Manual for Eye Examination and Diagnosis - Mark W. Leitman

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Ciliary body.Fig 377 Ciliary muscle contraction lessens tension on zonules causing the le...Fig 378 Tigroid fundus with clearly visible, lightly pigmented choroidal vas...Fig 379 A flat benign choroidal nevus is present in 8% of Americans. Maligna...Fig 380 Elevated malignant choroidal melanoma. Note change in direction as a...Fig 381 Ruthenium radioactive plaque sewn or glued to the episclera of the e...Fig 382 Gross section of malignant ↑ melanoma treated with removal of the ey...Fig 383 B‐scan ultrasound of a malignant choroidal melanoma showing typical ...Fig 384 Exenteration of the orbit for malignant melanoma extending beyond th...Fig 385 Benign iris freckle.Fig 386 Malignant iris melanoma with elevated lesions and distorted pupil.Fig 387 Gonioscopic view of elevated iris melanoma.Fig 388 Rubeosis iridis with neovascularization.Fig 389 Rubeosis iridis. These abnormal iris blood vessels scar the angle of...Fig 390 Iris coloboma.Fig 391 Iritis.Fig 392 Slit‐beam view of flare and cells in anterior chamber.Fig 393 Keratic precipitates (Fig. 395) and posterior synechiae.Fig 394 Larger greasy yellowish keratic precipitates called mutton‐fat occur...Fig 395 Sites of conjunctival injection and pupil size in three cases of an ...Fig 396 Patient with Behcet’s disease with ulcers and fissures on her tongue...Fig 397 Band keratopathy with calcium deposits in Bauman’s membrane in centr...Fig 398 Hilar adenopathy is the number one sign of sarcoidosis occurring in ...Fig 399 Iritis occurs in 25% of patients with sarcoidosis and is the number ...Fig 400 Sarcoidosis with intermediate uveitis and “snowballs” of inflammator...Fig 401 Intermediate uveitis (pars planitis) with snowballing of inflammator...Fig 402 CT scan of sarcoidosis with bilaterally enlarged lacrimal glands (↑)...Fig 403 Sarcoidosis with visibly enlarged right lacrimal gland (↑). Notice e...Fig 404 A lacrimal gland biopsy often helps confirm the diagnosis of sarcoid...Fig 405 Light photomicrograph of lacrimal gland infiltrated with non‐caseati...Fig 406 Tender erythematous subcutaneous sarcoid nodule.Fig 407 Sarcoidosis with vasculitis causing “candle‐wax” drippings on vessel...Fig 408 (A) Toxoplasma gondii is an intracellular parasite. It is the most c...Fig 409 Histoplasmosis with multiple punched out chorioretinitic lesions cal...Fig 410 Unknown southeastern US subretinal nematode (↑) causing neuroretinit...Fig 411 Syphilitic, yellow, flat chorioretinal lesions.Fig 412 Maculopapular syphilitic eruption involving palms.Fig 413 Maculopapular syphilitic eruption involving soles.Fig 414 Syphilitic zones of alopecia prompted patient to wear a wig.Fig 415 Syphilitic painless mucous membrane ulcers occurred at the corners o...Fig 416 Kaposi’s sarcoma of skin in AIDS due to the opportunistic infection ...Fig 417 Kaposi’s sarcoma of conjunctiva.Fig 418 AIDS retinopathy with cotton‐wool spots and intraretinal hemorrhages...Fig 419 Cytomegalovirus (CMV) is the most frequent opportunistic infection i...Fig 420 Fishhook in eye.Fig 421 Open‐globe injury through corneoscleral wall with prolapse of iris a...Fig 422 Penetrating injury through iris and lens capsule causing a cataract ...Fig 423 Enucleation: the eye is removed by first exposing and then severing ...Fig 424 Silicone orbital implant with scleral prosthesis.Fig 425 Porous hydroxyapatite implant allows ingrowth of blood vessels to pr...Fig 426 Enucleated socket with scleral prosthesis.

      10 Chapter 9Fig 427 Slit lamp view of lens: A, cornea; B, anterior capsule; C, nucleus; ...Fig 428 Anterior cortical spokes.Fig 429 Posterior subcapsular cataract.Fig 430 Congenital (zonular) cataract surrounded by clear cortex.Fig 431 Brunescent (brown) cataract.Fig 432 Mature lens dislocated into the anterior chamber, obscuring pupil an...Fig 433 Superiorly dislocated lens.Fig 434 A three‐plane corneal incision for entering the eye during cataract ...Fig 435 Iris prolapse into gaping wound causing superiorly peaked pupil.Fig 436 Laser or manual continuous tear capsulotomy (capsulorrhexis). Trypan...Fig 437 Anterior capsulotomy needle. Punctures of the anterior capsule could...Fig 438 Removal of nucleus by phacoemulsification.Fig 439 Manual phacofragmentation of nucleus after dislocation into anterior...Fig 440 After cracking the hard nucleus, it is removed in two pieces with to...Fig 441 Removal of hard nucleus in one piece.Fig 442 After removing the hard nucleus by any technique, the surrounding co...Fig 443 Insertion of rigid lens through a 6‐mm incision.Fig 444 Foldable implant inserted through a 3.2‐mm incision is overwhelmingl...Fig 445 Posterior chamber lens behind iris and in the capsular bag is first ...Fig 446 An anterior chamber lens is sometimes used when the posterior capsul...Fig 447 Femtosecond laser‐assisted grid fragmentation allows surgeons to sof...Fig 448 ReSTOR multifocal intraocular lens with 12 concentric steps of focus...Fig 449 Crystalens utilizes the natural action of the ciliary muscle during ...Fig 450 AcrySof IQ Toric intraocular lens. A marker is first used to mark th...Fig 451 Secondary cataract occurs in 12% of eyes at 1 year and 28% at 5 year...Fig 452 Office‐based YAG laser capsulotomy for secondary cataract of posteri...Fig 453 Dislocated intraocular lens due to weakened zonules.Fig 454 Lens implant (↑ lens haptic) and capsular bag dislocated into the vi...Fig 455 Dislocated posterior chamber lens with haptics sutured to iris. Sutu...Fig 456 Endophthalmitis with hypopyon following cataract surgery.Fig 457 Severe endophthalmitis with visibly dislocated lens implant in anter...

      11 Chapter 10Fig 458 Posterior retinal landmarks.Fig 459 Posterior retina.Fig 460 Cross‐section of peripheral retina.Fig 461 Peripheral retina.Fig 462 Schematic cross‐section of retina. The choroidal blood nourishes the...Fig 463 OCT of normal macula with central foveal pit. Note choroidal‐scleral...Fig 464 OCT ‐ Plaquenil toxicity causing disruption of outer retina includin...Fig 465 Normal color OCTA of perifoveal retina. Superficial retinal vessels ...Fig 466 Direct ophthalmoscope.Fig 467 Indirect ophthalmoscope.Fig 468 Three‐mirror contact lens.Fig 469 Three mirror contact lens allows detailed three‐dimensional visualiz...Fig 470 Normal fluorescein angiogram. Retinal vessels terminate at the perif...Fig 471 Normal tigroid (tessellated) fundus with pigment around disk and dee...Fig 472A Normal myopic conus (crescent) at disk margin.Fig 472B Pathologic myopic happens most often in eyes with more than 10 D of...Fig 473 Disk drusen are not related to retinal drusen that occurs in macular...Fig 474 Myelination of the optic nerve. The white myelin sheath covering the...Fig 475 OCT image of papilledema showing elevated disk margin and hyporeflec...Fig 476 Papilledema with elevated disk, engorged veins, and flame‐shaped hem...Fig 477A Fluorescein angiogram of papilledema reveals leakage in and around ...Fig 477B An enlarged blind spot can be plotted most accurately on a tangent ...Fig 478 Papilledema with macular star (↑) due to extension of disk edema.Fig 479 B‐Scan ultrasound showing hyperreflective calcification from buried ...Fig 480 CT scan performed during workup of what was thought to be papilledem...Fig 481 Fluorescein angiogram of vasculitis causing loss of the blood‐retina...Fig 482 Sickle cell retinopathy with vascular inflammation (↑), pale areas o...Fig 483 Sickle cell retinopathy with compensatory neovascularization at edge...Fig 484 Fluorescein angiogram showing leakage from abnormal new vessels.Fig 485 Retinal detachment.Fig 486 Stage III hypertensive retinopathy with cotton‐wool spots, flame‐sha...Fig 487 Drawing of branch retinal vein occlusion with flame hemorrhage and a...Fig 488A Arteriosclerosis with partial vein occlusion causing an engorged ve...Fig 488B OCT‐A of partial vein occlusion with dilated tortuous veins and cap...Fig 489 Central retinal vein occlusion 3 months after occurrence. Compensato...Fig 490 Colored OCT of macular edema after retinal vein occlusion causing th...Fig 491 OCT A of branch retinal vein occlusion with tortuous and engorged ca...Fig 492 Intravitreal steroidal implants last longer than injection and is co...Fig 493 OCT of resolved macular edema from retinal vein occlusion after intr...Fig 494 Retinal artery occlusion with a cholesterol Hollenhorst plaque on th...Fig 495 Branch retinal artery occlusion with embolus (↑) and sludging of blo...Fig 496 Late‐stage retinal artery occlusion with pale disc due to optic atro...Fig 497 OCT of central retinal artery occlusion with inner retinal layer thi...Fig 498 Stage 1: background retinopathy with microaneurysms, exudates, and d...Fig 499 Leakage of fluorescein from microaneurysms. Normal retinal vessels d...Fig 500 OCT of diffuse diabetic macular edema with hyporeflective (black) re...Fig 501 6 Stage 1: retinopathy with cotton‐wool spots, microaneurysms, and d...Fig 502 Fluorescein angiogram showing neovascularization (↓) adjacent to dar...Fig 503 Stage 2: Proliferative retinopathy with preretinal neovascularizatio...Fig 504 Stage 2: Bleeding into the vitreous may cause fibrous proliferation....Fig 505 Normal black and white OCTA. Note ring of interconnected capillaries...Fig 506 Black and white OCTA of diabetic retinopathy showing microaneurysms ...Fig 507 Normal black and white (OCT‐A) of perifoveal retina. Normal black an...Fig 508 Diabetic retinopathy imaged with color OCTA showing microaneurysms a...Fig 509 Pre‐retinal hemorrhages lie between the retina internal limiting mem...Fig 510 This central retinal vein occlusion shows superficial flame‐shaped h...Fig 511 Cross‐section of the retina.Fig 512 Intraretinal hemorrhages in partial central retinal

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