The accurate description of orbital surgery is extremely difficult, if not impossible. This difficulty arises because of highly variable presentation and extent of orbital disease, from the ready distortion of normal orbital anatomy by disease or during surgery, and as a result of complexities in the three dimensional portrayal of orbital conditions.

Jack Rootman, with his co-authors Bruce Stewart and Robert Goldberg, has approached this task with the superb skill—both surgical and artistic—for which he is internationally renowned.

In the early chapters, the authors lay the principles for surgical approaches to various types of lesion in different orbital locations, highlighting that surgery should be variations on a theme and not a rigid, unerring process. Having comprehensively presented the concept of themes for management, the normal anatomy is beautifully portrayed in a superb series of illustrations by Bruce Stewart; most of the illustrations are new, there being only minimal overlap with those in Jack Rootman’s previous epic, Diseases of the Orbit(Lippincott, 1988).

The later, major, part of the work is devoted to details of surgical approaches to regions of the orbit, as related to the treatment details for specific conditions. The comprehensive text is complemented by drawings of the highest standard and by radiographs and clinical photographs of illustrative clinical cases; this combination of details making for delightful reading. The reviewer approached review of the book with several varied (hypothetical) clinical problems to be answered: the book provided useful details or ideas for the treatment of all of the set problems, although obviously it cannot be a substitute for practical experience.

The quality of publication is immediately evident. The illustrations are of excellent reproduction, the text layout pleasing, and the binding good. The book is essential to all ophthalmic libraries and is very warmly recommended for the personal libraries of all orbital surgeons.