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This is the 4th edition of Bruce Shields’ excellent book, appearing about 5 years after the last edition. The text has been thoroughly revised and as noted in the preface 2300 original papers have been reviewed for this edition with 1440 new references incorporated into the text. For the first time a companion volume entitled Colour Atlas of Glaucoma has been produced which was not available for review. The text and photographs follow the same order in the two volumes.
Since the third edition there have been major changes in the understanding of many of the glaucomas particularly with regard to the factors responsible for causing the optic nerve head damage. This is reflected in a new classification which is based on the new concepts of mechanism, diagnosis, and therapy.
The layout of the book remains, as in previous editions, divided into three sections.
Section one deals with the basic aspects of glaucoma and covers the essentials of anatomy and physiology with good chapters on the optic nerve head and visual field testing.
The second part is a description of the clinical forms of glaucoma and is thorough and comprehensive. More time is devoted to chronic open angle glaucoma and normal tension glaucoma than in previous editions and some of the new concepts are considered. This section gives an excellent review of what used to be called the secondary glaucomas.
The final part “The management of glaucoma” is a very up to date account and assessment of all the treatment modalities available, again with a strong clinical emphasis.
As with all books there are some small criticisms. A few topics such as plateau iris get relatively scant attention compared with some other less common conditions. Surprisingly little mention is made of the attempts at neuroprotection now taking place in the treatment of glaucoma. However, in a book that attempts to cover such a large subject some selection has to be made and this has been generally well done. It is detailed enough to be of real clinical use and contains a wealth of practical advice. Being written by one author there is a coherent feel and I enjoyed reading it.
Overall this is a superb book that deserves its reputation as a standard textbook on glaucoma. It contains most of what the ophthalmologist needs to know for day to day practice and is an ideal text for those in training.
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