The Anatomy of the Eye and Orbit

The Anatomy of the Eye and Orbit

BOOK REVIEWS for the seasoned practitioner. Somehow these practices have become established and are difficult to dislodge, though ultimately they will...

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BOOK REVIEWS for the seasoned practitioner. Somehow these practices have become established and are difficult to dislodge, though ultimately they will doubtlessly be discarded. I am going to mention here only one such practice, namely, the current method of recording visual fields both normal and defective, diplopia fields, and other charts associated with the action of the extraocular muscles by a method sometimes called physiologic, which is the exact opposite of the anatomic method. In all branches of medicine, the parts de­ scribed and referred to are those of the patient as seen by the doctor facing the pa­ tient. Right and left always refer to the patient's right and left. The right blade of the obstetric forceps is the one placed to the right of the patient, for example. In ophthalmology, the anatomic nomenclature is sometimes followed because it is not possi­ ble to do it otherwise. Thus charts showing, say, lesions of the cornea, show the cornea of the patient as he faces the examiner. A pic­ ture of a strabismic patient shows the devia­ tion of the eye as the patient faces the ex­ aminer. But a record of the diplopia field shows the latter as it would be seen by the doctor, if he himself were the patient. Com­ plete reversal of orientation is necessary with resulting confusion and unnecessary mental strain. Or to cite just one other instance. Suppose the doctor sees with the ophthalmoscope a lesion in the right upper part of the right retina. The scotoma corresponding to this lesion is in the left lower part of the field. If this is charted by the anatomic method, the doctor can easily correlate the ophthalmoscopic picture with the scotoma shown on the field chart. But when the defect in the field is charted by the nonanatomic method the doctor has to reorient his thinking, per­ haps visualize the lesion as it would be in his own eye, and correlate this with the field chart. A great deal more could be written to show the awkwardness and confusion resulting

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from using the nonanatomic method. One can find a masterly discussion of this subject by Dr. Uribe Troncoso in the "Papers to be presented before the International Con­ gress of Ophthalmology," Washington, D.C., April, 1922, p. 513-520. For some reason or other this subject was not acted on by that congress nor by subsequent congresses. It may be added that, in addition to Dr. Troncoso, there have been a few brave souls who have defied all convention and presented the subject using the anatomic method. Dr. Luther C. Peter in his textbook, The Extraocular Muscles, Dr. M. Marquez in his several textbooks, to mention just two, use only the anatomic method throughout. I hope to bring up the subject before the next Pan-American Congress of Ophthal­ mology. Dr. Troncoso and Dr. Marquez wish this matter taken up and the change officially recommended. The objections against making the change are at best trivial. (Signed) Joseph I. Pascal, New York.

BOOK REVIEWS T H E ANATOMY OF THE E Y E VÎND ORBIT. By

Eugene Wolff. New York, The Blakiston Company, fourth edition, 1954. 491 pages, 406 illustrations, including 52 in color, chapter bibliographies, index. Price: $15.00. I suppose all English-speaking ophthal­ mologists, including the student just begin­ ning his career in ophthalmology, are familiar with this excellent textbook, the first edition of which appeared in 1933. It was reprinted three times. The second edi­ tion appeared in 1940 and was reprinted twice. The third edition came out in 1948 and had two reprintings. And now here is the fourth edition, better than ever, with 51 more pages and over 80 additional and beautiful illustrations. When a textbook has gone through as many editions and reprint­ ings as has this one, no further comment is

BOOK REVIEWS

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needed than merely to say, "it is very good indeed." One is apt to think of anatomy as a static science in which few discoveries of any note remain to be made. That this is not true is evident on a close study of this fine textbook and in comparing it with its predecessors. In his preface, Dr. Wolff mentions some of these changes that he has introduced in the new edition. These comprise the discovery of the Pacchonian-like bodies in the inner wall of the canal of Schlemm, and changes and additions in the description of the limbus ; the difference between the skin of the medial and lateral sides of the eyelids (of importance in the understanding of xanthelasma plaques) ; the optic tract; the commissure of Gudden and the lateral geniculate body (including the author's original and important studies in this field) ; the blood supply to the third, fourth, and sixth cranial nerves ; the development of the vitreous and its normal appearance as seen with the gonioscope. Those of us who. knew Eugene Wolff, and the warmth of his family circle, will always remember him with gratitude for this privilege. His sudden death in February, 1954, at the age of 58 years, brought heavy hearts to all of his friends and the large group of his colleagues, students, and those who knew him only through this book, his Pathology of the Eye, and, finally, his Dis­ eases of the eye. Our science has sustained a severe blow, but we are grateful that the fourth edition of his best book was in print when the blow fell. His life was full, gentle, and radiated human kindness. His works endure. Derrick Vail.

BEHANDLUNG FÜR

DEN

VON

AUGENKRANKHEITEN :

PRAKTISCHEN

ARZT.

By

Dr.

Alfred Bangerter. Bern and Stuttgart, Medizinischer Verlag, Hans Huber, 1954. (Exclusive representative for the United States and Canada: International Medical

Book Corporation, 381 Fourth Avenue, New York 16, New York.) 112 pages, illustrations and tables, index. Price: $4.00. This little volume is the second edition of Bangerter's treatment of eye diseases for the general practitioner. It covers exactly what the title implies : It deals only with the treat­ ment of eye diseases and it is intended only for the general practitioner. The usual text­ books on ophthalmology written for the medical student aim to cover the entire field, including anatomy, pathology, symptoma­ tology, and treatment. For the most part the purpose is to give the student a general idea of the specialty rather than to enable him actually to treat eye diseases. Bangerter assumes that the reader has a basic knowledge of ophthalmology. Diag­ nostic problems are hardly touched. Thera­ peutic procedures of eye diseases that can and should be undertaken by the general practitioner are presented in minute detail. Most of them involve the adnexa and the anterior section of the globe. There are instances in which the patient is likely· to consult his family doctor for conditions which distinctly belong to the domain of the ophthalmologist. Frequently, the general practitioner can render valuable assistance by taking steps that are of immediate im­ portance in preserving the function of the eye. At the same time, it is clearly stated how far he can go without detailed experi­ ence or suitable equipment. There must be occasions when a patient would like to discuss with his family doctor certain points that may have come up dur­ ing a consultation with an ophthalmologist who is more or less a stranger to him. Bangerter admirably covers such situations. Familiarity with his book should enable the family doctor to give intelligent explanations to his patients as to why and when glasses should be worn. He should be able to answer questions concerning what to expect during and after a cataract operation—yes, even to discuss the pros and cons of the Ridley lens !