Neuroimaging ...............................................................774

Optic nerve ...................................................................779

Pupils ...........................................................................806

Chiasm .........................................................................812

Retrochiasmal pathways ...............................................819

Ocular motor nerves .....................................................821

Supranuclear disorders of ocular motility ......................830

Nystagmus ....................................................................832

Ocular myopathies ........................................................838

Miller Fisher syndrome..................................................842

Neurofibromatosis ........................................................842

Migraine .......................................................................846

Neuralgias ....................................................................847

Facial spasm ................................................................848

Cornea..........................................................................852

Ciliary effusion ..............................................................853

Lens .............................................................................853

Uveitis ..........................................................................854

Retina ...........................................................................854

Optic nerve ...................................................................859

Eyelid trauma ...............................................................862

Orbital trauma ..............................................................864

Trauma to the globe .....................................................867

Chemical Injuries ..........................................................881

Index ............................................................................887

viii

I first met Jack Kanski when I rotated to The Prince Charles Eye Unit in Windsor as part of the Oxford Deanery ophthalmology residency programme. Jack had actually just retired from clinical practice, but continued to attend the unit’s weekly education meetings. As the senior registrar, I was responsible for the organization of these sessions, to which Jack brought the same qualities that have facilitated his amazing success as a medical author – his encyclopaedic knowledge of ophthalmology and unerring ability to isolate the critical issues in a topic, not to mention his incisive wit, made the meetings extraordinarily effective as well as hugely enjoyable.

Jack was aware that I had done some textbook writing previously, and after one of the teaching sessions asked me whether I would be interested in writing a basic interactive text with him for medical students and novice ophthalmologists. I was a little daunted at first – Jack had written more than thirty ophthalmology textbooks by this time – but duly proceeded; we worked together extremely well, the book was written to deadline, was critically popular and sold lots of copies.

After I left Windsor, Jack and I worked with each other again on one or two projects and kept in touch socially, and a couple of years later he raised the possibility of collaboration on the next edition of Clinical Ophthalmology. I was thrilled. I recall vividly when, just prior to my first ophthalmology post, I contacted two registrars independently to enquire about initial textbook choice, receiving a curt single-word response from both: ‘Kanski’, with the implication that there was no need to ask. Big shoes to fill.

I have striven to maintain Jack Kanski’s approach of presenting core clinical knowledge in a systematic and succinct form; the extent of subject coverage by the later editions of the book is easily underestimated, and it is intended that a thorough acquaintance with its contents will provide a comprehensive basis for general ophthalmic practice. In the present edition every attempt has been made to completely update each chapter, with inclusion of the latest practical evidence-based diagnostic and treatment approaches, and replacement and upgrading of images as appropriate, such as where novel imaging modalities offer an enhanced perspective. The index for this edition has been written by the author to ensure its ease of use and clinical applicability.

I am incredibly indebted to Jack Kanski for the opportunity to contribute to Clinical Ophthalmology and other books, and for his ongoing mentoring and support. I have received invaluable help with the eighth edition from colleagues; Simon Chen generously furnished a large number of photographic and other images and gave his time to advise in depth on various posterior segment topics, Chris Barry also kindly provided and edited very numerous images, and many other ophthalmologists, optometrists, ophthalmic photographers and other eyecare professionals contributed one or a small number of figures and are acknowledged in individual legends. Philip Spork was good enough to review the section on macular antioxidant supplements. I am also indebted to the numerous colleagues who contacted Jack Kanski or myself with helpful comments on particular points in the seventh edition. Many individuals have helped substantially with the previous editions of Clinical Ophthalmology, the core of which has been brought forward into the present book; Ken Nischal and Andy Pearson both carried out detailed reviews of sections in the seventh edition, Jay Menon made a major contribution to the fifth edition, Anne Bolton and Irina Gout provided photographic expertise over many years and, of course, Terry Tarrant supplied a large number of amazingly authentic ocular paintings. My wife, Suzanne, and sons, Edward and Oliver, supported me unreservedly during the extended revision of the book, tolerating my absence over the course of many months without complaint. Finally, I would like to acknowledge the cheerful and expert support and commitment of the staff at Elsevier, especially Russell Gabbedy, Louise Cook, John Leonard, Anne Collett and Marcela Holmes.

It would be impossible for me to replicate Jack Kanski’s style precisely, but I have tried to retain the essence of his approach as faithfully as possible, and hope that this book will prompt in the reader at least some of the enthusiasm for the subject that the second edition of Clinical Ophthalmology engendered in me.