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Show Journal of Neuro- Ophlhalmology 19( 2): 109- 111, 1999. Book Reviews Neuro- Ophthalmology. Clinical Signs and Symptoms, 4th ed, by Thomas J. Walsh. Lea & Febiger, Philadelphia, PA, 1997. Type of book: This is a problem- oriented core text in clinical neuro- ophthalmology designed to lead the reader through intermediate- level discussions of the most frequently encountered problems in the field. The focus is on interpretation of signs and symptoms, with emphasis on differential diagnosis and appropriate diagnostic testing. In most chapters, a series of illustrative clinical unknowns follows the primary discussion. Scope: The book was developed as a practical guide to clinical problems in neuro- ophthalmology. Although there are short introductory sections on pathophysiology of the various diseases, the emphasis is clearly on formulating an organized approach to diagnosis and management. Each chapter provides a survey of the potential causes of a particular entity, with an explanation of the appropriate initial steps to follow in management. A moderate level of detail is maintained throughout. Contents: The text encompasses 18 chapters, beginning with an introduction to the neuro- ophthalmic and neurologic examinations and including sections on the classic neuro- ophthalmologic problems, including papilledema, pupillary abnormalities, diplopia, facial nerve abnormalities, ptosis, decreased vision, visual field defects, headache, gaze disorders, and nystagmus. Separate chapters on neuroimaging and electrophysiologic testing provide more detail on these diagnostic tests. Additional reviews of orbital disease, chromosomal alterations, and neuro- otology supplement the basic material. Strengths: This text provides a practical guide to the common problems encountered in neuro- ophthalmology. I particularly liked the section on unexplained visual loss due to occult or not- so- occult abnormalities of the ocular media or fundus that may be mistaken for optic nerve or central nervous system disease. The chapter on magnetic resonance imaging is well illustrated and provides an excellent introduction to the anatomy required for interpretation of these images by ophthalmologists. There is a nice summary of the patterns of visual field loss to consider in neuro- ophthalmologic diagnosis. Deficiencies: As with any overview, the level of detail regarding individual clinical entities is limited, and specifics of therapy in many cases are not addressed. The section on " Blurred Vision" is actually the major discussion of optic neuropathies, but is not identified as such; I would favor renaming it to guide the reader better to this all- important topic. The chapter on chromosomal changes seems unrelated to the remainder of the text; a more detailed section on newer developments in heredi- © 1999 Lippincoll Williams & Wilkins, Inc., Philadelphia Barrett Katz, M. D., M. B. A. tary diseases such as Leber's hereditary optic neuropathy may be of greater value. Recommended audience: This volume is a useful guide for ophthalmology and neurology residents and for any non- neuro- ophthalmologist who might benefit from a basic review of the clinical syndromes encountered in this field. Critical appraisal: This work succeeds in its stated goal of providing practical clinical guidance through the potentially confusing array of data obtained in evaluation of neuro- ophthalmologic problems. It is a valuable initial reference for any nonsubspecialist involved in the care of these patients. Anthony C. Arnold, M. D. Jules Stein Eye Institute Los Angeles, California Oculoplastic Surgery, 3rd ed., edited by Clinton D. Mc- Cord, Jr., Myron Tanenbaum, and William R. Nunery. Raven Press, New York, NY, 1998. Type of book: This book is a multiauthored text relating specifically to oculoplastic surgery. Also included are sections on cosmetic surgery, orbital disease, and lacrimal disease. Scope of book: The book is primarily intended for the oculoplastic, lacrimal and orbital surgeon. As the authors state in the preface, this book is intended for the practicing clinician who will be performing these procedures. Contents: This book is divided according to the classic subjects related to oculoplastic surgery. There are 20 chapters. The first two chapters are general and are related to surgical technique and anatomy. The next 10 chapters relate primarily to eyelid diagnosis and management. One chapter is related to lacrimal drainage disorders, and the final 7 chapters relate to orbital disease, including the anophthalmic socket. Each of the chapters is authored by one or more contributing authors, all recognized as experts in their fields. Strengths: In general, the quality of this text book is excellent. It is a third edition, building on two excellent previous editions that have become standards in the field. Important advances in the management of oculoplastic disease have been included. Some of these areas include the use of mini- and microplating techniques, split-thickness calvarial bone grafting, the management of traumatic optic neuropathy, improvements of blepharo-plasty techniques, and updating of decompressive tech- 109 110 BOOK REVIEWS niques for Graves' orbitopathy. In addition, a thorough discussion of techniques for treatment of facial nerve palsy and blepharospasm have been updated. Weaknesses: This book is primarily intended for the oculoplastic or clinical surgeon. Although the anatomy section includes a discussion of neuroanatomy, specific neuro- ophthalmologic evaluation techniques for orbital disease, eyelid disease, and blepharospasm are weak. Some of the chapters seem to overlap. For instance, the chapter on orbital disease has a section on ophthalmic Graves' disease. However, there is another chapter exclusively on Graves' ophthalmopathy. The discussion of Graves' ophthalmopathy is excellent and includes the newer addition of possible environmental factors ( including Yersinia infection and the effects of smoking) on thyroid eye disease. In other areas, it appears somewhat incomplete- for example, the discussion of super voltage radiation therapy for the treatment of Graves' ophthalmopathy. There also seems to be some areas in which there is exclusion of certain areas of discussion that could be emphasized. An example is in the acute orbital trauma chapter; a more detailed discussion of orbital foreign bodies may be appropriate. Finally, the line drawings in the text vary in quality. Some are excellent, but others seem weak, making it difficult to follow the intended demonstration. For comparison, examples of weak figures are Figure 31 in Chapter 2, in which the line drawing is indistinct and the marked structures are difficult to follow because of the broken lines, and the drawings in Chapter 3, which are of rough quality. An example of a figure of excellent quality is Figure 8 in Chapter 4. Recommended audience: The text is intended primarily for clinical surgeons, be they oculoplastic specialists or ophthalmologists, residents or plastic surgeons. The book is not so much intended for neuro- ophthalmologists or for those seeking more information on the basic science of disease. Critical appraisal: This book is an excellent text for its intended audience. It is well written, with a wide authorship that brings a diversity of opinion to the subjects and presents them in a usable manner. Although it is probably not the best text book for basic science, it is one of the best, if not the best text book for the practicing clinician. James C. Orcutt, M. D., Ph. D. University of Washington Department of Ophthalmology Seattle, Washington Colour Atlas of Ophthalmic Plastic Surgery, by A. G. Tyers and J. R. O. Collin, Butterworth- Heinemann, Oxford, UK, 1995. Type of book: This is a hardcover surgical atlas of a variety of oculoplastic procedures. Each operation is described in detail using surgical photographs with legends and text. Scope of book: The book was written to serve as a guide for surgeons and was specifically designed to assist in the easy recognition of anatomy and understanding of each step of the described operations. The goal of the authors was to facilitate the performance of oculoplastics procedures by general ophthalmologists and plastic surgeons. Contents: The book is divided into 18 chapters. The first five chapters are introductory and cover anatomy, basic ophthalmic plastic surgical techniques, preoperative evaluation, anesthesia, and instruments. The remaining chapters are each devoted to a specific clinical problem and providing several surgical procedures designed to correct it. Strengths: The text and figures about the anatomy of the eyelids are vivid and excellent. However, the value of the atlas is its photographic illustrations of surgical techniques and surgical anatomy. The accompanying clinical and surgical pearls are practical for improving technique and outcome of common oculoplastic procedures. The illustrations and text are particularly well done for upper and lower lid retraction, tarsorrhaphy, and anterior lamellar repositioning for upper lid entropion. The description of management of a deep superior sulcus and formation of lower lid sulcus is exceptional. Weaknesses: The section on anatomy leaves any mention of the capsulopalpebral fascia, arguably the most important structure of the lower lid, until near the end of the book. A discussion of the detailed anatomy of the facial muscles other than the orbicularis would have made the section on anatomy more complete. There are several procedural recommendations in the text with which we do not agree. Although the section on levator repair suggests removing the excess skin of the upper lid after the ptosis repair, in our opinion this skin should be marked and excised beforehand, for the best cosmetic result. The text for the direct brow- lift should recommend staying superficially in the medial third of the dissection, to avoid the structures at the supraorbital notch. Also in that procedure, the blade should not be beveled at a right angle, as suggested, so that the brow follicles and scarring are avoided. The section on hy-droxyapatite fails to mention that magnetic resonance imaging is now considered a better technique than bone scan in determining vascularization of an implant. Finally, in our opinion, in the procedure on enucleation with hydroxyapatite reconstruction, the inferior oblique tendon does not need a window in the sclera because it is nonvascular. Cutting a window and suturing the tendon increases surgery time. Recommended audience: This atlas is likely to be very helpful to residents, plastic surgeons, and ophthalmologists by providing guidance in basic oculoplastics procedures and assisting in recognition of anatomy. It should also be useful to ophthalmologists and oculoplastic surgeons in teaching settings for introducing residents to the described techniques. Critical appraisal: The neuro- ophthalmologic value of this text is limited. Discussion of the neurophysiology of lid function, the facial nerve, and neurologic causes of J Neum- Ophthalmol, Vol. 19, No. 2, 1999 BOOK REVIEWS HI ptosis is necessarily limited. However, the atlas may be useful as a readily available guide for surgical procedures designed to correct several problems faced by neuro- ophthalmic patients. Books in Brief Competing on the Edge: Strategy as Structured Chaos, by Shona L. Brown and Kathleen M. Eisen-hardt. Cambridge: Harvard Business School Press, 1998. This wonderful book brought to us by the Harvard Business School Press advises executives, leaders, chairs, and all decision- makers to get used to being on the edge of chaos. It is an interesting and novel guide for management that criticizes past managers for spending too much time on forecasting, analysis, and measuring strategies, rather than acting on the here and now. The authors argue that organizations that compete on the edge create a constant flow of large- and small- scale competitive moves that, collectively, result in a coherent strategic direction. They postulate that organizations of the future will thrive with a loosely formed hierarchy in which most planning happens at the precarious border between rigidity and anarchy and offering just enough structure- and enough freedom- to adapt, change, and ultimately reinvent the organization, time and time again. This has as much applicability to ophthalmology, practices, and academic medical centers as it does to a manufacturing environment or other service industry. The philosophy behind this new mind- set comes from principles of complexity theory and keeps managers focused on how tightly the various parts of their organization are linked. It also reminds us as managers and leaders that less is often more, especially when it comes to control. Agility and adaptation are the name of the game, and recognizing patterns of change is the paradigm for organizational management and memory for tomorrow. The authors advise us to focus on five key activities: improvization, coadaptation, regeneration, experimentation, and time pacing. This is an overview that speaks to defining strategic intent for one's organization, be it a department or a practice. It is a compelling assessment of the world in which we are now competing. The medical community is not unique in this regard; it is in many ways not so different from any other business or any other market. This book will be a classic in strategy for the next decade and is worth a quick look. It is a reasonable and Timothy P. Carey, M. D. Eugene F. May, M. D. The Polyclinic Seattle, Washington thought- provoking monograph linking where we might want to go and how to get there. It is an important book for any supervisor who must operate in a fast- paced, dynamic, rapidly changing business environment. Brown and Eisenhardt provide a fresh way to think about change, and they offer an exciting, innovative, and compelling, yet practical, view on how to use change to create competitive advantage. Pragmatic Fundraising for College Administrators and Development Officers, by Ralph L. Lowenstein. Gainesville, FL: University Press of Florida, 1997. This brief book by a former dean of journalism and recognized maven in fundraising is an informative, cogent, and practical guide for those with an interest in and a job description that encompasses fundraising and development. Dean Lowenstein shares with us those messages that have made his past fundraising so successful. He includes such practical topics as how to organize a campaign and committee, how to recognize and approach a potential donor, how to arrange successful meetings for advisory boards, how to approach foundations, how to write a proposal, and the beginner's guide to alternatives to cash giving that enable one to ask not just for a check, but for a charitable unit trust or gift annuity. In addition to useful directions and ideas on following through, this book offers representative examples of letters that cover all types of campaigns and programs that may be encountered in fundraising efforts. Pragmatic Fundraising is a wonderful manual for both the planning and implementation of a successful fundraising strategy so important to all of our institutions, both now and in the future. If you have ever wondered how the experts do it and what is to be learned from someone who has devoted his career to development, read this little book. Barrett Katz, M. D., M. B. A. University of Rochester Rochester, New York J Neuro- Ophthalmol, Vol. 19, No. 2, 1999 |
