Book Cover           

Neuro-Ophthalmology: Diagnosis and Management, 2010, 2nd edition
Authors: Liu GT, Volpe NJ, Galetta SL
Publisher: Elsevier
( or to order)

Review of the first edition, by Anderson D. New England Journal of Medicine 2001;344:1872-1873.
Review of the second edition, by Jay W.  JAMA 2011;306:439-440. pdf.jpg

Released in the summer of 2010, this book is designed for the students of neuro-ophthalmology: the practitioners, ophthalmology and neurology residents, and medical students dealing with patients with disturbances of the afferent visual pathways and efferent ocular motor systems.

Our hope was to offer a book that could serve both as a guide for diagnosing and managing patients with neuro-ophthalmic problems and a one-volume textbook containing in-depth discussions of neuro-ophthalmic topics and disorders. With just three authors, our aim was to create a highly organized and uniform textbook, extensively illustrated and referenced, that would bridge the gap between neuro-ophthalmic handbooks containing tables, outlines, and flow-diagrams and neuro-ophthalmic encyclopedias.

How the book is organized (see below for table of contents)

The book is divided into four sections: history and examination, afferent disorders, efferent disorders, and headache. This initial grouping of the last three sections is symptom-based, and within each of those sections, the chapters then are divided neuroanatomically . Each chapter has roughly the same internal organization and starts with an introduction to the structures or disorders discussed, followed by a review of their neuroanatomy, symptoms, and signs. This is followed by a detailed discussion of the presentation, pathophysiology, diagnosis, neuroimaging and diagnostic studies, and management of the diseases which affect that structure.

Within the chapters, the liberal use of headings such as "neuro-ophthalmic manifestations" points the reader to exactly what he or she may want to know about a particular topic. The copious use of figures and tables aids the discussions, and the generous references direct those desiring to pursue a topic in greater depth. Repetition between chapters, sometimes unavoidable for the sake of completeness, was kept to a minimum by cross-referencing topics, figures, and tables. Because this is a book for clinicians, reviews of neuroanatomy and neurophysiology in most instances are based upon clinical and pathological observations in humans without extensive discussion of experimental literature involving nonhuman primates and other animals.

The first two chapters on history and examination were designed for students and residents unfamiliar with eliciting symptoms and signs in neuro-ophthalmic patients. The examination chapter also includes reviews of the neurological examination and the bedside neuro-ophthalmic evaluation of comatose patients. Often based on the history alone, the problem can be localized neuroanatomically and its etiology determined. The examination can then be used to support a suspected diagnosis and eliminate other causes.

The next section on afferent disorders discusses the diseases associated with structures responsible for transmitting and processing visual information coming from the eye. Here disorders of the retina, optic nerve, chiasm, and retrochiasmal structures, as well as disc swelling, higher cortical disorders, transient and functional visual loss, and hallucination and illusions are discussed. Readers unfamiliar with these subjects or topical localization of visual field defects might first review Chapter 3, which contains an overview of afferent visual disorders and visual field testing.

The section on efferent disorders reviews conditions involving motor neuro-ophthalmic structures. Thus pupillary, eyelid, and facial nerve abnormalities, then eye movement and orbital disorders are discussed here. Eye movement disorders are covered in four chapters: Chapter 15 reviews causes of dysconjugate gaze including third, fourth, and sixth nerve palsies; Chapter 16 discusses abnormalities of conjugate gaze such as defective saccades and pursuit; Chapter 17 outlines conditions where the eyes move excessively as in nystagmus and nystagmoid movements; and Chapter 18 discusses eye movement and other abnormalities in orbital disorders.

Chapter 19: headache, faceache, and disorders of facial sensation discusses topics such as migraine, cluster headache, trigeminal neuralgia, and trigeminal neuropathy.

Table of Contents

i) Introduction

I. History and Examination
1. Neuro-ophthalmic History
2. Neuro-ophthalmic Examination

II. Visual Loss and Other Disorders of the Afferent Visual Pathway
3. Visual Loss: Overview, Visual Field Testing, and Topical Diagnosis
4. Visual Loss: Retinal Disorders of Neuro-ophthalmic Interest
5. Visual Loss: Optic Neuropathies
6. Optic Disc Swelling: Papilledema and Other Causes
7. Visual Loss: Chiasmal Disorders
8. Visual Loss: Retrochiasmal Disorders
9. Disorders of Higher Cortical Visual Function
10. Transient Visual Loss
11. Functional Visual Loss
12. Visual Hallucinations and Illusions

III. Efferent Neuro-Ophthalmic Disorders
13. Pupillary Disorders
14. Eyelid and Facial Nerve Disorders
15. Eye Movement Disorders: Third, Fourth, and Sixth Nerve Palsies and Other
Causes of Diplopia and Ocular Misalignment
16. Eye Movement Disorders: Gaze Abnormalities
17. Eye Movement Disorders: Nystagmus and Nystagmoid Eye Movements
18. Orbital Disease in Neuro-ophthalmology

IV. Other Topics
19. Headache, Faceache, and Disorders of Facial Sensation