Clinical Pathways in Glaucoma. Thom J. Zimmerman, Karanjit S. Kooner, eds. New York: Thieme, 2001. Pages: 576. Price: 99. 00. ISBN 0‐86577‐919‐8.

Clinical Pathways in Glaucoma. Thom J. Zimmerman, Karanjit S. Kooner, eds. New York: Thieme, 2001. Pages: 576. Price: 99. 00. ISBN 0-86577-919-8. Clinical Pathways in Glaucoma is an edited text with 22 chapters and 26 contributors. As indicated by the editors, Thom J. Zimmerman, M. D. , Ph. D. , and Karanjit S. Kooner, M. D. , the purpose of this text is to provide the clinician with an up-to-date resource to aid in the care of the glaucoma patient. The contributors to the text represent a broad spectrum of authors at various career stages. Eleven of the contributors, including one of the co-editors (KSK), are affiliated with the Department of Ophthalmology at the University of Texas Southwestern Medical Center in Dallas, Texas. Each chapter in Clinical Pathways addresses a carefully selected, clinically relevant topic that should whet the practitioner's appetite for another condensed resource that has practical application. Prospective owners of the text will be particularly enticed by the inclusion of commonly addressed topics as well as others that have been compiled to help fill the void of adequate reference sources on topics such as Management of Glaucoma in Pregnancy and Management of (the) Blind, Painful Eye from Glaucoma. The reader of Clinical Pathways will be pleased with a user-friendly organization within each chapter that is designed to enhance the retrieval of information. Along these lines, topics are addressed in a consistent fashion according to Definition, Epidemiology and Importance, Diagnosis and Differential Diagnosis, Treatment and Management, and Future Considerations. Relevant discussions within these topical areas are then addressed utilizing an appealing question and answer format. Literally, the text is peppered with hundreds of question-formatted subheadings throughout. These question-formatted subheadings are variable in focus and number depending on chapter and section, and they tend to address the most important clinical issues that the doctor would need to know about. Clinical Pathways in Glaucoma is not a heavily illustrated text, so the reader should not anticipate a glut of photographs within. Accompanying illustrations that do exist include primarily summary tables as well as decision tree diagrams to improve information transfer relative to diagnostic and management strategies. This is a relatively unique and helpful feature that this text provides. Clinical Pathways is heavily referenced with original and pertinent citations, which is a major strength of this text that adds credibility and assurance relative to the material summarized within its covers. At the end of the text there are more than eighteen pages of heavy indexing that includes notations for the location of figures and tables. The 22 chapters included in this text are not subgrouped according to broader topical areas; rather, each stands alone as an autonomous and nonsegregated component of the book. To further illustrate the organization of material within the text, let's briefly tour some of Chapter 1, entitled Childhood Glaucoma. The chapter begins with a Definition section that is subcategorized using “question-formatted” subheadings including How Is Childhood Glaucoma Defined? ; What Is Buphthalmos? ; and How Is Childhood Glaucoma Classified? Following the Definition section, the Epidemiology and Importance section contains further subdivided material such as How Common Is Childhood Glaucoma? ; Are There Any Genetic Considerations for Childhood Glaucoma? ; and What Are the Characteristics of the Genes Involved in Primary Congenital Glaucoma? Including the initial chapter, Childhood Glaucoma, the first five chapters of the text are devoted toward the topics of Primary Open-Angle Glaucoma, Glaucoma Suspects, Normal Tension Glaucoma, and Primary Angle-Closure Glaucoma. Glaucoma Suspects contains question-formatted subsections such as How Are Glaucoma Suspects Defined? ; Why Is Understanding of IOP Important in Studying Glaucoma Suspects? ; and Is There Evidence of Abnormality in Blood Flow in Glaucoma Suspects? Titles of other chapters within Clinical Pathways in Glaucoma include Glaucoma Associated With Raised Episcleral Venous Pressure: The “Red-Eye” Glaucomas, Glaucoma Associated with Primary Disorders of the Corneal Endothelium, Glaucoma Associated with Inflammation, Pigmentary Glaucoma, Glaucoma Associated with Lens Disorders, and Glaucoma Associated with Vitreoretinal Disorders. The first chapter of this list provides a particularly good summary of a topic that is often not addressed in significant detail. I found all of these chapters to contain clinically oriented information that would serve as good reference material for any busy clinician. Other very important topics for which chapters are devoted include Glaucoma Associated with Ocular Surgery, Traumatic Glaucoma, Neovascular Glaucoma, Drug-Induced Glaucoma, Glaucoma Associated with Systemic Disease, and Glaucoma Associated with Intraocular Tumors. The Traumatic Glaucoma chapter, for example, is 54 pages in length and is referenced with 143 citations. It contains three tables and seven flow diagrams. There are no other line drawings or black and white photographs. The chapter covers topics including Glaucoma Complicating Hyphema, Ghost Cell Glaucoma, and Angle Recession Glaucoma. Each of these glaucoma types are subdivided according to the book's standard format, i. e. , Definition, Epidemiology and Importance, etc. Question-formatted components of the Angle Recession Glaucoma section include What Is the Mechanism of IOP Elevation in Angle Recession Glaucoma? and What Are the Risk Factors For IOP Elevation Following Angle Recession? Chapter 16 of the book, Glaucoma Associated with Systemic Disease, contains topics including Glaucoma Associated With Endocrine Disorders, Glaucoma Associated With Collagen Vascular Diseases, and Glaucoma Associated With Systemic Viral Disease. This chapter, which is particularly detailed and broad in nature, has 309 individual citations and is full of “hard-to-find, ” clinically relevant material! The final five chapters of the text are entitled Principles and Complications of Medical Therapy of Glaucoma, Principles and Complications of Surgical Therapy for Glaucoma, Management of Cataract and Glaucoma, Management of Glaucoma in Pregnancy, and Management of Blind, Painful Eye from Glaucoma. The chapter Principles and Complications of Medical Therapy of Glaucoma provides a very useful summary of pharmacologic agents used in the treatment of glaucoma. One table in the chapter is devoted to a listing of the available antiglaucoma agents, and another helpful table presents the “available classes of glaucoma medications, their contraindications, and concurrent systemic medications to avoid. ” Highly beneficial are discussions concerning compliance, the effects of beta-blockers on blood lipid profiles, and the effectiveness of topical agents relative to oral agents. Management of Glaucoma in Pregnancy (Chapter 21) contains a unique summary not typically found in other resources. Questions addressed include How Common Is Glaucoma in Pregnant Women? ; What Type of Glaucoma Occurs During Pregnancy? ; and What Glaucoma Management Issues Should be Considered for Women During the Reproductive Years? Clinical Pathways in Glaucoma is an up-to-date, unique reference that I am personally very glad to add to my bookshelves of resources to be utilized toward the management of patients with glaucoma. It is likely, however, that it won't spend much time between book ends due to my frequent use. I believe Clinical Pathways has a role in student and resident education and in all types of clinical practice. It is well organized, clinically relevant, and easily read. The text is edited with leadership in the field of glaucoma, and the information contained within it is credibly supported with appropriate and detailed referencing. I would highly recommend the text to anyone who participates in the management of glaucoma patients regardless of the size and depth of their current library.