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Clinical Strabismus Management: Principles and Surgical Techniques

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    Clinical Strabismus Management: Principles and Surgical Techniques. Eds AL Rosenbaum, AP Santiago. Pp 592; £135. Philadelphia: WB Saunders, 1999. ISBN 0-7216-7673-1.

    In their preface, the editors state that “The primary goal of this book is to provide an in-depth and detailed description of the various strabismic entities, followed by a review of the treatment options, in such a way that the reader can grasp the author's reasoning process as various alternative are considered.” In its 41 chapters by a total of 52 authors the book achieves this purpose in a uniformly excellent way.

    The book is divided into eight sections. The first section contains seven chapters and covers the evaluation of patients with a squint, including the role of orbital imaging and computer modelling. Sections 2 and 3 contain chapters on horizontal and vertical deviations respectively. Of particular value are chapters on difficult esotropia entities covering such topics as decompensated accommodative and monofixational esotropias, overcorrected, consecutive, and cyclic esotropias; on intermittent exotropias; and on selected unusual exotropias such as those caused by hemianopic field defects.

    Section 4 covers paralytic squints and section 5 restrictive squints including strabismus in thyroid eye disease and after scleral buckling, glaucoma implant procedures, orbital fractures, and sinus surgery. Selected strabismus syndromes are covered in section 6. Of particular value here is the chapter on Duane's syndrome which emphasises the importance of understanding the different patterns of aberrant innervation and taking these into account in planning treatment strategies to avoid paradoxical responses to surgery. Also valuable is an analysis of diplopia following cataract surgery and a chapter covering clinical evaluation and surgical management of nystagmus. After a section on techniques and indications for chemodenervation, the final section covers selected surgical procedures and complications. Differences in individual approach are most apparent in this section, but there are particularly valuable chapters on slipped, disinserted, severed and lost muscles, and selected surgical complications.

    The editors and contributors are to be congratulated on producing a very stimulating and valuable book. For all its diversity the editors have managed to maintain a remarkable uniformity of approach with chapters following a similar template. It is essentially a transatlantic book, with only two authors from east of the Atlantic and one from south of the equator. It highly recommended to all those dealing with patients with squints and will be of particular value to the more experienced squint surgeon.