Education and prevention: steadying your ship through choppy ophthalmic waters

This second part of our thematic look at what is available to add to your bookshelf in 2003 focuses on ophthalmic education and the prevention and treatment of ocular infection. And for the rest of the year, we aim to simply keep you at the leading edge of ocular surgery’s dynamic publishing environment.

For teachers and students

Illustrated Tutorials in Clinical Ophthalmology
Jack J Kanski & Anne Bolton
Butterworth-Heinemann, Woburn, MA, USA, 2001
Hardback /395 pages / over 600 figures
ISBN: 0-7506-5272-1 / $66.99

If you are preparing an examination in ophthalmology, getting ready to teach junior doctors, or have decided to brush up on your ophthalmological knowledge, this book and its accompanying CD make very useful tools.

The book consists of 46 structured tutorials covering a wide range of clinical ophthalmology conditions. The CD has the same material, plus an additional 18 tutorials, covering less common but completely different disorders.
The electronic version contains tutorials in PowerPoint, so they can be used directly for projection during lectures. If you travel with your laptop, or occasionally have some study time near a computer, you don’t even need to carry the book around to make good use of those spare minutes.
It was put together by a consultant ophthalmologist, Jack J. Kanski MD, and a medical photography expert, Anne Bolton BIPP, both working at the Prince Charles Eye Unit in Windsor, UK.

The composition of the team tells you that the emphasis of these tutorials is on clinical images of excellent resolution, clarity and variety. Through these images, the diagnosis, evaluation and treatment of the conditions are described step by step.
The contents are organised roughly in anatomical order from eyelid disorders to conjunctival infections and tumours, corneal illnesses and anomalies, scleritis, cataracts ... deeper and deeper into the eye. Every major ophthalmological problem has a tutorial dedicated to it: age-related problems and paediatric conditions, hereditary as well as diabetic and other systemically-induced alterations, tumours, optic nerve palsies and phacomatoses.

Although the photographs dominate the text both in book and on CD, the images are grouped under headings such as ‘natural history’, ‘histology’, or ‘frequent locations’. The images are accompanied by clear legends, and in addition, ‘important facts’ and ‘treatment options’ boxes with bullet points featuring in many cases.
Although not all the information on the CD is reproduced in the book, you get both for the same price. And the book’s contents page tells you what you will find and where.
Even if your exam days are long over, this teaching aid can be very rewarding. If sometimes you miss all those rare cases you used to see as a trainee in your teaching hospital, a few images will bring it all back!

For the preventive-minded

Antiseptic Prophylaxis and Therapy in Ocular Infections: Principles, clinical practice and infection control

Volume Editors:
Axel Kramer & Wolfgang Behrens- Baumann
Karger AG, Basel, Switzerland, 2002
Hardback / 367 pages / 27 figures / 68 tables
ISBN: 3-8055-7316-2 / $195

This one is a volume in the Developments in Ophthalmology series which is edited by Wolfgang Behrens-Baumann MD of the University Otto von Guericke, Magdeburg, Germany.
The book brings together our present collective knowledge of prevention and treatment of ocular infections. The volume editors are Dr Behrens-Baumann himself and Axel Kramer MD of Ernst Moritz Arndt University, Greifswald, Germany.

This relatively slim volume systematically collates available clinical and experimental studies and evaluates them in view of their relevance to clinical practice.
It takes an interdisciplinary approach and weighs up the effectiveness and indications of antiseptics for the prophylaxis and therapy of infections in ophthalmology. It does so in a trustworthy and methodical way.
The book first discusses the basics of microbial colonisation and the different sections of the eye as targets for infective agents. Prevention by protection, by antiseptic prophylaxis and by anti-microbial chemotherapy follow. The requirements for antiseptics are analysed following anatomical compartments such as periorbital, orbital and intraorbital.

The first section also includes the spectrum of action, the risk of resistance of only micro-biostatic active agents, and contamination of the eye caused by viruses, bacteria, fungus and protozoa as well as local and systemic tolerance. The section also defines the microbiological requirements of ocular antiseptics.

The second section, headed ‘Clinical use of antiseptics’, describes current scientific knowledge of prophylaxis and therapeutic antisepsis, including requirements in cornea banks. It also has a paper giving recommendations for isolation and antiseptic sanitation of patients infected with hospital-acquired MRSA.
The final section focuses on prevention. It includes measures to avoid transmission after infection has occurred, hand and contact lens hygiene and advice on sampling and transporting specimens for microbial diagnosis. All chapters are carefully referred.
For those who are impressed by having a look at the big picture of preventive aspects in medicine, let me give you an illustration extracted from the book’s foreword by Sherwin J. Isenberg.

Assuming that 25% of postoperative endophthalmitis results in functional blindness, and considering that around 2.5 million intraocular operations are performed annually in the US, the use of povidoneiodine preoperatively (which reduces the incidence of endophthalmitis from 0.24% to 0.06%) will, as a single intervention, spare more than 1,100 eyes from blindness in the US alone.
This book provides an up-to-date review on the fight against ocular infections. Not only ophthalmologists, but also optometrists, opticians, hygienists, microbiologists and pharmacists would find accurate information on the latest clinical and experimental findings in the field. There are no photographs, but there is a lot of good, old-fashioned clinical data.

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