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