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By Roger L. Coakes and Patrick J. Holmes Sellors (Auth.)

This variation has been revised and up-to-date and is in color and in a brand new layout. The booklet nonetheless allows the scholar or working towards physician to deal with daily ophthalmic difficulties, in addition to spotting these scientific occasions which require expert consciousness. It presents a concise account of recent ophthalmology. easy anatomy and body structure are lined in addition to the illnesses of the attention, defined symptom by way of symptom instead of by way of the standard systematic approach. the attention in systemic affliction, ophthalmic investigations and remedy, and customary misconceptions also are mentioned. All illustrations seem without delay contrary the appropriate textual content

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The black fly, which is found alongside running waters, is host to the Onchocerca volvulus worm which nigrates as microfilariae throughout the human body. These invade every structure of the eye causing corneal earring, chronic iritis and chorioretinal degeneration. Onchocerca volvulus. 46 An outline of ophthalmology Cataract and optic atrophy may develop. Damage is caused both by living microfilariae and through immunological reaction to the dead organisms. Treatment There is no effective treatment of the established disease.

There is pain, photophobia and a slight to moderate reduction in visual acuity. The pupil is smaller than the unaffected side and redness of the eye is most marked in the circumcorneal region. Diagnosis is dependent upon slit-lamp examination of the eye. Cells and protein 'flare' are visible as the slit beam of light illuminates the anterior chamber. Aggregates of cells on the posterior corneal surface, called keratic precipitates (KP), may be seen and, if the iritis is severe, a hypopyon may form.

Differential diagnosis Pigmented choroidal lesions are common, but the vast majority are benign naevi; the hallmarks of malignancy are elevation and progressive enlargement. Other lesions which may be confused with malignant melanoma of the choroid are disciform degeneration of the macula, choroidal haemangioma and secondary choroidal tumours, particularly from carcinoma of the breast. Treatment The beneficial effects of removal of an eye with a malignant melanoma are uncertain and if the tumour is small and useful vision remains a conservative approach is often adopted.

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