System of Ophthalmology Volume XIV Injuries Part 1 Mechanical InjuriesPDF|Epub|txt|kindle电子书版本下载

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CONTENTS OF PART1

INTRODUCTION1

CHAPTER Ⅰ THE NATURE AND INCIDENCE OF OCULAR INJURIES1

Ⅰ．History3

Ⅱ．Incidence5

Ⅲ．The Types of Ocular Injury7

(a) Intra-uterine Injuries8

(b) Birth Injuries9

(c) Non-occupational Domestic Injuries18

(d) Injuries in Travel and Sport24

(e) Injuries in Agriculture31

(f) Industrial Hazards34

Incidence36

trade distribution37

prevention43

(g) War Injuries49

Battle casualties51

aerial bombing54

(h) Self-inflicted Injuries56

(i) Iatrogenic Injuries59

SECTION Ⅰ MECHANICAL INJURIES61

CHAPTER Ⅱ CONCUSSIONS AND CONTUSIONS63

A．Concussions and Contusions of the Globe63

Ⅰ．Concussion Effects on the Cornea81

(a) CEdematous and Haemorrhagic Changes81

1．Epithelial Lesions81

2．Interstitial CEdematous Opacities82

3．Blood-Staining of the Cornea83

(b) Folding of the Corneal Tissues85

(c) Lacerations of the Cornea86

1．Interstitial Fractures86

2．Tears in Descemet＇s Membrane87

3．Complete Rupture of the Cornea88

Ⅱ．Concussion Effects on the Iris and Ciliary Body89

(a) Changes in the Pupil and Accommodation90

1．Traumatic Miosis and Spasm of Accommodation90

2．Traumatic Iridoplegia and Cycloplegia90

(b) Vascular Changes92

1．Reactive Hyperaemia and Exudation92

2．Haemorrhages into the Iris Tissue93

3．Traumatic Hyphaema93

(c) Lacerations of the Iris and Ciliary Body101

1．Interstitial Tears of the Sphincter102

2．Tears at the Pupillary Border102

3．Tears in the Stroma of the Iris104

4．Dehiscences of the Pigmentary Layer of the Iris104

5．Iridodialysis105

6．Irideremia108

7．Iridoschisis109

8．Traumatic Cyclodiulysis110

Recession of the angle of the anterior chamber111

(d) Retroflexion of the Iris114

(e) Inflammatory and Atrophic Changes115

1．Traumatic Iridocyclitis and Endophthahnitis115

2．Post-traumatic Atrophy116

3．Pigmentary Changes118

Ⅲ．Concussion Effects on the Lens and Zonule121

(a) Posterior Lenticonus121

(b) Lenticular Opacities and Concussion Cataract121

1．Vossius＇s Ring Opacity125

2．Discrete Subepithelial Opacities127

3．Traumatic Rosette-shaped Opacities130

Fresh type130

late opacities134

4．Traumatic Zonular Cataract136

5．Post-traumatic Atrophy of the Lens137

6．Pre-senile and Senile Lens Changes following a Concussion137

7．Diffuse Concussion Cataract137

8．Massage Cataract139

(c) Subluxation and Dislocation of the Lens142

Ⅳ．Contusion Effects on the Choroid150

(a) Choroidal Haemorrhage and Detachment150

(b) Rupture of the Choroid151

1．Indirect Ruptures153

2．Direct Ruptures158

(c) Traumatic Choroiditis160

Ⅴ．Concussion Effects on the Retina164

(a) Concussion CEdema of the Retina165

(b) Concussion Necrosis of the Retina166

(c) Concussion Changes at the Macula168

1．Macular CEdema168

2．Traumatic Macular Cysts and Holes169

3．Traumatic Macular Atrophy of Haab172

(d) Peripheral Atrophio Retinal Changes173

(e) Vascular Changes in the Retina175

Traumatic Retinal Haemorrhages175

(f) Retinal Tears176

(g) Traumatic Retinal Detachment181

Ⅵ．Concussion Effects at the Optic Disc187

(a) Papillitis and Optic Atrophy187

(b) Rupture and Avulsion of the Optic Nerve187

Ⅶ．Concussion Changes in the Vitreous194

(a) Vitreous Haemorrhages194

(b) Detachment of the Vitreous196

(c) Herniation of the Vitreous into the Anterior Chamber197

Ⅷ．Ruptures of the Solera198

(a) Direct Ruptures198

(b) Indirect Ruptures199

(e) Incomplete Ruptures208

Ⅸ．Concussion Effects on the Refraction210

Ⅹ．The Effects of Concussion on the Ocular Tension212

B．Concussions and Contusions of the Ocular Adnexa212

Ⅰ．Contusions of the Lids212

(a) CEdema and Haemorrhage of the Lids212

(b) Crush Wounds214

(c) Supra-orbital Amaurosis and Amblyopia218

Ⅱ．Fractures of the Orbit219

(a) Frontal Fractures involving the Orbital Roof223

(b) Middle Facial Fractures232

1．Naso-maxillary Fractures236

2．Malar Fractures240

(c) Internal Orbital Fractures243

(d) The Clinical Picture of Orbital Fractures249

(e) The Diagnosis of Orbital Fractures259

(f) Indirect Orbital Fractures associated with Head Injury265

(g) Ocular Injury in Orbital Fractures268

(h) The Treatment of Orbital Fractures272

Fractures of the orbital roof and superior orbital rim274

naso-maxillary fractures277

zygomatic fractures277

orbital floor fractures278

the repair of bony defects280

ptosis283

epiphora283

canthal deformities284

retraction of the lower lid284

infra-orbital nerve anaesthesia284

Ⅲ．Orbital Haemorrhage285

Orbital granuloma290

blood cysts290

Ⅳ．Orbital Emphysema291

Ⅴ．Contusion Injuries to the Orbital Contents294

(a) Changes in the Position of the Eyeball294

1．Luxation of the Globe295

2．Traumatic Enophthalmos295

(b) Injuries to the Optic Nerve297

(c) Concussion Injuries to the Orbital Muscles and Nerves298

(d) Traumatic Aneurysm of the Ophthalmic Artery305

(e) Serous Tenonitis305

Ⅵ．Concussion Injuries to the Lacrimal Apparatus306

(a) The Lacrimal Gland306

(b) The Lacrimal Passages307

CHAPTER Ⅲ INCISED WOUNDS311

Ⅰ．Introduction311

Ⅱ．Non-perforating Wounds of the Eye313

(a) Corneal Abrasions313

(b) Recurrent Corneal Erosions315

(c) Deep Non-perforating Corneal Wounds318

(d) Wounds of the Conjunctiva321

(e) Wounds of the Sclera322

Ⅲ．Perforating Wounds of the Eye323

(a) Perforating Wounds of the Ocular Coats324

1．Uncomplicated Corneal Wounds324

2．Complicated Corneal Wounds327

(ⅰ) Epithelial Ingrowths327

(ⅱ) Stromal Overgrowth332

(ⅲ) The Incarceration of Ocular Tissues in the Wound335

3．Ectasias and Staphylomata339

4．Cystoid Cicatrix:Corneal Fistula345

5．Perforating Corneo-scleral Wounds345

6．Perforating Scleral Wounds346

(b) Wounds of the Intra-ocular Tissues350

1．Wounds of the Iris350

2．Wounds of the Ciliary Body and Choroid350

3．Wounds of the Retina351

4．Wounds of the Lens:Perforating Traumatic Cataract351

Localized stationary cataract352

rosette cataract354

total traumatic cataract356

lacerated cataract357

(c) The Clinical Picture of Perforating Wounds360

(d) The Treatment of Perforating Wounds360

The immediate treatment of a perforated eye363

the delayed treatment of a perforated eye373

(e) The Post-traumatic Complications of Perforating Wounds383

1．Post-traumatic Non-infective Uveitis383

2．Chronic Haemophthalmitis390

3．Infected Perforating Wounds393

(ⅰ) Pyogenic Infections393

(ⅱ) Infections by Specific Organisms405

Gas gangrene405

tetanus407

4．Sympathetic Ophthalmitis410

5．Traumatic Cysts411

(f) The General Prognosis of Perforating Wounds420

Ⅳ．Perforating Wounds of the Adnexa424

(a) Perforating Wounds of the Lids424

Complications427

treatment431

(b) Perforating Wounds of the Lacrimal Passages434

(e) Penetrating Wounds of the Orbit437

The optic nerve438

the ocular muscles441

the orbital nerves442

intracranial extension443

complications445

CHAPTER Ⅳ RETAINED FOREIGN BODIES451

A．Extra-ocular Foreign Bodies451

Ⅰ．Mechanical Effects454

Multiple Foreign Bodies456

Ⅱ．Specific Effects459

(a) Unorganized Material459

Glass and plastics459

lead460

copper461

iron462

(b) Organized Material464

Ⅲ．Complications of Extra-ocular Foreign Bodies467

Infection467

corneal opacification469

implantation cysts469

Ⅳ．Diagnosis of Extra-ocular Foreign Bodies470

Ⅴ．The Treatment of Extra-ocular Foreign Bodies471

Superficial foreign bodies472

foreign bodies embedded in the cornea473

foreign bodies embedded in the conjunctiva and sclera476

B．Intra-ocular Foreign Bodies477

Clinical picture483

Ⅰ．The Mechanical Effects of Foreign Bodies485

Ⅱ．Specific Effects of Retained Foreign Bodies500

(a) Inert Substances501

Stone,sand,clay and cement501

coal and carbon502

gunpowder,cordite502

glass,quartz,porcelain and plastics503

india-rubber505

talc505

(b) The Irritative Metals508

1．Lead508

2．Zinc510

3．Nickel510

4．Aluminium510

5．Mercury511

6．Copper (Chaleosis)512

7．Iron (Siderosis)525

(c) Organized Material544

1．Vegetable Material545

2．Animal Matter551

Cilia553

Ⅲ．The Complications of Intra-ocular Foreign Bodies560

Intra-ocular haemorrhage562

pyogenic infection562

gas gangrene563

sympathetic ophthalmitis563

Ⅳ．The Diagnosis and Localization of Intra-ocular Foreign Bodies565

(a) Clinical Methods of Investigation565

(b) Special Methods of Investigation567

1．Methods depending on Magnetizability567

2．Methods depending on Electrical Induction570

3．Radiographic Methods572

(ⅰ) The Radiological Demonstration of Intra-ocular Foreign Bodies575

(ⅱ) The Radiological Localization of Intra-ocular Foreign Bodies579

α．Direct Methods580

β．Methods depending on Rotation of the Globe587

γ．Methods depending on Geometrical Construction592

δ．Stereoscopic Methods604

ε．Methods depending on the Delineation of the Globe by Contrast Media605

ζ．Bone-free Methods606

4．Ultrasonic Localization611

5．Methods for Determining the Nature of a Foreign Body by Chemical Analysis613

Ⅴ．The Treatment of Intra-ocular Foreign Bodies616

(a) The Removal of Magnetic Foreign Bodies620

(b) The Removal of Non-magnetic Foreign Bodies637

Ⅵ．The Ultimate Prognosis of Intra-ocular Foreign Bodies645

C．Foreign Bodies in the Ocular Adnexa650

Ⅰ．Foreign Bodies in the Lids650

Ⅱ．Foreign Bodies in the Lacrimal Passages652

Ⅲ．Foreign Bodies in the Orbit655

Clinical picture660

specific effects661

complications663

diagnosis665

treatment666

CHAPTER Ⅴ EXPLOSION AND GUNSHOT INJURIES671

Ⅰ．Multiple Explosion Injuries671

Ⅱ．Gunshot Wounds676

Types of injury676

treatment688

CHAPTER Ⅶ THE INDIRECT OCULAR EFFECTS OF MECHANICAL INJURIES693

Ⅰ．The Delayed Effects of Ocular Injury693

(a) The Post-traumatic Development,of Infection693

Zoster696

syphilis697

tuberculosis698

sarcoidosis699

(b) The Post-traumatic Incidence of Degenerative Changes699

(c) The Post-traumatic Development of Neoplasia700

Simple tumours701

malignant tumours702

Ⅱ．The Ophthalmological Implications of Head Injury705

(a) Injuries to the Visual Pathways706

(b) Pupillary Changes707

(c) Ocular Motor Phenomena709

(d) Vascular Complications712

(e) Late Effects of Head Injury715

Ⅲ．The Ophthalmological Implications of Remote Injury716

(a) Injury to the Sympathetic Nerve716

The whiplash syndrome716

cervical migraine717

(b) Traumatic Retinopathy717

(c) Multiple Fat Emboli720

(d) Compression Cyanosis728

(e) Retinal Ischaemia after Exsanguination733

(f) The Battered Baby Syndrome736

(g) Ocular Complications of Diagnostic and Therapeutic Procedures742