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If a reference book can ever be a 'good read', then these books are just that. Andrew and Ngaire Franklin bring a great sense of humour to their wealth of knowledge on contact lenses. Their down-to-earth approach embraces an historical perspective - gained only from having been there - as well as some original thinking. For example, the section on the principles of soft lens fitting introduces the reader to the concept of 'squeeze pressure' which describes how the forces generated within a lens may affect the fit and movement on the eye. Many of these ideas, while perhaps not clinically documented, are so ably explained and they will strike a chord with many practitioners. The authors urge practitioners to 'read it fast' as contact lens books go out of date so quickly, so that is exactly what practitioners should do.
Easy reference
The chapters follow a logical sequence from initial considerations before fitting commences to advice on trouble-shooting problems. They are also colour-coded which makes access to information both easy and quick, as well as giving the books a bright feel. The idea of putting the chapter title at the top of each left hand page and the key topic on the top right also works well for speedy access to information. References are also in a simplified format, and appear both within the text and at the end of a chapter. This idea is effective, but more references would have been welcome.
It is a little surprising to see silicone hydrogels linked to extended wear, as is the title of chapter six in Soft lens fitting. These days considerably more silicone hydrogels are fitted for daily wear than extended wear, a fact acknowledged by the authors later in the chapter. The background to overnight wear is most interesting, although there is a cautionary tone to this chapter. There is some inconsistency in the description of wearing modalities due in part to slightly fragmented product descriptions and the fast pace at which new product development occurs.
New issues
There is much information inevitably common to both books, for example patient examination, aftercare and complications. But both volumes address new and emerging issues that many practitioners will have little or no experience of. Topics such as orthokeratology and fitting after refractive surgery are covered extensively and would enable an inexperienced practitioner to proceed in these areas with confidence. There is invaluable practical advice relevant to today's practitioner. The sections on lens handling, lens care products and compliance are excellent, well worth revisiting, and advice surrounding new regulations is most welcome.
The rigid gas-permeable lens fitting book will be especially useful as many practitioners aren't exposed to these lenses very often nowadays. As has been remarked, students emerge with little experience in this area and often lack confidence to recommend and fit these lenses. Unfortunately this situation is perpetuated in many practices due to poor supervision or practice policy to fit only high volume lenses.
The section on RGP materials gives the practitioner a good insight into how and why material properties have developed and how lens selection can be vital for optimum on-eye performance. This information will demystify this topic for many and aid in trouble shooting problems. There is a great deal on fluorescence, which may at first glance seem a little overly detailed or academic. However, when the authors explain that several factors can affect fluorescence, one being the pH of the eye or saline used to wet a Fluoret, the reader has a better appreciation of how the reading of a fluorescein pattern can best be undertaken. Refreshingly, the authors are not afraid to challenge conventional thinking and the tips on lens selection - a result of years of experience - will save time and give novice practitioners a head start.
Universal appeal
One reason why these books succeed is they combine straightforward, pragmatic advice with a comfortable amount of clinical and technical content. This is a difficult balancing act but means that they will appeal to all in practice who need to either learn or refresh - so, in a word, everyone.
Soft Lens Fitting and Rigid Gas Permeable Lens fitting, both by Andy and Ngaire Franklin, Eye Essentials, Elsevier Science. Series editors S Doshi and W Harvey.
Jayne Schofield is contact lens consultant for CIBA Vision (UK)