Book Reviews

of 4 MHz. Moreover, at 37°C with a 60 MHz probe, theultrasound velocity of the cornea is 1575 m/second.

Chapter 2, “Ultrasonic Systems,” proceeds to discussa practical understanding of the ultrasound system,wherein various equipment of the system is discussedand illustrated using black and white linear diagramsand images. Beginning with system components includ-ing the probe, the servo, the pulsar, the receiver and thescan converter and display, the authors move on to dis-cuss issues of bandwidth of the equipment as well asdifferent forms of equipment including A-mode systemsand B-mode systems. Digital image processing is addressedas well as a host of other extremely important ultrasoundissues like biomicroscopy and M-mode.

Chapter 3 builds on the previous two chapters andproceeds into the field of ocular diagnosis. Commencingwith a historical background, the chapter presents a syn-opsis of diagnostic techniques and perimeters. The textdemonstrates both normalities and abnormalities foundin ocular tissue. The significant pathology noted in thetext includes abnormalities in ocular size, ocular shape,vitreous pathology, retinal pathology, uvular pathology,and ocular tumors. Chapter 3 is the longest of all thechapters because there is much information to cover.

Chapter 4 discusses very high frequency ultrasoundscanning in LASIK and phakic intraocular lenses. Then,Chapter 5 closes the text with orbital diagnosis with adiscussion of B-scan diagnosis of orbital pathology. Theauthors also present a section on artifacts encountered inorbital ultrasonography. A general classification of orbitalabnormalities is also presented along with orbital tumorsand orbital inflammation. Other pathology such as arterio-venous orbital abnormalities and optic nerve abnormali-ties are discussed as well as orbital trauma. Additionally,the appendices include ultrasound velocity in tissue, axiallength measurements for intraocular lenses, scan reports,and techniques for ultrasonic examination.

All in all, Ultrasonography of the Eye and Orbit is aninformative text for both medical and surgical ophthal-mologists. The text is a well-written, large reservoir of

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Ultrasonography of the Eye and Orbit Edited by D. Jackson Coleman, Ronald H. Silverman,Frederic L. Lizzi, Mark J. Rondeau, Harriet O. Lloyd,Suzanne W. Daly, and Dan Z. Reinstein. LippincottWilliams & Wilkins. 530 Walnut Street,Philadelphia, PA 19106. 254 pages. Illustrated.Hardbound. 2005. ISBN 0-7817-4650-7. $199.00.

Ultrasonography of the Eye and Orbit is the second edi-tion released 30 years after the original. The authors rec-ognized the need for an update of the original text tospecifically highlight breakthroughs in the field thatinclude power spectrum analysis, 3D scans, very highfrequency ultrasound, ultrasound biomicroscopy, arcscans, wavelets, Doppler and digital processing, andswept scans.

More than 186 pages, the text is subdivided into fivechapters and four appendices. A DVD-ROM is alsoincluded for added real time experience for the reader in ultrasound diagnosis. Chapter 1 is entitled “Physics ofUltrasound,” in which the authors discuss ultrasound asan acoustic wave comprised of a series of repetitivecompressions and rarefactions of matter through whichthe ultrasound wave passes. The different frequenciesused in the ultrasound process are also touched on,along with the different forms of ultrasound including A scan, B scan, C scan, and M scan. The diagrams, bothlinear and photographic, are excellent. There is a superbmontage of images toward the end of the chapter. Onpage 4, there is a table entitled “Reported Mean Veloci-ties of Ultrasound in Ocular Tissues” that is of particularinterest. Here, the authors have reported the mean veloc-ities of ultrasound in various ocular tissues at variousfrequencies and temperatures. The different combina-tions provided give the reader an insightful referencefrom which to further explore and understand how vari-ous factors can affect the ultrasound. For example, ultrasound on a cornea is classically quoted as 1639 m/second. However, it has been found to be 1550 m/second ata temperature of 22°C with an ultrasound probe frequency

Richard J. Fugo, MD, PhD

information that must be understood by ophthalmolo-gists at all levels. Many of the older ultrasound textbooksdo not present up-to-date discussions of ultrasonographicinformation, but we have in Ultrasonography of the Eyeand Orbit a modern source book. As stated in the text’spreface, this second edition is geared toward updating theophthalmologist to the latest info in a manner that is infor-mative and understandable. We believe that the authorshave successfully achieved their goals. Two thumbs up tothe authors.

Reviewed by: Richard J. Fugo, MD, PhD and Jennifer A. Fugo

Surgical Anatomy Around the Orbit: The System of Zones Edited by Barry M. Zide. Lippincott Williams &Wilkins. 530 Walnut Street, Philadelphia, PA 19106.128 pages. Illustrated. Hardbound. 2006. ISBN 0-7817-5081-4. $149.00.

Surgical Anatomy Around the Orbit: The System ofZones by Dr. Barry M. Zide is a continuation of a previ-ously printed publication from 1985 entitled SurgicalAnatomy of the Orbit, which was co-authored withGlenn W. Jelks. In this new volume, Dr. Zide furtherenlightens the reader by bringing our knowledge aboutthe orbital area up to speed, as much has changed in thelast twenty years especially regarding surgical advances.Dr. Zide’s stated purpose was to upgrade the surgeon’sknowledge of the orbital anatomy with regards to themodern surgeries of today.

The layout of this text is what we believe to be a sig-nature of Dr. Zide. His purpose is to the point. There isno frivolous text in which the most important points canbe lost, rather Dr. Zide uses diagrams, photographs,endoscopic images, and illustrations along with well-written, clear explanations. His ability to quickly directthe reader to important points makes this text a valuablebook to own. In addition, Dr. Zide provides us withcadaver photos, on which he has placed markings tobring the reader’s attention to key areas of interest andimportance. Dissections of the orbital area are dissecteddeeper and deeper in order to educate the reader onvarious layers of tissue and nerves. The sequentialphotographs are extremely well done, colorful, andinsightful.

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The text is relatively short and consists of eight chap-ters, which cover topics such as topography, bones, liga-ments, vessels, various nerves and nerve blocks, thelower eyelid, the superomedial zone, retro-orbicaularisoculi fat, and the orbital floor. Also, there is an additionalCD-ROM included at the rear of the book that containssignificant additional information.

Dr. Zide immediately jumps into the orbital area inChapter 1. This chapter contains some truly excellentand vivid color illustrations that direct the reader to notonly understand the location of various nerves, arteries,etc., but also provides the correct names of such things.

Afterward, Dr. Zide begins his dissections in Chapter2 and carries the deepening dissections throughout the remaining chapters of the text. There are other pho-tographs and illustrations presented, but the majority of this text is explained through dissections. All photo-graphs are in full color, which does not leave the readerto guess what the tissue will look like in real life asblack and white images often do.

I found the hallmark of this text to be an excellent,yet brief didactic discussion regarding the “ROOF” orretro-orbicularis oculi fat and the other areas found inthe superolateral zone. The following cadaver photosround out the chapter nicely.

Chapter 7 was divided into six subsections in order toclarify each specific area covered within this chapter. Dr. Zide felt it necessary to separate and highlight theseareas because of their renewed attention in the last fewyears. This chapter’s subsections focus on the inferioroblique muscle, lower lid retractors, Lockwood’s andWhitnall’s ligaments, the orbital floor, the medial orbitalexposure, and finally, the sphenopalatine ganglion block.

In summation, Surgical Anatomy Around the Orbit:The System of Zones is an excellent text, especially if you already have or can easily obtain a copy of theoriginal publication. Dr. Zide has a true talent forophthalmic anatomy. He has invited the readers to joinhim on a journey through orbital anatomy. With excel-lent photographs and illustrations as well as quick,succinct explanations, Dr. Zide has made his book intoa must-have for all ophthalmologists as well as eyesurgeons.

Reviewed by: Richard J. Fugo, MD, PhD and Jennifer A. Fugo