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Cornea: Fundamentals, Diagnosis and Management, 4th ed.

Miller, William L., OD, PhD, MS, FAAO

Optometry and Vision Science: July 2018 - Volume 95 - Issue 7 - p 625–626
doi: 10.1097/OPX.0000000000001247

UIW Rosenberg School of Optometry San Antonio, Texas

First published 20 years ago, Cornea: Fundamentals, Diagnosis and Management remains an authoritative text on the cornea. The text has 338 separate chapter editors providing expert insight into a comprehensive list of anterior segment conditions and ocular surface and corneal surgeries. It encompasses a wide range of topics, including corneal and conjunctival disease while also covering eyelid and uveitic disease processes. As in the previous edition, it is provided as a two-volume text with volume 1 entitled Fundamentals, Diagnosis and Management and volume 2 entitled Surgery of the Cornea and Conjunctiva. Volume 1, at 1247 hard copy pages, is both expansive in the topics coverage and detailed in the depth provided. Volume 1 includes half of the total collective page count. Volume 2 provides similarly impressive breadth and depth for almost every important anterior segment surgical procedure, past and present.

Cornea: Fundamentals, Diagnosis and Management is an excellent all-inclusive text for those practitioners and researchers with an interest in the anterior segment, for those specializing in the cornea and ocular surface, and for anyone else who has a keen desire to know about the cornea, conjunctiva, and adnexa. It is an inclusive text combining basic science concepts with clinical science approaches to disease management. I consider it my encyclopedia for all things related to the cornea, conjunctiva, and eyelids. It also serves as an excellent textbook for those in contact lens and corneal residencies and fellowships. To those in an eye care practice, it represents a great reference book. This is the foundational source of information in the discipline containing comprehensive text, augmented with excellent illustrations, figures, and clinical pictures.

Overall, this new edition is arranged similar to previous editions; however, each volume chapter begins with key concepts presented in a colorful box before the text, a new feature for the latest edition. General sections are divided into color-coded parts. Each part is further broken down into subsections and chapters. The text is filled with several excellent illustrations and figures that enhance the text. An effective use of tables and boxes to highlight key topics is available to the reader to illustrate or highlight key points. The edition also provides an updated chapter on molecular genetics of the cornea.

As an updated edition, it comprises surgical techniques and new methods to image and analyze the cornea, which provide eye care practitioners a greater ability to diagnose disease earlier and render treatments and managements before the disease progresses.

As indicated, volume 1 contains not only corneal disease but also conjunctival disease, scleral disease, episcleral disease, and uveitis. The first section covers basic science concepts of the cornea, conjunctiva, tear film, and eyelids. The second section covers examination of the ocular adnexa and anterior segment, which includes standard instrumentation and more recent imaging techniques such as anterior segment optical coherence tomography and in vivo confocal microscopy.

Part 3 includes seven chapters on differential diagnosis helping the reader differentiate between types of corneal ulcers, causes of corneal deposits, and vision loss secondary to corneal issues. Part 4 contains a couple of chapters on eye banking, which includes how eye banks are set up, and the medical standards for the preservation of biological tissue.

As with previous editions, there is a logical flow and a systematic approach to each chapter. The Basic Science section succinctly hits the highlights of the cornea and ocular surface. There are a few areas that are covered sparsely, especially in the area of corneal physiology. The chapter on the pathologic responses in the cornea presents a nice overview of the corneal response to injury. Accompanied drawings indicating these pathologic responses are useful as schematic drawings in a tabular format. The drawings describing the inflammatory and immunologic mechanisms of the cornea are clearly presented; however, they are stylistically a bit dated and would be more useful illustrations if presented alongside photographs of the responses.

Volume 2 highlights corneal surgeries including a number of different keratoplasty techniques: penetrating keratoplasty, anterior lamellar, and endothelial keratoplasty. Therapeutic procedures are also included for conditions such as perforations and conjunctival surgery (pterygium). In addition, corneal cross-linking, keratoprosthesis, ocular surface transplantation, and refractive surgery are covered in great detail. Augmenting the text are 72 videos of surgical procedures that provide 2 hours 41 minutes of material. Surgical videos are highlighted with an enclosed arrow, which can be watched on the e-book version. High-quality images that demonstrate post-surgical outcomes as well as surgical complications are also included. As with volume 1, several chapters include an inset box that outlines key concepts for the chapter, presenting an excellent initial summary to the content that follows.

The digital version of the book is also available for those who want on-the-go access. The text along with pictures, illustrations, figures, and videos is available via by access through a scratch off code. It then becomes part of My Library along with other possible Elsevier titles. In addition, the e-book can be accessed by scanning a QR code on your mobile device. The advantage of the electronic resources lies in the ability to search conditions and key words.

Overall, Cornea: Fundamentals, Diagnosis and Management represents an important addition to one's library. Its expansive treatment of the discipline as well as adequate depth on the topic makes it the first book I reach for when questions concerning the anterior segment arise. It also serves as an excellent resource for those who teach students and residents.

William L. Miller, OD, PhD, MS, FAAO

UIW Rosenberg School of Optometry San Antonio, Texas

© 2018 American Academy of Optometry