Media Type: Textbook

Synopsis: Ophthalmic echography is one of the basic diagnostic tests that ophthalmologists rely on when evaluation of the posterior segment is limited or for preoperative biometry. However, unlike other ophthalmic imaging technologies, the versatility of this technology crosses all specialties whether anterior segment, retina, or oculoplastics. Clinical Ophthalmic Echography – A Case Study Approach presents over 300 cases where ultrasound, with proper technique, can image intraocular and extraocular or adnexal pathology to aid in diagnosis and treatment of ophthalmic diseases.

Target Audience: General ophthalmologists.

Review: Dr. Harrie is known for his experience and expertise in ultrasonographic imaging of the eye. He has authored many papers and book chapters on this subject; this book is the highlight of his body of work. The book is intended to be the definitive reference and teaching guide for the ophthalmic professional interested in mastering ophthalmic ultrasonography. Despite some minor issues it hits the mark.

The book is divided into 8 sections. The first two sections broadly cover Indications for Ophthalmic Ultrasound, and Basic Principles and the remaining sections encompass clinical scenarios including Eye Pain, Blurred Vision, Bulgy Eyes, Lumps and Bumps, and Echography in Developing Countries. Each of these sections has an introductory section and is followed by multiple case studies demonstrating specific techniques and utility in ultrasonic imaging in these scenarios. This is where the true power of the book lies – each vignette is well-written in a case-report fashion, and is accompanied by appropriate photomicrographs of ultrasounds. The topics of these clinical scenarios are vast, ranging from intraocular, anterior segment, and orbital pathology. Harrie even demonstrates the ability of the ultrasound to diagnose extraorbital pathology such as sinusitis and nasal polyps; his skill and expertise truly shines in these case studies. The final section is devoted to comparing and contrasting other orbital imaging modalities to ophthalmic ultrasound.

Although this book is filled with excellent information, it is often difficult to access it, particularly when the book is used as a reference. The sections are organized in groups of clinical presentation. For example, in the section of Bulgy Eyes, cases of optic nerve disease, orbital tumors, lacrimal gland pathology, rectus muscle pathology, and eyelid abnormalities are included. This type of organization may make sense if lecturing on this information, but a reference on imaging technique is more useful if organized by anatomical location – imaging of the anterior segment in one section, or retina in another.

Furthermore, Harrie describes many different techniques to image the various tissue structures in and around the eye, but the reader is often left to his or her imagination to figure out how to replicate the technique. Perhaps additional sections specifically on technique or a DVD with videos on technique would be more instructive. Such additions, though, might price this text out of the hands of many.

Despite these short comings, this book is well thought and the information well presented in case study form. This book certainly should be part of the library of any ophthalmic professional interested in expanding the usefulness of the ophthalmic ultrasound in his or her practice.