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Introduction to Ophthalmology
AMERICAN JOURNAL OF OPHTHALMOLOGY
282
FEBRUARY, 1977
BOOK REVIEWS
REFERENCES
1. Abramson, D. H., Chang, S., and Coleman, D. J.: Pilocarpine therapy in glaucoma. Arch. Ophthalmol. 94:914, 1976. 2. Lebensohn, J. E.: Minus lenses as an effective adjuvant in control of juvenile glaucoma, Am. J. Ophthalmol. 35:1029, 1952.
Introduction to Ophthalmology. B y J o h n Parr. Dunedin, New Zealand, University of Otoga Press, J o h n M c l n d o e Ltd., 1976. Paperbound, 2 1 6 pages, preface, table of contents, index, 2 3 9 black and white figures. $ 1 4 .
Transvitreal Radiofrequency Diathermy Editor: Sometime ago I recommended a straight insulated probe for use of transvitreal diathermy of retina and retinal vess e l s . This probe is used with the radiofrequency (13 M H z ) diathermy unit of Medical Instrument Research Associates (MIRA). Recently, I have heard of two cases in which the probe was used to coagulate bleeding vessels in the vicinity of the optic nerve head during vitrectomy. In both cases the eyes ended up with no light perception. Possibly the stray radiofrequency current, intended to coagulate protruding tissue, reached the optic nerve and actually coagulated nerve tissue. Although this possibility is not proven, I feel that coagulation of tissue in close vicinity o f the optic nerve by radiofrequency diathermy with a simple insulated probe cannot be recommended anymore. T h e manufacturer has been informed of the potential hazard and has agreed to discontinue the sale of this probe. 1 - 3
R O B E R T M A C H E M E R , M.D.
Miami,
Florida
REFERENCES
1. Parel, J.-M., Machemer, R., and Aumayr, W.: A new concept for vitreous surgery. 4. Improvements in instrumentation and illumination. Am. J. Ophthalmol. 77:6, 1974. 2. Machemer, R.: A new concept for vitreous surgery. 7. Two instrument techniques in pars plana vitrectomy. Arch. Ophthalmol. 92:407, 1974. 3. Machemer, R.: Vitrectomy, A Pars Plana Approach. New York, Grune & Stratton, 1975.
Professor Parr has developed a book for medical students. His goal is to provide sufficient information at a reasonable level of ophthalmological competence required for medical practitioners who are not ophthalmologists. T h e book is organized into four parts: Basic Sciences; E x amination and Interpretation; Clinical Topics; and Casualty Officer Ophthalmology. T h e first part, Basic Sciences, is a particularly lucid explanation of the anatomy, optics and physiology of the eye, and the visual system. T h e illustrations are clear and helpful. It may be more than the average medical student will want to know or be able to learn about ophthalmology. It is an unusually clear exposition for the medical student who is especially interested in ophthalmology. I think it would be particularly appropriate for the student rotating on a clinical elective in ophthalmology with a special interest in the area. T h e second part, Examination and Interpretation, provides a description of the ocular systems and an explanation o f the various examination procedures. While it may not allow the student to approach the patient directly and his visual complaints after reading this chapter, it would be most helpful. T h e fundus diagrams clarify the correlation o f the ophthalmoscopic and structural characteristics of the fundus. Understandably, color photographs or simulations have not been included. T h e section on clinical conditions pro-
BOOK REVIEWS
VOL. 83, NO. 2
vides a sufficient initial cognitive basis for the student to begin to understand clinical problems. T h e section, Casualty Officer Ophthalmology, provides the most direct instruction on approaching the patient with a variety of signs and symptoms. T h i s may be the most useful section of the book for the medical student. T h e epilogue, on objectives in undergraduate ophthalmology, is an interesting addition to the text. T h e s e objectives, according to Professor Parr, guided the development of the content of the book, and identify what a student should b e able to do at the end of his training. As any text is wont to do, the book may provide more information than is necessary for the student to reach the objectives. Professor Parr is aware of a parallel effort in educational objectives in ophthalmology in the U . S . supported by the American Academy of Ophthalmology and Otolaryngology and the Association of University Professors of Ophthalmology (Ophthalmology Study Guide for Students and Practitioners of Medicine). T h e book is a sound contribution to the general textbook in ophthalmology for the nonophthalmologist. It is the first step in the goal that Professor Parr has outlined in developing a text which could approach ah educational support of the objectives he has outlined. T h i s book is an alternative to Newell, Vaughan, Scheie and Havener for the beginning student in ophthalmology. BRUCE E.
SPIVEY
Adas of Slit-Lamp Photography and Introduction to its Technical Problems. By Ernst-Martin Meyner. Stuttgart, Ferdinand E n k e Verlag, 1 9 7 6 . Clothbound, 142 pages, table of contents, index, 6 9 black and white figures; 8 6 color figures. $ 3 5 .
283
Dr. Meyner's stated objective," . . . to demonstrate that a photographic reproduction of differentiated slit-lamp findings is possible today" is convincingly accomplished in this book. However, such fine quality o f printed reproductions is ultimately dependent upon the skills and motivations of the engravers and printers. T h e unusually fine quality of engraving represented in this atlas is available in the United States only if one searches for the exceptional craftsmen. T h e book is divided into three sections; an atlas of representative conditions of the eye as seen with the slit-lamp camera, an appendix that is as much a photographic reference manual as a continuation o f the atlas, and a section on instrumentation, slit-lamp photographic approaches to specific areas o f the eye and photographic methods. T h e atlas section of 6 9 pages contains 122 reproductions, most of them in color, of fine slit-lamp photographs; subjects are arranged geographically from the anterior to posterior poles of the globe. T h e crystalline lens and related pathology has received more attention than other structures, there being 5 9 figures in this category. T h e atlas could have gained by having more chamber angle pathology, more studies of the vitreous body (granted it is not easily photographed, but it can be done) and a few good pictures using the narrow slit-lamp beam on such fundus changes as cystic degeneration of the macula, detachments of the retinal pigment epithelium, drusen, and glaucomatous cupping of the optic disk. T h e 16-page appendix contains 2 6 figures in black and white. T h e s e contribute additional examples of pathology but they should b e of greatest value to the beginner in slit-lamp photography because of the photographic data that accompany each picture. T h e s e are: type of illumination, camera aperture, lens pow-
282
FEBRUARY, 1977
BOOK REVIEWS
REFERENCES
1. Abramson, D. H., Chang, S., and Coleman, D. J.: Pilocarpine therapy in glaucoma. Arch. Ophthalmol. 94:914, 1976. 2. Lebensohn, J. E.: Minus lenses as an effective adjuvant in control of juvenile glaucoma, Am. J. Ophthalmol. 35:1029, 1952.
Introduction to Ophthalmology. B y J o h n Parr. Dunedin, New Zealand, University of Otoga Press, J o h n M c l n d o e Ltd., 1976. Paperbound, 2 1 6 pages, preface, table of contents, index, 2 3 9 black and white figures. $ 1 4 .
Transvitreal Radiofrequency Diathermy Editor: Sometime ago I recommended a straight insulated probe for use of transvitreal diathermy of retina and retinal vess e l s . This probe is used with the radiofrequency (13 M H z ) diathermy unit of Medical Instrument Research Associates (MIRA). Recently, I have heard of two cases in which the probe was used to coagulate bleeding vessels in the vicinity of the optic nerve head during vitrectomy. In both cases the eyes ended up with no light perception. Possibly the stray radiofrequency current, intended to coagulate protruding tissue, reached the optic nerve and actually coagulated nerve tissue. Although this possibility is not proven, I feel that coagulation of tissue in close vicinity o f the optic nerve by radiofrequency diathermy with a simple insulated probe cannot be recommended anymore. T h e manufacturer has been informed of the potential hazard and has agreed to discontinue the sale of this probe. 1 - 3
R O B E R T M A C H E M E R , M.D.
Miami,
Florida
REFERENCES
1. Parel, J.-M., Machemer, R., and Aumayr, W.: A new concept for vitreous surgery. 4. Improvements in instrumentation and illumination. Am. J. Ophthalmol. 77:6, 1974. 2. Machemer, R.: A new concept for vitreous surgery. 7. Two instrument techniques in pars plana vitrectomy. Arch. Ophthalmol. 92:407, 1974. 3. Machemer, R.: Vitrectomy, A Pars Plana Approach. New York, Grune & Stratton, 1975.
Professor Parr has developed a book for medical students. His goal is to provide sufficient information at a reasonable level of ophthalmological competence required for medical practitioners who are not ophthalmologists. T h e book is organized into four parts: Basic Sciences; E x amination and Interpretation; Clinical Topics; and Casualty Officer Ophthalmology. T h e first part, Basic Sciences, is a particularly lucid explanation of the anatomy, optics and physiology of the eye, and the visual system. T h e illustrations are clear and helpful. It may be more than the average medical student will want to know or be able to learn about ophthalmology. It is an unusually clear exposition for the medical student who is especially interested in ophthalmology. I think it would be particularly appropriate for the student rotating on a clinical elective in ophthalmology with a special interest in the area. T h e second part, Examination and Interpretation, provides a description of the ocular systems and an explanation o f the various examination procedures. While it may not allow the student to approach the patient directly and his visual complaints after reading this chapter, it would be most helpful. T h e fundus diagrams clarify the correlation o f the ophthalmoscopic and structural characteristics of the fundus. Understandably, color photographs or simulations have not been included. T h e section on clinical conditions pro-
BOOK REVIEWS
VOL. 83, NO. 2
vides a sufficient initial cognitive basis for the student to begin to understand clinical problems. T h e section, Casualty Officer Ophthalmology, provides the most direct instruction on approaching the patient with a variety of signs and symptoms. T h i s may be the most useful section of the book for the medical student. T h e epilogue, on objectives in undergraduate ophthalmology, is an interesting addition to the text. T h e s e objectives, according to Professor Parr, guided the development of the content of the book, and identify what a student should b e able to do at the end of his training. As any text is wont to do, the book may provide more information than is necessary for the student to reach the objectives. Professor Parr is aware of a parallel effort in educational objectives in ophthalmology in the U . S . supported by the American Academy of Ophthalmology and Otolaryngology and the Association of University Professors of Ophthalmology (Ophthalmology Study Guide for Students and Practitioners of Medicine). T h e book is a sound contribution to the general textbook in ophthalmology for the nonophthalmologist. It is the first step in the goal that Professor Parr has outlined in developing a text which could approach ah educational support of the objectives he has outlined. T h i s book is an alternative to Newell, Vaughan, Scheie and Havener for the beginning student in ophthalmology. BRUCE E.
SPIVEY
Adas of Slit-Lamp Photography and Introduction to its Technical Problems. By Ernst-Martin Meyner. Stuttgart, Ferdinand E n k e Verlag, 1 9 7 6 . Clothbound, 142 pages, table of contents, index, 6 9 black and white figures; 8 6 color figures. $ 3 5 .
283
Dr. Meyner's stated objective," . . . to demonstrate that a photographic reproduction of differentiated slit-lamp findings is possible today" is convincingly accomplished in this book. However, such fine quality o f printed reproductions is ultimately dependent upon the skills and motivations of the engravers and printers. T h e unusually fine quality of engraving represented in this atlas is available in the United States only if one searches for the exceptional craftsmen. T h e book is divided into three sections; an atlas of representative conditions of the eye as seen with the slit-lamp camera, an appendix that is as much a photographic reference manual as a continuation o f the atlas, and a section on instrumentation, slit-lamp photographic approaches to specific areas o f the eye and photographic methods. T h e atlas section of 6 9 pages contains 122 reproductions, most of them in color, of fine slit-lamp photographs; subjects are arranged geographically from the anterior to posterior poles of the globe. T h e crystalline lens and related pathology has received more attention than other structures, there being 5 9 figures in this category. T h e atlas could have gained by having more chamber angle pathology, more studies of the vitreous body (granted it is not easily photographed, but it can be done) and a few good pictures using the narrow slit-lamp beam on such fundus changes as cystic degeneration of the macula, detachments of the retinal pigment epithelium, drusen, and glaucomatous cupping of the optic disk. T h e 16-page appendix contains 2 6 figures in black and white. T h e s e contribute additional examples of pathology but they should b e of greatest value to the beginner in slit-lamp photography because of the photographic data that accompany each picture. T h e s e are: type of illumination, camera aperture, lens pow-