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Anatomy of the Eye and Orbit—The Clinical Essentials

Sanchez-Diaz, Patricia C., DVM, PhD, FAAO

Optometry and Vision Science: July 2018 - Volume 95 - Issue 7 - p 627
doi: 10.1097/OPX.0000000000001248

UIW Rosenberg School of Optometry San Antonio, Texas

Anatomy of the Eye and Orbit is a clear and concise text that will suit the needs of students and residents and will also spark the interest of eye care professionals. This book is a collaboration of a team of eye care professionals and researchers. Written by experts in the field, the book targets a broad audience. It incorporates abundant clinical pearls and novel findings and discusses controversies that are emerging in the field. The abundance of exceptional images and diagrams (with an average of two illustrations per page) will no doubt make the text appealing to visual learners.

This textbook is organized in six conceptual sections: Orbits, Lids and Adnexa; Overview of the Eye; Anterior Segment of the Eye; Posterior Segment of the Eye; Embryology of the Eye and Orbit; and Ocular Anatomy by Optical Coherence Tomography. Cross-referenced chapters for overlapping topics are always included and incorporate a direct-access link in the e-book. I particularly enjoyed the embryology section, which is easy to follow but, at the same time, very informative. I believe this chapter will allow the reader to comprehend the developmental basis of congenital ocular defects and their clinical manifestation. In addition, the Optical Coherence Tomography section is a timely and excellent closure to this clinically oriented ocular anatomy text. This chapter on optical coherence tomography starts with a succinct introduction to the technique and a thoughtful summary of common limitations the clinician needs to consider to avoid misinterpretations when analyzing clinical optical coherence tomography images. This section finishes with a synopsis about ongoing optical coherence tomography imaging research that aims to assess the potential uses of optical coherence tomography to evaluate blood and aqueous flow in the clinic.

The approach of this book highlights the notion that structural studies are far from static. As such, the authors are constantly providing well-documented data from new research that questions and challenges some of the traditional or classic knowledge and theories in the field. For instance, in the chapter about the aqueous outflow pathway, the authors mention the presence of endothelial stem cells in the transition zone between the trabecular meshwork and the cornea and discuss their potential therapeutic use in regenerative medicine.

Clinical applications are included throughout the text, exemplified in the first chapter where the authors illustrate the distribution of the ophthalmic nerve dermatome and to help the student comprehend the clinical presentation of herpes ophthalmicus. This chapter provides a very didactic description of the course and destination of the orbital nerves. However, it appears that the authors only depict the classic pathway for the innervation of the lacrimal gland via the zygomatic and lacrimal nerves and do not discuss the rami orbitales, rami lacrimales, or the retro-orbital plexus as the source of autonomic innervation to the lacrimal gland. Blood supply is a topic that students seem to struggle with, but that is paramount for understanding the presentation of vascular pathologies that involve the retina and optic nerve. The latest consensus regarding the innervation of the choroidal vasculature is discussed along with a thorough explanation of the anatomy of the posterior ciliary arteries. The chapters that focus on the retina, the optic nerve, and the visual pathway, challenging topics for students as well, are described in detail but without becoming too technical for a clinically oriented textbook. For readers eager to explore the details further, approximately 200 references are included at the end of these four chapters.

In summary, this textbook by Freddo and Chaum integrates well-supported molecular explanations of the clinical findings and nicely connects the structural study of the visual system and its clinical relevance. The entire text is written with enough depth and accuracy not only for students and residents but also for the eye care professional looking for an update on anatomy and histology of the visual system with clinical application.

Patricia C. Sanchez-Diaz, DVM, PhD, FAAO

UIW Rosenberg School of Optometry

San Antonio, Texas

© 2018 American Academy of Optometry