584 AMERICAN JOURNAL OF OPHTHALMOLOGY OCTOBER, 1980

ectropion, the chapter on ectropion de­scribes it without mentioning that erosioninto the eyeball is possible. The author'sinteresting techniques of split-level eye­lid resection and levator palpebrae su­perioris muscle hitch are well presentedin the chapter on blepharoptosis. Meth­ods of repairing congenital epicanthus,telecanthus, and blepharophimosis arepresented in a clear and understandablemanner. He also describes the newermethods of repairing hypertelorism byrepositioning the orbital-nasal skeleton.In the chapter on coloboma, severe orbit­al anomalies associated with coloboma ofthe eyelid are discussed. The last chapteris an excellent summary of the fine pointsof tissue transfer using skin grafts, mu­cous membrane and cartilage grafts, andforehead flaps.

Any surgeon dealing with eyelid tu­mors by frozen-section techniques mustbe prepared to reconstruct a defect largerthan the external appearance of thetumor would indicate. The author gives astep-by-step discussion of the surgery bywhich one can reconstruct a defect of anysize in the orbital region. Although thisbook describes the techniques used byDr. Mustards, there are other appropri­ate procedures which can be used foreyelid reconstruction. Even if one pre­fers other techniques, an understandingof this book would be useful becausethese techniques can be combined withother procedures.

FREDERICK MAUSOLF

Intervention Combinee Glaucome Cat­aracte. By A.-G. Ourgaud and P.Gastaud. Marseille, Diffusion Ceneralede Librairie, 1980. Paperbound, 151pages, 44 black and white figures.$34.45

The introductory section of this mono­graph contains an excellent description of

the macroscopic and microscopic appear­ance of the chamber angle. Next, theauthors review the problem of the com­bined presence of cataracts and glauco­ma. They make the obvious statementthat if the glaucoma is mild and thecataract severe, the latter should beremoved; if the situation is reversed,then the glaucoma should be treated.However, the bulk of their publicationdeals with those cases that require both afiltering operation and cataract extractionand they recommend that this be treatedby a combined trabeculectomy and cata­ract extraction. They recognize that thereare various techniques for performingthis but give their own in great detail.

Essentially it consists of a scleral flapunder a large conjunctival flap, a trabecu­lectomy done with scissors, and thenextension of the wound nasally and tem­porally to allow for extraction of thecataract. The wound is then closed withinterrupted 7-0 or 8-0 Vicryl sutures andthe conjunctiva with either a runningsuture or interrupted sutures. The finalsection lists their results and complica­tions.

Perhaps the most valuable portion ofthis monograph is the complete bibliog­raphy on surgical intervention in thepresence of glaucoma and cataracts.

DAVID SHOCH

Pediatric Ophthalmology Practice. ByEugene M. Helveston and Forrest D.Ellis. St. Louis, C. V. Mosby Co.,1979. Hardcover, 303 pages, index,bibliography, 422 black and white fig­ures. $43.50.

This book gives a practical account ofthe more common topics encountered inpediatric ophthalmology, in a concise,easy-to-read, atlas-like style. The au­thors, who are associates, do not intendto provide an exhaustive exposition on

VOL. 90, NO. 4 BOOK REVIEWS 585

these topics, but rather an informative,updated review of the subjects based ontheir experience and expertise.

Beginning with chapters on visual acu­ity testing, strabismus, and amblyopia,the authors go on to give their currentideas about diagnosis and treatment inchapters on the nasolacrimal system,glaucoma, blepharoptosis, the orbit, andtrauma. A chapter on the retina includesan excellent summary of the history andpathophysiology of retrolental fibropla­sia. This chapter also includes a succinct,thorough discussion of retinoblastomaand an excellent table summarizing manyretinitis pigmentosa-like disorders. In thechapter on infections, inflammations, anddevelopmental corneal abnormalities, thegreat quantity of material covered neces­sitates less specificity in discussion; thechapter includes an encyclopedic summa­ry of the developmental corneal abnor­malities and dystrophies. There are shortchapters on genetics and anesthesia. Inthe last of the 14 chapters the authorsgive an excellent short review of dyslexia,an often perplexing problem for the oph­thalmologist.

The book is well illustrated with goodcorrelation between the text and thefigures. The type is large and clear. In afew instances the use of black and whiteinstead of color photographs makes theabnormality difficult to see. Typographi­cal and editorial errors are few, andundoubtedly will be corrected in subse­quent editions. The bibliography at theend of the book is small and selective butserves as a good basis for additionalreading.

Inevitably a few statements in the bookwill give rise to some disagreement orquestion by other ophthalmologists. Forexample, it is not clear to me why theauthors use Neo-Synephrine HCI alongwith Cyclogyl for cycloplegic refractions.Neo-Synephrine HCI is a mydriatic and

not a cycloplegic agent and Cyclogylproduces both cycloplegia and excellentmydriasis. Also, refraction 30 to 40 min­utes after the instillation of Cyclogyl maybe too soon for full cycloplegia. Studieshave shown that full cycloplegia in somepatients is not reached for 90 minutes,but 60 minutes is a practical interval formost patients. In the treatment of infec­tions associated with nasolacrimal ductobstruction in infants, I avoid the use ofsulfacetamide drops (recommended bythe authors) because the antibacterialaction of sulfonamides is inhibited bypurulent material. Ketamine anesthesiafor intraocular pressure measurements inchildren is not used by many ophthalmol­ogists because ketamine may temporarilyincrease the intraocular pressure. For themost part, however, I agree with theauthors' sensible, middle-of-the-road ap­proach to the subjects covered.

The pediatrician will find this book auseful reference source; the pediatricophthalmologist will enjoy reading it "tocompare notes." The book will provemost useful, however, to the ophthalmol­ogy resident, the pediatric ophthalmolo­gy fellow, and the general ophthalmolo­gist who will find it a concise, currentoverview of pediatric ophthalmology.

LEONARD .APT

Ophthalmology. A Short Textbook, 9th ed.By Fritz Hollwich. Translated by Ger­hard Cibis. Chicago, Year Book MedicalPublishers, 1980. Paperbound, 336pages, index, 23 color plates, over 200black and white photographs. $18.50

This small pocket book was originallywritten in German by Professor FritzHollwich, former Director of the Univer­sity Eye Clinic in Munster, Germany.Dr. Hollwich was one of the leadingGerman ophthalmologists of his day, andhad the delightful knack of conveying in a