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Neuro-ophthalmology Review Manual.
  1. JOHN S ELSTON

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Neuro-ophthalmology Review Manual.5th ed. By Lanning B Kline, Frank J Bajands. Pp 288; £37.95. NJ: Slack Incorporated, 2000. ISBN1556424701.

The Neuro-ophthalmology Review Manualis the 5th edition of a well established favourite. The intention, as with previous editions, is to provide a readable compendium of “no nonsense” neuro-ophthalmology for neurologists, neurosurgeons, and ophthalmologists. The first edition of the book was envisaged as a coaching manual for the needs of the US Board examinations, but subsequent editions have been expanded in the hope of providing, in addition, a practical guide to the management of patients in the clinic and on the wards.

Apart from the senior author (Lanning B Kline) there are six contributing authors. The text of 280 pages is divided into 20 chapters, two of which on the phacomatoses and disturbances of higher visual function are completely new. The other chapters cover the full range of neuro-ophthalmic subject matter, including the major problems of disorders of eye movement, visual fields, pupils, and the optic disc. There are also chapters on the trigeminal nerve, the facial nerve, eyelid disorders, headache, carotid artery disease, and hysteria and malingering. The chapters are not formally referenced, but all have a useful bibliography of books, chapters, and original articles. The information is in note format, with line diagrams and a few tables.

Generally speaking an enormous amount of information is condensed into each chapter, but is readily accessible because of the layout. Mostly the information is clinically useful, with an emphasis on lists of differential diagnoses and pointers towards the diagnosis of individual conditions. The emphasis is very heavily on clinical diagnosis, with little detail on laboratory tests, imaging, etc, and virtually none on management. For this reason on occasion some of the information appears rather arcane, and seems to predate the modern imaging era.

Examination candidates will find the dogmatic approach in some chapters—for example, “The six syndromes of the sixth nerve” or “The five syndromes of the fourth nerve”—very helpful in evolving a rigorous examination technique for topical diagnosis, as well as a useful way of retaining a lot of information. On the other hand any practising ophthalmologist would find it useful to be reminded of the essentials of, for example, disorders of the facial nerve or of higher visual function when confronted with such a patient in the clinic.

All in all this book is a mine of useful information. It is comprehensive and covers the vast majority of practical neuro-ophthalmic scenarios, which may confront the ophthalmologist. It can be recommended as a revision aid for the Part 3 membership exam. It would be a useful quick reference book for both the ophthalmic casualty and the neuro-ophthalmology clinic.

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