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Sharpen your skills

Curbside consultations in Neuro-Ophthalmology is an ideal refresher

Leigh Spielberg

Posted: Wednesday, November 1, 2017

Curbside consultations in Neuro-Ophthalmology: 49 Clinical Questions (Slack), edited by Andrew G. Lee is the ideal refresher course for those of us who have noticed our grasp of neuro-ophthalmologic knowledge slip away since the end of our training. Diagnosing neurologic disorders, ophthalmology’s ultimate diagnostic puzzles, requires a certain understanding of that many of us might have lost.

Curbside Consultations encourages us to jump right into clinically relevant case studies that are described with a clarity that allows us to apply the principles in the clinic. For those looking for detailed anatomical diagrams and lengthy descriptions of exotic syndromes, look elsewhere. This book covers the diseases you’ll see on a weekly basis. Let me rephrase that: it covers the diseases you’ll see if you recognise them; and this book should help you do so.

Examples are extremely practical: “A 60-year-old man has binocular horizontal diplopia. He does not abduct OD well and has an incomitant esotropia. Now what?” This question describes the appropriate evaluation in a patient suspected of having a sixth nerve palsy. Beware: they’re not all that easy. “A 65-year-old woman presents with headaches and binocular oblique double vision. Examination reveals limited abduction ODS. Furthermore, OS will not adduct, elevate, or depress, and there is left ptosis. OS pupil is 2mm larger than OD. What should I do now?” This complex question is followed by an easy-to-follow description of the correct procedures for a patient with multiple ocular motor cranial nerve palsies. Ideal.

This 200-page book, illustrated with good clinical pictures and well-made tables, is intended for general ophthalmologists who would like to sharpen their neuro-ophthalmologic diagnostic skills; ophthalmology residents rotating through neuro; and neuro-ophthalmology fellows who absolutely do not want to miss a single standard diagnosis.