Helena M. Tabery Libros

As a young ophthalmologist, I found corneal epithelial diseases a subject diffcult to grasp. One day, it occurred to me that the reason might be a lack of images showing the nature of the components of the changes visible with the slit lamp. With the slit lamp, the inevitable eye movements that blur the image limited the magnifcation level, but perhaps photography might be the answer. It was not a short journey, but in the end the idea proved right. By trial and error, the quality of the images improved, and after some time, I found that the resolution allowed reasonable comparisons with available images of histological preparations. Such comparisons allowed better und- standing of the substructures of epithelial in vivo lesions and, in conjunction with their in vivo dynamic features, eventually an understanding of at least some mechanisms behind them. This book, originating from over 20 years of experience with observations of ocular surface changes at high magnifcation level, covers several aspects of corneal epithelial lesions caused in humans by herpes simplex virus: various shapes of the lesions, their substructure and mechanisms behind them; morphological features of the healing p- cess, sequelae, complications, and some accompanying signs; and some rare cases. For those less familiar with the slit lamp image, I have added explanatory drawings to facilitate comprehension.

This book presents high-magnification in vivo images of the morphology of recurrent corneal erosions and epithelial edema as captured by non-contact photomicrography. Part I of the book, on recurrent erosion syndrome, displays images covering a broad spectrum of epithelial changes, including manifestations of the ongoing underlying pathological process and epithelial activity aimed at elimination of abnormal elements or repair. The dynamics of the interplay between these opposing forces are captured in sequential photographs that aid interpretation. Part II of the book demonstrates typical features of corneal epithelial edema and also covers the contemporaneous occurrence, and dynamics, of phenomena indistinguishable from those commonly seen in recurrent erosion syndrome. Both parts include case reports illustrating typical features and documenting variability in symptoms and findings over time. The presented morphology will facilitate understanding of clinical appearances and assist in differential diagnosis.

This book presents in vivo captured high-magnification images of two conditions: keratoconjunctivitis sicca (KCS, or dry eye), an extremely common disease of the ocular surface, and filamentary keratopathy, a relatively rare phenomenon most commonly associated with KCS. The images of KCS represent the broad spectrum of ocular surface changes seen in the condition while the images of filamentary keratopathy clearly reveal the components of the ocular surface appendices, termed filaments. The photographs show phenomena captured in various illumination modes, without staining and after staining with diagnostic dyes, and the photographic sequences illustrate their dynamics. The images reflect the in vivo situation. Once aware of the various phenomena, anyone working with standard diagnostic equipment - the slit lamp and the diagnostic dyes- will be able to detect almost all of them. The book will be invaluable for all who deal with ocular surface diseases.​

Despite differences in frequency, causation, and infectivity, adenovirus epithelial keratitis and Thygeson's superficial punctate keratitis (TSPK) are often confused in clinical practice owing to the similarity between adenovirus epithelial infiltrates and ‘coarse’ epithelial TSPK lesions. This book presents the morphological features, dynamics, and sequelae of adenovirus and Thygeson's keratitides captured at high magnification in the living human cornea. It thereby fills the existing void between conventional photographs and slit-lamp observations. Case reports demonstrate the importance of patient history in differential diagnosis, illustrate the need for familiarity with early manifestations of adenovirus infections, and assist in the diagnosis of rare variants of TSPK. Furthermore, the detailed observations on the natural course of the diseases ensure that the book will serve not only as a diagnostic tool but also as a reference when evaluating the effects of potential new treatments.

Herpes zoster ophthalmicus (HZO) is a common disease in the elderly and the immunosuppressed, with potentially devastating sequelae. Diagnosis of HZO is clinical but almost all its manifestations are non-specific. The exception is varicella-zoster virus epithelial keratitis, which is frequently the only indicator of the true nature of the disease. This book is unique in presenting high-magnification images, obtained by non-contact in vivo photomicrography, that capture the distinctive features of varicella-zoster virus epithelial keratitis in HZO. Both the morphology and the dynamics of the corneal epithelial lesions are splendidly documented, including in patients with HZO sine herpete and recurrent disease. Three rare cases of ocular surface involvement in acute HZO are included, and the final chapter carefully compares varicella-zoster virus epithelial keratitis in HZO and the lesions of herpes simplex virus.