The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel
- Length: 896 pages
- Edition: 1
- Language: English
- Publisher: Elsevier
- Publication Date: 2022-04-15
- ISBN-10: 0323757545
- ISBN-13: 9780323757546
- Sales Rank: #586935 (See Top 100 Books)
Covering all the knowledge and skills needed for everyday duties as well as see success on certification and recertification exams, http://jannaorganic.co.uk/blog/2025/04/03/nldp3cevyv2 The Ophthalmic Assistant, 11th Edition, is an essential resource for allied health personnel working in ophthalmology, optometry, opticianry, and other eye care settings. Drs. Harold A. Stein, Raymond M. Stein, and Melvin I. Freeman are joined by new editor Dr. Rebecca Stein and several new contributing authors who provide go site practical, up-to-date guidance on ocular diseases, surgical procedures, medications, and equipment, as well as Buy Soma Usa paramedical procedures and office management for today’s practice. This outstanding reference and review tool provides essential knowledge and guidance for ophthalmic assistants, technicians, and technologists as critical members of the eye care team.
- Keeps you up to date with coverage of Buy Soma Online Overnight Delivery key topics such as topography-guided PRK, cataract surgery with multifocal IOLs to treat presbyopia, and OCT and OCTA, as well as the latest information on basic science, new testing procedures and equipment, and watch two new chapters on refractive surgery and eye banking.
- Provides https://mhco.ca/yy8wdai7ko full-color visual guidance for identification of ophthalmic disorders, explanations of difficult concepts, and depictions of the newest equipment used in ophthalmology and optometry― https://townofosceola.com/44m69wpo1gq more than 1,000 images in all.
- Features https://kirkmanandjourdain.com/bn8eeass more than 400 interactive multiple-choice review questions that test your knowledge and understanding of key concepts.
- Includes a go to link bonus color-image atlas that tests your clinical recognition of disease and disorders of the eye.
- Contains https://audiopronews.com/headlines/4zapgskm8j convenient quick-reference appendices with hospital/practice forms for more efficient patient record keeping, conversion tables, and numerous language translations, plus information on ocular emergencies, pharmaceuticals, and more.
- Order Tramadol Cod Only Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Front Cover The Ophthalmic Assistant Copyright Page Contents Preface Acknowledgments List of Contributors List of Reviewers Dedication 1 Basic Sciences 1. Anatomy of the eye Surface anatomy Tear film Cornea Sclera Uvea Iris Ciliary body Choroid Angle structures Lens Vitreous Retina Optic nerve Visual pathway Ocular muscles Summary Questions for review and thought 2. Physiology of the eye Alignment of the eyes Looking straight ahead (fixation) Locking images (fusion) Eye movements Control centers for eye movements Looking toward a close object Seeing in depth Focusing at near (accommodation) Transparent pathway for light Retinal images Intraocular pressure Tears Color vision Questions for review and thought 3. Optics Physical optics What is light? How does light travel? Nature of the world visible to humans Speed of light How do we measure intensity of a light source? Color Rays of light and the spectrum Bending of light How light can alter its direction Geometric optics Terminology Dispersion Color Mirrors and reflection Lenses How do lenses bend rays of light? What is a prism? How are prisms measured? The use of prisms Convex lenses Concave lenses Focal length Spherical aberration Chromatic aberration Cylinders Transposition Practical aspects of optics Fiberoptics Gonioscopy Telescopes Astronomical telescope Galilean telescope Optical illusions Questions for review and thought 4. Pharmacology General principles Locally applied medication Tolerance Tonicity Sterility Stability Penetration Alternative routes of medication Subconjunctival injections Continuous-release delivery Retrobulbar injections Intracameral injection Systemic medication Complications of locally administered drugs Allergic reactions Toxic reactions Discoloration of the eye Undesirable side effects Idiosyncrasy Loss of effect by inactivation Spread of infection Prescription writing Autonomic drugs Mydriatic and cycloplegic agents Mydriatic agents Cycloplegic agents Miotics Direct-acting miotics Cholinesterase inhibitors Side effects Drugs that lower intraocular pressure Anesthetics Topical anesthetics Side effects Injectable anesthetics Side effects Management of toxic side effects Fainting Central nervous system stimulation Respiratory emergency Allergic reaction Antiallergic and antiinflammatory agents Corticosteroids Temporal arteritis Nonsteroidal antiinflammatory drugs Mast cell stabilizers Antihistamines Antiinfective preparations Antibiotics Antivirals Antifungal agents Antiparasitic agents Decongestants Antiallergic agents Contact lens solutions Stains Side effects of systemic medication Questions for review and thought 5. Microbiology Bacteria Viruses Fungi Other microbes Clinical indications for smears and cultures Taking smears Making a stain Gram stain for bacterial identification Diff-Quik stain for cytologic identification Specimen collection for culture Other aids to identify organisms Summary Questions for review and thought 2 Clinical Practice 6. Office efficiency and public relations How to make patients happy New patients and returning patients The telephone Memory joggers Risk management Returning telephone calls Telephone manners Scheduling appointments Booking the arriving patient The reception room Running late Scribes Making future appointments Financing Recall cards Automated voice machines Filing Electronic medical and health records Prescription pads Office equipment Personal qualities for improved office efficiency Avoiding interruptions Improving the patient experience through service recovery Administrative assistant duties Handling the ophthalmologist’s schedule Handling sales representatives Handling mail Medical ethics In the physician’s absence Aids in public relations Patient surveys Publicity Cost Size of the audience Credibility Effect Versatility Longevity Advertising Summary Questions for review and thought 7. History taking Organization of a history History procedure General information Chief complaint History of present illness Loss of vision Blurred vision secondary to an error of refraction Blurred vision for close work Blurred vision for distance work Blurred vision secondary to organic disease Loss of central vision. Distorted vision. Night blindness. Transient gray-outs or blur-outs of vision lasting several seconds in one or both eyes. Inability to see to the right or to the left. Ascending veil. Headaches Asthenopia Red eye Discharge Pain Blurred vision Other causes Double vision or diplopia Floating spots and light flashes Tearing Past health, medications, and allergies Family history Common familial disorders Tips in history taking Scribes Acknowledgment Summary Questions for review and thought 8. Preliminary examination Vision assessment Early treatment diabetic retinopathy study chart Use of pinhole Dynamic visual acuity Contrast sensitivity Glare testing Macular photostress test Potential acuity Potential acuity meter Interferometer Retinometer Near vision testing Measurement of glasses Universal method of using any lensmeter Addition Automatic lensmeters Accommodation Measurement of amplitude of accommodation Proximity method Triple line test Effect of age Convergence Color vision Ishihara test plates Hardy-Rand-Rittler plates Colormaster Depth perception Fly test Wirt stereo test Worth four-dot test Biopter test External examination Symmetry of orbits Eyelashes Lid margins Conjunctiva Lacrimal apparatus Sclera Cornea Use of fluorescein, rose bengal, and lissamine green stains Iris Anterior chamber Penlight examination for estimating the depth of the anterior chamber Pupil Pupillary reflexes Relative afferent pupillary defect test Size Shape Equality of size Differential diagnosis of a dilated pupil Third nerve palsy. Trauma. Adie’s pupil. Acute glaucoma. Drug-induced dilation. Differential diagnosis of a constricted pupil Horner syndrome. Iritis. Drug-induced constriction. Lens Blinking When not to dilate before asking the eye doctor Examination of the ocular muscles Instillation of eyedrops and ointment Ophthalmoscopy Visual fields Summary Questions for review and thought 9. Visual function and impairment Introduction Vision loss Types of vision Photopic vision Mesopic vision Scotopic vision Luminance versus illumination Measurement and assessment of visual loss Aspects of visual impairment Visual functions Measurement and assessment of functional aspects Parameters of ocular function Analysis Ocular (visual screening) Peripheral Preventive medicine guidelines, CPT codebook’s evaluation/management guidelines, requirements Why perform visual screening Aspects of vision loss and function Functional vision Binocular vision Monocular vision Visual acuity Contrast sensitivity Testing Everyday visual experience Stereo depth perception: far Scoring with stereo test Color perception Phorias Heterophoria Lateral phoria Vertical phoria Interventions for rehabilitation 10. Understanding ophthalmic equipment Equipment used for refraction Projector and projector slides Trial case and lenses Use of trial lenses Refractor or phoropter Body Lenses Aperture control handle Auxiliary lenses Accessory equipment Aids in care of refractor/phoropter Retinoscope Spot retinoscope Streak retinoscope (see Fig. 10.7) Accessories used in refraction Cross cylinder Pinhole disc Distometer Halberg and Janelli clips Equipment used to detect muscle imbalance Maddox rod Prisms Instruments used to determine power of lenses Lensmeter Geneva lens measure Instruments used to examine the interior of the eye Direct ophthalmoscope Special devices on the ophthalmoscope Red-free light Red light Polarized light Slit illumination Aperture discs Cobalt-blue filters Indirect ophthalmoscope Relative merits of direct and indirect ophthalmoscopes Transilluminator Instruments used to study the anterior segment of the eye Slit-lamp microscope Use of slit lamp Design of slit lamp Types of slit lamps Technique of slit-lamp examination (Fig. 10.29) Slit-lamp attachments Hruby lens (Fig. 10.30). Fundus contact lens. Pachymeter. Instruments used to examine the angle structures of the eye Goniolens Posner diagnostic and surgical gonioprism Gonioscope Instruments used to assess the cornea Keratometer Specular microscope Instruments used to determine tear flow Dacryocystography/lacrimal scan Instruments used to measure intraocular pressure (tonometer) Special instruments Exophthalmometer Luedde exophthalmometer Hertel exophthalmometer Placido’s disc Optokinetic drum Ophthalmodynamometer Doppler test Automatic refractors Computerized corneal topography Corneal Tomography Visual field equipment, tangent screens, and perimeters Diagnostic ultrasound: A-scan and B-scan Radioactive phosphorus Electroretinography and electrooculography Lasers Summary Questions for review and thought 11. Maintenance of ophthalmic equipment and instruments Applanation tonometer Noncontact tonometer Bulb replacement Target illuminator bulb Source light indicator Fixation lamp Chin rest Headrest cushions Eyepiece and objective Lensmeter Keratometer Slit-lamp biomicroscope Phoropter (Fig. 11.4) Green’s refractor Projector Projection slide Cleaning the projector screen Replacing the lamp Projection front-surface mirrors Patient viewing mirror 12. Refractive errors and how to correct them Emmetropia Ametropia Hyperopia Cause Types Role of cycloplegia Symptoms Treatment Myopia Types Cause Progress Symptoms Progressive myopia Treatment Astigmatism Types Regular astigmatism. Irregular astigmatism. Cause Problems of astigmatic individuals Refractometry and refraction Methods of refractometry Steps for refractometry Cycloplegic drops Lensmeter Retinoscopy Streak retinoscope Autorefractors Historical development Objective refractors Manual objective refractors Automatic objective refractors Combination objective/subjective refractors Automated subjective refractors Remote-controlled refractors Accuracy of measurement Errors with automated refractors Where are we going with automated refraction? Subjective refining of refraction Astigmatism tests Astigmatic clock Cross cylinder Irregular astigmatism Spherical equivalent Duochrome tests Anisometropia Aniseikonia Treatment Aphakia When to refract after cataract surgery Refractive points specific to the aphakic and pseudophakic person Procedure after cataract surgery Cataract lens Presbyopia Symptoms Treatment Tests for the correct power Prescription Do’s and don’ts Myths to be dispelled Complaints: how to anticipate them Glasses checks and how to handle them: 12 key points Summary Acknowledgment Questions for review and thought 13. Facts about glasses History Frames A frame for every face Metal frames Plastic and composite frames Advantages Bridges Combination frames Semirimless frames Frame measurements Temples Specialty frames Frames for individuals with low, flat bridges Side shields Ptosis crutch Dispensing spectacle frames Measuring pupillary distance with a ruler and the reflex method Lenses Aphakic lenses Lenticular lenses Aspheric lenses Plastic lenses Plastic hard-resin lenses Polycarbonate lenses Trivex lenses Safety lenses Heat-treated impact-resistant glass lenses Role of protective lenses in sports Role of protective lenses in shooting, hockey, and racquet sports Antireflection (no-glare) coating Sunglasses and tinted lenses Densities Photochromic (indoor–outdoor) glasses Ultraviolet and blue-blocking lenses Mirrored sunglasses Multifocal lenses Special flat-top bifocals and trifocals Invisible bifocals (progressive-add lenses) Multivision lenses from a patient’s point of view (vocational lenses) Computer glasses Most popular types of multifocal lenses Flat-top segment Round-top fused segments (Kryptok, Achromat) Progressive lenses Centering of lenses Pantoscopic angle Use of prisms in glasses Fresnel lenses and prisms Press-on adds Production of prescription lenses Care of glasses Acknowledgment Questions for review and thought 14. Rigid contact lenses: basics Development Optics How the corneal contact lens works Terminology Designs Patient examination Fitting corneal contact lenses Measurements Trial lenses Materials and manufacture Fitting gas-permeable lenses Systems for fitting Inventory fitting and diagnostic lenses Nomogram fitting Special problem solving with gas-permeable silicone acrylate and fluorosilicone acrylate lenses Three o’clock and nine o’clock position staining Lid gap. Poor blinking. Poor tear film. Comment. Lens-flexure problems Evaluating contact lenses Measuring diameter Contacto Gauge and Radiuscope Shadowgraph and Contactoscope Measuring power Measuring thickness Insertion and removal techniques Insertion Removal Centering Do’s and don’ts with contact lenses Care Care of gas-permeable lenses Wetting solutions Soaking solutions Cleaning solutions Eyedrops with contacts Evaluating the fit Subjective criteria Adaptation symptoms Abnormal symptoms Objective criteria Fluorescein patterns (Figs. 14.30 and 14.31) Alteration of the blink rate Scratches, chips, and roughened edges of the contact lens Changes in the cornea Adjustments Problems associated with overwearing contact lenses Uses Summary Questions for review and thought 15. Soft contact lenses History of hydrophilic lenses Advantages Comfort Rapid adaptation Lack of spectacle blur Disposability Minimal lens loss Minimal overwear reaction Lack of glare and photophobia Difficulty in dislodging Protection of entire cornea Attractive alternative for rigid lens drop-outs No serious corneal abrasion on insertion Cosmetic lenses Disadvantages Lack of ability to correct severe astigmatism Variable vision Lack of durability Faulty duplication Deposit formation Modifications impossible Disinfection problems Patient evaluation Patient selection Manufacture Spin-cast lenses Lathe-cut lenses Molded lenses Inventory versus diagnostic lenses Lens inspection Edge and surface inspection Diameter Base curve Power Tight lens Loose lens Disinfection Cleaning Insertion and removal techniques Insertion by the fitter Removal by the fitter Insertion by the patient Removal by the patient Taco test Precautions for wear Wearing schedules Thin and ultrathin lenses Correction of astigmatism Toric lens design Prism ballast Truncation Truncation and prism ballast Double slab-off Medical uses Blisters of cornea (bullous keratopathy) Corneal ulcers Recurrent corneal erosion Dry eyes Conclusion Extended-wear lenses Myopic versus aphakic extended wear Problems with conventional extended-wear lenses Silicone hydrogel lenses (continuous wear) Conclusion Disposable lenses Innovations in design Contact lenses in industry Special occupations Downtime Discontinuance of wear Loss or removal of the lenses Problems with contact lenses Common questions and answers Role of the ophthalmic assistant Questions for review and thought 16. Advanced techniques in soft and rigid contact lens fitting Abnormal symptoms and signs Follow-up keratometry Special lenses Contact lenses for high myopia Aphakic lenses Contact lenses for astigmatism Nonrotating lenses Noncircular shapes Toric curve lens Prism ballast lenses Correction of high astigmatism Toric soft contact lenses Contact lenses for keratoconus Scleral lenses Corneal lenses Trial lens fitting Role of corneal topography Piggyback and hybrid lenses Thick-set lenses Bifocal contact lenses Magnification with contact lenses Orthokeratology Corneal refractive therapy Bandage lenses Manufacturing and modification Modifications of finished lenses Diameter reduction Blending Edge shaping Power change Peripheral curve Fenestration of rigid lenses Removing scratches Gas-permeable lenses Extended-wear rigid lenses Silicone-polymethyl methacrylate material Cellulose acetate butyrate Fluorosilicone-acrylate lenses Pure fluorocarbon lenses Hydrogel tinted contact lenses Recommendations for selection of rigid or soft contact lenses Questions for review and thought 17. Managing a contact lens practice Patient management How to make patients happy Minimize patient wait time Make patients feel important Create space for comfort Respect a patient’s right to privacy Look the part Pay attention to detail Master communication skills Be fair in all matters of finance Patient information Patient follow-up A successful practice Planning Understanding your organization Finances Pricing policy in the contact lens practice Cost control Performance bonuses Tracking finances Marketing Advertising Staff development The contact lens practice staff Office equipment and space Trial lens-fitting sets Contact lens inventory and ordering Ongoing care Lid care 18. Visual fields Preliminary procedures Facilities for field testing Confrontation test Perimeters Measuring a field on the perimeter Charts Special perimetric techniques Visual field screening Automated visual fields Amsler grid Normal visual field Pathologic defects in the visual field Scotoma Contraction of the visual field Hysterical visual field Summary Questions for review and thought 19. Automated visual field testing Understanding the principles of perimetry Test stimulus Understanding threshold Test patterns Testing strategies Full Threshold testing FASTPAC Swedish interactive thresholding algorithm Automated perimetry: basic rules of testing Before the test Preparing the patient Using best-corrected vision Determining the proper trial lens to use Preparing the perimeter During the test Monitoring fixation Choosing the best strategy Monitoring the test Fixation. False positives. False negatives. Analysis software and printouts Single-field analysis Visual field progression analysis Summary 20. Computers in ophthalmic practice Computer basics Computer components Central processing unit Input devices Output devices Storage devices (memory) Backups Computer tasks Applications software General office software Practice management software Appointment scheduling Billing and accounting Management reporting Electronic health records Computer-controlled ophthalmic equipment Automated lensometers Automated refractors Automated keratometers Visual field analyzers Scanning laser ophthalmoscopy Ophthalmic digital imaging Computerized corneal topography Ultrasonic biometry Optical coherence biometry Wavefront analysis aberrometry Fundus photography Emerging and future computerized technologies Special ophthalmic applications Online databases and Internet resources Health Insurance Portability and Accountability Act and patient privacy Summary 3 Common Clinical Eye Problems or Common Clinical Conditions 21. Ocular injuries Diagnosis of ocular injury Conjunctival and corneal foreign bodies Corneal abrasions Aftercare of patients with superficial injuries Intraocular foreign bodies Contusion of the eyelids: black eye Contusions of the globe Early complications Late complications Penetrating eye injuries Lacerations of the lids Fractures of the orbit Chemical injuries Acids Alkalis First-aid care Second-stage emergency care Personal protection against chemical eye hazards Injuries caused by sports Injuries caused by radiant energy Ultraviolet radiation: photokeratitis Infrared rays X-rays Prevention of traumatic injuries to the eye Prevention in industry Prevention at home First-aid care by the ophthalmic assistant Computed tomography scans (also see Ch. 41) Magnetic resonance imaging Questions for review and thought 22. The urgent case Ocular emergencies True emergencies (therapy should be instituted within the hour) Urgent situations (patients should be seen the same day) Semiurgent situations (patients should be seen within days) Urgent case: to be seen within the hour Sudden loss of vision in one eye without pain Vein occlusion Urgent case: to be seen the same day Painful red eye Swollen eyelid Flashes of light Double vision or lid droop Temporal arteritis Priority case: to be seen within days Halos around lights Headaches Lost or broken spectacles Gradual loss of sight in quiet eyes Summary Questions for review and thought 23. Common eye disorders Conjunctiva Hyperemia Subconjunctival hemorrhage Conjunctivitis Episcleritis Pinguecula/pterygium Conjunctival nevus Cornea Keratoconus Herpes simplex keratitis Recurrent herpes simplex Superficial punctate keratitis Herpes zoster ophthalmicus Marginal corneal ulcers Recurrent corneal erosion Eyelids Epicanthus Entropion Ectropion Ptosis Exaggerated blink activity Blepharochalasis and dermatochalasis Trichiasis Blepharitis Essential blepharospasm External hordeolum (stye) and internal hordeolum Chalazion Tumors of the lid Milia Xanthelasma Carcinoma Seborrheic keratosis (senile verruca) Keratoacanthoma Molluscum contagiosum Lacrimal apparatus Acute dacryoadenitis Lacrimal gland enlargement Tearing Dacryocystitis Questions for review and thought 24. Common retinal disorders Retinal artery occlusion Retinal vein occlusion Diabetic retinopathy Retinitis pigmentosa Retinopathy of prematurity Retinoschisis Retinal breaks Vitreous hemorrhage Workup for vitreous hemorrhage Management of vitreous hemorrhage Retinal detachment Central serous chorioretinopathy Changes in the retina from concussion Commotio retinae (Berlin’s “edema”) Retinal hemorrhages Retinal detachment Foreign body in the eye Solar retinopathy Age-related macular degeneration Risk factors Disease entity Classification Clinical presentation The ocular examination Natural history Diagnostic evaluation Amsler grid Optical coherence tomography Optical coherence tomography angiography Fluorescein angiography Indocyanine green Clinical treatment Atrophic age-related macular degeneration Exudative age-related macular degeneration Ocular manifestations of common systemic diseases Hypertension Sickle cell disease Thyroid disorders Infectious diseases of the retina and choroid Toxoplasmosis Histoplasmosis Malignant melanoma Retinal imaging modalities: fluorescein angiography References 25. Glaucoma Introduction Classification Primary open-angle or chronic glaucoma Ocular hypertension Secondary glaucoma Pseudoexfoliative (or exfoliative) glaucoma Pigmentary glaucoma Neovascular glaucoma Traumatic glaucoma Glaucomatocyclitic crisis Primary angle-closure glaucoma Congenital glaucoma Diagnosis Screening and aids in diagnosis Screening for glaucoma Open-angle glaucoma. Angle-closure glaucoma. Tonometry Applanation tonometry. Goldmann applanation tonometer. Checking the calibration of the Goldmann applanation tonometer. Errors in Goldmann tonometry. Evaluating the pressures. Hints for tonometry use. Perkins handheld applanation tonometer. Electronic applanation tonometer. Other applanation tonometers. Icare® tonometers. Dynamic contour tonometer. Indentation tonometry (Schiøtz tonometry). Patient preparation. Comparison of the Schiøtz tonometer and the applanation tonometer. Noncontact tonometers. Ocular response analyzer. Tonography Water-drinking test Gonioscopy NIDEK Gonioscope (GS-1) Corneal thickness Structural: optic nerve Examination of the optic disc. The nerve fiber layer. Stereo photography. Optical coherence tomography (for additional information see Ch. 44). The printout of the retinal nerve fiber layer and optic nerve head disc cube 200 × 200. Anterior segment optical coherence tomography. Optical coherence tomography angiography. Heidelberg retina tomograph. Pictor. Ultrasound biomicroscopy. Functional: visual fields Techniques of perimetry. Approaches to glaucoma field testing. Pathophysiology and the longitudinal treatment plan for progressive primary-angle glaucoma Treatment Medical therapy Pharmaceutical agents commonly used by class Prostaglandins Beta-adrenergic blocking agents Alpha-2 selective agonists Carbonic anhydrase inhibitors Rho-kinase inhibitors Combination drops Miotics Sympathomimetics Hyperosmotic agents Adherence with medication Contraindications of medications and the risk of dry eyes in glaucoma Office-based laser treatments Argon laser trabeculoplasty Selective laser trabeculoplasty (Fig. 25.42) When to treat Surgery for glaucoma Microinvasive glaucoma surgery (MIGS) Excimer laser trabeculostomy (Fig. 25.43) Trabectome iStent, iStent Inject, and iStent Inject W Hydrus Microstent Canaloplasty Invasive glaucoma surgical procedures Trabeculectomy (Fig. 25.47) Tube shunts (Fig. 25.49). Cyclophotocoagulation and cyclocryopexy Treatment of angle-closure glaucoma Management of the patient by the ophthalmic assistant Disinfection and sanitization of glaucoma instruments COVID-19 impact on glaucoma care COVID-19 route of infection from the eye Guidelines for glaucoma care during COVID-19 Summary Questions for review and thought References 26. Uveitis Introduction Classification of uveitis Causes of uveitis Approach to the patient with uveitis History Eye symptoms Medical history Review of systems Physical examination Ancillary clinic tests and laboratory workup Treatment of uveitis Questions for review and thought References 27. Dry eye disease Introduction Classification Subjective evaluation Objective evaluation Systemic External Lids and lashes Meibomian gland dysfunction Tear film Ocular surface staining Cornea, conjunctiva, and sclera Management Summary References 28. Examination of the newborn, infant, and small child Approach to parent and child Vision assessment External examination Pupils Instillation of eyedrops Refraction Retina and optic nerve examination Common pediatric disorders Amblyopia Strabismus Nasolacrimal duct obstruction Retinopathy of prematurity Cataracts and glaucoma Questions for review and thought 29. Ocular motility, binocular vision, and strabismus Evaluation of strabismus History Ocular motility Hirschberg test Krimsky test Cover test Sensory testing Maddox rod Hess screen test, Lancaster red-green test, and Lees screen test Sensory adaptation to strabismus Worth 4-dot test Bagolini striated glass test Afterimage test (Fig. 29.5) Synoptophore (major amblyoscope) Amblyopia Eccentric fixation Treatment of strabismus Summary Questions for review and thought References 4 Surgical Technique 30. Aseptic technique and minor office surgery Aseptic technique Disinfection of eyelid skin Scrubbing (degerming of hands) Instillation of eye medication Sterility of ophthalmic solutions Disinfection of tonometer prism Minor office surgery Safety considerations Instruments and surgical materials for ophthalmic procedures Forceps Scissors Needle holders Clamps Curets Scalpels, keratomes, and blades Lacrimal instruments Corrosion of stainless steel instruments Procedures Chalazion surgery Eyepatch application Tear duct irrigation Fluorescein test to determine lacrimal function Tear duct probing Ziegler cautery Electrolysis Electrosurgery Eyelid growth removal Pterygium removal Xanthelasma lesion removal Complications during and after office surgery Fainting Central nervous system stimulation Respiratory emergencies Allergic reaction Drug reaction Summary Questions for review and thought 31. The operative patient Arrangements for the operation Emergency admission Urgent admission Elective admission Operative booking schedule For previous retinal surgery Consent form Preparing the child and parent for surgery Preparing the adult for major ocular surgery Eye surgery Can an eye be transplanted? Is the eye taken out for surgery? Will there be any unsightly scars on the eye after surgery? Will both eyes be patched after surgery? Is there a great deal of pain after ocular surgery? Must the head be placed between heavy sandbags after surgery? Can both eyes be operated on at the same time? Types of anesthesia Questions for review and thought 32. Highlights of ocular surgery Strabismus surgery Preparation Surgery Postoperative routine Cataract surgery Preoperative evaluation Preparation Surgery Phacoemulsification Skin and eye preparation Anesthesia Incision construction Continuous curvilinear capsulorrhexis Hydrodissection and hydrodelineation Machine design Phaco technique Sutures Femtosecond laser Intraocular lenses Lens materials and design Accommodating intraocular implants Corneal inlays for reading vision Historical methods Intracapsular cataract surgery Extracapsular cataract surgery Femtosecond laser cataract surgery Femtosecond lasers: mechanism of action Education and training Cataract postoperative care Early complications after cataract surgery Subconjunctival hemorrhage Hyphema Raised intraocular pressure Corneal edema Shallow anterior chamber Flat anterior chamber Iritis Retinal detachment Cystoid macular edema Intraocular lens decentration Incorrect intraocular lens power Retained lens material (Fig. 32.19) Endophthalmitis (Fig. 32.20) Astigmatism Capsular opacification Pseudophakic bullous keratopathy Questions often asked about cataract surgery Summary Glaucoma surgery Retinal detachment surgery Summary of retinal surgery and postoperative care Additional information for patients having retinal surgery Vitreous surgery Laser surgery Corneal transplantation Eyelid surgery Pterygium removal Dacryocystorhinostomy Enucleation and evisceration Eye dressings Summary Questions for review and thought 33. Assisting the surgeon Bedside ophthalmic assistant Visually impaired patient Patient orientation The ophthalmic assistant Preoperative preparation Postoperative care Alarming postoperative signs and symptoms Instructions to patient on discharge Operating room assistant Aseptic technique in the operating room Routine procedure for the operating room assistant Before scrubbing Bringing the patient to surgery Scrubbing Gowning Gloving Arranging the preparation table Arranging the back table Arranging the instrument stand Example of a set of instruments for basic intraocular procedures. Instruments for extraocular procedures. Demagnetization Diamond knives Sapphire blade Ruby blade Special care of gem blades Sutures Types of ophthalmic sutures. Suture evaluation. Ophthalmic needles Preparing the patient’s eyelids Draping the patient Amoric environment Care and handling of surgical instruments Rust How to avoid a stained appearance Brown or orange stain Light and dark spots Purplish black stains Bluish black stains Multicolor stains Black stains Bluish gray stains Steps in cleaning and sterilization Cleaning Lubrication Inspection Preparing a set of instruments Sterilization Boiling. Dry heat (oven). Moist heat (autoclave). Chemical. Cold sterilization (germicidal solution bath). Acetone sterilization. Alcohol disinfection. Gas and radiation. Effectiveness. Sterile packs. Operating room microscope Troubleshooting Lamp failure Failure of the zoom operation Power focus Failure of foot switch Blurred image Filters Backup generators Ethical behavior of the ophthalmic assistant Medicolegal tips Questions for review and thought 34. Ambulatory surgery Ambulatory surgery centers Tips on medical/legal protection Preparation for admission Admission for surgery Postoperative recovery Summary Questions for review and thought 35. Lasers in ophthalmology Laser theory Pumping and spontaneous emission Stimulated emission Types of lasers and their clinical use Thermal mechanism Photodisruptive (ionizing) mechanism Photochemical mechanism Photorefractive and phototherapeutic keratotomy Safety in the laser clinic Future applications of laser technology Questions for review and thought 36. Refractive surgery: today and the future Laser vision correction Laser-assisted in situ keratomileusis and photorefractive keratectomy Small incision lenticule extraction procedure Phakic intraocular lenses Refractive lens exchange Extended depth-of-focus intraocular lenses Multifocal intraocular lenses Segmented bifocal intraocular lenses Accommodative intraocular lenses Small-aperture intraocular lenses Light-adjustable intraocular lenses Corrections of refractive errors in pseudophakes Corneal inlays Corneal laser for macular degeneration Summary Bibliography 37. Corneal collagen crosslinking in the management of ectatic diseases Keratoconus Clinical signs of keratoconus Computerized topography and tomography Etiology of keratoconus Pellucid marginal degeneration Corneal ectasia following laser-assisted in situ keratomileusis or small incision lenticule extraction Development of corneal crosslinking Basic research on safety of corneal crosslinking Technique of corneal crosslinking Contraindication to corneal crosslinking Clinical outcomes of corneal crosslinking Post-laser-assisted in situ keratomileusis or small incision lenticule extraction ectasia Topographically linked ablation Intrastromal corneal rings Potential future advances in corneal crosslinking Summary Further reading 38. Wavefront aberrations and custom ablation 5 Ocular Imaging 39. Ophthalmic photography Photographic terms The imaging sensor and film Focal length Lens speed Depth of field Resolution Shutter speed Setting Sensor sensitivity Digital imaging Digital imaging chips Color balance Digital imaging software Resolution File formats Exposure Exposure meters Flash illumination External photography Illumination Photo slit-lamp biomicrography Goniography Endothelial specular photomicrography Fundus photography Stereo fundus photography Fluorescein angiography Indocyanine green chorioangiography Video recording Image presentation Summary Questions for review and thought 40. Optical coherence tomography The technician’s role Normative databases Progression analysis Nonexudative age-related macular degeneration Exudative age-related macular degeneration Other macular abnormalities Vitreomacular traction Glaucoma Keratoconus screening Refractive surgery Corneal pathologies Femtosecond laser cataract surgery Summary 41. Computerized corneal topography Introduction and basics Axial map or sagittal map Elevation map Corneal thickness map Clinical uses Corneal topography analysis in refractive surgery Preoperative analysis Postoperative assessment of the cornea Corneal topography and cataract surgery Corneal topography and contact lens fitting Keratoconus Summary 42. Specular microscopy Specular microscope Endothelial specular photomicrography 43. Diagnostic ultrasound General considerations and conventional ultrasound diagnoses Theoretic considerations Technique of examination Basic examination Office biometry Intraocular disease Retinal detachment Choroidal detachment Intraocular tumors Choroidal melanoma. Retinoblastoma. Orbital cavernous hemangioma Orbital lymphoma Orbital rhabdomyosarcoma Orbital ultrasound Ultrasound biomicroscopy Technique Ultrasound biomicroscopy in ocular disease Glaucoma Pupillary block. Anterior synechiae. Plateau iris. Uveitis-glaucoma-hyphema syndrome. Supraciliary effusions and malignant glaucoma. Pigmentary dispersion syndrome. Anterior segment tumors Iris and ciliary body tumors. Cystic lesions of the iris. The zonule Scleral disease Ocular trauma Conjunctival and adnexal disease Suggested readings 6 Special Procedures 44. Blind persons in the modern world Blindness defined Partial sight and blindness Recent vision loss Total blindness Ophthalmic assistant’s role The blind child Braille Ophthalmic assistant’s role Rehabilitation Career development and employment Vocations Vocational teaching Available aids Questions for review and thought 45. Cardiopulmonary resuscitation Cardiopulmonary resuscitation How does cardiopulmonary resuscitation work? The first step of cardiopulmonary resuscitation: identify the need The second step of cardiopulmonary resuscitation: call for help and get an automated external defibrillator The third step of cardiopulmonary resuscitation: check for breathing and a pulse Common mistakes Hints The fourth and most critical step of cardiopulmonary resuscitation: perform chest compressions How to perform chest compressions Tips How it works Rescue breathing Hints The automated external defibrillator How automated external defibrillators work Special situations Children Hint Airway foreign body Trauma and motor vehicle accidents Cervical spine injury Bag-mask ventilation Hints Advanced cardiac life support/advanced airways Final thoughts Questions for review and thought 7 Ocular Vignettes 46. History of spectacles Antiquity The beginning Early eyeglasses Rivet spectacles Manufacture The frame Scissor spectacles and fork glasses Single lenses and monocles Spring spectacle frames Temple pieces and curved earpieces Lorgnettes Goggles and sunglasses Glasses in the Far East Summary Further reading 47. Art and the eye El Greco (1541–1614) The eyes of the Impressionists Claude Monet (1840–1926) Vincent van Gogh (1853–1890) Van Gogh’s halos Xanthopsia Edgar Degas (1834–1917) Camille Pissarro (1830–1903) Mary Cassatt (1844–1926) Summary Dedication Further reading 8 Role of Assistants in Eye Care 48. Allied health personnel in ophthalmology Evolution of training and service requirements of allied health personnel Divisions of ophthalmic medical personnel developing under the International Joint Commission of Allied Health Personnel in ... Business and administration Clinical evaluation and testing Generalized ophthalmic assistant Specialized ophthalmic assistant Education of ophthalmic medical personnel Certification and training levels for ophthalmic medical personnel The certified ophthalmic assistant Certified ophthalmic technician and certified ophthalmic medical technologist Subspecialty certification fields for ophthalmic medical personnel in the International Joint Commission of Allied Health P ... Corporate certified ophthalmic assistants Certified diagnostic ophthalmic sonographer Ophthalmic scribe certification examination Ophthalmic surgical assistant Registered ophthalmic ultrasound biometrist Ophthalmic medical personnel allied with the International Joint Commission of Allied Health Personnel in Ophthalmology Ophthalmic photographers Orthoptists Independent allied health personnel in visual science Ophthalmic operating room registered nurses Opticians The International Joint Commission of Allied Health Personnel in Ophthalmology certification process The educational and certification history of the International Joint Commission of Allied Health Personnel in Ophthalmology National organization of ophthalmic training and certification programs National and international ophthalmologic societies The future of allied health personnel in ophthalmology References 49. Ophthalmology ethics Introduction Informed consent Confidentiality Truth telling Boundary issues Multiculturalism Vulnerable populations Pediatric ethics Futility Medical error Impaired physicians and ophthalmic professionals Resource allocation Research ethics Surgical innovation Genetics ethics Conflicts of interest Advertising Fee splitting Medical industry Cosmetic surgery Refractive surgery Trainees in patient care Resolution of ethical dilemmas 50. Allied ophthalmic health personnel: scope of practice Introduction Defining scope of practice Determining the scope of practice Changing scope of practice Licensure and certification Patient information and privacy practices Insurance risk and malpractice Ethics and scope of practice Summary References Further reading 51. Testing and certification of ophthalmic skills Introduction Knowledge-based examinations Examination format and administration Skill-based examinations Value of certified allied ophthalmic personnel Career advancement Summary References 52. The development of allied ophthalmic personnel in North America and worldwide Introduction and history Nature of the work Future of ophthalmic assisting Conclusion References 53. Ophthalmic assisting in the international community and in the prevention of blindness Introduction VISION 2020: The Right to Sight Latin America and the Caribbean Brazil Guatemala Haiti Peru Puerto Rico Sub-Saharan Africa Notation: Egypt and Cameroon Kenya Malawi Mali Nigeria Tanzania Uganda North Africa and the Middle East Egypt Tunisia South-East Asia Bangladesh India Nepal Pakistan Western Pacific China Fiji Marshall Islands Micronesia, Federated States of Myanmar Singapore Thailand Australia: special note Summary In Remembrance Acknowledgments References 54. Eye banking Introduction The eye bank Placement Delivery to surgery Finances/sustainability Facility Management and Staff Eye bank associations and medical standards Ethics and guiding principles References Websites 9 Atlas of Clinical Ophthalmic Disorders 55. Atlas of common eye diseases and disorders Answers References to Figures Glossary Appendices Appendix 1: Ocular emergencies Appendix 2: Following universal precautions References Appendix 3: Principles of informed consent Informed consent Contents of an informed consent document Duty of disclosure Material risks Special and unusual risks Consent Exceptions Failure to disclose Appendix 4: Abbreviations and symbols in clinical use Appendix 5: Optical constants of the eye Appendix 6: Metric conversion (United States) Appendix 7: Skill checklists Skill checklistsa Appendix 8: Translations of commonly asked questions and commands Appendix 9: Office supplies in common use Appendix 10: Estimating visual loss Estimating loss of visual field Estimating loss of muscle function Appendix 11: Vision and driving Visual acuity Visual fields Ocular muscle imbalance Color blindness Dark adaptation Depth perception Appendix 12: Diopters to millimeters of radius conversion tables Appendix 13: Vertex conversion table Appendix 14: Diopters of corneal refracting power to millimeters of radius of curvature Appendix 15: Compensation for effect of vertex distances when plus lens is moved away from the eye Appendix 16: Compensation for effect of vertex distances when plus lens is moved toward the eye Appendix 17: Dioptric curves for extended range of keratometer Supplementary resources Supplementary resources Index
To access the Link, solve the captcha.
1. Disable the https://www.masiesdelpenedes.com/av3s4yy8neh AdBlock plugin. Otherwise, you may not get any links.
2. Solve the CAPTCHA.
3. Click download link.
4. Lead to download server to download.
Somatic Exercises For Dummies
2025-04-30
Patient Advocacy For Dummies
2025-05-01
