Media Type: Textbook

Synopsis: It is rare for any book to be both informative and entertaining, much less a medical textbook. But, with a wealth of practical information conveyed in a jaunty, almost irreverent style, Dr. Jonathan Walker’s Diabetic Retinopathy for the Comprehensive Ophthalmologist manages to be just that.

Target Audience: Residents, retina fellows, and comprehensive ophthalmologists.

Review: Dr. Walker, who is a retina specialist in private practice, and also an Assistant Clinical Professor at the Indiana University School of Medicine in Fort Wayne, has written an outstanding overview on his subject. Geared toward transferring clinical management skills to residents, retina fellows, and comprehensive ophthalmologists, the book does not aspire to be a comprehensive review of laser physics or the metabolic etiology of diabetic pathology, and the reader is directed elsewhere for more information on subjects such as these. What it DOES do, however, is deliver exactly what the title promises – an in-depth overview of how to diagnose and treat diabetic retinopathy, offered by an author who clearly has extensive knowledge of his subject, and also the best manner for passing this information on.

With chapter titles like “Contact Lenses and the Wrangling Thereof,” and “Proliferative Diabetic Retinopathy and Other Things That Go Bump in the Night,” one gets a sense of the humor that pervades the text. But, the jocular tone should not in any way give the impression that the book is not serious in its intent, and in the coverage of the subject matter. Early chapters deal with the “tools of the trade” – ie, lasers, contact lenses – giving a very practical overview of their use without going into excessive detail about the mechanics involved. Later chapters deal with the diagnosis and treatment of both proliferative and non-proliferative retinopathy, with a great deal of information provided about the scientific basis for treatment, as well as an abundance of practical pearls which have clearly been gleaned from years of experience.

The book, however, is not just a treatise on the mechanical aspects of treating disease. A great deal of attention is given to the “reality” of caring for patients; discussion of informed consent, the psychological aspects of dealing with patients with potentially blinding disease, and the economic considerations of treatment, both in the United States and in the less “favored” countries. Additional chapters discuss the aspects of diabetic eye care that are rarely discussed in such comprehensive form: diabetic papillopathy, dealing with diabetic retinopathy and pregnancy, the implications of treatment in the anti-coagulated patient, and consideration of diabetic retinopathy when cataract surgery is planned. Other discussions include the evolving use of intravitreal agents, and how they fit into the armamentarium of diabetic treatment modalities.

Diabetic Retinopathy for the Comprehensive Ophthalmologist is a valuable addition to the library of any ophthalmologist who treats diabetic disease. It offers a wealth of information both to the doctor in training, as well as providing a comprehensive update for the more experienced generalist.