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Untersuchungemethoden des Auges
VOL. 93, NO. 1
BOOK REVIEWS
which will make the use of such potentially dangerous procedures unnecessary. FRANK J . WEINSTOCK, M . D .
Canton,
Ohio
133
in the treatment of severe bacterial ocular infections. I hope other investigators will continue research in this new field. RICHARD A. EIFERMAN, M . D .
Louisville,
Kentucky
Pseudomonas Scleritis
REFERENCES
Editor: Pseudomonas aeruginosa can cause severe scleritis (Figure). I recently treated two patients who had this condition with localized cryotherapy at — 79 C and topical and subconjunctival aminoglycosides; both patients responded to this therapy. These cases, however, were not as severe as those described by Räber and associates. They documented corneal and scleral devastation in these infections and the ineffectiveness of medical therapyAlpren and associates demonstrated the in vivo efficacy of cryotherapy in Pseudomonas keratitis in animals. They reported a 99% reduction in bacteria in rabbit corneas after one application of a brass probe at —79 C for six seconds. When they combined cryotherapy with topical applications of tobramycin, they achieved a 99.9% kill rate. Presumably, the same results can be obtained in the sclera. Cryotherapy appears to be promising
1. Codère, F., Brownstein, S., and Jackson, W. B.: Pseudomonas aeruginosa scleritis. Am. J. Ophthalmol. 91:706, 1981. 2. Raber, I. M., Laibson, P. R., Kurz, G. H., and Bernardino, V. B.: Pseudomonas corneoscleral ulcers. Am. J. Ophthalmol. 92:353, 1981. 3. Alpren, T. V. P., Hyndiuk, R. A., Davis, S. D., and Sarff, L. D.: Cryotherapyforexperimental Pseudomonas keratitis. Arch. Ophthalmol. 97:711, 1979.
1,2
2
3
Figure (Eiferman). Severe scleritis (arrows) caused by Pseudomonas aeruginosa.
BOOK REVIEWS Untersuchungemethoden des Auges. By W. Leydhecker and G. K. Krieglstein. Stuttgart, Gustav Fischer Verlag, 1981. Softcover, 223 pages, index, approximately 115 black and white figures. This German compendium describes the various tests and devices used for ocular examinations. The authors wrote this text for medical students and interns as well as for general practitioners and those in specialties such as internal medicine and neurology. The booklet introduces the various techniques used in ophthalmology, from careful historytaking, and simple observation, and the use of the penlight and ophthalmoscope to the more specialized tests used by ophthalmologists in daily practice. It ends with chapters on advanced clinical techniques such as electroretinography, ultrasonography, fluorescein angiography, and the radioactive phosphorus uptake test. Since the senior author's research is primarily in the area of glaucoma, it is not surprising that the clinical tests in this
134
AMERICAN JOURNAL OF OPHTHALMOLOGY
field are described in detail. The discussion includes the use and merits of tonometers, static and kinetic perimeters, both computerized and noncomputerized, tonography, and provocative tests. The chapter on gonioscopy is most instructive to the neophyte. It is interesting that the authors consider the Bjerrum tangent screen, which is still widely used in the United States, to be outdated because it lacks fixation control and standardized illustrations. It also should be noted that the MaklakofF, MacKay-Marg, and noncontact tonometers described have not been approved for use in West Germany. Tests for motility, fusion, diplopia, refraction, tear flow, and localization of intraocular foreign bodies and slit-lamp and ophthalmoscopic examinations are discussed clearly, but with less fervor. Many instruments, both German and non-German, are described and pictured, and the names of manufacturers are given. However, since monocular direct and indirect ophthalmoscopy are discussed in detail, more than one sentence should have been devoted to binocular indirect ophthalmoscopy, a widely used technique. For the medical student, the first-year resident, and the practitioner in other fields, this book will be a useful and concise guide to the bewildering array of available tests. It should be especially valuable as a supplement to practical instruction in the clinic. The practicing ophthalmologist will need more comprehensive texts for reference, but will enjoy reading about the many new and important advances in diagnosis. MAX HIRSCHFELDER
Ophthalmic Electrodiagnosis. Volume 1 in the series Major Problems in Ophthalmology, 2nd ed. By N. R. Galloway.
JANUARY, 1982
London, England, Lloyd-Luke, 1981. Hardcover, 180 pages, index, 92 black and white figures. $30.50 This is the second edition of a book, first published in 1975, dedicated to clinical electrophysiology. The first part of the book is devoted primarily to the methods and theory of measuring electroretinograms, electro-oculograms, and visualevoked potentials and describes the equipment used and the responses obtained. The second part of the book covers the clinical applications, including the costs and organization of the clinic, and measuring responses. Five chapters are devoted to specific clinical problems: hereditary degenerations, acquired disorders, opacities, toxic disorders, and injuries. The text is clear and descriptive. There are ample illustrations. This book will be valuable to the ophthalmologist establishing a retinal function clinic. Further, the concise descriptions of typical results obtained in a wide variety of diseases will prove useful to the practicing clinician. VIVIANNE SMITH POKORNY
Dorland's Illustrated Medical Dictionary, 26th ed. Philadelphia, W. B. Saunders Co., 1981. Hardcover, 1,485pages, 240 illustrations. Standard edition, $32.50; indexed edition, $37.50 Twenty-six editions over a period of 81 years must make this one of the most venerable medical books still in use. There is a preface describing the computer as a lexicographic tool. It is easy to imagine how helpful the computer must be to the lexicographer who can store entries and bring them back from the computer's memory by pressing a button. The introductory essay on "Fundamentals of Medical Etymology" emphasizes
BOOK REVIEWS
which will make the use of such potentially dangerous procedures unnecessary. FRANK J . WEINSTOCK, M . D .
Canton,
Ohio
133
in the treatment of severe bacterial ocular infections. I hope other investigators will continue research in this new field. RICHARD A. EIFERMAN, M . D .
Louisville,
Kentucky
Pseudomonas Scleritis
REFERENCES
Editor: Pseudomonas aeruginosa can cause severe scleritis (Figure). I recently treated two patients who had this condition with localized cryotherapy at — 79 C and topical and subconjunctival aminoglycosides; both patients responded to this therapy. These cases, however, were not as severe as those described by Räber and associates. They documented corneal and scleral devastation in these infections and the ineffectiveness of medical therapyAlpren and associates demonstrated the in vivo efficacy of cryotherapy in Pseudomonas keratitis in animals. They reported a 99% reduction in bacteria in rabbit corneas after one application of a brass probe at —79 C for six seconds. When they combined cryotherapy with topical applications of tobramycin, they achieved a 99.9% kill rate. Presumably, the same results can be obtained in the sclera. Cryotherapy appears to be promising
1. Codère, F., Brownstein, S., and Jackson, W. B.: Pseudomonas aeruginosa scleritis. Am. J. Ophthalmol. 91:706, 1981. 2. Raber, I. M., Laibson, P. R., Kurz, G. H., and Bernardino, V. B.: Pseudomonas corneoscleral ulcers. Am. J. Ophthalmol. 92:353, 1981. 3. Alpren, T. V. P., Hyndiuk, R. A., Davis, S. D., and Sarff, L. D.: Cryotherapyforexperimental Pseudomonas keratitis. Arch. Ophthalmol. 97:711, 1979.
1,2
2
3
Figure (Eiferman). Severe scleritis (arrows) caused by Pseudomonas aeruginosa.
BOOK REVIEWS Untersuchungemethoden des Auges. By W. Leydhecker and G. K. Krieglstein. Stuttgart, Gustav Fischer Verlag, 1981. Softcover, 223 pages, index, approximately 115 black and white figures. This German compendium describes the various tests and devices used for ocular examinations. The authors wrote this text for medical students and interns as well as for general practitioners and those in specialties such as internal medicine and neurology. The booklet introduces the various techniques used in ophthalmology, from careful historytaking, and simple observation, and the use of the penlight and ophthalmoscope to the more specialized tests used by ophthalmologists in daily practice. It ends with chapters on advanced clinical techniques such as electroretinography, ultrasonography, fluorescein angiography, and the radioactive phosphorus uptake test. Since the senior author's research is primarily in the area of glaucoma, it is not surprising that the clinical tests in this
134
AMERICAN JOURNAL OF OPHTHALMOLOGY
field are described in detail. The discussion includes the use and merits of tonometers, static and kinetic perimeters, both computerized and noncomputerized, tonography, and provocative tests. The chapter on gonioscopy is most instructive to the neophyte. It is interesting that the authors consider the Bjerrum tangent screen, which is still widely used in the United States, to be outdated because it lacks fixation control and standardized illustrations. It also should be noted that the MaklakofF, MacKay-Marg, and noncontact tonometers described have not been approved for use in West Germany. Tests for motility, fusion, diplopia, refraction, tear flow, and localization of intraocular foreign bodies and slit-lamp and ophthalmoscopic examinations are discussed clearly, but with less fervor. Many instruments, both German and non-German, are described and pictured, and the names of manufacturers are given. However, since monocular direct and indirect ophthalmoscopy are discussed in detail, more than one sentence should have been devoted to binocular indirect ophthalmoscopy, a widely used technique. For the medical student, the first-year resident, and the practitioner in other fields, this book will be a useful and concise guide to the bewildering array of available tests. It should be especially valuable as a supplement to practical instruction in the clinic. The practicing ophthalmologist will need more comprehensive texts for reference, but will enjoy reading about the many new and important advances in diagnosis. MAX HIRSCHFELDER
Ophthalmic Electrodiagnosis. Volume 1 in the series Major Problems in Ophthalmology, 2nd ed. By N. R. Galloway.
JANUARY, 1982
London, England, Lloyd-Luke, 1981. Hardcover, 180 pages, index, 92 black and white figures. $30.50 This is the second edition of a book, first published in 1975, dedicated to clinical electrophysiology. The first part of the book is devoted primarily to the methods and theory of measuring electroretinograms, electro-oculograms, and visualevoked potentials and describes the equipment used and the responses obtained. The second part of the book covers the clinical applications, including the costs and organization of the clinic, and measuring responses. Five chapters are devoted to specific clinical problems: hereditary degenerations, acquired disorders, opacities, toxic disorders, and injuries. The text is clear and descriptive. There are ample illustrations. This book will be valuable to the ophthalmologist establishing a retinal function clinic. Further, the concise descriptions of typical results obtained in a wide variety of diseases will prove useful to the practicing clinician. VIVIANNE SMITH POKORNY
Dorland's Illustrated Medical Dictionary, 26th ed. Philadelphia, W. B. Saunders Co., 1981. Hardcover, 1,485pages, 240 illustrations. Standard edition, $32.50; indexed edition, $37.50 Twenty-six editions over a period of 81 years must make this one of the most venerable medical books still in use. There is a preface describing the computer as a lexicographic tool. It is easy to imagine how helpful the computer must be to the lexicographer who can store entries and bring them back from the computer's memory by pressing a button. The introductory essay on "Fundamentals of Medical Etymology" emphasizes