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The Basic Aspects of the Glaucomas
168
AMERICAN JOURNAL OF OPHTHALMOLOGY
traction, gives us some of his "secrets for success." These include large volumes of retrobulbar anesthetic, prolonged massage of the globe, and double-armed, preplaced su tures. However, it is obvious that the real se cret is Dr. Havener's meticulous attention to detail and thoroughgoing evaluation of each step of his surgical procedure. For example, such seemingly minor points as eversion of the eyelids for scrubbing, and arrangement of the head drape are described in detail. Further, at the end of each chapter there is a series of checkpoints which determine whether the operation is "go" or "no go." As Dr. Havener appropriately points out, ignor ing or failing to note a negative clue may foredoom the operation to complications no matter how carefully the procedure itself is performed. A smaller second section reviews some of these complications, again in a sen sible, orderly fashion. Every surgeon will find points of proce dure with which he disagrees, or omissions, in this atlas, but these are minor variations on a theme and do not need comment. However, a reasonable point might be made for the in clusion of a discussion on the use of the op erating microscope for cataract surgery or at least for inspection of the eye at the comple tion of surgery. Certainly most ophthalmic surgeons do not use the microscope for rou tine cataract surgery, yet there is no gainsay ing the fact that courses in microsurgery are ever more popular and that there is wide spread interest in this field by those now in residency programs. One feels that the inclu sion of the pros and cons of microsurgery in the next edition of this book would be use ful. Finally, a word must bè said about the drawings which face each page of text. They are not merely an adjunct but an integral part of the book. Their importance was obvi ously apparent to Dr. Havener, since he ap propriately listed Sallie Gloeckner as a co author. She certainly deserves this recogni tion for a superb job of illustration. All ac tive and potential cataract surgeons will ben
JULY, 1973
efit from this book. The experienced surgeon will find himself forced to appraise critically his current techniques and the novice will find an excellent base oh which to develop his own variations. David Shoch T H E BASIC ASPECTS OF THE GLAUCOMAS. By
Adnan H. Halasa. Springfield, 111., Charles C Thomas, 1972. Clothbound, 226 pages, table of contents, index, references, two color plates. 68 black and white figures. $14.50 This book has as its goal the presentation of basic concepts of glaucoma in the context of current information. This is indeed a for midable task, but the author has been fairly successful in this regard. The book is divided into, four sections. The first contains a chapter on glaucoma his tory and classification. This chapter is well done, as is the short chapter oh the historical background of tonometry and tonography which heads the second section of the book. Four chapters follow pertaining to tonome try and scierai rigidity. The latter material is quite exhaustive and, despite lengthy mathe matical derivation, only partially succeeds in providing a practical explanation of scierai rigidity. A chapter on tonography is also laden with formulas, while many practical points are not mentioned. In the third section of the book, the pri mary glaucomas are covered. Seven chapters make up this section, including one on con genital glaucoma. The fourth section dis cusses the secondary glaucomas. The last two sections are well written and informative. The clinical information is abundant and quite current, although one might quarrel with the exclusive use of brand names of carbonic anhydrase inhibi tors, particularly in a book with "basic con cepts" in its title. A short chapter on the genetics of glau coma in section three is now historic in light of the recent twin study of Schwartz and as sociates.
VOL. 76, NO. 1
BOOK REVIEWS
The black and white illustrations are of good quality, while two color plates add lit tle. There is a good bibliography and ade quate index. In short, this text contains much valuable information about glaucoma. The material is presented in a concise, easily read manner. Practicing ophthalmologists and residents would not go wrong in having this book on hand. Paul R. Lichter ATLAS OF STRABISMUS, 2nd ed. By Gunter
K. von Noorden and A. Edward Maumenee. St. Louis, C. V. Mosby, 1973. Clothbound, 204 pages, table of contents, index, 325 illustrations, 124 figures, 34 color plates. $23.50 The second edition of Atlas of Strabismus is basically a refined version of the first edi tion, with a few excellent additions such as the technique of scotoma measurement with prism and retinal correspondence measure ments on the major amblyoscope. This book is still a primer of basic techniques in stra bismus evaluation, including its concise de scription of the way each test works and the indications for its use. This volume hews to the concept of an atlas, is well illustrated with diagrams and photographs, and the au thors have admirably resisted the temptation to explain excessively what is illustrated graphically. The illustrations are well chosen to carry out the instructional task assigned to them. There are several sections of the atlas which deserve special mention for their clar ity: The four-prism diopter test is so well described that it should allow anyone to un derstand it well enough to begin using it rou tinely. Similarly, the section on fixation be
169
havior and testing is exceptionally good, with clear description of the behavior of the patient in regard to retinal areas of fixation during Visuscope observation. Another plus is the new section describing transposition of horizontal muscles to correct A and V pat terns. The critical comments that do seem appro priate all involve the prose rather than the illustrations. The authors do not point out the main weakness of Visusope testing— namely, that the target is usually not large enough to extend past the scotoma onto suffi cient areas of the retina to permit the exam iner some idea of the manner in which the patient actually fixates. However, they do point out several methods that the examiner can use to confirm the patient's fixation pat tern. Another criticism is that while the of ten-suggested method for treating alternat ing sursumduction has been weakening the superior recti muscles, some of us feel that strengthening the inferior recti muscles—not mentioned in the present volume—is a better procedure. More disturbing, however, is the inclusion in this edition of Dr. von Noorden's past suggestions that patients with V esotropia be treated by weakening of the inferior oblique muscles in one sitting, with the esotropia corrected in another, de spite the well known resultant worsening of the esotropia (it becomes comitant from the prior V ) . I believe that we should be encour aging correction in a single procedure. Simi lar comments could be made about several of the other suggested treatments, but these would be expressions of my own bias. No criticism should obscure the basic great merit of this atlas. Certainly every ophthal mologist should profit from and enjoy read ing it, and I heartily recommend it. Robert D. Reinecke
AMERICAN JOURNAL OF OPHTHALMOLOGY
traction, gives us some of his "secrets for success." These include large volumes of retrobulbar anesthetic, prolonged massage of the globe, and double-armed, preplaced su tures. However, it is obvious that the real se cret is Dr. Havener's meticulous attention to detail and thoroughgoing evaluation of each step of his surgical procedure. For example, such seemingly minor points as eversion of the eyelids for scrubbing, and arrangement of the head drape are described in detail. Further, at the end of each chapter there is a series of checkpoints which determine whether the operation is "go" or "no go." As Dr. Havener appropriately points out, ignor ing or failing to note a negative clue may foredoom the operation to complications no matter how carefully the procedure itself is performed. A smaller second section reviews some of these complications, again in a sen sible, orderly fashion. Every surgeon will find points of proce dure with which he disagrees, or omissions, in this atlas, but these are minor variations on a theme and do not need comment. However, a reasonable point might be made for the in clusion of a discussion on the use of the op erating microscope for cataract surgery or at least for inspection of the eye at the comple tion of surgery. Certainly most ophthalmic surgeons do not use the microscope for rou tine cataract surgery, yet there is no gainsay ing the fact that courses in microsurgery are ever more popular and that there is wide spread interest in this field by those now in residency programs. One feels that the inclu sion of the pros and cons of microsurgery in the next edition of this book would be use ful. Finally, a word must bè said about the drawings which face each page of text. They are not merely an adjunct but an integral part of the book. Their importance was obvi ously apparent to Dr. Havener, since he ap propriately listed Sallie Gloeckner as a co author. She certainly deserves this recogni tion for a superb job of illustration. All ac tive and potential cataract surgeons will ben
JULY, 1973
efit from this book. The experienced surgeon will find himself forced to appraise critically his current techniques and the novice will find an excellent base oh which to develop his own variations. David Shoch T H E BASIC ASPECTS OF THE GLAUCOMAS. By
Adnan H. Halasa. Springfield, 111., Charles C Thomas, 1972. Clothbound, 226 pages, table of contents, index, references, two color plates. 68 black and white figures. $14.50 This book has as its goal the presentation of basic concepts of glaucoma in the context of current information. This is indeed a for midable task, but the author has been fairly successful in this regard. The book is divided into, four sections. The first contains a chapter on glaucoma his tory and classification. This chapter is well done, as is the short chapter oh the historical background of tonometry and tonography which heads the second section of the book. Four chapters follow pertaining to tonome try and scierai rigidity. The latter material is quite exhaustive and, despite lengthy mathe matical derivation, only partially succeeds in providing a practical explanation of scierai rigidity. A chapter on tonography is also laden with formulas, while many practical points are not mentioned. In the third section of the book, the pri mary glaucomas are covered. Seven chapters make up this section, including one on con genital glaucoma. The fourth section dis cusses the secondary glaucomas. The last two sections are well written and informative. The clinical information is abundant and quite current, although one might quarrel with the exclusive use of brand names of carbonic anhydrase inhibi tors, particularly in a book with "basic con cepts" in its title. A short chapter on the genetics of glau coma in section three is now historic in light of the recent twin study of Schwartz and as sociates.
VOL. 76, NO. 1
BOOK REVIEWS
The black and white illustrations are of good quality, while two color plates add lit tle. There is a good bibliography and ade quate index. In short, this text contains much valuable information about glaucoma. The material is presented in a concise, easily read manner. Practicing ophthalmologists and residents would not go wrong in having this book on hand. Paul R. Lichter ATLAS OF STRABISMUS, 2nd ed. By Gunter
K. von Noorden and A. Edward Maumenee. St. Louis, C. V. Mosby, 1973. Clothbound, 204 pages, table of contents, index, 325 illustrations, 124 figures, 34 color plates. $23.50 The second edition of Atlas of Strabismus is basically a refined version of the first edi tion, with a few excellent additions such as the technique of scotoma measurement with prism and retinal correspondence measure ments on the major amblyoscope. This book is still a primer of basic techniques in stra bismus evaluation, including its concise de scription of the way each test works and the indications for its use. This volume hews to the concept of an atlas, is well illustrated with diagrams and photographs, and the au thors have admirably resisted the temptation to explain excessively what is illustrated graphically. The illustrations are well chosen to carry out the instructional task assigned to them. There are several sections of the atlas which deserve special mention for their clar ity: The four-prism diopter test is so well described that it should allow anyone to un derstand it well enough to begin using it rou tinely. Similarly, the section on fixation be
169
havior and testing is exceptionally good, with clear description of the behavior of the patient in regard to retinal areas of fixation during Visuscope observation. Another plus is the new section describing transposition of horizontal muscles to correct A and V pat terns. The critical comments that do seem appro priate all involve the prose rather than the illustrations. The authors do not point out the main weakness of Visusope testing— namely, that the target is usually not large enough to extend past the scotoma onto suffi cient areas of the retina to permit the exam iner some idea of the manner in which the patient actually fixates. However, they do point out several methods that the examiner can use to confirm the patient's fixation pat tern. Another criticism is that while the of ten-suggested method for treating alternat ing sursumduction has been weakening the superior recti muscles, some of us feel that strengthening the inferior recti muscles—not mentioned in the present volume—is a better procedure. More disturbing, however, is the inclusion in this edition of Dr. von Noorden's past suggestions that patients with V esotropia be treated by weakening of the inferior oblique muscles in one sitting, with the esotropia corrected in another, de spite the well known resultant worsening of the esotropia (it becomes comitant from the prior V ) . I believe that we should be encour aging correction in a single procedure. Simi lar comments could be made about several of the other suggested treatments, but these would be expressions of my own bias. No criticism should obscure the basic great merit of this atlas. Certainly every ophthal mologist should profit from and enjoy read ing it, and I heartily recommend it. Robert D. Reinecke