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Self-Assessment of Current Knowledge in Ophthalmology
VOL. 84, NO. 3
BOOK REVIEWS
BOOK REVIEWS Self-Assessment of Current Knowledge in Ophthalmology. By Timothy Van Scott and Sidney Jay Weiss. Flushing, New York, Medical Examination Pub lishing Company, Inc., 1977. Spiral, paperbound, 265 pages, table of con tents. $15 Fact—Most people hate taking exami nations; ophthalmologists are no excep tion to this rule. Fact—For the foreseeable future, the American Board of Ophthalmology will continue to give written qualifying exam inations preceding the oral examinations for certification. Fact—The American Board of Medical Specialists is committed to some sort of written examination as part of the recerti fication process. Subfact—The American Board of Internal Medicine has used only a written examination for its recertifica tion process. Query—Why isn't there a book of ques tions culled from past examinations? Answer—The questions change every year so that such a book would not help to prepare for a specific examination, but answering questions is an excellent mechanism for reviewing one's knowl edge. The present text is the third such publication issued by the Medical Exami nation Publishing Company in ophthal mology. The first, written by Charles Thomas of Cleveland, appeared in 1965. It had several defects: too many types of questions, the frequent use of "all of the above" as a correct answer, and occasion al incorrect answers. Nevertheless it was a useful volume to introduce one to the mechanics of multiple choice questions. A second edition appeared in 1969 which was an improvement over the first, and now we have a third with new authors and a new title (in the interval there was a
441
book of essay questions and answers also written by Dr. Thomas, which appeared in 1972). The authors of the current vol ume have placed less emphasis on the basic science and on anatomic classifica tion and more on disease entities. This may be because the work is addressed to practitioners to be used as a selfassessment test. As in previous volumes there is an answer key in the back but with the added advantage of a specific reference after each question; the refer ences are current, as late as 1976. Nevertheless, there are shortcomings. First, no questions in optics are provided. The authors have addressed this book to practitioners and have concentrated on current published reports but it would certainly seem appropriate to include questions to test an activity that is at the heart of general ophthalmologic practice. Secondly, there are still questions where the correct answer is "all of the above." This is an unacceptable answer because if one knows two of the foils to be correct, then the only correct single answer possi ble is "all of the above." Finally, an inordinate number of questions relate to percentages and to time. For example, three of the choices on the incidence of side effects to a specific antibiotic are 10%, 20%, 40%. The correct answer is 20% but knowledge of the side effects would be just as important if the inci dence were only 10%. Similarly, three of the choices for the incidence of cataract in congenital rubella are 15%, 30%, and 60%. Knowing the exact percentage would not alter one's management of the infant. Despite these criticisms, this is a useful book for the practicing ophthalmologist: It will re-expose him to the mechanics and logic of multiple choice questions, and if used appropriately it will expand his fund of knowledge. This reviewer suggests that only a few of the questions
442
AMERICAN JOURNAL OF OPHTHALMOLOGY
should be answered and references read at a sitting. A practicing ophthalmologist should be selective in his use of the book, skipping over questions that seem esoter ic or unrelated to his practice. Residents should obviously answer all the questions since all ophthalmology is in their ken. DAVID SHOCH
The Waysiders: Reading and the Dyslex ic Child. By R. M. N. Crosby. New York, John Day Company, Inc. 1976. Clothbound, table of contents, index, 49 black and white illustrations. $9.95 "For parents; teachers, psychologists, physicians!" Pediatrie neurosurgeon, R. M. N. Crosby, of the University of Mary land School of Medicine, and profession al writer Robert A. Liston have combined their talents of basic neurology and clear language to produce a straight forward volume on dyslexia, its neurological sub strate, its variations with involvement of different sensory modalities, and good suggestions for therapy. This second edi tion of "Reading and the Dyslexic Child" comes on strong. It is based on sound neurological development and emphasiz es the fact that differentiation of brain cells continues until about 4he age of 18 years. Children are affectionately encour aged to speak over an easy span of six years, but must make a transition from verbal to visual symbols on entering school. Discipline and punishment for failure to master complex neurologic or ganization then enter a child's life. The authors hold back no punches in analyzing methods used to teach reading. Educational research in the modern era has not basically improved failing meth ods of teaching problem readers or dys lexic children. The search for a pill, an operation, or a simple gross motor ex ercise is not related to the complex neurologic task of learning to read and
SEPTEMBER, 1977
calculate. Reading deficiencies may ac company children who are idle, lack in telligence, have emotional problems, are culturally deprived, or poorly taught. But, these are not the problems of neurologic deficit in the specifically dyslexic child. With absolute clarity, the authors point out "there are in fact no eye defects which prevent a child from reading," and ocular exercises for inability to interpret visually derived symbols have no more logic than finger exercises to help a blind child learn to read Braille. Treatment is a remedial and education al process of sensory augmentation, or cross modality transfer. The need to pur sue reading and writing simultaneously is inherent in such sensory augmentation drills. Command of individual letters and fundamental spelling constitute building blocks which must precede reading. This book is an accurate, handy, reada ble volume; I highly recommend it. ARTHUR H. KEENEY Ophthalmology Series, vol. 1, Clinical Glaucoma. Edited by George Gorin. New York, Marcel Dekker, Inc., 1977. Clothbound, 424 pages, table of con tents, author index, subject index, 115 black and white figures. $44.69 The author states that the purpose of this book is to describe the pathophysiological basis of the major entities of glaucoma in adults. However, he has un dertaken a considerably broader task and provides extensive experimental data con cerning the blood aqueous barrier, the histology of the aqueous pathways, the mechanism of optic disk cupping, and similar studies derived mainly from ani mals. Far more than clinical glaucoma is discussed, which constitutes one of the difficulties of the text inasmuch as it is not possible to discuss in depth all of the complex topics presented.
BOOK REVIEWS
BOOK REVIEWS Self-Assessment of Current Knowledge in Ophthalmology. By Timothy Van Scott and Sidney Jay Weiss. Flushing, New York, Medical Examination Pub lishing Company, Inc., 1977. Spiral, paperbound, 265 pages, table of con tents. $15 Fact—Most people hate taking exami nations; ophthalmologists are no excep tion to this rule. Fact—For the foreseeable future, the American Board of Ophthalmology will continue to give written qualifying exam inations preceding the oral examinations for certification. Fact—The American Board of Medical Specialists is committed to some sort of written examination as part of the recerti fication process. Subfact—The American Board of Internal Medicine has used only a written examination for its recertifica tion process. Query—Why isn't there a book of ques tions culled from past examinations? Answer—The questions change every year so that such a book would not help to prepare for a specific examination, but answering questions is an excellent mechanism for reviewing one's knowl edge. The present text is the third such publication issued by the Medical Exami nation Publishing Company in ophthal mology. The first, written by Charles Thomas of Cleveland, appeared in 1965. It had several defects: too many types of questions, the frequent use of "all of the above" as a correct answer, and occasion al incorrect answers. Nevertheless it was a useful volume to introduce one to the mechanics of multiple choice questions. A second edition appeared in 1969 which was an improvement over the first, and now we have a third with new authors and a new title (in the interval there was a
441
book of essay questions and answers also written by Dr. Thomas, which appeared in 1972). The authors of the current vol ume have placed less emphasis on the basic science and on anatomic classifica tion and more on disease entities. This may be because the work is addressed to practitioners to be used as a selfassessment test. As in previous volumes there is an answer key in the back but with the added advantage of a specific reference after each question; the refer ences are current, as late as 1976. Nevertheless, there are shortcomings. First, no questions in optics are provided. The authors have addressed this book to practitioners and have concentrated on current published reports but it would certainly seem appropriate to include questions to test an activity that is at the heart of general ophthalmologic practice. Secondly, there are still questions where the correct answer is "all of the above." This is an unacceptable answer because if one knows two of the foils to be correct, then the only correct single answer possi ble is "all of the above." Finally, an inordinate number of questions relate to percentages and to time. For example, three of the choices on the incidence of side effects to a specific antibiotic are 10%, 20%, 40%. The correct answer is 20% but knowledge of the side effects would be just as important if the inci dence were only 10%. Similarly, three of the choices for the incidence of cataract in congenital rubella are 15%, 30%, and 60%. Knowing the exact percentage would not alter one's management of the infant. Despite these criticisms, this is a useful book for the practicing ophthalmologist: It will re-expose him to the mechanics and logic of multiple choice questions, and if used appropriately it will expand his fund of knowledge. This reviewer suggests that only a few of the questions
442
AMERICAN JOURNAL OF OPHTHALMOLOGY
should be answered and references read at a sitting. A practicing ophthalmologist should be selective in his use of the book, skipping over questions that seem esoter ic or unrelated to his practice. Residents should obviously answer all the questions since all ophthalmology is in their ken. DAVID SHOCH
The Waysiders: Reading and the Dyslex ic Child. By R. M. N. Crosby. New York, John Day Company, Inc. 1976. Clothbound, table of contents, index, 49 black and white illustrations. $9.95 "For parents; teachers, psychologists, physicians!" Pediatrie neurosurgeon, R. M. N. Crosby, of the University of Mary land School of Medicine, and profession al writer Robert A. Liston have combined their talents of basic neurology and clear language to produce a straight forward volume on dyslexia, its neurological sub strate, its variations with involvement of different sensory modalities, and good suggestions for therapy. This second edi tion of "Reading and the Dyslexic Child" comes on strong. It is based on sound neurological development and emphasiz es the fact that differentiation of brain cells continues until about 4he age of 18 years. Children are affectionately encour aged to speak over an easy span of six years, but must make a transition from verbal to visual symbols on entering school. Discipline and punishment for failure to master complex neurologic or ganization then enter a child's life. The authors hold back no punches in analyzing methods used to teach reading. Educational research in the modern era has not basically improved failing meth ods of teaching problem readers or dys lexic children. The search for a pill, an operation, or a simple gross motor ex ercise is not related to the complex neurologic task of learning to read and
SEPTEMBER, 1977
calculate. Reading deficiencies may ac company children who are idle, lack in telligence, have emotional problems, are culturally deprived, or poorly taught. But, these are not the problems of neurologic deficit in the specifically dyslexic child. With absolute clarity, the authors point out "there are in fact no eye defects which prevent a child from reading," and ocular exercises for inability to interpret visually derived symbols have no more logic than finger exercises to help a blind child learn to read Braille. Treatment is a remedial and education al process of sensory augmentation, or cross modality transfer. The need to pur sue reading and writing simultaneously is inherent in such sensory augmentation drills. Command of individual letters and fundamental spelling constitute building blocks which must precede reading. This book is an accurate, handy, reada ble volume; I highly recommend it. ARTHUR H. KEENEY Ophthalmology Series, vol. 1, Clinical Glaucoma. Edited by George Gorin. New York, Marcel Dekker, Inc., 1977. Clothbound, 424 pages, table of con tents, author index, subject index, 115 black and white figures. $44.69 The author states that the purpose of this book is to describe the pathophysiological basis of the major entities of glaucoma in adults. However, he has un dertaken a considerably broader task and provides extensive experimental data con cerning the blood aqueous barrier, the histology of the aqueous pathways, the mechanism of optic disk cupping, and similar studies derived mainly from ani mals. Far more than clinical glaucoma is discussed, which constitutes one of the difficulties of the text inasmuch as it is not possible to discuss in depth all of the complex topics presented.