Neuro-Ophthalmology, ed. 2

Neuro-Ophthalmology, ed. 2

BOOK REVIEWS Edited by H. Stanley Thompson, M.D. static tangent screen, automated threshold perimetry with a 2-degree central grid, automated thresho...

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BOOK REVIEWS Edited by H. Stanley Thompson, M.D.

static tangent screen, automated threshold perimetry with a 2-degree central grid, automated threshold perimetry with a 6-degree grid, kinetic tangent screen, and standard Amsler grid testing. As presented, the superiority of threshold Amsler grid testing is convincing. The text is a valuable addition to the library of both clinical and research ophthalmologists. Reading the book will improve the treatment of patients with such diverse problems as mild paracentral visual loss, opaque media, and functional visual loss. Although a few of the tests described in the book, such as pattern electroretinography, are not yet in everyday clinical use, refinements of these procedures will certainly be in widespread use in the near future, and clinicians will certainly benefit from knowing about them. The brief foreword by Harry Quigley, M.D., contains an interesting historical perspective on the development of new tests of visual function and is well worth reading.

New Methods of Sensory Visual Testing. Edited by Michael Wall and Alfredo A. Sadun. New York, Springer-Verlag, 1989. 137 pages, index, illustrated. $49.95


Madison, Wisconsin

Clinicians are becoming increasingly aware of the limitations of some of the old reliable tests of visual sensory function. Snellen visual acuity and kinetic perimetry are unable to detect and characterize many of the abnormalities in patients with optic nerve and retinal disease. The inadequacy of these tests becomes obvious when one considers that as many as 40% of the axons in the optic nerve may be lost in patients with normal Snellen visual acuity and kinetic perimetry. At the same time, improvements in therapy make it imperative that damage to the visual system be detected in its earliest stages. A number of newer testing methods, such as contrast sensitivity function, have been derived from basic laboratory investigation and are now in limited clinical use. The aim of this book, which is fulfilled admirably, is to outline the physiologic basis of some of these newer testing procedures and to "acquaint clinical and research ophthalmologists with the proper interpretation of test results and emphasize the advantages and utility of each test." The text is valuable from both a practical and an academic point of view. It begins with a short, clear chapter on a complex topic: "Parallel Processing in the Human Visual System." This is followed by six chapters, each by a different author, covering brightness testing, critical flicker fusion frequency, contrast sensitivity testing, clinical electrophysiology, examination of the 10 degrees of visual field surrounding fixation, and automated perimetry. The physiologic basis of each test is fully explained, and the appropriate applications for each are well documented. Each of the chapters can be read alone as a detailed review of the subject. The chapter, "Examination of the Ten Degrees of Visual Field Surrounding Fixation," is a good example of the practical value of the book. Six standard tests that have been used for evaluation of central visual function are compared. These include threshold Amsler grid,

Neuro-Ophthalmology, ed. 2. Edited by Joel S. Glaser. Philadelphia, J. B. Lippincott, 1990.557 pages, index, illustrated. $75

Reviewed by JOHN W. GITTINGER, JR.

Worcester, Massachusetts

In 1977 when I finished my neuro-ophthalmology fellowship and joined the ranks of junior faculty, one of the more useful books on my shelf was the then recently published first edition of Glaser's Neuro-Ophthalmology. Glaser was usually the best source, short of going to the library and slogging through the Index Medicus, for a current reference. Walsh and Hoyt provided the in-depth background, and Glaser brought the topic up to date. The second edition is longer by 200 pages and has 13 collaborators rather than three, but the text still stands ready to do the same for its readers. Using the format of Duane's Clinical Ophthalmology, of which they are a part, these 17 chapters cover most of the important, and a 215




few not so important, topics in neuro-ophthalmology. Chapters on history and examination are followed by a review of visual system anatomy. Three chapters cover topical diagnosis of the afferent visual system. May and Galetta provide a comprehensive discussion of the facial nerve and its disorders. Three chapters on ocular movements follow. The sophistication of ocular motor system analysis by Daroff, Dell'Osso, Troost, and Leigh is implicitly acknowledged by an appended glossary. The final six chapters offer an overview of the current and classic literature on infranuclear and neuromuscular ophthalmoplegia, orbital disease, the pupil, migraine, and vascular malformations. Dr. Glaser is not afraid to express his opinions, which occasionally differ from mine and perhaps those of other neuro-ophthalmologists. He prefers the description, "hyaline bodies of optic nerve," to optic disk drusen, with the consequence that the latter are not indexed. He considers retrobulbar depot corticosteroid injection on the involved side "a reasonable procedure" for the treatment of arteritic anterior ischemic optic neuropathy. I would like to see the evidence that this is effective before recommending it for general use, especially since Glaser advocates that therapy "not be delayed for results of erythrocyte sedimentation rate or biopsy." In terms of emphasis, functional visual loss, which constitutes a large portion of my neuro-ophthalrnic practice, receives short shrift. Setting aside these minor limitations, I recommend this book to neurology residents for their libraries. Ophthalmology residents will probably want to purchase the entire five volumes of Duane. The vigorous writing, the copious illustrations, and the expertise of the authors all combine to make this the best available one-volume text of neuro-ophthalmology.

Surgery of the Eyelids and Orbit. An Anatomical Approach. By Bradley N. Lemke and Robert C. Della Rocca. Norwalk, Connecticut, Appleton & Lange, 1990. 332 pages, index, illustrated. $150


Ann Arbor, Michigan

The text of this combined atlas and textbook is organized according to anatomic divisions

August, 1990

rather than disease entities, which is an interesting approach to the clinical and surgical management of eyelid and orbital problems. The five major sections are Osteology, Nose and Paranasal Sinuses, Lacrimal Excretory System, Eyelids, and Orbits. Each chapter begins with a clinical review of the topic, followed by pertinent anatomy, important abnormalities, and selected surgical procedures. As stated in the Preface, this text is intended for the surgeon planning the surgical approach, the clinician, the resident, and the medical student. The photographs, gross dissections, and illustrations are the great strengths of this atlas. There are numerous illustrative, black and white, clinical photographs accompanying well-done, clear, and accurate line drawings. They all help to emphasize the text. Supplementing these figures are superb photographs of cadaver dissections that demonstrate the gross anatomy described. This surgical atlas clarifies complex surgical procedures by using the gross anatomy as a basis for understanding. The scope of this book does not allow any discussion of the histologic aspects of the disease entities and virtually none are included. This text will be best used in conjunction with a basic oculoplastics textbook. Its greatest drawback is the shortage of reference citations. I would like to have easy access to specific references while reading each chapter. There is, however, an extensive bibliography at the end of each section. This text should be thought of as an adjunct reference work on eyelid or orbital disorders. The chapter, "Clinical Considerations:' though comprehensive, is brief, and little discussion of inevitable complications of the surgical procedures is included. The text is an excellent atlas to complement a basic textbook.

Ophthalmic Lasers. A Second Generation. Edited by Wayne F. March. Thorofare, Slack Inc., 1990.363 pages, index, illustrated. $90


Miami, Florida

Wayne March has assembled an impressive group of authors for this book. The approaches to the subjects are as varied as the individual personalities. The chapter by Charles Townes, "The Development of Laser:' contains great