Book Review

Principles and Practice of Ophthalmology

N Engl J Med 1994; 331:62-63July 7, 1994

Article

Principles and Practice of Ophthalmology
Edited by Daniel M. Albert and Frederick A. Jakobiec. 5237 pp. in six volumes, illustrated. Philadelphia, W.B. Saunders, 1994. $825. ISBN: 0-7216-6592-6

In his preface to this series, one of the editors writes that many students probably are attracted to ophthalmology because of the erroneous notion that one should be able to master all available knowledge about an organ as small and anatomically well defined as the eye. This book demonstrates the folly of such a fantasy. This six-volume series makes up a single large textbook (1437 pages) on basic science and five volumes (totaling 3800 pages) devoted to clinical practice and contains more than 6000 illustrations, diagrams, graphs, and tables. The project was designed to be a comprehensive but not exhaustive resource for practicing ophthalmologists, and despite its few blemishes, the editors and authors have succeeded in creating a masterpiece.

The volume on basic science purposely does not reiterate standard embryologic and anatomical material that is covered adequately in existing textbooks but, rather, summarizes recent applications of cellular biology, genetics, immunology, microbiology, pharmacology, and toxicology to ophthalmology; it also includes useful information on development, changes related to aging, epidemiology, and lasers. The breadth and depth of the chapters on basic science probably exceed what most practicing clinicians need (or want) to know, but the volume offers a superb, coherent foundation that should be studied assiduously by all residents and fellows.

The other five volumes review multiple facets of contemporary ophthalmologic practice. Although excellent single-volume or multivolume works have been published during the past decade in each of the recognized subspecialties of ophthalmology, Principles and Practice of Ophthalmology effectively brings together a superb array of experts on virtually every disorder that one might encounter in a comprehensive practice. Historical vignettes introduce most sections. Information about up-to-date techniques and procedures is frequently included, reflecting the relatively short interval required by the editors to guide this mammoth project from inception to publication (less than five years). A unique and particularly useful feature is the section on the psychological, social, and legal aspects of practice. As is likely with any work of this magnitude, however, some topics receive less than their proper due; examples include even some entities that are relatively common, such as acquired nasolacrimal drainage obstruction and essential blepharospasm.

Even though the total number of contributing authors exceeds 400, thoughtful editing has produced a text that reads well. The majority of the illustrations, more than half of which are in color, are well reproduced and shown near their citations in the text. The index is functional. The individual volumes are substantial in size and weight but are not unwieldy.

The editors state that this work was inspired by Sir Stewart Duke-Elder's 15-volume System of Ophthalmology (London: Kimpton), which was published in installments be tween 1958 and 1976 and served as the worldwide standard for at least a generation of practitioners. If Cyril Connolly's observation that “imprisoned in every fat man a thin one is wildly signalling to be let out” is correct, then this new series is the trim and muscular successor to Duke-Elder's work. Principles and Practice of Ophthalmology should grace the bookshelves of all ophthalmologists and medical libraries, and each volume will be well-worn and much appreciated by grateful readers by the time the second edition is published.

George B. Bartley, M.D.
Mayo Clinic, Rochester, MN 55905