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Glaucoma. 3rd ed.
  1. N Spencer
  1. Bristo Eye Hospital, Lower Maudlin Street, Bristol B S1 2LX UK;

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    Eds J Salmon, J Kanski. £46, pp 169. Oxford: Butterworth-Heinemann, 2004, ISBN 0750655283.

    This excellent text has been in print since 1989 and its longevity is testament to its high quality. This is the third edition, with a new co-author John Salmon. Since its previous edition over 8 years ago there have been many advances in both the genetics, and the diagnosis, monitoring and treatment of glaucoma. This text successfully updates the previous edition, and provides a concise, systematic, detailed and well balanced representation of modern glaucoma diagnosis and management.

    This book is aimed at the trainee ophthalmologist and optometrist, although it is also good basic revision for the practising ophthalmologist. This is a comprehensive text in that each type of glaucoma is described in terms of its main clinical features and management. There are many colour illustrations and photographs, these help the reader to correctly interpret clinical signs and diagnostic tests. It also covers current controversies and new techniques such as non-penetrating glaucoma surgery. The landmark glaucoma studies and their significance are also mentioned. It is perhaps too brief in sections, particularly in the chapters looking at glaucoma diagnosis, perimetry, and imaging; however, adequate and key references are provided to allow further pursuit of these topics in more depth.

    The text begins by covering the basic sciences including the physiology of aqueous secretion. Then there is a comprehensive definition and classification of glaucoma. The different types of glaucoma are described at length. Tonometry is covered well, including the range of tonometers, potential errors in tonometry, and calibration. Gonioscopy is discussed including angle structure identification and the different systems of angle classification.

    Retinal nerve fibre and optic nerve head assessment is described briefly including the new imaging techniques of scanning laser tomography (Heidelberg retinal tomogram II), ocular coherence tomography (OCT), and scanning laser polarimetry (GDx nerve fibre analyser). The images or readouts produced by each machine are provided in colour along with a very brief description of their interpretation. The various modalities of perimetry are described, their interpretation is given, and new techniques such as the frequency doubling contrast test (FDT) and shortwave automated perimetry (SWAP) are discussed and examples provided.

    Glaucoma medications are covered very well. Long standing medication are discussed as well as new treatment options, including combined topical preparations. Neuroprotective agents are covered with the recent research regarding these agents. There is a chapter on laser therapy which covers argon, diode, and selective laser trabeculoplasty, Nd-YAG laser iridotomy, and diode laser cycloablation.

    Trabeculectomy surgery with early and late complications are discussed comprehensively. There is an excellent and concise chapter on non-penetrating filtration surgery, covering the two most popular techniques—deep sclerectomy and viscocanalostomy.

    The next chapter deals with antimetabolites in filtration surgery; established antimetabolites are covered (5-fluorouracil and mitomycin C), new agents such as antibodies to TGF-β are also mentioned. The final chapter is on drainage implants, the Molteno, Baerveldt, and Ahmed implants are discussed. Finally the actual surgical techniques and the complications are well described.

    Overall, this is an excellent book, it is concise, with only 163 pages of illustrated text, easy to read, and extremely pertinent to clinical practice. A text I thoroughly recommend for any trainee ophthalmologist or optometrist and anyone wanting a brief, contemporary revision text on the diagnosis and management of glaucoma. Although, fortunately or unfortunately, in the end it may only whet your appetite for information and leave you wanting more.