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Immunology of the lacrimal gland, tear film and ocular surface
  1. M Berry
  1. Bristol Eye Hospital, Lower Maudlin Street, Bristol, UK;

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    Eds Manfred Zierhut, Michael E Stern, David A Sullivan. £75, pp 288. London: Taylor and Francis, 2005, ISBN 184184568X

    A short quotation (p 152) summarises the book: “These systems are all part of the multiple and redundant and protective mechanisms…[that] maintain a functioning cornea.” Reflecting this complexity, chapters range from the pathogenesis of herpetic keratitis to dry eyes, to mucosal immunity and the use of topical ciclosporin, to tear film and contact lenses and, of course, inflammation. The book includes more unusual chapters on ocular surface: these integrate the eye into the upper aerodigestive tract. Parallels between lacrimal and salivary glands, which are not often conducted, focus attention to the inflammatory and immune processes common to these mucosae and the diagnostic markers they might offer.

    Some chapters are dense and scholarly: “Sex, sex steroids and dry eye syndromes” has no fewer than 232 references, and provides a “must read” synthesis of approaches, results and hypotheses of the research undertaken to understand sex related differences in lacrimal and meibomian gland (dys)function. Other chapters have a narrower focus: events leading to Acanthamoeba infections and candidates for therapy are presented in an very clearly organised and chapter.

    Equally elegantly and authoritatively presented are hypotheses and results showing that constant parasympathetic input is necessary for tear production and thus ocular surface homeostasis.

    Though not stated by the editors, this book contains contributions to a meeting with the same title, which provided a wonderful opportunity for discussions. It is rather a pity that these are not part of the book. Putting up with different styles is a small price to pay for this highly informed and expertly abstracted state of knowledge publication.