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Ocular motility and strabismus
SURVEY OF OPHTHALMOLOGY
VOLUME20
BO 0 K REV I EWS Adler’s Physiology of Application, 6th edition,
the
Eye,
*NUMBER
4
JANUARY-FEBRUARY
??
1976
STEVEN M. PODOS, EDITOR
Clinical
edited by Robert A. Moses. St. Louis: C. V. Mosby, 1975, 702 pp., 624 illustrations, Price: $27.50.
It is refreshing that a major revision of an essential textbook should have fewer pages and illustrations, yet be so current and allencompassing. Once again, Dr. Moses has done us a great service. This sixth edition of Physiology of the Eye includes only one new chapter topic, “Mechanisms of Sensation,” but a plethora of new authors represent their spheres of expertise. “The Extraocular Muscles” has been rewritten by Ronald M. Burde and Gill Roper-Hall, “The Aqueous” by Marvin L. Sears, and “The Lens” by Edward Cotlier. New chapters on all aspects of the retina are the contributions of Adolph I. Cohen, Sidney Futterman, Alan L. Pearlman, and Eliot L. Berson. Color vision, binocularity, and visual function are covered by W.A.H. Rushton, Nigel Daw, and Peter 0. Bishop. Just as it is difficult for one person to write on all of these topics, it is unfair for an individual to review them all. Variability exists in content and style of any multi-authored textbook. In this one the quality is uniformly fine, no doubt reflecting the editor’s direction. One can be picayune and, for example, point out that the section on diurnal intraocular pressure needs updating, or evaporation through the cornea is a good explanation for aqueous hyperosmolarity. There is a glaring error in the formulas of the aqueous flow systems. However, the chapters on aqueous and intraocular pressure are quite excellent. All residents in ophthalmology should own, and more importantly, read this textbook. Its cost is nominal. Each medical library should have a copy, and all ophthalmologists should be familiar with its contents. STEVEN M PODOS
General
Ophthalmology, 7th edition, by Daniel Vaughan and Taylor Asbury, Los Altos, California: Lange Medical Publications, 1974, 334 pp., illustrated, Price: $9.50.
On its own merits, this book is excellent as an accompanying text to Adler or Newell, as a quick reference for one who does not know any basics, as a guide to delineating the boundaries of the ophthalmic province, and as a primer. In general, it is succinct, has excellent pictures, and can be used by medical students and nurses. However, the student who knows the basics in a specific area will 291
be dissatisfied. It is a “How to” but not “Why” book. For a medical student on an ophthalmology clerkship, this text would be satisfactory if used in conjunction with more complete works. If a brief description covering the pertinent terminology is desired, this text is good. The pictures frequently accentuate the summary. However, it is a poor text to read from cover to cover. It fulfills the need for a simple summarizing introduction to ophthalmology, yet it seems inadequate for a medical student. By the time I am in need of a summarizing reference, I refer to the more detailed texts. In short, I would begrudgingly purchase this book and comment on its usefulness during its infrequent use. PAM GALLIN MEDICALSTUDENT Ocular
Motility and Strabismus, by Marshall M. Parks. Hagerstown, Md., Harper and Row, 1975. 186 pp., 100 illus. Price: $25.00.
This book represents the cumulative personal experience of one of our most respected authorities in the field of strabismus. The author acknowledges in the preface that much of his subject is art rather than science, and that his principal aim is to provide a framework upon which readers can build their own approaches to strabismus patients. This is a highly desired goal and has been more than achieved in this volume. The first 10 chapters deal with the features of ocular anatomy and physiology which are pertinent to motility and binocular vision and with the abnormal motor and sensorial states that are encountered in strabismus. Of particular value is the concise, yet complete, discussion in Chapter 1 of the anatomic relations of the extraocular muscles to the globe and to Tenon’s capsule, the orbital fat compartments, and the intermuscular septum. This is accompanied by excellent illustrations, which emphasize the importance of these details to proper surgical handling of these structures. The discussion of fusion and stereopsis, the critique of Worth’s classic categorization of fusion into 3 grades, and the concepts of central and peripheral fusion states with different capabilities (Chapter 5) are stimulating variations from standard dogma, as is the discussion of retinal correspondence and its importance (Chapter 8). Also in this portion of the book are reviews of commonly employed tests for alignment, sensory status, and vergences, including details on the correct performance of these investigations. The remaining 10 chapters deal with the treat-
292
SurvOphthalmol
20 (4) January-February
ment of abnormal sensory adaptations, and with the clinical features and management of the various entities in strabismus. In keeping with his overall intent, the author’s preferred concepts and methods are emphasized, with references to the work of other individuals who have influenced his thinking. There is an in-depth approach to the more common deviations, at a level suitable to the needs of both the student and the experienced practitioner. For the reviewer, this was particularly well illustrated in the discussions of oblique dysfunction and dissociated deviations. Dr. Parks’ monotixation syndrome is discussed in a separate chapter, which does much to clarify the semantic confusion associated with this entity. There are occasional errors of an editorial nature, and one might question the statement that cornea1 reflex tests are unsuitable for measuring near alignment, since a light and an almost coaxial detailed target can be employed. Also, succinyl choline usually is not classified as an anticholinesterase agent. Discussion of the rare but interesting entity of cyclic strabismus would have been welcome. The opportunity to understand and share the clinical insight of a recognized expert in the field of motility and strabismus is presented by this book. Its organization, style, convenient length, and pleasing format will encourage its continued use. It is recommended very highly to ophthalmologists at all levels of experience. EDWARDL RAAB Practical Management Glaucoma, Strabismus,
of Eye Visual
Problems: Fields, by
Frederick Hampton Roy. Philadelphia: Febiger. 1975, 217 pp., Price: $10.00.
BOOK REVIRWS
1976
Lea &
This text by Dr. F.H. Roy (along with his previous text, “Ocular Differential Diagnosis,” Lea and Febiger), is designed to follow the Problem Oriented Medical Record (POMR) system. Defined data bases are presented for evaluation of glaucoma, strabismus, and visual fields. Depending upon the level of individual training, this data becomes a differential diagnosis. A logical sequence is, thereby, created for solving the patient’s problems. The POMR has been controversial ever since its physician-creator, Lawrence L. Weed, introduced it late in the 1950’s. The basic structures of the POMR are a defined data base, problem list, plans for each problem and formal progress notes on each problem including subjective and objective data, assessment and plan (abbreviated SOAP). The POMR was initially associated with academic and institutional medicine. Its main pur-
pose was to bring logical order and form and improved performance to medical education and patient care. Recently, the POMR has gained attention due to its method of record keeping. The residency program of the Department of Ophthalmology at Washington University has experimented with the POMR since 1970. Interest has varied and a modified system has been developed. A defined data base has proved beneficial for establishing a framework upon which residents can build. It has promoted a more comprehensive assessment of patients by providing a protocol to deal with patients’ general and ocular problems. Dr. Roy’s book should be of interest to both residents and practitioner. It is a reference book and is not meant to be read from cover to cover. Hopefully, it will stimulate more ophthalmic interest in the POMR, a concept that systematizes and organizes what we have found out about the patient and what we are doing about it. THEOLXIRE KRUPIN Metabolic
Eye Disease,
edited by Heskel M. Haddad. Springfield, Ill.: Charles C Thomas, 1974, 442 pp., illus. Price: $42.00. The proceedings of the First International Symposium on Metabolic Eye Diseases held in Israel in 1972 are compiled in this book. It suffers from the same problems as most books based on symposia. The material is three years old in a very vital and ever-changing field. The chapters, for the most part, read like transcribed lectures and vary greatly in quality and content. The topics are diverse and often repetitive. In general, referencing is poor. In addition, spelling errors abound. Content and scope of the chapters vary greatly. Some attempt to review entire fields (for example, the eye signs of all of the lipidoses and mucopolysaccharidoses). Some present simple case reports, and others, such as the chapter on aqueous humor lactic dehydrogenase in retinoblastoma, are research papers. The latter portions of this book discuss thyroid disease and eye disease and diabetic retinopathy. Certain highlights should be mentioned. The chapter by Francois, on Aminoacidurias Ophthalmological Manifestations is a superb, well organized, well illustrated complete review. The chapters on chronic renal disease, dialysis and ocular disease put all of this hard-to-find information into a convenient package. The chapter on the new TRH-TSH test for “euthyroid” eye disease also is of interest. STEVENM. Pooos
VOLUME20
BO 0 K REV I EWS Adler’s Physiology of Application, 6th edition,
the
Eye,
*NUMBER
4
JANUARY-FEBRUARY
??
1976
STEVEN M. PODOS, EDITOR
Clinical
edited by Robert A. Moses. St. Louis: C. V. Mosby, 1975, 702 pp., 624 illustrations, Price: $27.50.
It is refreshing that a major revision of an essential textbook should have fewer pages and illustrations, yet be so current and allencompassing. Once again, Dr. Moses has done us a great service. This sixth edition of Physiology of the Eye includes only one new chapter topic, “Mechanisms of Sensation,” but a plethora of new authors represent their spheres of expertise. “The Extraocular Muscles” has been rewritten by Ronald M. Burde and Gill Roper-Hall, “The Aqueous” by Marvin L. Sears, and “The Lens” by Edward Cotlier. New chapters on all aspects of the retina are the contributions of Adolph I. Cohen, Sidney Futterman, Alan L. Pearlman, and Eliot L. Berson. Color vision, binocularity, and visual function are covered by W.A.H. Rushton, Nigel Daw, and Peter 0. Bishop. Just as it is difficult for one person to write on all of these topics, it is unfair for an individual to review them all. Variability exists in content and style of any multi-authored textbook. In this one the quality is uniformly fine, no doubt reflecting the editor’s direction. One can be picayune and, for example, point out that the section on diurnal intraocular pressure needs updating, or evaporation through the cornea is a good explanation for aqueous hyperosmolarity. There is a glaring error in the formulas of the aqueous flow systems. However, the chapters on aqueous and intraocular pressure are quite excellent. All residents in ophthalmology should own, and more importantly, read this textbook. Its cost is nominal. Each medical library should have a copy, and all ophthalmologists should be familiar with its contents. STEVEN M PODOS
General
Ophthalmology, 7th edition, by Daniel Vaughan and Taylor Asbury, Los Altos, California: Lange Medical Publications, 1974, 334 pp., illustrated, Price: $9.50.
On its own merits, this book is excellent as an accompanying text to Adler or Newell, as a quick reference for one who does not know any basics, as a guide to delineating the boundaries of the ophthalmic province, and as a primer. In general, it is succinct, has excellent pictures, and can be used by medical students and nurses. However, the student who knows the basics in a specific area will 291
be dissatisfied. It is a “How to” but not “Why” book. For a medical student on an ophthalmology clerkship, this text would be satisfactory if used in conjunction with more complete works. If a brief description covering the pertinent terminology is desired, this text is good. The pictures frequently accentuate the summary. However, it is a poor text to read from cover to cover. It fulfills the need for a simple summarizing introduction to ophthalmology, yet it seems inadequate for a medical student. By the time I am in need of a summarizing reference, I refer to the more detailed texts. In short, I would begrudgingly purchase this book and comment on its usefulness during its infrequent use. PAM GALLIN MEDICALSTUDENT Ocular
Motility and Strabismus, by Marshall M. Parks. Hagerstown, Md., Harper and Row, 1975. 186 pp., 100 illus. Price: $25.00.
This book represents the cumulative personal experience of one of our most respected authorities in the field of strabismus. The author acknowledges in the preface that much of his subject is art rather than science, and that his principal aim is to provide a framework upon which readers can build their own approaches to strabismus patients. This is a highly desired goal and has been more than achieved in this volume. The first 10 chapters deal with the features of ocular anatomy and physiology which are pertinent to motility and binocular vision and with the abnormal motor and sensorial states that are encountered in strabismus. Of particular value is the concise, yet complete, discussion in Chapter 1 of the anatomic relations of the extraocular muscles to the globe and to Tenon’s capsule, the orbital fat compartments, and the intermuscular septum. This is accompanied by excellent illustrations, which emphasize the importance of these details to proper surgical handling of these structures. The discussion of fusion and stereopsis, the critique of Worth’s classic categorization of fusion into 3 grades, and the concepts of central and peripheral fusion states with different capabilities (Chapter 5) are stimulating variations from standard dogma, as is the discussion of retinal correspondence and its importance (Chapter 8). Also in this portion of the book are reviews of commonly employed tests for alignment, sensory status, and vergences, including details on the correct performance of these investigations. The remaining 10 chapters deal with the treat-
292
SurvOphthalmol
20 (4) January-February
ment of abnormal sensory adaptations, and with the clinical features and management of the various entities in strabismus. In keeping with his overall intent, the author’s preferred concepts and methods are emphasized, with references to the work of other individuals who have influenced his thinking. There is an in-depth approach to the more common deviations, at a level suitable to the needs of both the student and the experienced practitioner. For the reviewer, this was particularly well illustrated in the discussions of oblique dysfunction and dissociated deviations. Dr. Parks’ monotixation syndrome is discussed in a separate chapter, which does much to clarify the semantic confusion associated with this entity. There are occasional errors of an editorial nature, and one might question the statement that cornea1 reflex tests are unsuitable for measuring near alignment, since a light and an almost coaxial detailed target can be employed. Also, succinyl choline usually is not classified as an anticholinesterase agent. Discussion of the rare but interesting entity of cyclic strabismus would have been welcome. The opportunity to understand and share the clinical insight of a recognized expert in the field of motility and strabismus is presented by this book. Its organization, style, convenient length, and pleasing format will encourage its continued use. It is recommended very highly to ophthalmologists at all levels of experience. EDWARDL RAAB Practical Management Glaucoma, Strabismus,
of Eye Visual
Problems: Fields, by
Frederick Hampton Roy. Philadelphia: Febiger. 1975, 217 pp., Price: $10.00.
BOOK REVIRWS
1976
Lea &
This text by Dr. F.H. Roy (along with his previous text, “Ocular Differential Diagnosis,” Lea and Febiger), is designed to follow the Problem Oriented Medical Record (POMR) system. Defined data bases are presented for evaluation of glaucoma, strabismus, and visual fields. Depending upon the level of individual training, this data becomes a differential diagnosis. A logical sequence is, thereby, created for solving the patient’s problems. The POMR has been controversial ever since its physician-creator, Lawrence L. Weed, introduced it late in the 1950’s. The basic structures of the POMR are a defined data base, problem list, plans for each problem and formal progress notes on each problem including subjective and objective data, assessment and plan (abbreviated SOAP). The POMR was initially associated with academic and institutional medicine. Its main pur-
pose was to bring logical order and form and improved performance to medical education and patient care. Recently, the POMR has gained attention due to its method of record keeping. The residency program of the Department of Ophthalmology at Washington University has experimented with the POMR since 1970. Interest has varied and a modified system has been developed. A defined data base has proved beneficial for establishing a framework upon which residents can build. It has promoted a more comprehensive assessment of patients by providing a protocol to deal with patients’ general and ocular problems. Dr. Roy’s book should be of interest to both residents and practitioner. It is a reference book and is not meant to be read from cover to cover. Hopefully, it will stimulate more ophthalmic interest in the POMR, a concept that systematizes and organizes what we have found out about the patient and what we are doing about it. THEOLXIRE KRUPIN Metabolic
Eye Disease,
edited by Heskel M. Haddad. Springfield, Ill.: Charles C Thomas, 1974, 442 pp., illus. Price: $42.00. The proceedings of the First International Symposium on Metabolic Eye Diseases held in Israel in 1972 are compiled in this book. It suffers from the same problems as most books based on symposia. The material is three years old in a very vital and ever-changing field. The chapters, for the most part, read like transcribed lectures and vary greatly in quality and content. The topics are diverse and often repetitive. In general, referencing is poor. In addition, spelling errors abound. Content and scope of the chapters vary greatly. Some attempt to review entire fields (for example, the eye signs of all of the lipidoses and mucopolysaccharidoses). Some present simple case reports, and others, such as the chapter on aqueous humor lactic dehydrogenase in retinoblastoma, are research papers. The latter portions of this book discuss thyroid disease and eye disease and diabetic retinopathy. Certain highlights should be mentioned. The chapter by Francois, on Aminoacidurias Ophthalmological Manifestations is a superb, well organized, well illustrated complete review. The chapters on chronic renal disease, dialysis and ocular disease put all of this hard-to-find information into a convenient package. The chapter on the new TRH-TSH test for “euthyroid” eye disease also is of interest. STEVENM. Pooos