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BOOKS, SOFTWARE, AND

ELECTRONIC MEDIAEDITED BY NEIL R. MILLER, MD

Systemic Diseases and the Eye: Signs and Differential

Diagnoses. Kanski, JJ. CV Mosby, London, 2001. pp. 241.$79.95

REVIEWED BY DANIEL GARIBALDI, MDBaltimore, Maryland

UNIQUE AMONG THE MYRIAD OF AVAILABLE OPHTHAL-mic atlases, Kanskis Systemic Diseases and the Eye;Signs and Differential Diagnoses, proves of equal value toboth general practitioners and ophthalmologists. Its statedgoal is twofold: to familiarize ophthalmologists with theocular manifestations of common systemic conditions andto remind non ophthalmologists that ocular signs maycontribute to the differential diagnoses of systemic disease.In a 249-page, concisely organized manuscript that in-

cludes hundreds of well-described systemic, facial, andfunduscopic photographs, Kanski clearly succeeds in hisgoals.

Systemic Diseases is divided into three well-demar-cated sections. In Differential Diagnosis of Eye Signs,Kanski outlines common systemic diseases that may beassociated with specific ocular signs, ranging from ptosis toophthalmoplegia. For each sign, he provides helpful cluesto differentiate among the various systemic diseases asso-ciated with the ocular feature.

In Differential Diagnosis of Systemic Signs, Kanskideparts from the field of ophthalmology to provide adifferential for commonly observed systemic features, or-ganized in an anatomic and organ-system approach. Cov-ering a variety of conditions ranging from pyodermagangrenosum to deafness, Kanski again provides helpfulfeatures that contribute to the correct systemic diagnosis.

In the final section, Systemic Features and Eye Signs,Kanski reviews, in alphabetical fashion, each systemicdisease referenced in the previous two sections. Fromacromegaly to xeroderma pigmenosum, he lists the seminalsystemic features and eye signs of each condition andprovides dozens of striking photographs to ensure that oneretains the material covered.

Systemic Diseases is not without its flaws. Although

the third section is organized in a user-friendly alphabet-ized fashion, it is somewhat difficult at first reading tonavigate through the multilevel index to find a specificophthalmic or systemic sign of interest. In addition, certain

commonly observed diseases of interest to both generalpractitioners and ophthalmologists, such as herpes simplexand herpes zoster, receive brief mention only in thecontext of other systemic diseases (in this case, AIDS).Other ophthalmic signs, such as hypopyon and hyphema,that require immediate diagnosis and potentially urgenttherapeutic intervention are also buried within specificsystemic disease subsets.

Despite its minor shortcomings, the utility of KanskisSystemic Diseases in the management of patients withpotential systemic conditions is readily apparent. Forophthalmologists, it provides a reference to help guide the

differential diagnosis of commonly observed eye signs andhelps ensure that conditions with significant morbidity andmortality are not missed. For the non-ophthalmologist,Systemic Diseases is useful as an atlas of clinical featuresof systemic diseases, as a reference that may guide moreinformed ophthalmic consultation, and as a reminder thatcommon systemic conditions may have devastating ocularconsequences. For these reasons, Kanskis Systemic Dis-eases should be a staple of the library of general praction-ers and ophthalmologists alike.

The Eye in Clinical Practice, 2nd ed. by Frith, P.Blackwell Publishers, London, 2001. 221 pages, illustrated.$79.00

REVIEWED BY RICHARD ADLER, MD

Baltimore, Maryland

THE EYE IN CLINICAL PRACTICE, SECOND EDITION, IS Aconcise, well-focused text written for the generalmedical practitioner who wishes to approach ophthalmicdiagnoses with a greater fund of knowledge and practicalskill. As the authors acknowledge in their preface, oph-thalmology too often is relegated to a brief and often

2002 BY ELSEVIER SCIENCE INC. ALL RIGHTS RESERVED.592 0002-9394/02/$22.00