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Atlas of the Peripheral Ocular Fundus
  1. TOM BARRIE

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    Atlas of the Peripheral Ocular Fundus. 2nd ed. By William L Jones. Pp 328, £75. Oxford: Butterworth-Heinemann, 1998. ISBN 0-7506-9050 X.

    This book fills a niche in ophthalmology texts and is a welcome addition. The introductory sections describe the techniques of examination and the spectrum of normal appearances. This is well laid out and, with many of the illustrations being photographs taken through the indirect ophthalmoscope, the reader is well prepared for examining patients. The first main section is on developmental abnormalities and it is noteworthy that the author thought it appropriate that this section should occupy more than one third of the book. Many referrals, both to ophthalmologists from optometrists and to retinal specialists, are as a result of this type of pathology and this text explains and illustrates the problems well. The section on vitreous degeneration and its relation to retinal disease is particularly well written, alluding to the most recent concepts in the role of changes in the vitreous and their effects on the retina. The different types and extents of vitreous detachment together with their symptoms and the implications are discussed well, as is the section on the role of trauma. In the chapter on retinal breaks the overall tenor is perfectly sound but I would perhaps take issue with the lack of differentiating between a retinal dialysis and a giant retinal tear since the vitreous structure and configuration are completely different, as is the prognosis, and I feel that this should have been emphasised much more.

    The chapters on the management of retinal detachment are, to my mind however, a little disappointing in relation to the rest of the book. The description of the factors normally responsible for the retina remaining attached is excellent but the descriptions of the techniques and rationale of surgery are somewhat inflexible. This book does not purport to be a textbook of retinal detachment surgery and it seems inappropriate to discuss the finer points of scleral buckling, particularly when there is controversy as to whether vitrectomy or scleral buckling should be the primary procedure. It does, however, give readers who may not themselves perform retinal surgery an idea of the techniques involved and the results obtainable.

    The book is written in a very readable style and is extremely well researched with comprehensive references in all chapters. The illustrations and diagrams are plentiful and helpful and the only slight criticism I might offer here would be the number of ultrasound pictures since, unless the reader is familiar with these, and in particular the dynamic features which they can demonstrate in real time scanning, they may be difficult to interpret.

    Overall, this is a well worthwhile book which would be of benefit to ophthalmologists and optometrists, and particularly those in training, with the bibliography being an excellent guide to further reading.

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