《眼科学=Textbook of Ophthalmology:英文改编版》由经典的英文眼科学教材Vaughan & Asbury''s General Ophthalmology改编而成,编者为国内眼科学各专业领域富有临床和教学经验的著名学者。以我国教育部颁布的教学大纲为依据,结合国情,对各章节内容进行了适当的修改和关键术语的中英文对照,力求既原汁原味保留英文特色,又适合国内教学实际,充分体现科学性、权威性和实用性。
目錄:
CONTENTS
CHAPTER 1 ANATOMY & EMBRYOLOGY OF THE EYE 1
CHAPTER 2 OPHTHALMOLOGIC EXAMINATION 23
CHAPTER 3 OPHTHALMIC EMERGENCIES 54
CHAPTER 4 LIDS & LACRIMAL APPARATUS 62
CHAPTER 5 CONJUNCTIVA & TEARS 76
CHAPTER 6 CORNEA 108
CHAPTER 7 UVEAL TRACT & SCLERA 130
CHAPTER 8 LENS 156
CHAPTER 9 VITREOUS 164
CHAPTER 10 RETINA 170
CHAPTER 11 GLAUCOMA 197
CHAPTER 12 STRABISMUS 211
CHAPTER 13 ORBIT 229
CHAPTER 14 NEURO-OPHTHALMOLOGY 239
CHAPTER 15 OCULAR DISORDERS ASSOCIATED WITH SYSTEMIC DISEASES 277
CHAPTER 16 IMMUNOLOGIC DISEASES OF THE EYE 306
CHAPTER 17 SPECIAL SUBJECTS OF PEDIATRIC INTEREST 315
CHAPTER 18 OPHTHALMIC GENETICS 323
CHAPTER 19 OPHTHALMIC TRAUMA 326
CHAPTER 20 CAUSES AND PREVENTION OF VISION LOSS 339
CHAPTER 21 OPTICS & REFRACTION 350
CHAPTER 22 OPHTHALMIC THERAPEUTICS 365
CHAPTER 23 LASERS IN OPHTHALMOLOGY 381
CHAPTER 24 LOW VISION 390
GLOSSARY OF TERMS RELATING TO THE EYE 400免费在线读CHAPTER 1 ANATOMY & EMBRYOLOGY OF THE EYE
A thorough understanding of the anatomy of the eye, orbit, visual pathways, upper cranial nerves, and central pathways for the control of eye movements is a prerequisite for proper interpretation of diseases having ocular manifestations. Furthermore, such an-atomic knowledge is essential to the proper planning and safe execution of ocular and orbital surgery. Whereas most knowledge of these matters is based on anatomic dissections, either postmortem or during surgery, noninvasive techniques—particularly mag-netic resonance imaging MRI, ultrasonography, and optical coherence tomography OCT —are increas-ingly providing additional information. Investigating the embryology of the eye is clearly a more difficult area because of the relative scarcity of suitable hu-man material, and thus there is still great reliance on animal studies, with the inherent difficulties in infer-ring parallels in human development. Nevertheless, a great deal is known about the embryology of the human eye, and—together with the recent expansion in molecular genetics—this has led to a much deeper understanding of developmental anomalies of the eye.
1 NORMAL ANATOMY
1.1 THE ORBIT FIGURES 1-1 AND 1-2
The orbital cavity is schematically represented as a pyramid of four walls that converge posteriorly. The medial walls of the right and left orbit are parallel and are separated by the nose. In each orbit, the lateral and medial walls form an angle of 45°, which results in a right angle between the two lateral walls. The or-bit is compared to the shape of a pear, with the optic nerve representing its stem. The anterior circumfer-ence is somewhat smaller in diameter than the region just within the rim, which makes a sturdy protective margin.
The volume of the adult orbit is approximately 30mL, and the eyeball occupies only about one-fifth of the space. Fat and muscle account for the bulk of the remainder.
The anterior limit of the orbital cavity is the orbit-al septum, which acts as a barrier between the eyelids and orbit see Eyelids later in this chapter.
The orbits are related to the frontal sinus above, the maxillary sinus below, and the ethmoid and sphe-noid sinuses medially. The thin orbital floor is easily damaged by direct trauma to the globe, resulting in a “blowout” fracture with herniation of orbital contents into the maxillary antrum. Infection within the sphe-noid and ethmoid sinuses can erode the paper-thin medial wall lamina papyracea and involve the con-tents of the orbit. Defects in the roof eg, neurofibro-matosis may result in visible pulsations of the globe transmitted from the brain.
Figure 1-1 Anterior view of bones of right orbit.
Figure 1-2 Medial view of bony wall of left orbit.
Orbital Walls
The roof of the orbit is composed principally of the orbital plate of the frontal bone. The lacrimal gland is located in the lacrimal fossa in the anterior lateral aspect of the roof. Posteriorly, the lesser wing of the sphenoid bone containing the optic canal completes the roof.
The lateral wall is separated from the roof by the superior orbital fissure, which divides the lesser from the greater wing of the sphenoid bone. The anterior portion of the lateral wall is formed by the orbital sur-face of the zygomaticmalar bone. This is the stron-gest part of the bony orbit. Suspensory ligaments, the lateral palpebral tendon, and check ligaments have connective tissue attachments to the lateral orbital tu-bercle.
The orbital floor is separated from the lateral wall by the inferior orbital fissure. The orbital plate of the maxilla forms the large central area of the floor and is the region where blowout fractures most frequently occur. The frontal process of the maxilla medially and the zygomatic bone laterally complete the inferior orbital rim. The orbital process of the palatine bone forms a small triangular area in the posterior floor.
The boundaries of the medial wall are less dis-tinct. The ethmoid bone is paper-thin but thickens anteriorly as it meets the lacrimal bone. The body of the sphenoid forms the most posterior aspect of the medial wall, and the angular process of the frontal bone forms the upper part of the posterior lacrimal crest. The lower portion of the posterior lacrimal crest is made up of the lacrimal bone. The anterior lacrimal crest is easily palpated through the lid and is com-posed of the frontal process of the maxilla. The lacri-mal groove lies between the two crests and contains the lacrimal sac.
Orbital Apex Figure 1-3
The apex of the orbit is the main portal for all nerves and vessels to the eye and the site of origin of all ex-traocular muscles except the inferior oblique. The su-perior orbital fissure lies between the body and the greater and lesser wings of the sphenoid bone. The superior ophthalmic vein and the lacrimal, frontal, and trochlear nerves pass through t