Contact lenses are a large part of clinical practice, with more than 125 million soft contact lens wearers worldwide, making up roughly 30% of revenue in an optometric practice. Although not common, along with prescribing contact lenses comes the management of complications imposed from the more asymptomatic microcysts to the urgently symptomatic microbial keratitis. The third edition of Nathan Efron’s book Contact Lens Complications is truly an evidence-based approach to contact lens–related adverse events and fulfilling the difficult task of making it a clinically useful and relevant reference.
The reader is first introduced to a “Quick-Find Index” that sets the stage for the author’s “tissue-by-tissue” approach. The inclusion of color images of each complication and the related page number associated with the event further elevate the index’s usefulness in the clinic. Two chapters are devoted to the justification and use of illustrated grading scales and grading morphs, which a reader may find useful for the more subtle signs of progression or in aiding a student learning each complication in how to best determine a management plan.
This text seeks to help the reader understand the relationship of the contact lens to the eye, and each chapter is organized by structure (“tissue by tissue”) rather than by contact lens modality. The thoroughness in this book is its triumph and its possible weakness. The inclusion of so many facets to each complication and in the attempt for completeness, there are a few areas that touch on a sign or symptom but do not unequivocally relate or dismiss an association. There is also the challenge of incorporating all new lens modality trends related to complications within the corresponding tissue. The complications associated with hybrids are minimally addressed, and there is little explicitly related to scleral contact lenses.
This book highlights some major studies and provides a great background on the different imaging techniques of the anterior segment. It is truly a companion to the Efron Grading Scales. It is a book that will be often used, and the comprehensive cited reference section is invaluable and will satisfy any curious mind. Overall, the book is a nice addition as a clinical reference in contact lenses and their related ocular pathologies.
Forest Grove, OR