Glaucoma, 2nd ed.

Glaucoma, 2nd ed.


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needs to know to become a first class retinoscopist. Corboy’s book is nicely printed and clearly and profusely illustrated. However, it is bound in very inexpensive form, with soft paper covers and a plastic binding device that does not hold the pages together well. It deteriorated quickly in my briefcase. A book such as this, which will probably see rough service in clinics and refracting lanes, would be more practical in a sturdier format.

The Retinoscopy Book. A Manual for Beginners, by John M. Corboy. Thorofare, N.J., Charles B. Slack, Inc., 1979, 143 pp., illus. Price: $9.50 Dr. Corboy has written an earnest, straightforward book of instructions on how to do streak retinoscopy according to Copeland. The book that invites comparison is the Weinstock and Wirtschafter volume entitled A Decision Oriented Manual of Retinoscopy. Both are manuals, or “how to” books. Weinstock and Wirtschafter are dedicated to the idea that clinical streak retinoscopy is taught best by a decision-making protocol that can be shown in diagrams representing the process. Corboy does not use that approach, although he employs one of their diagrams and recommends its use. Instead, he sets out to teach people, step-by-step, how to proceed to refract with a streak retinoscope, and he is good at it. I know of no published instructions that are as clear and easy to understand as his. His language is conversational and the cartoons and photographs with Hawaiian shirts and funny faces set a pleasant informal tone that invites the reader to relax and enjoy the process. Writing a book review is an opportunity and an invitation to express personal opinions, and I do not pretend to do otherwise. When I reviewed Weinstock and Wirtschafter’s book (Surv Ophthalmol22:144, 1977), I said that a process as complex as retinoscopy would probably not be best taught by a “how to” method based on rules to be remembered. I wonder now whether Corboy’s similar effort, good as it is, will teach ophthalmologists how to do streak retinoscopy at a high level of skill. Retinoscopy, in my opinion, will be best learned and most skillfully practiced by those who understand why they see what they see through the sighthole of the instrument. Where the images of the patient’s retina lie in space, how big they are, and whether they are erect or inverted are the crucial concepts. No mathematics or formal optics are needed for learning these ideas (See Safir A: Retinoscopy. Znt Ophthalmol Clin II:1 15-129, Spring 1971, and Safir A: Retinoscopy, in Duane T (ed): Clinical Ophthalmology, Vol. 1. Hagerstown, MD, Harper and Row, 1979). Once such an understanding has been established, a “how to” manual is the next step in gaining proficiency in retinoscopy. There is not now, to my knowledge, any single publication that tells the reader all that he or she



Glaucoma, 2nd ed., by Paul A. Chandler and W. Morton Grant. Philadelphia, Lea and Febiger, 1980, 460 pp. Price: $26.00 The long-awaited second edition of this classic text has arrived. The book adheres closely to the format of the first edition but has been expanded and updated. Several additional authors have contributed chapters or sections. The volume is divided into four parts. Part I is an introductory section which deals mainly with methods of examination of the eye in glaucoma. Part II is entitled “Diagnosis and Treatment of Glaucomas in Adults” and contains 24 chapters of various sizes (2 to 35 pages) dealing with primary open angle glaucoma, angle-closure glaucoma, and numerous forms of secondary glaucomas. Part III on surgical procedures, covers peripheral iridectomy, filtering procedures, cyclodialysis, and cyclocryotherapy. These sections include chapters and portions by Doctors Richard Simmons, David Epstein, David Dueker, B. Thomas Hutchinson, David Walton, and A. Robert Bellows. Part IV, written entirely by David Walton, contains eleven chapters of various lengths covering examination of the eye in infants and children, primary congenital open angle glaucoma, and a number of secondary forms of glaucoma. As in the first edition, the style is eminently readable, lucid, and folksy. In today’s world of homogenized data, it’s nice to see a little humor in textbooks (,‘ . . . . . 40 years ago, Doctor Chandler still had a lot to learn about glaucoma”). The editing has achieved a remarkable consistency of style throughout and there are only rare typographical errors. There are also few instances of repetition of information between chapters. Some of the best portions of this book are the beautifully detailed discussions of observations and techniques, which are not easily found else279



Ophthalmol 25 (4) Jonuary-February 1981

where. Chapter 2, on the examination of the eye, should be required reading for residents early in their training. The authors draw on their long and varied clinical experience to portray in minutest detail their methods of examination and of avoiding pitfal!s in various diagnostic techniques. The description of digital massage is a basic for anyone performing filtration surgery. In addition, pearls are scattered throughout. In comparison to the first edition, there are many more case reports. These occupy approximately 15% of the total length of the book and are used to illustrate or enhance various points emphasized in the text. In some cases, they are detailed and complete, while in others, pertinent details only are mentioned. Most of the cases are useful in proving the point, although some appear to be redundant or drawn out. Case 5 1 is an example of this. The indexing is adequate though incomplete. (Looking up Neptazane, I was told to see methazolamide, from whence I was told to see carbonic anhydrase inhibitors, where methazolamide wasn’t specifically mentioned. This could be instructive in a way, almost like a programmed text.) The major drawback of the book is the lack of illustrations. In view of the massive detail in which descriptions of the angle on gonioscopy and optic nervehead are given, it is surprising that there are not photographs which would be valuable for elucidation. Even the diagrams of visual fields in the first edition are not reproduced in the second. Figures would have been helpful also in the discussion of interpretation of results of tonography on page 20, where various forms of tonographic curves and artifacts are described. As with any textbook, there are arguable points. Little emphasis is given to visual fields in general, and the authors appear to rely heavily on Schiotz tonometry, using applanation tonometry as a backup. The authors are strong adherents of Koeppe gonioscopy and seem to dismiss all other forms. No mention is made of the value of supine pressures, particularly in the diagnosis of low tension glaucoma, and I wonder if Case 45 is not actually primary open angle glaucoma. The advocacy of pilocarpine q.3h. in ocular hypertension (Case 23) or starting epinephrine q.i.d (Case 20) represents, I suppose, a variation of schools of thought. It is interesting to compare this edition with the first, especially for those of us who had never heard of glaucoma in 1965, when the first edition was published. In 1965, cyclocryotherapy had just been described, but had not yet made it into the text, and trabeculectomy was still a few years off. The widespread application of beta-blockers and lasers was a decade yet to come. This was to be expected. Yet, surprising is the amount of knowledge which has not really ,changed, particularly in the area of clinical observation, and, compared to what was described in 1965, how relatively little has been added. The 1980’s will be a decade in which the


applications of cellular and molecular biology will begin to permeate ophthalmology, and it will be interesting to see how a third edition, 15 years hence, will have changed. To sum up, this is a valuable and highly readable text which is recommended to all in ophthalmology. ROBERTRITCH

Ophthalmic Ultrasonography: Comparative Techniques, by Richard L. Dallow. International Ophthalmology Clinics, Vol. 19, No. 4. Boston, Little, Brown and Company, 1979, pp. 310, illus. Price: $15.00 Dr. Dallow has edited the best up-to-date reference on ocular and orbital ultrasonography. The authors review A and B scan, immersion, and contact scanning, and linear, log and s-shape amplification. They also discuss the indications, the differences in diagnostic techniques and the various types of commercially available equipment for ocular ultrasonography. The first section covers the development and present status of ophthalmic ultrasound, giving credit to important innovators in the field such as Drs. Baum, Pernell, Oksala, Bronson, Ossoinig, Coleman, and their associates. It includes a summary by Drs. Lizzi and Fellepa of the present technical status of ophthalmic ultrasound. They adequately review the physics and electronics of ultrasound such that the clinician understands the usefulness and limitations of ultrasonography. In the second section, the authors contrast A scan, B scan, water immersion and contact scanning. Dr. Coleman and associates outline valuable reasons for using simultaneous A and B immersion scanning with linear amplification. In direct contrast, Dr. Ossoinig and his associates emphasize the need for standardized A scan with s-shape amplification for adequate tissue diagnosis. Dr. Fischer’s section on contact B scanning gives valuable hints on three dimensional thinking for diagnosing intraocular pathology. In the last section, the actual techniques used for immersion and contact scanning are discussed by several excellent ultrasonographers. Any newcomer to this field would be remiss not to heed their advice concerning methods and equipment used in ocular ultrasound. Dr. Dallow ends this series with a discussion on orbital ultrasonography. He uses the differences in scanning techniques to give valuable information on the purchase of equipment. I strongly recommend this reference for a short overall review. If you wish a more in-depth review, the references listed in the bibliography provide a good starting place. SAMUELGUILLORY