VOL. 64, NO. 4 BOOK REVIEWS 797

The primary benefit appears to be in eye-grounds with vascular retinopathy and hem­orrhage. Field does not recommend this pro­cedure for anyone over the age of 40 years, and Rand and Roth state that visual acuity should be at least 20/70 in the best eye for pituitary ablation to be considered. Skepti­cism about the benefit of hypophysectomy is not resolved by reading this section ( for ex­ample, Davis points out that in 50% of the untreated patients that he has followed the abnormal condition did not progress).

Only some of the highlights of this book are mentioned here. It should be read in full by any practioner, specialist or investigator interested in diabetic retinopathy.

Alex E. Krill

T H E YEAR BOOK OF OPHTHALMOLOGY (1966-1967 Year Book Series.) William F. Hughes, editor. Chicago, Year Book Medical Publishers, 1967. Clothbound, 365 pages, 76 black and white figures. Price: $9.00. Since the Year Book of Ophthalmology

was launched in 1958, the cover-to-cover ad­dict has probably observed the variations that occur in successive years. A striking innovation in the current volume consists of rather extensive introductory material to most chapters by men of special competence in the field covered. These include in alpha­betical order Chester Black, Eugene Folk, William Hughes, Ira Jones, Thomas Kearns, Alex Krill, Irving Leopold, Samuel McPherson, Richard O'Connor, Albert Potts, Theodore Schwartz, David Shoch and Lorenz Zimmerman. Their perspective is ably supplemented by editorial footnotes to individual articles, many of which are truly gems. For vernal catarrh, when topical corticosteroids fail in effectiveness, beta radiation is advised, and excision of vegeta­tions with pedicles. Hughes suggests for ep­ithelial downgrowth withdrawal of 1.0 cc fluid vitreous, a large basal iridectomy and, after four to six weeks, cryodestruction of epithelium remaining on the posterior cor-

neal surface. Since IDU does not completely eliminate the herpetic virus and effects inhi­bition of interferon, a rebound follows ov­erextended usage. The ophthalmopathy of endocrine exopthalmos is now definitely conceded to be caused by an exopthalmos-producing substance and not by the thyro-tropic hormone. Any ophthalmologist handy with goldfish can confirm the diagnosis by intraperitoneal injection of the patient's un­diluted serum. Recovery of the diplopia in upward gaze requires recession of the fibrot-ic inferior rectus and severance of its adhe­sions to the inferior oblique. The retrobul-bar mesenchymitis is best treated by month­ly subconjunctival injections of 10-15 mg Depo-Medrol. For the topical treatment of corneal edema, cheap Karo syrup is as effec­tive as any other medication.

This superb compact survey of the cur­rent trends in ophthalmology is recom­mended for reading, reference and reread­ing.

James E. Lebensohn

E I N F Ü H R U N G I N D I E O P H T H A L M O L O G I S C H E

ULTRASCHALLDIAGNOSTIK. By Werner Buschmann. Leipzig, Georg Thieme, 1966. Volume 33 of a series. Paperbound, 175 pages, 63 black-and-white figures, 2 color plates. Price: $13.00. Besides representing the only monograph

yet published on ultrasound and the eye, this publication presents the personal atti­tudes and knowledge of one of the most ac­tive workers in the field. The book contains an adequate treatment of basic theory, a de­scription of instruments and their calibra­tion and much detail on clinical findings.

Some of the information on ultrasound in ophthalmology must still be read between the lines, however. As many are aware, there are two principal systems for exam­ination by ultrasound. The older, less com­plex and less expensive system is the time-amplitude method or A-scan. In this tech­nique a single axis is examined at any one time and the size of the echo is expressed as

798 AMERICAN JOURNAL OF OPHTHALMOLOGY OCTOBER, 1967

height of the displayed cathode ray trace. The second system involves scanning with the beam (used in a stationary manner in the A-scan) along a horizontal axis. This creates a sonic section of the eye which may be displayed as an intensity-modulated trace on a radar type screen. This second system, the so-called B-scan, is at least 10 times more expensive than the A-scan system and is correspondingly more difficult to keep oper­ating.

The chief applications of ophthalmic ul-trasonography are two. One of these is mea­surement of anteroposterior diameter of the eye. If proper precautions are taken to in­sure sighting along the optic axis, A-scan is adequate for the job. The second major ap­plication is the detection of masses in the interior of the globe when the media have lost their transparency. This is distinctly easier by B-scan when the system is work­ing optimally. The problem with A-scan is that by present techniques a moderate-sized mass may be missed. However, it is conceiv­able that a systematic search technique can make the A-scan highly effective.

From the moderately large amount of publication on ultrasonography, some of it highly polemic, the kind of over-all estimate mentioned above is emerging. The present monograph will be of great help to the re­searcher or clinician who is contemplating entering the field.

Albert M. Potts

CURRENT CONCEPTS IN OPHTHALMOLOGY. By Bernard Becker and Robert C. Drews. St. Louis, Missouri, C. V. Mosby Com­pany, 1967. Clothbound, 265 pages, 127 fig­ures. Price: $17.25. The authors' intent in writing and editing

this book is "to provide the practicing oph­thalmologist as well as the investigator, resi­dent and student with useful and provoca­tive material." Contributors are members of the staff of the Department of Ophthalmol­

ogy, Washington University, St. Louis, and topics discussed represent fields of current interest for these individuals. As with any pot pourri, ingredients vary in degree of ex­cellence and this book is no exception. Some are exceedingly well done, others, less so, and an occasional one is dull and unreward­ing. Most come in the first category and, as might be expected, the chapters having to do with glaucoma, the great forte of the St. Louis group, are outstanding.

Bibliographies are for the most part com­prehensive but, in several of the poorer chapters, which inadequately cover the topic at hand, one who desires to read further would be hard put to do so without time-consuming combing of the literature.

The book's format is good, illustrations graphic and well reproduced and the index accurate and full. It will find its greatest use­fulness in the hands of the busy ophthal­mologist who is unable to cope with the flood of current literature, but it will also be a valuable addition to any ophthalmic library.

DuPont Guerry, III

RADIOLOGY IN NEURO-OPHTHALMOOLGY. By Guido Lombardi, M.D. Baltimore, Mary­land, Williams & Wilkins Company, 1967. Clothbound, 244 pages, 167 figures in black and white. Price: $13.25. This monograph covers in broad outlines

and some detail a field which borders on ophthalmology, neurology and neurosurgery. First, techniques for visualization of the structures of the orbit are described, fol­lowed by a section on craniofacial malfor­mations. Most valuable is the long chapter discussing vascular diseases affecting the visual system and the neuroradiologic tools for their investigation. Subsequent sections deal with areas of interest to the general ophthalmologist, such as orbital and facial injuries, tumors of the orbit, nasopharynx and skull, with some focus on tumors of the sellar region.