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Clinical Ophthalmology

A Systematic Approach

Seventh Edition

Jack J Kanski, M D, M S, FRCS, FRCOphth


Honorary Consultant Ophthalmic Surgeon, Prince Charles Eye Unit, King Edward VII Hospital, Windsor, UK

Brad Bowling, FRCSEd(Ophth), FRCOphth


Consultant Ophthalmic Surgeon, Blackpool Victoria Hospital, Blackpool, UK

Copyright © 2011 Elsevier

Dedication

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To our wives

Val & Suzanne

Front Matter

Get fully searchable text and more online @ expertconsult.com

Clinical Ophthalmology

A SYSTEMATIC APPROACH

Seventh Edition

Jack J Kanski

M D, M S, FRCS, FRCOphth

Honorary Consultant Ophthalmic Surgeon

Prince Charles Eye Unit

King Edward VII Hospital

Windsor, UK

Brad Bowling

FRCSEd(Ophth), FRCOphth

Consultant Ophthalmic Surgeon

Blackpool Victoria Hospital

Blackpool, UK

With contributions from

Ken Nischal FRCOphth

Consultant Ophthalmic Surgeon

Great Ormond Street Hospital for Sick Children

London, UK

Andrew Pearson M RCP, FRCOphth

Consultant Ophthalmic Surgeon

Prince Charles Eye Unit, Windsor, and

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Royal Berkshire Hospital

Reading, UK

Edinburgh, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto

Commissioning Editor: Russell Gabbedy

Development Editor: Louise Cook

Editorial Assistants: Kirsten Lowson & Poppy Garraway

Project M anager: Frances Affleck

Design: Stewart Larking

I llustration M anager: Bruce Hogarth

I llustrator: Terry Tarrant, Ian Ramsden and Antbits

M arketing M anager: Helena Mutak

Copyright

An imprint of Elsevier Limited.

© 2011, Elsevier Limited. All rights reserved.

First edition 1984

Second edition 1989

Third edition 1994

Fourth edition 1999

Fifth edition 2003

Sixth edition 2007

Seventh edition 2011

The right of Jack J Kanski and Brad Bowling to be identified as authors of this work has been asserted by them in
accordance with the Copyright, Designs and Patents Act 1988.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center

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Page 10 of 11

and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions .

Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
understanding, changes in research methods, professional practices, or medical treatment may become
necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such information
or methods they should be mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.

With respect to any drug or pharmaceutical products identified, readers are advised to check the most current
information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered,
to verify the recommended dose or formula, the method and duration of administration, and contraindications.
It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to
make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all
appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.

Standard Edition: 978-0-7020-4093-1

I nternational Edition: 978-0-7020-4095-5

Kanski, Jack J.

Clinical ophthalmology : a systematic approach. – 7th ed.

1. Ophthalmology.

I. Title II. Bowling, Brad (Bradley)

617.7-dc22

ISBN-13: 9780702040931

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

Printed in China

Last digit is the print number: 9 8 7 6 5 4 3 2 1

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Preface to the seventh edition

The purpose of the seventh edition of Clinical Ophthalmology, as in previous editions, is to present the basics of
clinical ophthalmic practice in a systematic and succinct manner, to be used as a springboard to more in-depth
study of individual topics. We have tried to be comprehensive in the inclusion of key advances, with considerable
updating and revision of the text. The majority of the illustrations in this edition are new, and provide a more
effective and vivid representation of many conditions. In response to trainees’ requests the present edition also
places a greater emphasis on practical management, taking into account numerous published guidelines and other
authoritative sources. The book is intended principally for the trainee and practising ophthalmologist, but previous
editions have also been widely utilized by other eye care professionals, particularly optometrists.

Recent editions have benefited immeasurably from chapter reviews by experts in the relevant field, but this edition
is the first in which a co-author has joined Jack Kanski in taking overall responsibility for the book. Brad Bowling
has extensive experience in the teaching and training of ophthalmologists, and has brought an invaluable fresh
perspective and energy to the text which we trust is conveyed in the pages.

We are extremely grateful for input and expert advice received from numerous colleagues, in particular Andy
Pearson for a meticulous review of the sections on adnexal disease and Ken Nischal for detailed suggestions on
paediatric topics. We also very much appreciate Irina Gout's contribution of her medical photographic expertise,
without which many of the images in the book would not have been possible. The benevolence of other colleagues
and ophthalmic photography departments, particularly Steven Farley, Tim Cole and Lorraine Rimmer at Blackpool
Victoria Hospital, in kindly allowing the use of photographs from their collections is gratefully received, and each
is acknowledged in individual legends. Finally, we would like to acknowledge the support and commitment of the
staff at Elsevier Science, especially Russell Gabbedy.

The authors are acutely conscious of the privilege of involvement in contemporary ophthalmological education.
We have attempted to imbue the book – and infect the reader – with our enthusiasm for the specialty.

JJK & BB

2011

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