Clinical Atlas of Peripheral Retinal Disorders

Book excerpt: A comprehensive understanding of diseases of the peripheral retina is essential to the general ophthalmologist as well as to the vitreoretinal surgeon. Expertise in in direct ophthalmoscopy, scleral depression, and contact lens biomicroscopy serves as a basis for observing the peripheral retina. These observations are then re corded on fundus drawing paper and the Tolentino vitreo-retinal chart. This or derly sequence of skills allows the ophthalmic surgeon to objectively diagnose and evaluate specific peripheral retinal disorders and plan for their therapeutic management. The Clinical Atlas of Peripheral Retinal Disorders is a compilation of fundus paint ings by David A. Tilden based on our observations of a large number of patients over the past 15 years. The atlas is organized along functional and anatomical lines. After a brief introduction to the clinical anatomy of the peripheral retina, the appearance of the fundus as a function of skin color and aging is presented. Many of the diseases of the peripheral retina can be divided into trophic (nutritional), tractional, and a combination of trophic plus tractional etiologies. This classifica tion system, although somewhat simplistic, appears adequate for our present level of understanding of the pathogenetic mechanisms of these disorders. Un doubtedly, once the molecular biology of these conditions is elucidated through future research, the classification will be revised. In addition, there are other con ditions that affect the peripheral retina that do not fit the proposed classification system and are covered under separate headings, i. e.