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Visual optics and refraction, a clinical approach
BOOK REVIEWS
71
On the other hand, the book suffers from the technology of optical wave guides (e.g., fiber optics). The goal of photoreceptor optics, according negative aspects of the excellent qualities described to the editors, is “to explain the structural basis of above. It is a curious compendium of elementary a photoreceptor’s absolute, spectral, directional operations and highly complex techniques far and polarization sensitivities.” To achieve this, the beyond the reach of the general ophthalmologist. contributors examine the intricate and varied Thus, a simple Z-plasty, with variations, is detailed arrangements of membranes within invertebrate in six pages, but is followed later by two pages wiring fixation and vertebrate photoreceptive structures, the devoted to the transnasal geometric ordering of molecules within procedure, with the rather cavalier comment that, photoreceptor membranes, and the consequences “It is not unusual for the transnasal wiring of these structural arrangements for the absorption technique to be accompanied by bilateral of light through interaction of photons with the dacryocystorhinostomy.” ordered molecules. On balance, this is a useful and thoughtBecause “each participant was invited to review provoking volume, to be absorbed with the proviso the fundamentals of his field, in addition to pre- that the surgeon new to plastics be thoroughly familiar with the fully detailed classic texts before senting recent research results and perspectives,” there is much overlapping and repetition among proceeding to the knife. the papers. Furthermore, some of the papers preVIRGINIALUBKIN sent mathematical arguments that most readers, I would guess, will not attempt to wade through (even if they are able). Nevertheless, anyone in- Visual Optics and Refraction, A Clinical Approach, terested in deepening her/his understanding not by David G. Michaels. St. Louis, C. V. Mosby, 1975, 517 pp. Price: $42.50. only of what happens to light in a photoreceptor, but also of the astonishingly varied visual David Michaels was a superb teacher of strategies that different orders of animals have physiological optics before he entered medical evolved, can enjoy spending some time here. school. Fortunately, on becoming an ophthalPapers which I found particularly stimulating dis- mologist and entering private practice, he has not cussed physiological optics and electrophysiology lost any of his genius at pedagogy as is of invertebrate eyes (Laughlin, Franceschini, demonstrated beautifully in this book. His Waterman, Horridge); molecular orientation of background in physiological optics has also left its rhodopsin in receptors (Laughlin et al); membrane mark, since the scope of the book extends far structure of rod outer segments (Liebmen); and the beyond the limited, strictly optical purview of most directional sensitivity of rods (Enoch). Also, I refraction texts, to include such topics as ocular gained some new insight not only into mechanisms motility, visual perception and binocular vision. of the Stiles-Crawford effect, but also into its im- Happily, he relates even his “offbeat” subject plications for retinal organization and function; matter to clinical experience rather than just inthe effect is a consequence of the light-guiding jetting it as a curiosity or unrelated distraction, as properties of the receptors - and it became clear has been the case in some other authors’ attempts how these properties are responsible for higher to broaden the ophthalmologic horizon. And he is sensitivity without sacrifice of acuity (and vice ver- not averse to slipping in an anecdote or colorful sa) than would otherwise be possible. turn of phrase on occasion, which certainly makes ADAMATKIN the reading more pleasant. An old problem in refraction texts is just how much mathematics to include. Dr. Michaels comes down on the “keep it to a minimum” side of the Reconstructive and Plastic Surgery of the Eyelids, fence, for the most part, but compensates well for by Frank P. English and Warren A. Keats. any lack this might introduce by including an exSpringfield, Ill., Charles C 7’homa.s, 1975, 95 pp. tensive bibliography for further study, a practice Price: $11 .OO. continued throughout the book. Another potential This brief volume (95 pages) is statedly designed problem for texts such as this is the diagrams and Michaels has successfully suras an introduction to ophthalmic plastic surgery illustrations. mounted the usual obstacles with illustrations not geared to the ophthalmologist in his novitiate. Written with the charm and readability of the only sufficient in number but so well done in many cases, that it seems clear that many of them - parBritish mode, it is to be commended for a thoughtful exposition of the principles underlying plastic ticularly in refraction - are going to be widely plagiarized by lecturers on refraction! surgical repair. Readers are thus intelligently The author attempts to give the reader insights guided into comprehending the rationale of the various operations, and can nurture the expecta- into many areas of refraction, including aption that they can now extrapolate into other propriate reference to the optician’s vs. the procedures on their own. Undoubtedly, such an ap- ophthalmologist’s role and even takes the time to define the ambiguous term “visual skills.” History proach is superior to the usual recipe book.
72
Surv Ophtholmol 21 (1) July-August 1976
is covered as it relates to refraction in a somewhat spotty, but pleasant, manner. The history of bifocals on page 377 is particularly good and the author even gives us a short section on philosophy, which is entirely appropriate in his chapter on perception. The author frequently relates the various facets of refraction to amblyopia; the latter is perhaps the weakest portion of this strong book. I enjoyed reading this book. While the book is nominally directed at the neophyte ophthalmologist, the wealth of Michaels’ experience and reflection provide many useful nuggets of information that the “old pro” will benefit from even more than the beginner will. And all of us will do well to reflect on his repeated admonition that, in refraction, it is the needs of the patient rather than the refractive findings that should serve as your guide to treatment. ROBERT D. REINECKE
Phacoemulsification and Aspiration: The Kelman Technique of Cataract Removal, by Charles D. Kelman. Birmingham, Ala., Aesculapius, 1975, 137 pp., 269 illus., Price: $42.50. It is unusual in modern ophthalmology to devote an entire book to a single specific procedure, and even more unusual for the author to use his own eponym. In this case both appear to be justified. The Kelman technique of cataract extraction by phacoemulsification and aspiration has engendered considerable controversy in recent years. Although the stated function of this brief book is as a practical guide to performance of the technique, it also presents the arguments for its inclusion in the ophthalmic surgical armamentarium. The history, instrumentation, patient selection, surgical technique, and complications are presented in a profusely illustrated manner intended to supplement a practical phacoemulsification course. Additional presentations of techniques for practice surgery are useful for the beginner. Brief chapters on anesthesia and nursing are of less value. On the whole, this book succeeds admirably as a technical manual. Some criticisms are warranted,
BOOK RRVIEWS
however. Although mention is made of the high degree of success and the surgeon is cautioned frequently to avoid specific errors which could lead to various complications, no data is given. Such documentation might bolster the author’s case. The failure to mention permanent bullous keratopathy as an occasional complication is notable. Although literature is cited, full references are never given. This is a book which should be read by all ophthalmologists who are considering adopting the phacoemulsification procedure and reread several times by all beginning to perform it. ALAN SUGAR
Contact Lens Practice, Baltimore,
by Montague
Ruben.
Williams and Wilkins, 1975, 368 pp.
Price $6 1.OO. In this complete and well-illustrated volume, Doctor Montague Ruben presents the Moorfields Eye Hospital approach to contact lenses. The discussion is thorough, beginning with the history and ending with the manufacture of contact lenses. Physiology, optics, materials, indications, and special disease states are all well presented and there is an especially complete discussion of keratometry. The “meat” of any contact lens book, though, is the fitting of lenses. This is presented in a manner which is not likely to simplify the task for the practitioner. There is a strong tendency to rely on the mathematics of lens curves without an actual how-to-do-it scheme. A confusing system of abbreviations is used for lens parameters, often without explanation. Many unusual fitting situations are well presented and there are excellent illustrations of fluorescein patterns. In relation to current American practice, there is a great excess of material on scleral lenses, while the presentation of soft lenses is incomplete. Perhaps the greatest value of this book is as a source of information on contact lens details for those already well-grounded in fitting techniques. The resident or practitioner beginning to lit lenses is better off seeking a basic contact lens fitting manual for less than half the price of this volume. ALAN SUGAR
71
On the other hand, the book suffers from the technology of optical wave guides (e.g., fiber optics). The goal of photoreceptor optics, according negative aspects of the excellent qualities described to the editors, is “to explain the structural basis of above. It is a curious compendium of elementary a photoreceptor’s absolute, spectral, directional operations and highly complex techniques far and polarization sensitivities.” To achieve this, the beyond the reach of the general ophthalmologist. contributors examine the intricate and varied Thus, a simple Z-plasty, with variations, is detailed arrangements of membranes within invertebrate in six pages, but is followed later by two pages wiring fixation and vertebrate photoreceptive structures, the devoted to the transnasal geometric ordering of molecules within procedure, with the rather cavalier comment that, photoreceptor membranes, and the consequences “It is not unusual for the transnasal wiring of these structural arrangements for the absorption technique to be accompanied by bilateral of light through interaction of photons with the dacryocystorhinostomy.” ordered molecules. On balance, this is a useful and thoughtBecause “each participant was invited to review provoking volume, to be absorbed with the proviso the fundamentals of his field, in addition to pre- that the surgeon new to plastics be thoroughly familiar with the fully detailed classic texts before senting recent research results and perspectives,” there is much overlapping and repetition among proceeding to the knife. the papers. Furthermore, some of the papers preVIRGINIALUBKIN sent mathematical arguments that most readers, I would guess, will not attempt to wade through (even if they are able). Nevertheless, anyone in- Visual Optics and Refraction, A Clinical Approach, terested in deepening her/his understanding not by David G. Michaels. St. Louis, C. V. Mosby, 1975, 517 pp. Price: $42.50. only of what happens to light in a photoreceptor, but also of the astonishingly varied visual David Michaels was a superb teacher of strategies that different orders of animals have physiological optics before he entered medical evolved, can enjoy spending some time here. school. Fortunately, on becoming an ophthalPapers which I found particularly stimulating dis- mologist and entering private practice, he has not cussed physiological optics and electrophysiology lost any of his genius at pedagogy as is of invertebrate eyes (Laughlin, Franceschini, demonstrated beautifully in this book. His Waterman, Horridge); molecular orientation of background in physiological optics has also left its rhodopsin in receptors (Laughlin et al); membrane mark, since the scope of the book extends far structure of rod outer segments (Liebmen); and the beyond the limited, strictly optical purview of most directional sensitivity of rods (Enoch). Also, I refraction texts, to include such topics as ocular gained some new insight not only into mechanisms motility, visual perception and binocular vision. of the Stiles-Crawford effect, but also into its im- Happily, he relates even his “offbeat” subject plications for retinal organization and function; matter to clinical experience rather than just inthe effect is a consequence of the light-guiding jetting it as a curiosity or unrelated distraction, as properties of the receptors - and it became clear has been the case in some other authors’ attempts how these properties are responsible for higher to broaden the ophthalmologic horizon. And he is sensitivity without sacrifice of acuity (and vice ver- not averse to slipping in an anecdote or colorful sa) than would otherwise be possible. turn of phrase on occasion, which certainly makes ADAMATKIN the reading more pleasant. An old problem in refraction texts is just how much mathematics to include. Dr. Michaels comes down on the “keep it to a minimum” side of the Reconstructive and Plastic Surgery of the Eyelids, fence, for the most part, but compensates well for by Frank P. English and Warren A. Keats. any lack this might introduce by including an exSpringfield, Ill., Charles C 7’homa.s, 1975, 95 pp. tensive bibliography for further study, a practice Price: $11 .OO. continued throughout the book. Another potential This brief volume (95 pages) is statedly designed problem for texts such as this is the diagrams and Michaels has successfully suras an introduction to ophthalmic plastic surgery illustrations. mounted the usual obstacles with illustrations not geared to the ophthalmologist in his novitiate. Written with the charm and readability of the only sufficient in number but so well done in many cases, that it seems clear that many of them - parBritish mode, it is to be commended for a thoughtful exposition of the principles underlying plastic ticularly in refraction - are going to be widely plagiarized by lecturers on refraction! surgical repair. Readers are thus intelligently The author attempts to give the reader insights guided into comprehending the rationale of the various operations, and can nurture the expecta- into many areas of refraction, including aption that they can now extrapolate into other propriate reference to the optician’s vs. the procedures on their own. Undoubtedly, such an ap- ophthalmologist’s role and even takes the time to define the ambiguous term “visual skills.” History proach is superior to the usual recipe book.
72
Surv Ophtholmol 21 (1) July-August 1976
is covered as it relates to refraction in a somewhat spotty, but pleasant, manner. The history of bifocals on page 377 is particularly good and the author even gives us a short section on philosophy, which is entirely appropriate in his chapter on perception. The author frequently relates the various facets of refraction to amblyopia; the latter is perhaps the weakest portion of this strong book. I enjoyed reading this book. While the book is nominally directed at the neophyte ophthalmologist, the wealth of Michaels’ experience and reflection provide many useful nuggets of information that the “old pro” will benefit from even more than the beginner will. And all of us will do well to reflect on his repeated admonition that, in refraction, it is the needs of the patient rather than the refractive findings that should serve as your guide to treatment. ROBERT D. REINECKE
Phacoemulsification and Aspiration: The Kelman Technique of Cataract Removal, by Charles D. Kelman. Birmingham, Ala., Aesculapius, 1975, 137 pp., 269 illus., Price: $42.50. It is unusual in modern ophthalmology to devote an entire book to a single specific procedure, and even more unusual for the author to use his own eponym. In this case both appear to be justified. The Kelman technique of cataract extraction by phacoemulsification and aspiration has engendered considerable controversy in recent years. Although the stated function of this brief book is as a practical guide to performance of the technique, it also presents the arguments for its inclusion in the ophthalmic surgical armamentarium. The history, instrumentation, patient selection, surgical technique, and complications are presented in a profusely illustrated manner intended to supplement a practical phacoemulsification course. Additional presentations of techniques for practice surgery are useful for the beginner. Brief chapters on anesthesia and nursing are of less value. On the whole, this book succeeds admirably as a technical manual. Some criticisms are warranted,
BOOK RRVIEWS
however. Although mention is made of the high degree of success and the surgeon is cautioned frequently to avoid specific errors which could lead to various complications, no data is given. Such documentation might bolster the author’s case. The failure to mention permanent bullous keratopathy as an occasional complication is notable. Although literature is cited, full references are never given. This is a book which should be read by all ophthalmologists who are considering adopting the phacoemulsification procedure and reread several times by all beginning to perform it. ALAN SUGAR
Contact Lens Practice, Baltimore,
by Montague
Ruben.
Williams and Wilkins, 1975, 368 pp.
Price $6 1.OO. In this complete and well-illustrated volume, Doctor Montague Ruben presents the Moorfields Eye Hospital approach to contact lenses. The discussion is thorough, beginning with the history and ending with the manufacture of contact lenses. Physiology, optics, materials, indications, and special disease states are all well presented and there is an especially complete discussion of keratometry. The “meat” of any contact lens book, though, is the fitting of lenses. This is presented in a manner which is not likely to simplify the task for the practitioner. There is a strong tendency to rely on the mathematics of lens curves without an actual how-to-do-it scheme. A confusing system of abbreviations is used for lens parameters, often without explanation. Many unusual fitting situations are well presented and there are excellent illustrations of fluorescein patterns. In relation to current American practice, there is a great excess of material on scleral lenses, while the presentation of soft lenses is incomplete. Perhaps the greatest value of this book is as a source of information on contact lens details for those already well-grounded in fitting techniques. The resident or practitioner beginning to lit lenses is better off seeking a basic contact lens fitting manual for less than half the price of this volume. ALAN SUGAR