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Coding System for Disorders of the Eye
VOL. 67, NO. 3
429
BOOK REVIEWS
tion of the field of view that this necessi tates, is a discipline that apparently is not too difficult to learn, but is one that has to be learned. The pioneers in this field are now teaching their pupils this art as a first step, for they have found that surgery of the eye without the microscope, if indicated, is then more simple, if not as exquisite or refined. So, I think it is essential, in view of the ex periences shown in this report of microsur gery, that every department head of oph thalmic surgery at once take up this disci pline and train his residents in microsurgery as soon in the course of their careers as is possible. The first and second sessions of the sym posium were concerned with reports and dis cussions of the "Operating Microscopes, Experiences and Requests for Improve ment." These sessions were chaired by José I. Barraquer of Bogota, Columbia. The dis cussions ranged from details of personal ex periences with the various microscopes avail able, to preferences and ideas concerning im provements in magnification, illumination, angles of direction, operating positions, fo cusing, monocular vs. binocular microscopes, etc., a valuable melange of ideas of these pioneers forging a new path in a technique of surgery. The second session, chaired by J. Bo berg-Ans (Denmark), is composed of a wide range of remarks on "Suture Material and the Technique of Suturing in Microsur gery." Among these were valuable discus sions on needles, needle-holders, forceps, su ture material and of course, techniques. The final session consisted of elaborate summaries of what had been presented. I am sure that every ophthalmic surgeon will be keenly interested and even entranced by a careful study of this book. He will be convinced of the importance of microsur gery and if not too sclerotic, be determined to master the discipline for the advantage of his patients. He will also join in the fervor that is here now, to better the discipline. Derrick T. Vail, M.D.
CODING
SYSTEM
FOR DISORDERS
OF THE
EYE. By J. Schappert-Kimmijser, A. Colenbrander and S. Franken. Basel, S. Kar ger AG, 1968. Clothbound, 206 pages, 8 tables. Price : $12.50. This book, recommended by the Interna tional Council of Ophthalmology and the In ternational Federation of Ophthalmological Societies, represents a useful addition to the various coding systems available to the oph thalmologist, ophthalmology clinics, and hospital record rooms. The good and very thorough work which characterizes this vol ume, offers a much more detailed classifica tion for ophthalmology than any other in current usage and this is the authors' great est forte. But what is the advantage of a highly detailed classification? For that mat ter, what is the purpose of classification in general? Coding of symptoms, diagnoses, and procedures is necessary if one foresees the possibility that in the future charts or books may be searched by these symptoms, diagnoses, or procedures, for retrospective studies. By choosing the codes to reflect a classification scheme, narrow and broad searches can be performed with equal ease. In highly specific searches the detail of clas sification will be helpful in reducing the number of nonpertinent cases which will be retrieved. The authors restricted their coding sym bols to numbers. If alphabetic symbols have been added to the numerals, many more "spaces" could have been opened up for the classification scheme. The tables at the be ginning of the book will illustrate the orga nization of the system. It is commendable that provision is made for coding the ab sence of disorders (diabetes, without retinopathy). On the other hand it would seem to be advantageous to separate diagnoses from procedures (postoperative aphakia, intracapsular cataract extraction) instead of grouping them under the same code. A sec ond volume in which the codes are arranged in sequence should be published in addition to the alphabetic listing of this book if this
430
AMERICAN JOURNAL OF OPHTHALMOLOGY
coding scheme is to be used for practical purposes. Although the tables do reflect the general scheme, it is essential to have a com plete schedule available, since one does not really know what is included in the system or which diseases share the same code. Such a volume provided by other classification schemes, is also needed to allow intelligent assignment of new codes, or changes in codes to keep pace with the advances in med icine. I believe that anyone planning to set up a coding system in ophthalmology, be it in his office, clinic or hospital, should study and consider the authors' system before deciding to use one of the better established systems in this country. Tibor G. Farkas LECTURE
NOTES ON OPHTHALMOLOGY
by
Patrick D. Trevor-Roper. Third edition. Philadelphia, F. A. Davis Co., 1968. Clothbound, 112 pages, 78 figures (12 color, 66 black and white). Price: $3.25. This charming manual dealing with some clinical and practical aspects of ophthalmol ogy is aimed at medical students and general practitioners. It is written with the crisp confidence and clarity long characteristic of its British author and inspires admiration in its American readers. The medical and scientific content of these conveniently sized and low-priced lecture notes is almost too suitable for praise and too vulnerable to criticism for a review. It is a fair game, however, in any text aimed to help the student and practitioner to ask how the information given about the eye helps these overburdened folks in their general diagnostic and therapeutic work-up of the patient. I turned this question over to several of our students and they were a little un happy with the amount of information they retrieved in answer to this question. It was not immediately apparent to them that the
MARCH, 1969
author had completely defended his state ment that the eye "serves as a window through which evidence can be seen of half the maladies to which man is heir." Nonethe less, I am one of those who are prone to su pine positions while reading and like my books small and light. M. L. Sears LA
PARTICIPACION
OCULO-ORBITARIA
LOS T R A U M A T I S M O S
EN
ENCEFALO-CRANEA-
NOS. By Virgilio Victoria and Ricardo Fanjul. Buenos Aires, Libreria Universitaria de Oscar Macchi, 1968. Paperbound, 160 pages, 51 figures in black and white. Price: Not listed. This is a unique, small (145 pages of text) paperback volume issued from the Univer sity of Tucuman, describing the ocular and orbital findings in head trauma. The discus sions are accurate and concise. The first sec tion is devoted to concussion injury, detail ing first the cranial manifestations and then the manifestations in the eye and orbit. There is further discussion of the extent of involvement throughout the visual pathways to the occipital cortex. Good description is also given of details in the postconcussion syndromes, even to the degree of evaluation several times within the course of a single day. In the final section, fractures of the facial bones involving the orbit are considered in careful detail, both as to ocular and neuro logic manifestations. The illustrations are frequently repro duced from standard works and lack sharp ness of detail. This unfortunately is a major drawback and is inconsistent with the valu able details in the text. For the ophthalmologist or neuro-ophthalmologist who handles the Spanish language with ease, this is a delightful reference vol ume. Arthur H. Keeney
429
BOOK REVIEWS
tion of the field of view that this necessi tates, is a discipline that apparently is not too difficult to learn, but is one that has to be learned. The pioneers in this field are now teaching their pupils this art as a first step, for they have found that surgery of the eye without the microscope, if indicated, is then more simple, if not as exquisite or refined. So, I think it is essential, in view of the ex periences shown in this report of microsur gery, that every department head of oph thalmic surgery at once take up this disci pline and train his residents in microsurgery as soon in the course of their careers as is possible. The first and second sessions of the sym posium were concerned with reports and dis cussions of the "Operating Microscopes, Experiences and Requests for Improve ment." These sessions were chaired by José I. Barraquer of Bogota, Columbia. The dis cussions ranged from details of personal ex periences with the various microscopes avail able, to preferences and ideas concerning im provements in magnification, illumination, angles of direction, operating positions, fo cusing, monocular vs. binocular microscopes, etc., a valuable melange of ideas of these pioneers forging a new path in a technique of surgery. The second session, chaired by J. Bo berg-Ans (Denmark), is composed of a wide range of remarks on "Suture Material and the Technique of Suturing in Microsur gery." Among these were valuable discus sions on needles, needle-holders, forceps, su ture material and of course, techniques. The final session consisted of elaborate summaries of what had been presented. I am sure that every ophthalmic surgeon will be keenly interested and even entranced by a careful study of this book. He will be convinced of the importance of microsur gery and if not too sclerotic, be determined to master the discipline for the advantage of his patients. He will also join in the fervor that is here now, to better the discipline. Derrick T. Vail, M.D.
CODING
SYSTEM
FOR DISORDERS
OF THE
EYE. By J. Schappert-Kimmijser, A. Colenbrander and S. Franken. Basel, S. Kar ger AG, 1968. Clothbound, 206 pages, 8 tables. Price : $12.50. This book, recommended by the Interna tional Council of Ophthalmology and the In ternational Federation of Ophthalmological Societies, represents a useful addition to the various coding systems available to the oph thalmologist, ophthalmology clinics, and hospital record rooms. The good and very thorough work which characterizes this vol ume, offers a much more detailed classifica tion for ophthalmology than any other in current usage and this is the authors' great est forte. But what is the advantage of a highly detailed classification? For that mat ter, what is the purpose of classification in general? Coding of symptoms, diagnoses, and procedures is necessary if one foresees the possibility that in the future charts or books may be searched by these symptoms, diagnoses, or procedures, for retrospective studies. By choosing the codes to reflect a classification scheme, narrow and broad searches can be performed with equal ease. In highly specific searches the detail of clas sification will be helpful in reducing the number of nonpertinent cases which will be retrieved. The authors restricted their coding sym bols to numbers. If alphabetic symbols have been added to the numerals, many more "spaces" could have been opened up for the classification scheme. The tables at the be ginning of the book will illustrate the orga nization of the system. It is commendable that provision is made for coding the ab sence of disorders (diabetes, without retinopathy). On the other hand it would seem to be advantageous to separate diagnoses from procedures (postoperative aphakia, intracapsular cataract extraction) instead of grouping them under the same code. A sec ond volume in which the codes are arranged in sequence should be published in addition to the alphabetic listing of this book if this
430
AMERICAN JOURNAL OF OPHTHALMOLOGY
coding scheme is to be used for practical purposes. Although the tables do reflect the general scheme, it is essential to have a com plete schedule available, since one does not really know what is included in the system or which diseases share the same code. Such a volume provided by other classification schemes, is also needed to allow intelligent assignment of new codes, or changes in codes to keep pace with the advances in med icine. I believe that anyone planning to set up a coding system in ophthalmology, be it in his office, clinic or hospital, should study and consider the authors' system before deciding to use one of the better established systems in this country. Tibor G. Farkas LECTURE
NOTES ON OPHTHALMOLOGY
by
Patrick D. Trevor-Roper. Third edition. Philadelphia, F. A. Davis Co., 1968. Clothbound, 112 pages, 78 figures (12 color, 66 black and white). Price: $3.25. This charming manual dealing with some clinical and practical aspects of ophthalmol ogy is aimed at medical students and general practitioners. It is written with the crisp confidence and clarity long characteristic of its British author and inspires admiration in its American readers. The medical and scientific content of these conveniently sized and low-priced lecture notes is almost too suitable for praise and too vulnerable to criticism for a review. It is a fair game, however, in any text aimed to help the student and practitioner to ask how the information given about the eye helps these overburdened folks in their general diagnostic and therapeutic work-up of the patient. I turned this question over to several of our students and they were a little un happy with the amount of information they retrieved in answer to this question. It was not immediately apparent to them that the
MARCH, 1969
author had completely defended his state ment that the eye "serves as a window through which evidence can be seen of half the maladies to which man is heir." Nonethe less, I am one of those who are prone to su pine positions while reading and like my books small and light. M. L. Sears LA
PARTICIPACION
OCULO-ORBITARIA
LOS T R A U M A T I S M O S
EN
ENCEFALO-CRANEA-
NOS. By Virgilio Victoria and Ricardo Fanjul. Buenos Aires, Libreria Universitaria de Oscar Macchi, 1968. Paperbound, 160 pages, 51 figures in black and white. Price: Not listed. This is a unique, small (145 pages of text) paperback volume issued from the Univer sity of Tucuman, describing the ocular and orbital findings in head trauma. The discus sions are accurate and concise. The first sec tion is devoted to concussion injury, detail ing first the cranial manifestations and then the manifestations in the eye and orbit. There is further discussion of the extent of involvement throughout the visual pathways to the occipital cortex. Good description is also given of details in the postconcussion syndromes, even to the degree of evaluation several times within the course of a single day. In the final section, fractures of the facial bones involving the orbit are considered in careful detail, both as to ocular and neuro logic manifestations. The illustrations are frequently repro duced from standard works and lack sharp ness of detail. This unfortunately is a major drawback and is inconsistent with the valu able details in the text. For the ophthalmologist or neuro-ophthalmologist who handles the Spanish language with ease, this is a delightful reference vol ume. Arthur H. Keeney