OCULAR TRAUMA
Ocular trauma is one of several categories of pathology that every ophthalmologist, including the subspecialists, encounters from time to time. And yet, due to the relative rarity of these cases, staying up to date regarding optimal management remains a challenge. I thus decided to review
Mechanical Ocular Trauma: Current Consensus and Controversy (Springer), edited by Hua Yan.
The preface reminds us that ocular trauma is the leading cause of blindness in young people. It often involves healthy people who are suddenly thrust into a long-term treatment trajectory. This serves to focus our attention on the necessity of optimal treatment, as many disability-adjusted life years can be avoided by good decision-making and prompt treatment.
Simply figuring out what has happened is a big challenge. Injury classification is thus the focus of Chapter 1, which outlines the ways we can evaluate the pathology and communicate our findings. Chapter 2 deals with anterior segment trauma. Particularly interesting are the descriptions of the ways that iris rupture can be surgically repaired, near the pupillary margin or at the iris base.
Chapter 3: Posterior Segment Trauma describes the complex interventions required when the choroid, retina and / or vitreous base are affected. The crucial aspect of timing of each intervention is discussed at length, making use of illustrative cases.
Chapters 4 and 5 cover intraocular foreign bodies (IOFB) and traumatic endophthalmitis, respectively. The two are often related, as IOFB can lead to endophthalmitis, which dictates the general rule of immediate IOFB removal. Chapter 6 discusses ocular trauma in children, and Chapter 7 provides insight into severely traumatised eyes with no light perception.
This book is intended for ophthalmology residents and fellows and any ophthalmologist who is on call and is likely to be asked to treat ocular trauma.
QUESTIONS AND ANSWERS
There are a million and one ways to study ophthalmology. But once one has mastered the material, there is only so much one can continue to learn from standard textbooks. A next step might be to read question-and-answer books that resemble exams one expects to take.
Ophthalmology Clinics for Postgraduates (Jaypee), by Prafula Kumar Maharana, Namrata Sharma and Atul Kumar, is aimed at those studying for the postgraduate exam in India.
“This book attempts to present the important topics in a format that is exactly the same as required in the practical exams,” the preface reads. This entails “long cases” like thyroid-associated ophthalmopathy and “short cases” such as cherry-red spot. The information is presented in such a way as to facilitate rapid review, with a particular focus on history taking, clinical examination and differential diagnosis.
Ophthalmology Clinics was written for those studying for postgraduate exams, but is useful for anyone looking to sharpen their clinical skills.