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Clinical Ophthalmology

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Clinical Ophthalmology. 4th ed. By J J Kanski. Pp 673; £105. Oxford: Butterworth-Heinemann, 1999. ISBN 0 7506 4014 6.

The fourth edition of this standard text lives up to its enormous reputation. Jack Kanski sets out “to provide the trainee with a systematic and easily assimilated introduction to ophthalmology and a reference and update for the more experienced practitioner”. Undoubtedly these clear and circumscribed aims are well met in this beautifully and even more lavishly illustrated text. In addition to covering all those aspects of ophthalmology dealt with in previous editions, a new chapter on ocular trauma has been added in addition to descriptions of new surgical techniques and some pruning of outdated material.

This is and has been an extremely successful primer text for the trainee ophthalmologists and one might ask why this book rather than the many other texts available. Perhaps the answer lies in part in the approach taken with this text which is intuitively “patient oriented”: one can almost envisage the author examining the patient presenting to the ophthalmic clinic by starting systematically at the front of the eye and working his way posteriorly towards the orbit and/or cortex until he finds the source of the patient's complaints. There is less emphasis on why the patient might have his complaints than finding out what exactly the problem is and what the practitioner can do about it. As such it works very well because it is concise but sufficiently detailed and above all immediately accessible. In fact there is a remarkable amount of detail (see, for instance, the section on corneal dystrophies) while one could debate occasional diagnoses attached to some of the fundus photographs (see, for instance, serpiginous choroiditis). There are also some very helpful line diagrams such as those included in the retina and orbit chapters. The section on neuro-ophthalmology contains several excellent illustrative radiological scans. Overall this is an excellent starting text. If there is any criticism that can be levelled at this classic text, it is that it leaves this reader thirsting for further information. If a similar effect is induced in the trainee ophthalmologist it will have achieved its aim. I can therefore recommend this book as essential reading.