BOOKS REVIEWS

“Which patients should I refer, how urgent is the referral, and which patients can I treat myself?” These are common questions for primary care physicians, and are particularly relevant in ophthalmology.

For most ocular diseases, only careful examination with a slit-lamp microscope and fundus lens can provide a true diagnosis. Very few primary care professionals have received the necessary training for this.

Fast Facts: Ophthalmology, by Peter Simcock and Andre Burger (Health Press), seeks to educate our colleagues regarding the problems most commonly encountered in the community. Its stated goal is to allow the healthcare provider to determine the urgency of each case: refer now, refer later or no referral needed.

The book is mostly organised by patient symptoms such as red eye, blurred vision, double vision, and “gritty, itchy, watery eyes”. Other topics include “children’s eye problems”, eye trauma, eyelid disease and diabetes, hypertension and systemic medications.

I found this 100-page book concise and easy to use - it is both small and light enough to carry around in a lab coat pocket. Particularly useful is the chapter on “abnormal eye appearance”, which covers alarming-looking abnormalities such as thyroid eye disease and orbital cellulitis.

This book is appropriate for any health professional who looks into a patient’s eye: general practitioners, optometrists, ophthalmic nurses, and even pharmaceutical and surgical company representatives.

SIMPLE EXPLANATION

Once the patient has been referred, the rest is up to us. One disease that continues to bedevil ophthalmologists is glaucoma. Many serious studies have clearly indicated that there is significant inter-observer variability, even among experienced glaucoma specialists, regarding the evaluation of the optic disc, both at baseline and regarding progression.

Fast Facts: Glaucoma, by Paul R Healey and Ravi Thomas (Health Press), is a very basic reintroduction to the disease. This book is not intended to provide new and surprising insights, but rather to reiterate the spectrum of known facts in a simple fashion.

Particularly useful aspects include the glaucoma medical management algorithm, which was adapted from national guidelines, and an overview of the various classes of intraocular pressure-lowering medications, with their systemic and local side effects, period of peak effect, and washout period.

Fast Facts: Glaucoma is most appropriate for ophthalmology residents in training, non-glaucoma specialist ophthalmologists seeking to brush up on their knowledge, and primary care physicians interested in a disease that affects so many of their patients.