I
III Ophthalmology A Pocket Textbook Atlas Gerhard K. Lang, MD Professor and Chairman University Eye Hospital Ulm, Germany With contributions by Oskar Gareis, Gabriele E. Lang, Doris Recker, Peter Wagner Second edition, revised and enlarged 510 illustrations 50 tables Thieme Stuttgart New York
IV Library of Congress Cataloging-in-Publication Data Lang, Gerhard K. [Augenheilkunde. English] Ophthalmology : a pocket textbook atlas / Gerhard K. Lang ; with contributions by O. Gareis... [et al.]. 2nd ed., rev. and enl. p. ; cm. This book is an authorized revised and enlarged translation of the German edition published and copyrighted 2004 by Georg Thieme Verlag, Stuttgart, Germany T.p. verso. Includes index. 1. Ophthalmology Handbooks, manuals, etc. 2. Ophthalmology Textbooks. 3. Ophthalmology Atlases. I. Gareis, O. (Oskar) II. Title. [DNLM: 1. Eye Diseases. WW 140 L269a 2007a] RE48.9.L3613 2007 617.7 dc22 2006029787 1st German edition 1998 1st English edition 2000 2nd German edition 2000 1st Turkish edition 2001 1st French edition 2002 1st Spanish edition 2002 2nd Spanish edition 2006 Based on the original translation by John Grossman, Berlin, Germany Illustrator: Markus Voll, Munich, Germany 2007 Georg Thieme Verlag Rüdigerstraße 14 D-70469 Stuttgart, Germany http://www.thieme.de Thieme New York, 333 Seventh Avenue, New York, NY 10001, USA http://www.thieme.com Cover design: Thieme Marketing Typesetting by Druckhaus Götz GmbH, Ludwigsburg Printed in Germany by Appl Aprinta Druck, Wemding 10-ISBN 3-13-126162-5 (GTV) 13-ISBN 978-3-13-126162-5 (GTV) 10-ISBN 1-58890-555-1 (TNY) 13-ISBN 978-1-58890-555-0 (TNY) 123456 Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book. Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user s own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed. If errors in this work are found after publication, errata will be posted at www.thieme.com on the product description page. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation, without the publisher s consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing, preparation of microfilms, and electronic data processing and storage.
V The Concept behind the Book in Brief Definition. The concept behind this book was to organize the content and layout according to a uniform structure. This enhances the clarity of the presentation and allows the reader to access information quickly. Each chapter has its own header icon, which is shown on every page in the chapter. Figure headings summarize the key information presented in the respective figure, eliminating the need for the reader to read through the entire legend. Epidemiology. In the absence of precise epidemiologic data, the authors state whether the disorder is common or rare wherever possible. Etiology. This section usually combines information about the etiology and pathogenesis of a disorder and in so doing helps to illuminate important relationships. Symptoms and diagnostic considerations. These items are usually discussed separately. The section on symptoms includes only the phenomena with which the patient presents. How and using what methods the examiner proceeds from these symptoms to a diagnosis is only discussed under diagnostic considerations. Sections highlighted with a bar at the left contain important facts. These may be facts that one is often required to know for examinations, or they may be practical tips that are helpful in diagnosing and treating the disorder. Differential diagnosis. Wherever possible, this section discusses not only other possible diagnoses, but also important criteria for differentiating the disorder from others. Treatment. This section goes beyond merely documenting all possible therapeutic options. It also explains which therapeutic measures are advisable and offer a prospect of success. The discussion of medical treatment occasionally includes dosage information and examples of preparations used. This is done where such information is relevant to cases students will encounter in practice. The trade names specified do not represent a comprehensive listing. Prognosis and clinical course. The further development of the book depends in no small measure on your criticism. We are happy to receive any suggestions for improvements as this will help us tailor the next edition to better suit your needs. Please use the enclosed postcard.
VI About the Author Prof. Gerhard K. Lang (born 1951) studied medicine in Erlangen, Germany. After residency and research work in Erlangen and at the Johns Hopkins Hospital in Baltimore, he served as Co-Chairman at the Department of Ophthalmology at the University of Erlangen-Nuremberg. Since 1990 he has been Chairman of the Department of Ophthalmology at the University of Ulm. The author s special interests lie in European and international ophthalmology, and in particular the field of medical teaching.
VII Preface In this second edition, we have again designed the book in accordance with the principles of understanding it in medical school, learning it for the examination, and using it during internship. The broader goal was to give students a textbook that would kindle their interest and indeed their enthusiasm for ophthalmology. In an age in which teaching is undergoing evaluation, we felt this was particularly important. In pursuing this admittedly ambitious goal, we were able to draw on many years of teaching experience, which has shaped the educational concept behind this book. It can be seen in details such as the layout, which is characterized by numerous photographs and illustrative drawings. We have placed particular emphasis on the figures. These illustrations are meant to make ophthalmology come alive, and hopefully they will be able to let the reader share in the enthusiasm the authors themselves have for their specialty. I would like to take this opportunity to offer my heartfelt thanks to my teacher, Prof. G.O.H. Naumann (Erlangen, Germany), and also to my coauthors, Dr. Oskar Gareis, Prof. Gabriele E. Lang, Doris Recker, and Dr. Peter Wagner, for the willing collaboration and the exceptional initiative they have shown during the writing of this book. I would also like to extend special thanks to Dr. Jürgen Lüthje and Sabine Bartl of Thieme Medical Publishers, whose professionalism and active and tireless support were a constant source of inspiration to us all. I would again like to thank Markus Voll (Fürstenfeldbruck, Germany) for his splendid illustrations. Gerhard K. Lang
VIII Contributors Oskar Gareis, MD Chairman Department of Ophthalmology Municipal Hospital Pforzheim, Germany Gabriele E. Lang, MD Director Department of Medical Retina and Laser Surgery University Eye Hospital Ulm, Germany Doris Recker Orthoptist University Eye Hospital Ulm, Germany Peter Wagner, MD Chief of Medical Staff University Eye Hospital Ulm, Germany