Description

Review of
“Glaucoma Handbook”
by Anthony B Litwak
Publisher: Butterworth Heinemann
Pages: 114
Price: £ 68.00
ISBN: 0 7506 9776 8

What the text claims

“…this handbook provides clear and practical clinical guidelines on how to best manage your glaucoma patients”

“…designed for use in your daily practice”

This book does exactly as advertised. It is not intended as an over-clever research text, but as a very readable and useful addition to the literature on this difficult subject. It is intended specifically for optometrists and will help clinicians at any level from undergraduate and pre-registration through to those who have practiced for many years. There is something for everyone, and I found it an enjoyable read.

This hardback book (with 36 colour plates, 134 halftones and 114 line illustrations) is divided into 9 sections dealing with glaucoma diagnosis, glaucoma treatment and management, the specifics of the various glaucoma subgroups, and some helpful glaucoma case studies. The heavy use of illustrations makes the text interesting and easy to follow.

Why Another Glaucoma Textbook?

Even the author raises this question in the preface to his own text. There is good reason now in 2002 to consider buying yet another glaucoma text and it is simply that things have, at last, moved on in glaucoma. Over the last ten years our basic awareness of the multitude of causes of glaucoma has grown, as has our ability to diagnose and treat the condition.

At the same time, the general pace of scientific and technological advancement has considerably altered the way that we investigate the disease. Rapid developments in computer and scanning laser technologies, methodological paradigms such as Short Wavelength Automated Perimetry and Frequency Doubling Perimetry are now part of most glaucoma research toolkits and will increasingly enter the optometrist’s clinical domain.

Greater understanding of glaucoma through research and clinical experience has also introduced new clinical pearls that can aid diagnosis without the need for expensive and complicated clinical tools. The book usefully discusses these approaches including: the need for consideration of disc size as a context for the interpretation of cup:disc ratios for both the detection of true abnormality or true asymmetry; the ISNT rule (if you don’t know this one it is a must!); and the role of systemic health factors such as vascular disease and sleep disturbance, to name but a few.

Why Another American Textbook?

It can be frustrating to read textbooks describing the current wisdom, when they are specific to a country where the laws, treatments and terminology are different from our own. There is no doubt that this can cause confusion, especially in a text where drug names are involved. Fear not however, in this book management regimens are familiar to UK readers, and generic drug names are used widely throughout the text.

Where an American text of this nature comes into its own is in the depth of clinical experience of its authors, based on the opportunity our US colleagues have to diagnose and treat glaucoma. Whatever the future of the optometrist’s role in glaucoma management in this country, we can only benefit from sharing these years of experience.

The final verdict

Anyone who thinks that glaucoma diagnosis is solely based on the clinical hat-trick of obvious optic nerve head abnormality, raised intraocular pressure and confirmed visual field damage, needs to read this book. Anyone who thinks that UK optometry should play a greater role in the diagnosis and/or management of glaucoma, either unilaterally or through shared care, will benefit from the clinical wisdom imparted here.

Reviewed by:
Dr SL Hosking
PhD MCOptom FAAO DBO
Director of Postgraduate Development
Vision Sciences
Aston Triangle
Birmingham B4 7ET