Handbook of Ocular Therapeutics and Pharmacology

Handbook of Ocular Therapeutics and Pharmacology

VOL. 77, NO. 3 BOOK REVIEWS procedure that I have long practiced to fore­ stall traumatic keratitis from a Schi0tz tonometer. My secretary places th...

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VOL. 77, NO. 3


procedure that I have long practiced to fore­ stall traumatic keratitis from a Schi0tz tonometer. My secretary places the patient in a supine position so the face is perfectly horizontal, thus widening the palpebral fissures and making the cornea more accessible. She then instills the anesthetic, and when I apply the tonometer she watches the needle until it settles down, and reads off the tension. This permits me to concentrate my entire atten­ tion on the eye and to remove the tonometer instantly when there is the slightest untoward movement by the patient. I cannot recall having had any cases of corneal abrasion. W a r r e n S. Reese, M.D. Philadelphia, Pennsylvania




PHARMACOLOGY. By Philip C. Ellis and D. L. Smith. St. Louis, C. V. Mosby, 1973. Clothbound, 262 pages, table of contents, index, two black and white figures. $14.75 It is one decade since the first edition of this handbook was published. The present fourth edition continues the same funda­ mental purpose of the original handbook; namely, to present in concise form the basic considerations of current ocular therapy and pharmacology. This fourth edition in­ cludes new therapeutic agents that have ap­ peared in the area since the last publication, as well as side reactions to local and systemic ocular medications not previously mentioned. New techniques of therapy and drug de­ livery also are presented and the pediatric dosage tables have been expanded. Not all books achieve their purpose but this one does. It is designed as a quick reference for the busy practicing ophthalmologist and as a guide for beginning residents in ophthalmol­ ogy, as well as all physicians who are treating ocular disorders. As in the past, the handbook is divided


into two sections: the first section on thera­ peutics and the second section on pharma­ cology. T h e latter presents the most com­ monly used medications that a practicing ophthalmologist would have occasion to ad­ minister and describes their actions, uses, side reactions, contraindications, and prepara­ tions. Dosages of each of the drugs are in­ cluded. The entire handbook primarily emphasizes the current use of drugs in oph­ thalmology. One may pick up this book for a quick reference for treatment of a specific condition without necessarily reading through the entire text. T h e authors have succeeded in maintaining this book as a concise, brief, and informative text. However, in so doing they had to make decisions to omit considerable data. They do discuss, for example, drug interactions briefly, but go into detail in the text only in dealing with anticoagulants. Ophthalmologists would like to know what drugs interact with those that they commonly employ in their practice, such as Diamox, antibiotics, antihistamines, and tranquilizers. Ready access to such infor­ mation could be quite helpful to ophthalmolo­ gists. T h e authors do not discuss in detail the use of soft contact lenses in the management of corneal conditions. They briefly mention the use of the soft contact lens in the manage­ ment of endothelial and epithelial dystrophy, and in dry eye syndromes. F o r the proper use of soft lenses in therapeutics, one would have to turn elsewhere for specific instruc­ tions. Again, for the sake of brevity they have not mentioned any of the details of cyclic A M P action in participation in ocular re­ sponses to drugs. If one were interested in the mechanism by which carbonic anhydrase agents produce side effects, such as the renal stones, there is little information in this text to help. T h e text is not intended to give de­ tails of all drug actions, but rather, to make available to the busy practitioner an oppor­ tunity of determining how to manage a spe­ cific problem promptly in adequate and direct fashion. No attempt has been made to give the



pros and cons of various therapeutic ap­ proaches or to justify the selection of the agents that they have made. Such efforts would enlarge the text and their decisions are apparently popular and acceptable ones. This fourth edition continues their fine tradition of providing a brief handbook for guidance in the management of ocular disorders and an understanding of pharmacologic agents. Irving H . Leopold




MARCH, 1974

points of disagreement, I would emphasize the following positive features: ( 1 ) the case material consists of actual cases seen by the author, and are well-selected and interesting; ( 2 ) good documentation by photographs is provided; ( 3 ) the book is 232 pages and yet sells for only $10, certainly a bargain in to­ day's market. This is a good book for medical students, house officers, and practitioners in ophthalmology who did not have a basic ex­ posure to neuro-ophthalmology. J. Lawton Smith


STUDY. By J. A. McCrary I I I . Flushing, N.Y., Medical Examination Publishing Company, 1973. Paperback, 232 pages, table of contents, index, approximately 30 black and white figures. $10 This small monograph consists of an initial section of 85 pages with a basic introduction to the neuro-ophthalmology examination in children, and chapters on the pupil, ocular motility, visual fields, and optic nerve and retina. A series of 45 case studies is presented in which the history, examination findings, and appropriate photographs are presented, followed by a series of questions with multi­ ple choice answers provided. The answers selected by the author are given with a discus­ sion and pertinent references. This is, there­ fore, an excellent little book for students in­ terested in neuro-opthalmology, as it has a built-in selfassessment value included. There are certain points about which I have a different opinion. In my experience, ophthalmoplegic migraine is a much more com­ mon cause of third nerve palsy in childhood than heavy metal intoxication, although the table in this text implies it is less frequent. The author's definition of a pseudo-Argull Roberton pupil differs from that of my experience in that the pupil here reacts not by light-near dissociation but characteristically reacts not only on the near reflex but also with adduction. Factors are included (as field de­ fects in syphilitic optic neuritis, on page 48) that are not primarily pediatric material. However, rather than pointing out the few

SYSTEM OF O P H T H A L M O L O G Y , vol. 6, O c u l a r

Motility and Strabismus. By Sir Stewart Duke-Elder and K. Wybar. St. Louis, C. V. Mosby, 1973. Clothbound, 873 pages, table of contents, index, 858 black and white figures. $56.50 This book is the most complete treatise ever published in the field of ocular motility and strabismus. Beautifully written in the lucid, scholarly style which typifies the entire Duke-Elder series, it attempts to update every detail of this difficult subject. All state­ ments throughout the text are made only after the authors have reviewed and weighed all pertinent claims and counterclaims re­ corded in world literature. The references are conveniently listed at the end of multiple subdivisions within each chapter. Despite the book's faultless clinical accuracy a warm personal touch characterizes the work. O n e method used by the authors to accomplish this is incorporation of a picture and a brief biographical sketch of each significant con­ tributor to all facets of the subject. T h e book is divided into two sections: normal and abnormal ocular motility. Ap­ proximately two thirds of the volume is de­ voted to strabismus. The section on normal ocular motility begins with in-depth presen­ tations about the gross and minute anatomy of the ocular muscles: their innervation, physiology, and neurology. A most thorough discussion of the mechanism of eye move­ ments with details about each type concludes