Ocular Anatomy and Physiology (2nd ed.)
Al Lens, Sheila Coyne Nemeth, and Janice K. Ledford, Thorofare, NJ: Slack Inc.; 2008. $39.95.
Explaining how, as an optometrist, she became a self-taught, well-known corneal microbiologist, one of my instructors in graduate school told us in a seminar that if you want to embark on a brand new field of interest, the first thing you should do is find the thinnest book possible on the subject. This advice would certainly fit perfectly for the newly updated second edition of “Ocular Anatomy and Physiology,” which states that it is targeted for ophthalmic and optometric assistants, sales representatives, and premed students.
Written primarily by Certified Ophthalmic Medical Technicians, the book is part of a larger series of books “The Basic Bookshelf for Eyecare Professionals,” focusing on teaching the didactic elements of eye care in a succinct format. This book in the series fulfills that purpose quite well. Indeed, the longest chapter, “The Posterior Segment” is a mere 26 pages, 10 pages longer than the next longest chapter. In fact, nine of the 16 chapters are only eight pages long, making for a very high-yield learning experience. Of course, this brevity is supplemented by references to more complete sources, oftentimes the books that make up the rest of the series. The figures and tables throughout the book are mostly reprinted from other books in the series and are well done and quite helpful.
The book is fairly a quick read and the material, while concise, goes beyond its title in covering not only just the basics of ocular anatomy and physiology but also binocular vision, visual optics, psychophysics (e.g., color vision), and refractive errors. Chapter 11, “Nerve Supply” is especially well written and a very high yield, and also a table is included, which shows what clinical problems would arise with damage to each cranial nerve.
A nice feature in the second edition is that in many of the chapters, the authors include a clinical evaluation section, which gives the reader a concise understanding of the potential instruments that can be used to evaluate a specific ocular structure. This includes common clinical equipment such as a slit lamp and more sophisticated techniques such as optical coherence tomography and electroretinography. The authors also include recent clinical developments such as anterior segment optical coherence tomography.
Each chapter, except for the first, also gives a bullet point list of the key points within the chapter. This provides a quick review before starting the chapter and also in solidifying the information after finishing the chapter.
There are a few inadequacies in the book, however. Chapter 1, which is a well-written new jump-start or introductory chapter would have been well served by basic eye figures, which are not seen until chapters 4 and 15. Additionally, some terms are used in the book for which the definition is not immediately available. There are also some points that may not be accepted among all clinicians such as, “a normal [non-invasive] Tear Break Up Time is between 15 and 30 s,” that contrast sensitivity testing is a “retinal test” that can be an indicator of nerve fiber layer death, that the anomaloscope only involves matching luminosity, that most humans are born farsighted with emmetropia occurring in the teens, or that retinoscopy involves evaluating the “light as [its] reflected off the cornea.” The section on cover testing is also a bit confusing, because the alternative cover test (which they refer to as the “cross-cover test”) is presented before the unilateral cover test, as these are usually clinically performed in the opposite order. Despite these potentially confusing points, the book presents an enormous amount of material for the most part, which is quite accurate and clinically useful.
For its intended audience, the book is well presented. Indeed, if all eye care assistants and/or technicians garnered the knowledge that can be obtained in this book rather quickly, the entire profession would certainly reach new heights and improve patient care.
Jason S. Ng
Southern California College of Optometry