The book covers ocular anatomy and the anatomy of the brain and brain stem rel- evant to the eye or visual function. It
C L I N I C A L
A N D
E X P E R I M E N T A L
OPTOMETRY
Book reviews
Book reviews
Clinical Anatomy of the Visual System LA Remington Boston, USA: Butterworth-Heineman, 1997 260 pages RRP $145.00 Reviewed by DR ALGIS J VINGRYS, Department of Opometry and Vision Sciences, The University of Melbourne
The book covers ocular anatomy and the anatomy of the brain and brain stem relevant to the eye or visual function. It is a useful adjunct in an area where the majority of books are either too complex and specialised or lacking in practical application. Remington has produced a book aimed at the undergraduate student and practising clinician that will become a valued reference. The author wrote all but Chapter 5 on the crystalline lens, which was written by EC McGill. The subject matter loosely falls into one of two sections, either ocular structures or neuroanatomy, and is covered in chapters entitled: • Basic definitions, useful insights into the nomenclature used for scanning planes (coronal, sagittal, transverse) and an overview of the major histology of the eye and body • Cornea and sclera • The uvea • Retinal anatomy and neurocircuitry • Lens
• • • • • • •
Aqueous and vitreous chambers Ocular embryology Bones of skull and orbit Ocular adnexa and lacrimal system Extraocular muscles Orbital blood supply Cranial nerve innervation and pathways • Autonomic nervous system and the visual pathway. There are 11 excellent colour plates illustrating different anatomical aspects, and a well-referenced index. Each chapter includes an adequate and up-to-date bibliography (references up to 1996). It appears that the book was written as a teaching text for optometry students. As such, it provides the right flavour in its approach. Throughout, it is replete with beautiful schematics, most of which have been derived from other sources but some excellent figures were generated by the author. Her use of figures from other publications has enabled her to include only the best figures available. The wonderful collage of excellent anatomical drawings is one of the book’s strengths. In the retinal chapter the quality of neurocircuitry and presentation is superior to that in any other anatomical book available, but some aspects of ganglion cell physiology (magno- and parvo-cellular) should have been included for completeness. More could have been covered on the brain stem and pontine centres that control and co-ordinate eye movements and the superior colliculus. The visual centres of the brain receive a reasonable account in terms of visual field represen-
tation, but the nature of the brain’s processing streams and the processes underlying binocularity, disparity and amblyopia all lacked decent coverage. In fact, although I acknowledge that this type of approach is lacking in other anatomical books, I was hoping that it might have been included in a book which was specific for optometry. Perhaps the author might do so in a later edition. Throughout there are numerous practical examples, called ‘clinical comments’, of the relevance of certain anatomical features to clinical optometry. This is one of the major strengths of the book and should make it popular for undergraduates trying to learn about the significance of the anatomy of the eye, as well as for practising clinicians who need a refresher. I was surprised at the strong neuroanatomical emphasis, but then optometry is a discipline enshrined in neuroanatomy. It is a great feature and an approach that is sorely missing elsewhere. The neuroanatomy starts right at the beginning of the book where the various planes used for CT scans are defined and as it continues, there is a reasonable overview of retinal circuitry. A later chapter gives an excellent account of embryology. The retinal chapter is limited by its lack of discussion on retinal metabolism although the role of the Müller cell is alluded to later. The final six chapters are all linked somehow with neuro-ophthalmic issues and I am sure to use this book as a student reference in teaching the topic. I was impressed by the inclusion of Chapter 13, in which the autonomic nervous system is
Clinical and Experimental Optometry 82.4 July–August 1999
159
82-4book.p65
159
16/11/99, 4:12 pm
Book reviews
detailed, but at the same time, I was disappointed that the author did not go far enough into this area as there is much detail lacking in discussion of the various classes of muscarinic and adrenergic receptors (alpha, beta, et cetera), given their importance for modern therapeusis. Apart from these omissions, I highly recommend Clinical Anatomy of the Visual System for anyone wanting a good overview of the anatomy of the eye, orbit and relevant brain centres. It should become a standard for undergraduates. The price should not be seen as a deterrent as it is one of the finest books on this topic and it reflects the high quality production of the volume, which is sure to last practitioners for the length of their working lives.
Eye Examination and Refraction, 2nd ed. Fletcher & Still United Kingdom: Blackwell Science Pty Ltd, 1998. 268 pages RRP $96.00 Reviewed by: ANTHEA COCHRANE Victorian College of Optometry
Eye Examination and Refraction, which was first published in 1991, is a paperback with a four-page colour insertion. It is one of four books in a series designed to assist optometrists who are in the early stages of education prepare for qualifying examinations in the United Kingdom. The book is divided into three sections. The first section covers the ‘basic’ eye examination. This section is not written as a procedures manual where various techniques are discussed in detail. Instead some components of the examination are discussed but others are overlooked. The emphasis is on points that the author, who has years of experience in optometry, wishes to highlight. For example, the cover test is barely described, although the section on ophthalmoscopy covers the various techniques, how to draw what is seen, and some useful pointers in regard to retinal blood vessels and macular appearance. The last two chapters in this section cover reports and referrals and preparation for examinations. These chapters are not really relevant for Australian optometrists as the section on reports and referrals is written in the context of the United Kingdom professional environment, and the preparation for examinations chapter is written to assist in the British professional qualifying examinations. Section two covers oculo-refractive techniques and is objective and subjective. Once again this section does not describe how to perform a particular technique, for example retinoscopy, but highlights the important issues to consider when doing the technique. Chapter 11 covers subjective refraction. It is a concise summary of the refractive process and gives
sound advice in many areas relating to refraction which would assist new optometrists avoid the pitfalls. Section three covers refraction and subjective examination by using 100 case reports. A point is raised by the author and then highlighted through case examples. The cases are divided into chapters covering: patient records, prescribing for reading, when visual acuity does not improve as expected, field defects, ocular muscle defects and prism prescribing problems. This is a unique way of presenting common pitfalls for inexperienced practitioners such as prescribing for anisometropia, incorrectly setting multifocal/ bifocal heights and under-correcting or missing refractive error. I found the way this section was presented enjoyable and interesting to read. The appendices include some revision questions that cover the first two sections of the book and some problems regarding prescribing which relate to the third section of the book. In addition the appendices include guidelines for the routine optometric eye examination and a reference bibliography section. This book contains some very important messages for the new optometrist or for an optometrist returning to the workforce after a break. It is not a book which purely describes clinical procedures and this is really its strength, as the authors endeavour, and succeed, to go beyond just describing optometric techniques. This means that the book does not extend to cover many techniques and should not be purchased for this purpose. I think the style of presentation will be enjoyed by most, although some may find the way the book highlights some areas and skims over others frustrating. I do not recommend that the more experienced practitioners should purchase it, although reading the case reports should be of interest to most. Optometrists in teaching roles may find this book useful because of the many hints for inexperienced and student practitioners.
Clinical and Experimental Optometry 82.4 July–August 1999
160
82-4book.p65
160
16/11/99, 4:12 pm
