VOL. 97, NO.2 BOOK REVIEWS 253

94:817, Dec. 1982) removes bubbles byshaking an inverted bottle. We havefound both of these methods to be un­satisfactory.

We believe we have a superior meth­od of preventing air bubbles. Simplyflip off the spout of a new bottle ofGoniosol (Figure), and throw the spoutaway. The solution is then easily pouredinto the gonioprism without bubble for­mation. Despouted bottles can bestored in the conventional upright fash­ion with the cap on.

JOEL A. MILLER, M. D.DONG H. SHIN, M. D.

Detroit, Michigan

EDITOR'S NOTE: This concludes the cor­respondence concerning the removal ofair bubbles from gonioscopic solutions.

Unilateral and Asymmetric Optic DiskSwelling With Intracranial

Abnormalities

EDITOR:In their article, "Unilateral and asym­

metric optic disk swelling with intracra­nial abnormalities" (Am. J. Ophthalmol.96:484, Oct. 1983), L. A. Sedwick andR. M.· Burde endorsed the theory thatthe absence of papilledema in a patientwith increased intracranial pressure de­pends on congenital or acquired ob­struction of the perioptic subarachnoidspace in the orbit or the optic canal. In1981 my colleagues and I reported twocases of unilateral papilledema in obeseyoung women with pseudotumorcerebri.! In both patients, orbital com­puted tomographic scans showed bilat­eral symmetric enlargement (distension)of the optic nerve images. We conclud­ed that the anatomic and physiologicfactors, whatever these might be, thatdetermine whether an optic disk does ordoes not swell with increased cerebro-

spinal fluid pressure must operate at thedistal end of the optic nerve.

RAYAEL MUCI-MENDOZA, M. D.Caracas, Venezuela

REFERENCE

1. Muci-Mendoza, R., Arruga, J., and Hoyt,W. F.: Distensi6n bilateral del espacio subaracnoid­eo perioptico en el pseudotumor cerebral con papile­dema unilateral. Su demonstraci6n a traves de latomografla computarizada de la 6rbita. Rev. Neurol.9:11, 1981.

Reply

EDITOR:We are chagrined that we overlooked

the article by Mud-Mendoza, Arruga,and Hoyt in which they clearly de­scribed two cases of unilateral papille­dema. We agree that the factors deter­mining whether an optic disk does ordoes not swell operate at the distal endof the optic nerve, probably in the re­gion in and around the lamina cribrosa.Experimental data in primates havedemonstrated that whether the insult tothe optic nerve is one of increasedintraocular pressure, decreased intraoc­ular pressure (hypotony), or increasedintracranial pressure, both antegradeand retrograde axoplasmic flow is ob­structed in this region. We thank Dr.Mud-Mendoza for bringing this articleto our attention.

RONALD M. BURDE, M. D.LYN A. SEDWICK, M. D.

St. Louis, Missouri

BOOK REVIEWSEdited by H. Stanley Thompson, M.D.

Retinal Detachment and Allied Diseases.Volume 2. By Charles L. Schepens, Phil­adelphia, W. B. Saunders, 1983. Hard­cover, 720 pages, index. $99

254 AMERICAN JOURNAL OF OPHTHALMOLOGY FEBRUARY, 1984

Reviewed by BRADLEY R. STRAATSMA,M.D. Los Angeles, California

In this second volume of his text,Charles L. Schepens emphasizes re­search conducted at the Eye ResearchInstitute of the Retina Foundation andthe extensive experience gained from themore than 30,000 vitreoretinal operationsthat he and his associates have per­formed. The treatise gains immeasurablyfrom the author's long and brilliant careerin research and clinical practice. Theobservations and surgical techniques ofDr. Schepens and his associates are wellpresented, but the contributions of otherscientists receive less attention, and, asmay occur in a rapidly evolving field,references to the work of other scientistsoften do not cite their most recent work.

The first third of the volume is devotedto complex and unusual cases. Fixed reti­nal folds, massive preretinal retraction,severe myopia, retinoschisis, and otherconditions associated with retinal detach­ment are discussed. The long-term obser­vations on congenital retinoschisis and itsvariable clinical course are particularlyinformative. Additionally, comments re­garding retinal detachment surgery andcataract, vitreous hemorrhage, and intra­ocular foreign bodies provide practicalinformation.

The middle third of of this book coversvitreous surgery. There are chapters onvitreous replacement, closed vitreoussurgery, open-sky vitrectomy, and thecomplications of vitreous surgery. Intro­ducing this section, the author writes that"it is hoped that the chapters in Part VIIwill convince the reader that closed vitre­ous surgery is important but limited inscope" and states his preference for open­sky vitrectomy when others might electclosed vitrectomy. This forthright state­ment of preference invites one to studyother schools for there can be no argu-

ment with his conclusion that "observa­tions underline the importance for vitreo­retinal surgeons to be equally welltrained in vitreous surgery and in retinaldetachment surgery."

Complications of retinal operations,prophylaxis of retinal detachment, andnew procedures occupy the final third ofthe volume. Recommendations concern­ing avoiding and managing the complica­tions of scleral buckling procedures arecertain to aid retinal specialists, becausethese are derived from a vast amount ofsurgical experience.

This fine treatise presents the knowl­edge, experience, and recommendationsof a world leader in retinal detachmentresearch and clinical practice. I recom­mend both volumes of this text to allophthalmologists who take part in thediagnosis and management 'of retinal de­tachment. They are a source of valuablepractical information.

The Lacrimal System. Edited by Benja­min Milder (Bernardo A. Weil, Editor ofthe Spanish Edition). East Norwalk,Appleton-Century-Crofts, 1983. Hard­cover, 240 pages, index. $52.50

Reviewed by ROBERT B. WILKINS, M.D.Houston, Texas

This book gives a superb description ofthe lacrimal system and contains an excel­lent bibliography of lacrimal articles.This extensive work has 11 contributors,each an expert in the field. The book isdivided into two sections:

The first, on basic dacryology, includesan excellent history of dacryology andinformation on the development of thelacrimal apparatus, the anatomy of thelacrimal system, and the clinical bio­chemistry of tears. There are also sectionson the physiology of tears and lacri-