care, 731TSCPC treatment, 731
cyclophotocoagulationendoscopic, 750–751techniques/features, 750
indications, 749inflow
cyclophotocoagulation, 760endoscopic cyclophotocoagulation, 760–762
iriscorneal edema and angle closure, 723–724indications and contraindications, 723
light properties and parametersabsorption path length, 753irradiance, 753principles, 753tissue interaction, 753
micropulse diode laser trabeculoplasty (MDLT), 757–758Nd:YAG laser, 749neovascular glaucoma, 735nonpenetrating deep sclerectomy (NPDS), 759occluded inner ostium, 734–735outflow
argon laser trabeculoplasty (ALT), 755excimer laser trabeculostomy, 755
peripheral iridotomy, 531process, 713sealing hypotonous cyclodialysis clefts, 734suture lysis, 733–734technique and treatment pararmeters comparison, 736titanium, sapphire laser trabeculoplasty (SLT), 757trabecular meshwork
history, 714–716indications and contraindications, 714methods, 717–723
Laser trabeculoplasty, 531, 675LASIK effects. See Laser assisted in situ keratomileusis effectslatanoprost, 27–30, 51, 56, 75, 414, 513, 548, 573, 585, 591, 593,
599–604, 615, 616, 629–635, 637, 638, 644, 674, 685, 686, 897, 966, 970
Latisse, 604Latrunculia magnifica, 956Lebensohn's vision rule, 360Leber's hereditary optic neuropathy (LHON), 276levobunolol, 599, 600, 629, 631Limbal-based flap technique
advantages and disadvantages, 773creation steps, 773postoperative complications, 768
Lumigan, 304, 600, 638, 966Limited pars plana vitrecomy (LPPV), 910
1033Index
Localized neuroretinal rim loss, 205Localized RNFL loss, 205–206Low vision
blindness networking systemsorganizations, 378–379primary service providers, 376–377reimbursement sources, 377–378
contact lensescomplications, 359fitting characteristics, 357–358uses, 358–359
examination sequencehealth history, 353observation, 353ocular history, 353–354social history, 354
field enhancement devicesamorphic lens, 369electronic type, 369–370field expanders, 365–366Fresnel prisms, 367–368glare control, 370–372inwave channel lenses, 368minus lenses, 366reverse telescopes, 368–369scanning, 365
glare, 352lighting, 372magnification
computer screen programs and reader, 363–364electronic magnifiers, 362–363handheld magnifiers, 361handheld scanner/reader, 364–365Kestenbaum's rule, 359Lebensohn's rule, 360microscopes, 360stand magnifiers, 361–362
non-optical devicesadaptive and talking devices, 374–375embossed paper and large-print checks, 374labeling systems, 375–376plasticized and bold line marker, 373–374signature guides, 373tactile dots, 373talking books, 376typoscopes, 372–373
PRL and eccentric fixation training, 372vision rehabilitation, 352–353visual acuity
blindness standard, 352measurement, 354–357
visual field loss, 351–352Lutein, 662
MMalignant glaucoma
anterior chamber, 495argon laser treatment, 495classic, 489, 490clinical manifestations, 489, 490clinical picture consistent, 490, 491contralateral eye management, 496differential diagnosis
choroidal effusion, 493overfiltration and wound leakage, 494pupillary block, 493
suprachoroidal hemorrhage, 493–494ultrasound biomicroscopy (UBM), 494
medical and surgical management, 494–495non-phakic, 490–491pathogenesis
aqueous misdirection or posterior aqueous diversion, 490, 491ciliary block, 491vitreous cavity, 491, 492vitreous mechanisms, 492
surgery complicationsmanagement, 849–850prevention, 850
surgical therapy, 495–496Malyugin ring, 900mannitol, 472, 483, 484, 494, 612–615, 908McCannel suture technique, 874Medical insurance
codingoffice services, 384–387postoperative period, 387–388surgical procedures, 387
infrastructurebilling department, 383–384imperative items, 384
reconciliation, 388resources and suggestions, 388
Medical legal considerations, glaucoma careclinical practice guidelines, 394compliance
drug side effects, 392–393physician instructions, 392
patient expectationscomplaints, 394postsurgical recovery, 393–394
prognosis and diagnosis errors, 391standard therapy, 395triage, 392
Medical therapiesaqueous outflow, 983–984beta-adrenergic antagonists, 598–600carbonic anhydrase inhibitors (CAI), 605–608challenges, 983drug delivery methods, 986drug selection characteristics, 596–597gene therapy, 985–986genetics and pharmacogenomics, 985hyperosmotics, 612–615hypotensive lipids (HLs), 600–605intraocular pressure-lowering effects, 600new glaucoma pathogenic pathways, 985parasympathomimetic agents, 610–611sympathomimetic agonists, 608–610targeting glaucomatous retinopathy and optic neuropathy, 984treatment options and timeline, 598
Mesodermal dysgenesis syndromes, 97methazolamide, 494, 565, 572, 605, 606, 608, 634, 681Methylcobalamin, 662metipranolol, 599, 629, 631Micropulsed diode laser trabeculoplasty
anterior chamber angle, 718laser energy, 715postoperative care, 718tissue temperature interpretation, 717treatment and settings, 717–718
Micropulse diode laser trabeculoplasty (MDLT), 757–758Migraine, ocular blood flow, 119–120
1034 Index
Miotic agents. See Parasympathomimetic agentsMiotics, systemic side effects
pharmacology and physiologycholinomimetics classes, 684neural pathways, 684–685
systemic toxicity, 685Mitomycin C (MMC), 777, 820, 861–862Molteno implants, 816Monocular photography, 224Monocular therapeutic drug trial, IOP reduction
circadian rhythm, 644clinical utility, 643contralateral crossover, 644drug efficacy assessment, 645–646lowering medication, 644medical therapy, 643patient use, 644–645retrospective evaluation, 645spontaneous variation, 643–644
Moorfields regression analysis (MRA), 214Morcher pupil dilating ring, 900Multifocal (mfERG) electroretinogram
advanced instrumentation, 1002diagnosis, 266
Multifocal visual evoked potential (VEP), 1002Multiple sphincterotomies, 898Myocillin
locus, 96optineurin, 96prevalance, 95TIGR sequence homology, 95
Myocillin GLC1A, 1010Myopic disc, 199Myosin light chain phosphatase (MLCP), 955
NN-Acetyl-l-cysteine, 662Nasolacrimal occlusion digital massage technique, 594Natural compound treatments
alpha-lipoic acid, 657alpha-tocopherol and tocotrienol, 658carnitine, 658citicoline
brain pharmacotherapy, 658–659phospholipids biosynthesis, 659retinal ganglion cells (RGCs), 659
coenzyme Q10, 659curcumin
beneficial effect, 659diabetic cataract, 659–660neuroprotective, 659
Dan shen (Salvia miltiorrhiza), 658fish oil and omega-3 fatty acids
age-related macular degeneration (ARMD), 658oxidative damage, 657–658retina protection, 658types, 657
folic acidexfoliation syndrome (XFS), 660homocysteine, 660
Ginkgo biloba extract (GBE)bioactive compound, 660diabetic retinopathy, 661neuroprotective, 660–661protective effects, 660
Ginseng RB1/RG3, 661
grape seed extract, 661green tea catechins, 662hemorheologic abnormalities, 657L-glutathione, 661lutein and zeaxanthine, 662methylcobalamin, 662N-acetyl-l-cysteine, 662neuroprotection, 657optic nerve head perfusion, 657pycnogenol
angiotensin-converting enzyme (ACE), 663composition, 662cytotoxicity, 663oral administration, 662vascular endothelial cells, 663
quercetin, 663resveratrol, 663taurine, 663–664
Neovascular glaucoma (NVG), 733clinical presentations, 518–520 diabetes, 520–522differential diagnosis, 517–518pathophysiology, 517treatment
anti-VEGF, 523aqueous shunts, 523–524cyclophotocoagulation, 524medical therapy, 523pan-retinal photocoagulation (PRP), 522trabeculectomy, 523
Neptazane, 606Neuroprotection, retinal ganglion cells
causesexcitotoxicity and antioxidantsgene therapyimmune systemnatural compoundsneurotrophinstechnique
Nitric oxide synthase, 648N-methyl-d-aspartate (NMDA) antagonists, 647Nocturnal hypotension, ocular blood flow, 116Nocturnal IOP
24H IOP curves, 55pneumatonometry measurement, 55
Nominal scale distributions, 152Nonarteritic anterior ischemic optic neuropathy (NAION), 270–271Noncontact air puff tonometry, IOP, 40Nonglaucomatous optic neuropathy
vs. glaucomaafferent pupillary defects (APD), 272Alzheimer’s disease, 276clinical features, 270compressive lesions, 275cupping, 270–272intermittent IOP elevation, 276–277nasal step, 272optic nerve excavation, hereditary, 276optociliary shunt vessels (OCSV), 274–275peripapillary nerve fiber hemorrhage, 274prevalence, 270shock, 275–276temporal visual field defects, 272–274traumatic, 276
neuro-imaging, 279neuroprotection, 277
1035Index
prophylactic IOP lowering, 277vascular events mimicking, 278–279
Nonpenetrating deep sclerectomy (NPDS), 759Nonselective beta-blockers, 599Nonvalved implants, Baerveldt and Molteno type, 816Norepinephrine, 594Normal pressure glaucoma. See Normal tension glaucoma (NTG)Normal tension glaucoma (NTG)
argon laser trabeculoplasty (ALT), 450–451definition, 421differential diagnosis, 448epidemiology
clinical studies, 422population studies, 421–422
filtering surgery, 451–452IOP-lowering treatment
Collaborative Normal Tension Glaucoma Study (CNTGS), 448–450compliance issues, 450differential diagnostic possibilities, 449elements of the medical and ocular exam, 449–450medications, 450
non-IOP-lowering therapy, 452–454vs. primary open angle glaucoma (POAG), 270risk factors
IOP-related, 422–425optic-nerve related, 425–434
sleep apnea syndrome (SAS), 135systemic factorsmigraine headache and Raynaud’s phenomenon, 445–447
obstructive sleep apnea syndrome, 448visual field defects
age, gender and refractive error, 444–445patterns of loss, 433–436progression characteristics, 436–445
Neurotrophic keratitis, 550
OObstructive sleep apnea (OSA)
apnea/hypopnea index (AHI), 135diagnosis, 702glaucoma prevalencenormal-tension glaucoma (NTG), 136polysomnography result, 135prevalence, 701–702relationship, glaucoma, 703retinal nerve fiber layer (RNFL), 136sleep disordered breathing (SDB), 135treatment, 136
Occluded inner ostium, 734–735OCT. See Optical coherence tomographyOcular blood flow
anatomycentral retinal artery, 112–113ophthalmic artery, 112uveal system, 113
ischemia and optic neuropathyretinal ganglion cells, 111vascular role, 112
measuring methodscanon laser Doppler flowmeter (CLBF), 124color Doppler ultrasound imaging, 121–122confocal scanning laser Doppler flowmeter (CSLDF), 125–126laser Doppler flowmeter (LDF), 124–125pulsatile ocular blood flow, 126–128retinal oximetry, 128–129retina vessel analyzer (RVA), 128
scanning laser ophthalmoscope (SLO), 122–124open angle glaucoma (OAG), 115–119optic nerve vascular anatomy
lamina cribrosa and the retrolaminar region, 113–114prelaminar region, 113superficial nerve fiber layer, 113–114
prospective studies, glaucoma patients, 120regulation
angiotensinconverting enzyme (ACE), 115autonomic nervous system, 114endothelins, 115extrinsic and intrinsic controls, 114soluble vasoactive molecules, 114–115superoxide anions, 115
signs and conditionsdiabetes, 120disc hemorrhages, 119migraines, 119–120
vascular risk factors, OAGnocturnal hypotension, 116ocular perfusion pressure, 116–119systemic hypertension and hypotension, 115–116
visual function and structureneuroretinal rim blood flow, 129ocular perfusion pressure (OPP), 129retrobulbar blood flow, 129
Ocular Hypertension Treatment Study (OHTS)central corneal thickness (CCT), 79, 105–106randomized clinical trials, IOP, 37–38
Ocular perfusion pressure (OPP), 195, 411–413Ocular trauma
diagnosis, 561early onset glaucoma
chemical injuries, 563hyphema, 563intraocular inflammation, 561–562trabecular meshwork injury, 563
epidemiology and pathogenesis, 561late onset glaucoma
angle recession, 563cyclodialysis cleft closure, 564epithelial downgrowth, 564ghost cell glaucoma, 563–564lens injury, 564retained intraocular foreign body, 564rhegmatogenous retinal detachment, 564secondary angle closure, 564
treatmentangle recession and ghost cell glaucoma, 565hyphema, 565medical and surgical management principles, 564–565
Ocupress, 599, 600Omega-3 fatty acids
age-related macular degeneration (ARMD), 658oxidative damage, 657–658retina protection, 658types, 657
Open angle glaucomaclinical information, 200findings, 201fluorescein angiography, 199glaucoma populations, 201–202optic nerves, 199principal component analysis, 201stereo optic disc photographs, 199
Open tube drainage devices. See Nonvalved implants
1036 Index
Ophthalmic assistant–patient interviewchart review, 303Glaucoma Consultation Report, 327–334information recording
central corneal thickness (CCT), 305current eyeglasses, 305demographic, 304pupillary responses to light, 306tonometry, 306–307visual acuity, 304–305visual fields, 305–306
language translation, 303open-ended and directed questions, 304
Ophthalmic literature evaluationBland–Altman analysis, 153citations, 142discussion section, 141–142distributions
density function, 146mean, median and mode, 146measures of variability, 146–147null hypothesis, 145statistical power, 145
figures, tables, and graphs, 142measurement scales, data types
ordinal and interval data, 144ratio, nominal and timeline data, 144robust test, 145student’s t-test, 145
methods, 153publishing criteria, 140randomization
double-masked experimental treatments, 143key elements, 143post hoc analysis, 144
results section, 141reviewing process, 152–153statistical testing
clinically significance, 149inference, 147level of statistical significance, 147sample size, 148study power, 148
statistic essentials, box of truth, 142–143tests and errors
analysis of variance (ANOVA), 150confounding, 151nominal and binomial scale distributions, 152nonparametric test, 151–152parametric tests, 149–150parametric vs. non-parametric statistical tests, 149Poisson test, 152
Optical coherence tomography (OCT), 79, 210, 215, 220, 467drawback and advantage, 294iris, pigment dispersion, 299narrow angle, plateau component., 297normal angle, 295pupillary block angle closure, 296time domain, 294
Optic nervesanatomy
intralaminar, 169normal optic disc, 170optic disc, 169retinal nerve fiber layer (RNFL), 169retrobulbar, 170
camerasCanon CR-1, 226Nidek AFC-230-210, 225, 226Topcon TRC-50DX, 227
comparisons, 425, 433differential diagnosis
anterior ischemic optic neuropathy (AION), 178–181compressive optic neuropathy, 182–183congenital optic disc pits, 182morning glory syndrome, 181–182optic disc drusen (ODD), 181optic neuritis, 181
digital imaging devicescomparison, 210confocal scanning laser ophthalmoscopy (CSLO), 209–210,
214–215detecting ability, 210GDx, 215–216optical coherence tomography (OCT ), 210, 215progression assessing ability, 216scanning laser polarimetry (SLP), 210
examining methodsdirect ophthalmoscope, 170indirect ophthalmoscopy, 171optic disc photography, 171retinal nerve fiber layer examination, 171RNFL and optic disc analyzers, 172
focal ischemic discs, 430, 431generalized optic cup enlargement, 431head (ONH)
biomechanics, 185–188clinical implications, 188–191cupping, 185, 188IOP-related stress and strain, 186lamina cribrosa, 185
myopic glaucomatous discs, 431neuroretinal rim loss, 431optic disc evaluation
classification systems, 172disc asymmetry, 175disc damage likelihood scale (DDLS) determination, 173–174disc drawing, 172hemorrhages, 176neuroretinal rim size, shape and pallor, 175peripapillary atrophy (PPA), 176size, 174–175
optic disc hemorrhages (ODHs), 431–432optic disc size, 425patterns of, 426–430peripapillary atrophy (PPA), 432–434photography
black and white, 223digital fundus, 225–226monocular, 224Polaroid, 227retinal nerve fiber layer (RNFL), 223–224stereo color, 224–225
progressive damage evaluationdisc hemorrhages, 206neuroretinal rim loss, 204–205optic disc photographs, 203quality evaluation, 203–204retinal nerve fiber layer (RNFL) loss, 204–206
senile sclerotic discs, 431stereo image viewing frequency, 227–228structural changes, 176–178
1037Index
OptiPranolol, 599Optineurin, 96Optineurin GLC1E, 1011Oral carbonic anhydrase inhibitors, 572, 605–606Osmitrol, 612, 613Osmoglyn, 612, 613Overfiltration and wound leakage, 494
PPAC. See Primary angle closurePACG. See Primary angle-closure glaucomaPachymetry
advantages and disadvantages, 85anterior segment optical coherence tomography (AS-OCT), 84central corneal thickness CCT measurement, 84–86consistency, 85Goldmann applanation tonometry (GAT), 85partial coherence interferometry, 85ultrasound, 84
PACS. See Primary angle-closure suspectPanretinal photocoagulation (PRP), 522Parasympathomimetic agents
classes, 610local and systemic side effects, 611
Pars plana tube insertion devices, 820Pars plana vitrectomy, 919Partial radial sphincterotomy, 898Pathogenesis
malignant glaucomaaqueous misdirection or posterior aqueous diversion, 490, 491ciliary block, 491vitreous cavity, 491, 492vitreous mechanisms, 492
POAGaqueous humor, 411ocular perfusion pressure (OPP), 411–413population studies, OPP, 411proteoglycan biosynthesis and degradation, 411–413
Patient examinationconsultation reports and dictations, 320digital image analysis, 319dilation, 316gonioscopy
anterior chamber angle, 314–316Posner style goniolens, 314–315
indigent patients, 319intake process
consent for dilation, 303, 325consent for medical photography, 303, 326Medical History Questionnaire (MHQ), 302, 321–322ophthalmic assistant role, 303–307physician role, 307welcome letter, 302–303, 323–324
ophthalmic assistant rolechart reviewglaucoma consultation report, 327–330information recording, 4–7language translationopen-ended and directed questions
physician role, 307refill requests, 319–320slit-lamp
anterior chamber (AC), 313–314conjunctiva, 308–309cornea, 309–313extraocular muscles and lids, 307
iris, 308lens, 316optic nerve and retinal nerve fiber layer, 317pupils, 307–308retina, 317–319
telephone appointment booking processmedical records, 301visual field print-out, 302Zeiss-Humphrey visual field examination (HVF), 302
Pattern (PERG) electroretinogram, 265–266Penetrating keratoplasty (PK)-glaucoma
incidence and medical therapy, 883mechanisms, 883surgical management
cyclophotocoagulation (CPC), 884glaucoma drainage implants, 883–884trabeculectomy with mitomycin C, 883
Peng Khaw’s adjustable suture technique, 777Peripapillary atrophy (PPA), 195Peripheral anterior synechia (PAS), 519Peripheral iridectomy (PI), 781Peripheral iris, 499, 501Phacoemulsification surgery, 762Phacotrabeculotomy, 794Pharmacokinetics, Intravitreal triamcinolone (IVTA), 671Phospholine, 611, 684, 685, 767Photodisruption, 753Photorefractive keratectomy (PRK) effects, 424–425Photovaporization, 753Physician Quality Reporting Initiative (PQRI), 389Pigmentary dispersion syndrome (PDS)
asymmetric or unilateral, 502differential diagnosis, 502examination, 501–502inheritance, 502–503pathophysiology
iris transillumination defects, 499, 500Krukenberg spindle, 499, 500mechanisms, 499peripheral iris, 499, 501pupillary block, 499trabecular meshwork, 499, 500
presentation, 500–501temporal evolution, 503treatment, 503–504
pilocarpine, 26, 73, 75, 149, 304, 359, 414, 451, 472, 475, 476, 484, 503, 504, 531, 573, 586, 595, 598, 600, 608, 611, 633–635, 652, 657, 684, 685, 725, 744, 746, 767, 803, 844, 892, 909
Plateau irisanterior segment imaging, 468configuration and syndrome, 463
Pneumatonometer, IOP, 40Polaroid photography, 227Portable lightweight handheld electronic magnifiers, 363Posner lens, 465–466Posner–Schlossman syndrome (PSS), 537Posner style goniolens, 314–315Posterior aqueous diversion syndrome. See Malignant glaucomaPosterior corneal lamellar surgery, DSEK, 886Posterior uveitis, 534–535Post-herpetic neuralgia (PHN), 549, 550Postoperative bleb evaluation
anatomical sites, 783–784bleb leakage, 785flat blebs, 785–786iris tissue, 786
1038 Index
Postoperative considerations, 913–914Preferred retinal locus (PRL), 372Pregnancy
glaucoma therapyb-blockers, 674concentration and frequency, 674–675medications' effects, 673–674miotics, 674prostaglandin analogs, 674
intraocular pressure (IOP), 673laser trabeculoplasty, 675
Preoperative considerations, 913Primary angle closure (PAC)
acute and sub-acutelaser and surgical treatment, 472–473medical treatment, 472narrow or occludable anterior chamber angle, 473–475signs, 471–472symptoms, 471
management, 742risk factors
age, race and gender, 470biometrics, 470–471genetic predisposition, 470iris cross-sectional area, 471
Primary angle-closure glaucoma (PACG), 462Primary angle-closure suspect (PACS), 461Primary congenital glaucoma (PCG)
angle histopathology, 569diagnoses, 570epidemiology and genetics, 569–570infantile, 567trabecular meshwork, 569
Primary open angle glaucoma (POAG)CD44
cell growth and survival, 945–947cell signalling, 945functions, 939interactions, 939–940localization, 941NF-kB and lactate stress, 948
clinical assessmentgeneralized enlargement, 406glaucoma suspect situation, 409–410Goldmann-style 3 mirror lens, 404, 405gonioscopy lenses, 404nerve fiber layer hemorrhage, 408preferred practice pattern (PPP), 405superior nerve fiber layer hemorrhage, 408thin rim inferiorly with nerve fiber layer, 408vertical elongation, 434–436Zeiss-style 4 mirror lens, 404
cost, 414definition, 400genetics, 400–401Gonio lens
narrow angle, 401open angle, 400
pathogenesisaqueous humor, 411population studies, OPP, 411proteoglycan biosynthesis and degradation, 411–413
patient unawareness, 399, 400risk factors
early manifest glaucoma trial (EMGT), 401, 402intraocular pressure (IOP), 401
ocular hypertensives (OHTS), 401types, 403
risk of monocular or binocular blindness, 399, 400sCD44
Alzheimer’s disease, 941–943antagonists, 947aqueous humor concentration, 943–944cell growth and survival, 945–947cell signaling, 945disease process, 944–945ectodomain shedding, 941internalization of, 947–948NF-kB and lactate stress, 948
treatment and compliance, 414–415Zeiss-style 4 mirror lens, 400
Primary open-angle glaucoma (POAG), 104PRK effects. See Photorefractive keratectomy effectsPrognosis
future treatment, 1019intraocular pressure (IOP), 1015open-angle glaucoma treatment, 1018–1019risk calculations, 1018risk factors, 1016–1017structural and functional changes, 1017–1018technologies, 1018
Progression characteristics, normal pressure glaucomaage, gender and refractive error, 444–445risk factors, 442, 443VF damage
color disc, 436, 439, 442dense paracentral VFD, 439–442SITA standard, 442–447
VF test, 436–442measurement
axon screamometer, 15functional and structural tests, 13provisos, 12visual loss effects, 13–15
Progressive iris atrophy, 553Propine, 591, 609, 972Prostaglandin analogs
bimatoprost, 27–30, 307, 415, 513, 548, 573, 593, 599–605, 615, 616, 629–635, 685, 897, 966, 970
latanoprost, 27–30, 51, 56, 75, 414, 513, 548, 573, 585, 591, 593, 599–604, 615, 616, 629–635, 637, 638, 644, 674, 685, 686, 897, 966, 970
Lumigan, 304, 600, 638, 966pseudophakic cystoid macular edema, 902Rescula, 600, 966systemic side effects
pharmacology and physiology, 685systemic reactions and clinical recommendations, 685–686
Travatan, 304, 414, 592, 600, 966Travatan Z, 592, 600travoprost, 27–29, 56, 87, 415, 513, 573, 591, 593, 599–604, 615,
616, 629–635, 685, 966unoprostone, 600, 601, 685Xalatan, 60, 304, 600, 966
Pseudo neovascularization, NVGclinical presentations
anterior segment NV, 518contraction, 520IOP rate, 520iris angiogram, 519massive end-stage fibrosis, 519peripheral anterior synechia (PAS), 519
1039Index
smooth muscle antigen (SMA), 519VEGF influence, 519
differential diagnosis, 515–518Pupillary block, 467–468Pupil management, 898–900Pupil-stretching technique, 899Purite, 591, 609, 631, 638Pycnogenol
angiotensin-converting enzyme (ACE), 663composition, 662cytotoxicity, 663oral administration, 662vascular endothelial cells, 663
QQ-switched laser, 713Quality of life (QOL) measurement
familiarity and application, 18human resources utilization, 18–19instruments, 18questionnaire, 19
Quercetin, 663
RRadial sphincterotomy, 898Rectangular scleral flap technique, 774–775Refractive surgery
intraoperative considerations, 913–914preoperative considerations, 913
Relative risk reduction (RRR), 30Rescula, 600, 966Resveratrol, 663Retinal ganglion cells (RGCs)
anti-self T cells, 928cell death mechanisms
apoptosis, 647excitotoxicity, 647genes control, 647metabolic substrates, 647neurotrophin, 647nitric oxide synthase, 648optic nerve, 648
Citicoline, 659histologic studies, 647immune system, 927neuroprotection
causes, 648–649excitotoxicity and antioxidants, 648gene therapy, 648immune system, 648natural compounds, 649technique, 649
protective autoimmunity, 928Retinal nerve fiber layer (RNFL)
photography, 223–224Retinal oximetry, 128–129Retinal surgery
intravitreal gas, 918–919panretinal photocoagulation, 918pars plana vitrectomy, 918scleral buckle, 917silicone oil, 919–920
Retina vessel analyzer (RVA), 128Retinopathy of prematurity (ROP), 517RGC nerve fiber layer, electroretinography, 265Rhegmatogenous retinal detachment, 564
Risk factorscentral corneal thickness (CCT)
case presentation, 79corneal hysteresis, 87–88correction factors, 87differences, 80–83drug effect, 87measuring methods, 83–87practical aspects, 88
geneticsangle closure glaucoma, 97congenital glaucoma, 96definitions and nomenclature, 91–94early observations, 94exfoliation glaucoma, 96genes and loci associated, 92gene therapy, 97genetic testing, 97–98mesodermal dysgenesis syndromes, 97pharmacogenetics, 98potential phenotypic differences, OAG, 93types of glaucoma, 94–96
intraocular pressure (IOP), 509, 545, 673Advanced Glaucoma Intervention Study (AGIS), 51aqueous humor production and outflow, 35–36clinical import, 56–57continuous monitoring method, 59–63cyclic oscillations, 54distribution, 41diurnal role, 54early manifest glaucoma trial (EMGT), 51history, glaucoma link, 35influencing factors, 41–43intravitreal triamcinolone (IVTA) effects, 671–672long-term IOP fluctuation, 51measurement, 39–41medication efficacy analysis, 56medications influence, 43–44nocturnal and diurnal IOP, 55ocular hypertensive patients, 53randomized clinical trials, EMGT, 38rapid oscillations, 52risk factor, glaucoma development, 38target IOP, 44tonometry measurements, 54
obstructive sleep apnea syndrome (OSA)apnea/hypopnea index (AHI), 135normal-tension glaucoma (NTG), 136retinal nerve fiber layer (RNFL), 136sleep disordered breathing (SDB), 135treatment, 136
ocular blood flowanatomy, 112–113ischemia and optic neuropathy, 111–112measuring methods, 120–129open angle glaucoma (OAG), 115–119optic nerve vascular anatomy, 113–114prospective studies, glaucoma patients, 120regulation, 114–115vascular risk factors, OAG, 115–119visual function and structure, 129–130signs and conditions
race/ethnicityage, 104–105incidence, 104Latinos, 102–103
1040 Index
Risk factors (Con’t)non-ocular risk factors, 107ocular risk factors, 105–106prevalence, 101primary open-angle glaucoma (POAG), 104variability, 103–104
SSapphire laser trabeculoplasty (SLT), 757Sara document reader, 364Scanning laser ophthalmoscope (SLO)
fluorescein angiography, 122–123indocyanine green angiography, 123–124
Scanning laser polarimetry (SLP), 210, 220Scanning peripheral anterior chamber depth analyzer (SPAC), 467sCD44. See Hyaluronic acid receptor CD44 (sCD44)Schiotz tonometry, IOP, 41Schlemm’s canal outflow
ab externo devicesdeep dissection, 801iScience microcatheter, 802laser goniopuncture, 804prolene suture and knots, 803scleral flap, 800–801trabeculodescemet window (TDW), 801–802
ab interno devicestrabectome handpiece, 805–807trabecular micro-bypass iStent, 805
distal system, 797proximal system, 796–797scleral flap
exposing technique, 790–792location, 790opening technique, 792–794
vs. trabecular meshwork, 797tubules, 1012
Schwalbe’s line, 315–316Scleral buckle, 917Scleral spur (SS), 315Sealing hypotonous cyclodialysis clefts, 734Selective alpha agonists, systemic side effects
pharmacology and physiology, 683systemic reactions, 683–684
Selective laser trabeculoplasty (SLT)anterior chamber angle, 718postoperative care, 716treatment and settings, 716
Senile sclerotic disc, 199Sequential stereoscopic optic disc photography
Allen stereo separator, 224manual shift technique, 224
Serologic evaluation, nonglaucomatous optic atrophy, 280Serous choroidal effusions
conservative management, 868diagnosis and symptomatology, 867filtering bleb and sclerostomy, 868vs. hemorrhagic choroidals, 867reform methods, 869
Silicone oil, 919–920Simultaneous stereoscopic optic disc photography, 224–225Sleep disordered breathing (SDB), 135Slit-lamp examination
anterior chamber (AC), 313–314conjunctiva, 308–309cornea, 309–313
extraocular muscles and lids, 307iris, 308lens, 316–317optic nerve and retinal nerve fiber layer, 317pupils, 307–308retina, 317–318
Smooth muscle antigen (SMA), 520Snuff syndrome, 850–851SPAC. See Scanning peripheral anterior chamber depth analyzerStand magnifiers, 361–362Statins
HMG-CoA inhibitors, 703immune activity and LDL lowering potential, 703medications, 704–705optic nerve injury, 704
Stem cells, 953–954Stereo color photography
sequential, 224simultaneous, 224–225
Sterile neurotrophic ulcer, 550Stress and agings, POAG, 936Stretch theory, 1012Stromal keratitis, 549, 550Student’s t-test, 145Subconjunctival filtration
anterior and posterior types, 796Ex-PRESS shunt devices
gonioscopic view, 800sapphire blade, 799schematic diagram, 798vs. trabeculectomy, 800
Suprachoroidal outflowab interno cyclodialysis, 797–798gold microshunt device
fornix-based conjunctival peritomy, 807–811implantation, 807models, 807
Surgical techniquescombined surgery, 900–901filtering bleb, 901pupil management, 898–900
Sussman lens, 466Swing-arm electronic magnifiers, 363Sympathomimetic agonists
brimonidine, 609–610epinephrine, 608–609iopidine, 609systemic side effects
nonselective agonists, 684pharmacology and physiology, 684systemic reactions, 684
types, 608Systemic side effects
beta-adrenergic blockerscardiovascular medicine, 678pharmacology and physiology, 677–678
carbonic anhydrase inhibitorsphysiology and pharmacology, 681systemic reactions, 605–606, 681–683
hypotensive lipids (HLs), 603–604miotics
pharmacology and physiology, 684–685systemic reactions, 685
parasympathomimetic medications, 611prostaglandin analogs
1041Index
pharmacology and physiology, 685systemic reactions and clinical recommendations, 685–686
selective alpha agonistspharmacology and physiology, 683systemic reactions, 683–684
sympathomimeticsnonselective agonists, 684pharmacology and physiology, 684systemic reactions, 684
sympathomimetic agonists, 608–610systemic reactions and clinical recommendations
advantage and disadvantage, 680–681asthma and obstructive lung disease, 679bradycardia and dysrhythmia, 679depression, 679–680lipoprotein inhibition, 680
topical beta-blockers, 600
TTargeting glaucomatous retinopathy and optic neuropathy, 986Taurine, 663–664T cut exposing technique, 789–792Teachers of children with visual impairment (TCVI), 377Telemetry, 12Tenon’s cyst, 779Therapeutic armamentarium
laser procedures, 531POAG, 531surgery
aqueous drainage devices, 532trabeculectomy, 531
Therapy and indicationsadjunctive therapy and combination agents, 615–616aqueous humor outflow, 588–590colored glaucoma graph
activities of daily living (ADL), 158cup/disc ratio system, 159disc damage likelihood scale (DDLS), 160treatment justification factors, 161
corneal penetrationdrug penetration anatomy, 591preservatives, 592–593
disease stagedefinite damage, 162purposes, 162uncertain damage, 161–162
drug activityparasympathetic nerve system, 595sympathetic nerve system, 594–595
duration, 163effectiveness and safety, 163–164eye drops, 590–591goals and approaches, 583history taking primacy, 156individualizing indications
change predicting speculations, 156reasons, 156
intraocular pressure (IOP) controlcircadian variation, aqueous humor dynamics, 584–586multicenter, randomized clinical trials, 587–588
maximum tolerated medical therapy (MTMT), 584medications
beta-adrenergic antagonists, 598–600carbonic anhydrase inhibitors (CAI), 605–608drug selection characteristics, 596–597
hyperosmotics, 612–615hypotensive lipids (HLs), 600–605intraocular pressure-lowering effects, 599parasympathomimetic agents, 610–611sympathomimetic agonists, 608–610treatment options and timeline, 598
pragmatic considerations, 616–617predictors of
intraocular pressure (IOP), 157standard risk factors, 157–158visual field, 158
prostaglandins vs. prostamidesbimatoprost, 593nasolacrimal occlusion digital massage technique, 594
socioeconomic factors, 164treatment purposes, 155–156
Timolol GFS, 599, 600timolol hemihydrate, 599timolol maleate, 599, 674, 967Timoptic, 304, 592, 599, 600, 967, 972Timoptic Ocudose, 592, 599Timoptic XE, 599, 600Tocotrienol, 658Tolerable treatment
lasers, 16medications, 16surgical techniques, 16–17
Tonometry, 306–307Tono-pen tonometry, IOP, 40Topical beta-blockers, 600Topical carbonic anhydrase inhibitors, 607Topical steroids, 549, 550Trabectome surgery
IOP reduction, medications, 837–838scanning electron micrograph, 836
Trabecular bypass surgical gonioscope, 833Trabecular cells
age, 1011CD44 toxic, 1012oxidation and senescence, 1011size and volume, 1012
Trabecular iStentapplicator tubing, 834development, 831–832gonioscopes, 833
Trabecular meshwork (TM)Fuchs’ Endothelial Dystrophy, 557gonioscopy, 317injury, 563schematic diagram, 958
Trabeculectomyalternative filtration routes, 765AMT, 861–862anesthesia, 765–766anterior chamber paracentesis, 774anticoagulants, 769–770antimetabolites
avascular cystic bleb, 778complications, 780encapsulated bleb, 779
conjunctival closure, 781–782conjunctival incision
limbal-base vs. fornix-base techniques, 768, 772–773Tenon’s capsule, 771wet field cautery, 771
1042 Index
Trabeculectomy (Con’t)corneoscleral flap, 766external approach, Schlemm’s canal
location, 790opening technique, 792–794T cut exposing technique, 789–792
eye exposure, 766, 768failure and complications, 575flap suturing techniques, 776–7775-fluorouracil and mitomycin C, 452–453guarded fitration procedure, 765intraocular pressure (IOP), 767–768peripheral iridectomy (PI), 781PK-glaucoma, 883postoperative follow-up
bleb evaluation, 783–786complications, 783
potential candidates, 790procedure, 574–575scleral flap
corneal tunnel and surgical limbus, 775rectangular technique, 774–775triangular technique, 774–776
technique, 575traction suture, 768
Trabeculoplastyhistory
continuous wave laser system, 714–715micropulsed diode laser trabeculoplasty
(MDLT), 715–716spot size, 716
indications and contraindicationsbeneficial response, 714IOP reduction, 714
methodscomplications, 718continuous wave laser system, 716inflammation, 718infrared laser energy application, 722–723instruments comparison, 719–721IOP response, 718–719micropulsed diode laser trabeculoplasty, 717–718preparation, 716pressure spikes, 718selective laser trabeculoplasty, 716
Trabeculotomyindication, 574results, 574technique, 574
Transpalpebral scleral palpation, IOP, 40Travatan, 304, 414, 592, 600, 966Travatan Z, 592, 600travoprost, 27–29, 56, 87, 415, 513, 573, 591, 593, 599–604, 615, 616,
629–635, 685, 966Trial frame refractions
Halberg clips, 357Oculus universal, 356
Triangular scleral flap technique, 774–776Trusopt, 607Tube shunt surgery
hypertensive phase (HP)etiology, 824–825treatment techniques, 825–826
TVT, 814–815Tube Versus Trabeculectomy Study (TVT), 814–815
UUltrasound biomicroscope (UBM)
anterior segment imaging, 467–468axial resolutions, 293ciliary body cleft, 300ciliary sulcus posterior, iris, 300cyst, 298higher frequency, 293iris, pigment dispersion, 299narrow angle, plateau component., 297normal angle, 294occludable angle, 296peripheral anterior synechiae, 298pupillary block angle closure, 296
Uveitic angle closure management, 532Uveitis-related elevation, IOP
acute uveitic angle closureIris bombe, 528, 529non-pupillary block, 529pupillary block, 528–529
chronic, mixed-mechanism ocular hypertension, 530corticosteroid-induced ocular hypertension, 529IOHS
herpes zoster keratouveitis, 528, 529Posner Schlossman syndrome, 528
VValved implants
Ahmed type, 813, 816Eagle Vision type, 816
Varicella–zoster virus (VZV), 549Vascular risk factors
hypertension, blood flow, and glaucoma riskblood pressure, 694intraocular pressure, 695optic nerve, 964
systolic blood pressure, 693nocturnal hypotension, 116ocular perfusion pressure, 116–119systemic hypertension and hypotension, 115–116
Vision distance test chart, 354–355Visual acuity
blindness standard, 352measurement
Bailey–Lovie near reading card, 355trial frame refractions, 356–357vision distance test chart, 354–355visual field assessment, 355
Visual evoked potential (VEP) electroretinogram, 266Visual field assessment, 355Visual field defects
age, gender and refractive error, 444–445patterns of loss, 433–436progression characteristics, 436–445
age, gender and refractive error, 444–445 risk factors, 442, 443 VF damage, 436–448 VF test, 436–442
Visual functionautomated visual fields
Humphrey vs. Goldmann, 251nonspecific defects, 252
hill of visionHumphrey field analyzer, 230procedure, 229schematic representation, 230
1043Index
testing, 230, 233visual field defects, 231
Humphrey field analyzermultiple field analysis, 257single field analysis, 254–257test frequency, 253–254
screening methodseffectiveness, 239flicker perimetry, 244, 245frequency doubling technology perimetry, 240, 242high pass resolution perimetry (HPRP), 244, 246kinetic vs. static perimetry, 236–238motion perimetry, 240, 243multifocal electroretinograms, 246–247multifocal visual evoked potentials, 247, 248rarebit perimetry, 244, 246short wavelength automated perimetry
(SWAP), 239–241structural vs. functional methods, 229–236testing strategies
threshold evaluation, 247
visual field screening, 247–248Vitamin E. See Alpha-tocopherol
WWater-drinking test (WDT), 12WDR36, 96Weill–Marchesani syndrome, 475–476Wet field cautery, 771
XXalacom, 616, 631, 634, 635, 970, 1018Xalatan, 60, 304, 600, 966
YYAG iridotomy, 895
ZZeaxanthine, 662Zeiss lens, 465Zeiss-style 4 mirror lens, 404ZoomText magnifier, 364