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Each chapter is systematically laid out and the various complications arranged logically, by tissue pathology and slit-lamp appearance - an ideal way for practitioners to become skilled at approaching the clinical conundrums they face in contact lens practice.
Contact Lens Complications provides a clinician-friendly guide to identifying, understanding and managing ocular response to contact lens complications in modern-day practice. Its concise, easy-to-read style and vast collection of outstanding full colour schematic diagrams, clinical images and peer reviewed references provide practitioner and student with the perfect combination of consulting room handbook, study manual and evidence-based reference guide.
Rapid diagnosis
The updated 'Complications Quick-Find Index' at the start of the book is not only an incredibly useful study tool for exam revision but a valuable in-practice aid to help formulate a rapid diagnosis and management plan. Simple to follow, cross referencing to relevant pages for further reading, makes this a great gateway to information, in contrast to the typical alphabetic listing of words in the index at the back of a book.
Chapter 1, on anterior eye examination, while clearly illustrating basic slit-lamp illumination and observation techniques, expands to review the latest instrumentation for anterior eye examination. My only criticism is perhaps the limited reporting of benefits of corneal topographical instruments, although corneal irregularity and associated conditions and complications are covered in Chapter 26, under corneal warpage.
Professor Efron is perhaps most well known among contact lens practitioners and students for the development, design and delivery of the Efron Grading Scales, so it will be of no surprise that this third edition includes an entire chapter devoted to grading. The appendices include the full colour version of the grading images painted by ophthalmic artist Terry Tarrant.
The appendices also contain the skilfully illustrated Guillon tear film classification system, enabling practitioners to examine, record and grade the diverse assortment of patterns of the tear film prior to and during contact lens wear. With increasing interest in dry eye in recent years, due in part to the findings from the 2007 Dry Eye Workshop (DEWS) and the 2010 International Workshop on Meibomian Gland Dysfunction, it is perhaps not surprising that the section of the book dedicated to the tear film reports and references much of these latest findings.
Chapter 24 provides an excellent referenced review of corneal inflammatory events (CIEs) based on the Manchester Keratitis Study and pronouncing CIEs to be a disease continuum. The test clearly explains how microbial keratitis (MK) should be considered as a severe form of CIE, further along the same spectrum as a sterile infiltrative event. The chapter conclusion concerns general principles of clinical management and outlines the varying levels of clinical presentation. This needs to be carefully read in association with the final paragraphs on 'clinical caveats' to fully appreciate the author's suggested management strategy of this particular complication. MK is possibly the only sight-threatening complication that practitioners may encounter in everyday contact lens practice, so clarity on detection and subsequent management is important.
The final chapters on corneal endothelium may be of more historic or theoretical interest with the advent of modern silicone hydrogel materials and the demise of prescribed overnight wear contact lenses. However, as contact lens wearers are not immune to anterior segment disease, degenerative or dystrophic changes, the ability to differentially diagnose corneal tissue changes is important.
Online edition
This third edition is available online. The entire book; chapter, verse, word and image! My well loved and worn CD, which accompanied the second edition, is replaced with downloadable, re-designed grading morphs, featuring a self-help tutor computer program to hone grading scale recording.
As a renowned technophobe, but invited book critic, I felt duty-bound to check out this offering. I visited www.ExpertConsult.com and typed my personal activation code and, hey presto, I was in.
In summary, this latest third edition has been completely updated and revised to reflect the most current knowledge, research findings, technological developments, and updates in the contact lens field. Its easy-to-use design and systematic approach provide instant access to information that is ideal for use in a busy clinic or for exam revision. ?
? Caroline Christie is associate director of contact lenses at City University and director, Clearview Training