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This is the 3rd edition of John Sandford-Smith’s excellent companion volume to his Eye Surgery in Hot Climates. Its purpose is to be a practical guide for the hard pressed health worker, doctor, nurse, or medical assistant. The book is written bearing in mind that for many readers English will not be their first language and so the text is kept simple and lucid.
It is written against a background of 38 million people in the world who are blind, the majority living in hot developing countries. The introductory chapter is an excellent overview of the problem touching on the contributory causes, particularly poverty and lack of education and all that follows on from that. Approaches to prevention and treatment are discussed.
The remainder of the book deals with eye disease in a systematic way starting with chapters on basic anatomy, physiology, history taking, and eye examination. The common eye diseases in hot climates are mainly the same as in more temperate parts but the thrust of the book is the approach to these diseases in situations where there are limited resources in expertise, diagnostic equipment, and treatment. There are clear descriptions of how to perform basic examinations with limited cheap equipment and treatments recommended include the cheaper alternatives as well as the most modern medications. I particularly liked the advice on how to make up fortified antibiotic drops for corneal ulcers for example. As expected there are several good chapters on those diseases more specifically associated with tropical countries such as trachoma, xerophthalmia, onchocerciasis, and leprosy
A minor criticism is that the whole of ophthalmology is tackled and many rarer conditions just get a mention. Perhaps it would have been better to leave them out altogether and concentrate on the common conditions that are done so well. Nevertheless, this is a very valuable book for those working in developing countries where many workers find it indispensable. I will certainly continue to recommend it to students going overseas on electives for eye projects.
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