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Developments in Ophthalmology. Vol 32 Mycosis of the Eye and its Adnexa.
  1. COLIN M KIRKNESS

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    Developments in Ophthalmology. Vol 32 Mycosis of the Eye and its Adnexa. Ed W Behrens-Baumann. Pp 201; £93.26. Basle: Karger, 1999. ISSN 0250-3731.

    It really is a misnomer to refer to Professor Behrens-Baumann as editor since he has written all but the first chapter himself. I must plead a certain personal pleasure in being asked to review this book, since I have always found Behrens-Baumann's writing clear and to the point. He writes from a position of strength about things he understands in a way that is comprehensible to the clinician.

    The approach is straightforward and logical. An overview of important ocular pathogenic fungi is provided by a mycologist. Thereafter, there is a clear exposition of the few antifungal drugs available to us including a useful description of how these can be manufactured in drop form, which is of considerable use to those ophthalmologists working without the support of a good manufacturing pharmacy department.

    There follow three large chapters or sections covering adnexal infection, keratomycosis, and fungal endophthalmitis. Histoplasmosis is treated separately and, finally, there is a chapter on laboratory experimental work which probably could be subdivided into animal models and pharmacology.

    If I have any criticism it is about the very extensive listing the author provides in the clinical section. He has large tables listing fungi that have caused infection in various site—for example, lids, cornea, or endophthalmitis. It is not explicit that these lists are meant to be exhaustive but the presentation makes one assume they are. They are not. He omits a number of single case reports of infections while including others. This may just be the fault of his search engine or perhaps more likely the fact that he missed them when they were first published. It is a small point but it detracts from what otherwise would be an encyclopaedic work.

    The text is, nevertheless, concise. There are only 201 pages and many of these are lists of references (381 on keratomycosis). It is highly readable and of good practical value not just for the candidate cramming for Part 3 membership but for anyone, either specialist or non-specialist, who has to manage a case of fungal infection. He gives useful information on how to improve the yield of laboratory investigation, always a difficult question. Perhaps this section could have been expanded a little. I would also have liked to have seen a little more on epidemiology (although this was covered) and on geographic variation which was only mentioned in passing.

    These relatively minor whinges aside, this is an important text which should be on the shelves of every departmental library. The pages should be worn from constant reference. Fungal infection in the UK is rare enough that most of us have fairly limited experience in dealing with it. The easily accessed advice of an expert such as Behrens-Baumann is a godsend and is very welcome. Mr clinical director, please buy this book.

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