Glaucoma Handbook. Anthony B. Litwak: Butterworth-Heinemann, Boston, MA, 2001, 364 pp., $85.00.
This new glaucoma text provides a good basic clinical reference with easy-to-read coverage of the topic. The material is presented in 18 chapters including the introduction. There are 14 contributing optometrist authors who provide chapters in their areas of expertise. The authors generally reference lots of current literature when appropriate. There are numerous enriching clinical “pearls” offered throughout the book, though sometimes not prominently displayed.
This is intended to be a clinical reference and ‘not intended to replace the classic academic textbooks of glaucoma; it is designed to give practical clinical information and guidelines.” While I think that the text holds true to this objective in the most traditional clinical context, I would like to have seen more exploration into the wealth of contemporary information on non-traditional clinical testing. Though many new instruments and tests are unproven in diagnostic value, they hold promise and insight for the future management of the disease. At the pace of research and discovery for glaucoma, that future may come quickly. Holding true to the intent of the book, the reader will not find much discussion on current theory in the pathophysiology of the disease.
The areas that I think this book covers particularly well relative to other available texts are epidemiology, risk factors, clinical examination, visual retinal nerve fiber layer analysis and visual field evaluation. The subject of clinical chairside examination is exhaustive and includes pupil testing, contrast sensitivity, color vision, and corneal thickness measurement. I would like to have seen some coverage on pachometry instrumentation and technique. I believe that this is a valuable instrument in glaucoma management today. There is a very comprehensive section on nerve fiber layer analysis, which leaves little mention of scanning laser polarimetry, optical coherence, tomography and other new technology.
Probably the best section is the automated perimetry chapter, which provides many examples and gives an appropriately detailed guide to visual field testing and interpretation. Here, also, it would have been nice to see some discussion on cutting edge techniques that currently enjoy primarily research application, such as motion automated perimetry and high pass resolution perimetry. The text provides numerous figures, tables, black and white photos and, particularly, lots of visual fields correlating with specific optic nerve damage. There is a short color plate section. I think it would be helpful in the next edition to include more coverage on glaucomatous optic nerve changes and color photos since the optic nerve and ganglion fiber layer are the primary objective guides to glaucoma diagnosis and management.
One of the best sections is the final chapter. The author presents an analysis of eight case studies. They are all interesting and well selected for their informative value. The student of glaucoma (that would include each of us) will find this section a useful aid in helping to put all the thinking that goes into glaucoma management together.
Guest Reviewer: Dr. David Cale
Assistant Professor
Southern College of Optometry