Ophthalmology for optometrists

Bill Harvey reviews two useful texts recently published on ophthalmology

There can be few readers who have either not heard of or seen Jack Kanski's textbooks on ophthalmology. However, another key reference book in this subject area, often overshadowed by Kanski but used by our optometry university departments, is David  Spalton's book - Atlas of Clinical Ophthalmology.

It has been in need of an update for some time, the second edition is now over 10 years old, and so it was with great interest that I read the just-published third edition. Though the book is widely known as Spalton's, the Atlas of Clinical Ophthalmology (£150, Elsevier Mosby ISBN 0-3230-3656-2),was co-edited by Roger Hitchings, the glaucoma specialist at Moorfields, and Paul Hunter of Kings College Hospital. The text has been significantly expanded from the second edition, but still retains excellent line drawings to explain many of the photographs within. The 20 chapters are written by experts of world renown in their particular arena, and include Bertil Damato (uveal tract), Gordon Plant (optic disc) and Christopher Hammond (strabismus).

As typical for this sort of comprehensive text, the opening chapter concerns examination technique, but the breadth of coverage here is both unusual and welcome. Many such texts briefly mention tonometry, fields and ophthalmoscopy, but here we get succinct but cogent mention of assessments as diverse as frequency doubling perimetry, topography, electrophysiology, laser ophthalmoscopy and aberrometry.

The following chapters assume a familiar sequence from external structures, through anterior to the fundus and nerve. Each is lavishly illustrated and the quality of the photographs is exceptional (see, for example, the photographs in the chapter on vitreo-retinal disorders) and the book includes many histological, scan and angiographic images. As an atlas, the book has less by way of text to explain the photos, but each figure has a clear and concise caption and the short sections of text are occasionally usefully supplemented by summarising tables.

The book is an essential buy for any busy clinician or student and, unusually for a text of over £100, represents good value. With the new PQEs likely to include a significant picture interpretation element, I also suggest it is worth consideration by all pre-registration optometrists and their students.

A much smaller investment will buy the new softback Practical Ophthalmology - A Survival Guide for Doctors and Optometrists by Anthony Pane and Peter Simcock (£19.99, Elsevier Churchill Livingstone, ISBN 0-443-10112-4). This book is  aimed directly at GPs and optometrists by ophthalmologists and gives excellent summaries of emergency treatment or referral management of a wide range of ocular diseases. As such, it is a useful addition to the consulting room, but readers might wish to avoid the first two chapters which explain the fundamentals of the eye examination at a very basic level. One can only hope that the patronising tone of these chapters is more aimed at our GP colleagues.