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Diabetic retinopathy. A guide for diabetes care teams.

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    Diabetic retinopathy. A guide for diabetes care teams. By William D Alexander. Pp 62, £14.95. Oxford: Blackwell Science, 1998. ISBN 0-632-05171-X.

    Fear of eye disease is a major anxiety of individuals with diabetes. Monitoring the eyes of these individuals is a major anxiety of those charged with managing their diabetes. The situation is complicated by the fact that advanced diabetic retinopathy may have no effect on current visual function, but denied timely treatment it is likely to progress to irreversible visual loss. The need for efficient and reliable eye screening is therefore very considerable, as also is the need for the diabetic individual to participate in his own care and management.

    This attractive and refreshingly unpretentious little volume embraces these central issues relating to the monitoring and treatment of diabetic eye disease in a concise “Introduction and Aims” chapter. It proceeds to summarise the classification and natural history of diabetic retinopathy followed by a description of ocular examination and a discussion of options for methodology and organisation of screening. The next two sections consider the indications for referral from the primary screener to the specialist ophthalmologist, and the management of diabetic retinopathy. Then, true to the pragmatic theme of the book, it concludes with a very useful chapter on management of visual loss, followed by an annotated picture gallery of non-diabetic eye abnormalities which may be encountered on funduscopic examination.

    The layout of short chapters and bullet pointed lists is excellent and easy to read and refer to. The liberal use of panels listing key points or summarising information is also very helpful. The widespread use of (a wide variety of) illustrations makes the book attractive to look at. The quality of reproduction of some of the retinal images, however, will be a particular disappointment to those who do not already know what they are trying to illustrate.

    Bill Alexander is to be congratulated on producing this thoughtful and informative book at a time when the development of a variety of models for provision of diabetic services is contemporaneous with heightened awareness of a need to set and observe rigorous standards of practice. I am sure that for those wishing to increase their understanding of diabetic retinopathy it will be money well spent.