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Doody's Review ServiceReviewer: Tony Tsai, MD (Johns Hopkins Hospital)
Description: This book covers the overlap between an ophthalmic atlas and a clinical atlas of general physical diagnosis. Fully illustrated with color photographs, it is organized into three parts. The first provides clinical photographs of eye signs and lists the differential diagnosis of associated systemic associations, the second illustrates clinical photographs of general physical findings and lists the potential associated ocular findings, and the third is an alphabetical list of systemic conditions and their associated ophthalmic findings.
Purpose: The author's stated purpose is twofold. First, the atlas attempts to provide the ophthalmologist with a reminder of the non-ophthalmic physical signs of systemic conditions affecting the eye. Second, it aims to acquaint general physicians with the ocular findings associated with the systemic diseases that are of greatest interest to them. The objective is noble, because ophthalmologists and general physicians can feel separated in disparate disciplines, connected only by the patient that needs them both. Given the topic, this surprisingly concise book meets the author's objective, providing a unique and well-organized compilation of clinical photographs.
Audience: The author states his intended audience as practicing ophthalmologists and general medical practitioners, but by virtue of the ophthalmic focus of the book, it functions much better as a tool for the ophthalmologist. The author intends for the atlas's three sections to be read sequentially, and the tone and layout are more appropriate and helpful for review by students and residents.
Features: The atlas, while not all-inclusive, is concisely comprehensive in its coverage of ocular findings with systemic associations and systemic conditions with ophthalmic signs. The most useful and unique feature of the atlas is its three-part organization by eye signs, systemic signs, and systemic conditions. Of necessity, it duplicates information in triplicate, but provides a clear framework for understanding the three major ways in which ophthalmology and general medicine overlap. Although information such as differential diagnoses are duplicated in each section, the excellent glossy color illustrations are not, and the comprehensive index provides a guide for finding all of the illustrations pertinent to a particular topic. Because the clinical photos are cross-referenced in the contents and index, one wonders if this would be better as a CD-ROM, which would facilitate the search for, and juxtaposition of, associated systemic and ophthalmic illustrations. Nevertheless, the atlas is well organized and easy to navigate with sections and icons to highlight ophthalmic or systemic signs, potential complications to be noted, systemic or ophthalmic findings to look for, associations to note, and typical presentations for ophthalmic or systemic conditions. The organization, size, and scope are virtually identical to the author's Ophthalmology: Clinical Signs and Differential Diagnosis (Mosby, 1999), another atlas that seems best intended for the ophthalmologist in training.
Assessment: This atlas is not an essential component of either the ophthalmologist's or the general practitioner's library. However, it is unique in its focus and scope. The illustrations are excellent, the format is thoughtful, and the topic interesting. With its outline format and limited objective it achieves its goal of being a very readable atlas. I doubt that this atlas will appeal to the larger audience of general medical practitioners, although it may make many ophthalmic diagnoses seem less mysterious to the non-ophthalmic medical community. The atlas's best serves as a reminder that the ophthalmologist's general medical training ought not be forgotten. The ability to recognize the ophthalmic complications of systemic disease is an important skill of the well-informed and comprehensive ophthalmologist, and this atlas provides a concise and accessible compilation of these associations.