Book Review

Neuro-Ophthalmology: Diagnosis and Management

N Engl J Med 2001; 344:1872-1873June 14, 2001

Article

Neuro-Ophthalmology: Diagnosis and Management
By Grant T. Liu, Nicholas J. Volpe, and Steven L. Galetta. 756 pp., illustrated. Philadelphia, W.B. Saunders, 2001. $125. ISBN: 0-7216-6533-0

Reading this book was a pleasure. The three authors have a wealth of experience, and their book is uniformly high in quality, authoritative, cohesive, down to earth, and easy to read. It has none of the unevenness and missing or overlapping topics so common in multiauthored books. It is probably the best-illustrated, most comprehensive single-volume textbook on neuro-ophthalmology available today.

The book is divided into four sections. It opens with a practical review of the neuro-ophthalmic history and examination. The next section, on disorders of the afferent visual pathways, begins with an overview of the topical diagnosis and diagnostic testing of diseases of this system. Subsequent chapters cover disorders of the retina, the optic nerve, and the intracranial visual pathway that cause visual dysfunction. The chapters entitled “Retinal Disorders,” “Disorders of Higher Cortical Function,” “Functional Visual Loss,” and “Visual Hallucinations and Illusions” are particularly good. The third section, on efferent neuro-ophthalmic disorders, covers the pupils, facial-nerve dysfunction, cranial-nerve and gaze palsies, nystagmus, and abnormal eye movements. There is an excellent chapter on diseases of the orbit as they relate to neuro-ophthalmology. The last section discusses headache, facial pain, and disorders of facial sensation, all of which are common symptoms in nearly every field of medicine.

Each chapter follows a well-organized outline, in which a review of the relevant neuroanatomy, symptoms, and signs is followed by detailed discussions of presentation, pathophysiology, diagnosis, neuroimaging, diagnostic studies, and management of the diseases. The numerous tables allow for quick reference to entities more or less likely to be encountered. The authors venture outside of neuro-ophthalmology to list detailed endocrine, systemic, and imaging characteristics of the various disorders. The book is illustrated with high-quality, clearly labeled neuroimages and images of the fundus. There is an extensive list of up-to-date references (most from the late 1990s) at the end of each chapter; they include both the original sources and review articles for those who want to delve deeper into the subject.

There are two minor irritants, which I suspect are related to attempts to keep the price down. The figures and tables are commonly one page and occasionally two pages ahead of the related text, resulting in a certain amount of flipping of pages. The photographs of the fundus would have been more useful had they been reproduced in color. A minority of the black-and-white photographs of the fundus scattered throughout the text are reproduced in a central collection of 55 color plates, without any legends for the plates or cross-referencing with the original figures in the chapters. More pages to be flipped!

In their preface, the authors write,

Our hope was to offer a book that could serve both as a guide for diagnosing and managing patients with neuro-ophthalmic problems and a one-volume textbook containing in-depth discussions of neuro-ophthalmic topics and disorders. With just three authors, our aim was to create a highly organized and uniform textbook, extensively illustrated and referenced, that would bridge the gap between neuro-ophthalmic handbooks containing tables, outlines, and flow-diagrams and neuro-ophthalmic encyclopedias.

This book is everything that they hoped for.

Duncan P. Anderson, M.D.
University of British Columbia, Vancouver, BC V6Z 1Y6, Canada