Media Type: Textbook (soft cover)

Synopsis: In the foreword, the authors note that neuro-ophthalmology is at the crossroads of several medical specialties, combining pieces of each; at the same time, neuro-ophthalmology is generally the subspecialty area in which ophthalmologists, neurologists, and neurosurgeons alike feel the least knowledgeable. The authors have provided a combination manual/atlas replete with almost 900 high-quality color images which serves to assist clinicians in the initial diagnostic evaluation and management of patients with the neuro-ophthalmologic symptoms and signs they are most likely to encounter in practice. It is a gem of a work that each component of the target audience will find extremely useful.

Target Audience: Practicing ophthalmologists, neurologists, and neurosurgeons; ophthalmology, neurology, and neurosurgery residents and fellows.

Review: Drs. Biousse and Newman constitute a duo of some of the world’s most prominent neuro-ophthalmologists, internationally acclaimed for their clinical acumen, fund of knowledge, and research productivity. They are superb lecturers and teachers, and this is quite obvious in their new book.

The book opens with four chapters on neuro-ophthalmologic examination techniques, including fundus evaluation, visual field testing and interpretation, and a review of ancillary tests (including ophthalmology tests like electrophysiology, OCT, and fluorescein angiography), with the bulk of this chapter focusing on neuroimaging. The next 14 chapters focus on common complaints and the classic topical diagnoses of neuro-ophthalmologic disease. There are two final chapters dealing with non-organic visual complaints, and common disorders encountered in practice such as cerebrovascular disease, giant cell arteritis, infectious disease, the phacomatoses, and sarcoidosis, among others.

Despite the broad-intended audience for this work, no one will be disappointed. For those on the “eye side,” who may have limited background in neurology, there are excellent figures of representative neuro-imaging and clear detailed color diagrams of orbital and intracranial anatomy. For those on the “neuro side,” the chapters on basic eye exam are quite helpful, and the fundus pictures are excellent in quality and great in number. Particular concise highlights in this work, many of which are difficult to find in a succinct format anywhere else, include the following: a review of exam of the comatose patient; indications for choosing the appropriate imaging test; a review of the symptoms, localization, and etiology of the common types of higher cortical visual dysfunction and abnormal visual perceptions; the chapter on headache and facial pain. The chapter on ocular motility comprises the single largest component of this book, which is appropriate, as this is generally the area of least comfort for ophthalmologists, neurologists, and neurosurgeons alike. Finally, scattered through the manual in well-demarcated blue boxes are numerous clinical pearls of several lines in length pointing out classic dictums and tips to avoid serious errors in management.

The few criticisms of this book are related to the nature of any review manual/clinical summary/medical atlas, and the broad spectrum of people for whom it is written. Depending on one’s background, different portions of the manual will seem very basic and constitute material already well-known by the reader. By design many details are left out, and those seeking detailed descriptions, history, and extensive bibliographies should look elsewhere. Treatment summaries are limited, and second- and third-order topics (e.g., neurometabolic disease, genetic details, rare strabismic conditions) are not included. Nevertheless, readers will note an abundance of useful material and will find much more valuable than repetitive content in this manual.

In summary, this book soundly fulfills its intended purposes for its intended audiences. It should be part of every resident and fellow library, will be an excellent resource for examination review, and ought to be within ready access for ophthalmologists, neurologists, and neurosurgeons in the midst of a busy clinic.