Lecture Notes on Ophthalmology

Lecture Notes on Ophthalmology

BOOK REVIEWS Factors j o u r n a l ; they should be commended for their wisdom. Three additional papers were added and this excellent volume is the re...

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BOOK REVIEWS Factors j o u r n a l ; they should be commended for their wisdom. Three additional papers were added and this excellent volume is the result. T h e subject matter covers a wide range of human factors' space vision re­ search. T h e simulation of star fields, ren­ dezvous, visual displays, spacecraft illumi­ nation, vibrational and gravitational forces, surveillance and reconnaissance, vestibular influence on perception, vigilance and space visual environment are but a few of the sub­ jects covered. It is apparent that the authors assume that man has a mission in space. H y m a n , Narva and Muckler and White consider the man-versus-machine concepts but resolve the controversy in favor of the human com­ ponent. H y m a n ' s technique for distance es­ timation of spheres and discs by angular subtense a n d / o r visual magnitude is note­ worthy, and his equations for calculation of star magnitudes and illumination of satel­ lites should prove to be of great assistance to the interested scientist. T h e visual experiences of the astronauts and cosmonauts, reported by Zink, are in­ teresting but date back to early 1963. Wil­ liam White, in his report on visual experi­ ments for extended manned space flight, does report on the objectives of the Gemini flights and in this way helps to complement and update the material presented by Zink. Vigilance, a review and re-evaluation by Jerison and Pickett, is a fine review but is perhaps of minor interest to most visual scientists. Their summary and conclusions synthesize the article quite well, and the reader might begin with this before reading the complete paper. Visual surveillance and reconnaissance from space vehicles, by N a r v a and Muckler, cites authorities who place a one-minute subtense requirement for target detection, 12 minutes for recognition and 20 minutes for operational purposes. T h e r e are a num­ ber of factors that would moderate this, such as shape, contrast and, especially, the experience of the trained astronaut.


Each of the authors appears to be knowledgable in his particular area of interest, and the "state-of-the-art" research data have been summarized quite well. W h e r e data are scanty or inadequate, future re­ search endeavors are recommended. T h e graphs and tables are well chosen and per­ mit maximum utilization of the data pre­ sented. In spite of previous publications of some of the articles, this volume affords an excellent reference for those of us who have an intense interest in man's visual capabili­ ties in the space environment. James F . Culver


N O T E S ON O P H T H A L M O L O G Y .


Patrick D. Trevor-Roper, M.A., M.D., B.Chir. ( C a n t a b . ) , F.R.C.S., D . O . M . S . ( E n g . ) . Oxford, England, Blackwell Sci­ entific Publications, 1966, edition 2. Clothbound, 103 pages, 66 figures in black and white, 12 figures in color, 1 table, ap­ pendices, index. Price : $3.00. This cannot be ! A book on ophthalmology for three dollars—and what a book. Let me state flat out : I like it. H a v i n g said so, let me now, like Elizabeth Barrett Browning, "count the ways." Item: Not only is the price as given above, but this is fifty cents less than the first edition. I t e m : T w o appendices have been added (more on this l a t e r ) , and some of text ma­ terial has been revised; yet the number of pages has increased only from 94 to 103. I t e m : T h e author continues to think small. This book is not for the medical stu­ d e n t ; not for the general practitioner; not for the resident in ophthalmology; but only for the harassed student preparing for his final exams. Item: Profuse illustrations-—about one for every page and a half—and a beauty on page 26. Item : T h e bulk of the book is presented in just three sections: the painful red e y e ; gradual loss of sight in quiet eyes ; and sud-



den loss of sight in quiet eyes. (For this we need 15-volume systems?) Item : Facts to keep you one-up ophthalmologically and to dine out on all next year. For example: At 25 yards a car numberplate (British one supposes) is equal to the 6/12 line on a visual acuity chart. "Wood­ en-spoon" bathing relieves pain. (One must wrap cotton wool around the end of the spoon and dip it in hot water.) Lachesine, a weak cycloplegic, was named after Lachesis —and guess whose sister she was. And a final example: An adherent leech will need a touch of salt before it releases its hold. Item : An appendix with typical questions from recent final examination papers. For example: A wicket-keeper is struck in the eye by a fast-rising ball. What immediate injuries may result, and how would you in­ vestigate them in hospital ? Apropos of which this reviewer will send his copy of the 1960 edition of this marvel­ ous book to the first non-Englishman who writes in describing a sticky wicket and tell­ ing why this makes batting difficult. David Shoch ON GLAUCOMA. By Paul A. Chandler, M.D., and W. Morton Grant, M.D. Philadelphia, Lea and Febiger, 1965. 431 pages, illustrated. Price: $12.50. This series of lectures on glaucoma by two outstanding experts makes most fasci­ nating reading. The book covers in didactic fashion various aspects of the diagnosis and management of glaucoma. Although the au­ thors make no effort to cover every aspect of glaucoma, the many areas described are done in a very practical fashion with consid­ erable attention to minute details of exami­ nation, testing and management. Gonioscopy, tonometry and tonography are pre­ sented in considerable detail, and these sec­ tions should be required reading for both the student and the experienced ophthalmologist. LECTURES

Of necessity, since this book is based on the extensive personal experiences of the authors, it also includes their preferences and prejudices. Thus, great emphasis is placed on ophthalmoscopic evaluation of the optic nerve and very little reliance is put on visual field testing, especially with small test objects. The sections on low-tension glaucoma, glaucoma in infants and children and the management of angle-closure and malignant glaucoma are excellent. One can only under­ score such important discussions as the em­ phasis on the other eye in hemorrhagic glau­ coma, the precautions about measurement of intraocular pressure under anesthesia, the avoidance of pupillary block in congenital cataract surgery, the management of dislo­ cated lenses and the emphasis on iridectomy in angle-closure glaucoma. In a book containing as much information as this, there are always isolated areas where one can find room for disagreement or dis­ cussion. One may question such statements as "Since we know that we can detect changes in the disc long before there is any permanent significant field defect . . ." Many ophthalmologists place more reliance on visual fields and feel that functional loss precedes anatomic changes. However, this may be merely the more astute observations of nerveheads by the authors. A better case could be presented for prism methods of gonioscopy, and there certainly are minor differences of opinion as to when to treat and how vigorously to treat some of the early stages of primary open-angle glauco­ ma. Such controversial issues do not, how­ ever, detract in any way from the value of the present book. It is recommended en­ thusiastically for both the student and the clinician. Bernard Becker