Pharmacology of The Eye. Handbook of Experimental Pharmacology

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

Pharmacology of The Eye. Handbook of ExperimentalPharmacology. Volume 69. Edited by Marvin L.Sears. New York, Springer-Verlag, 1984. 736 pages,index, illustrated

Reviewed by CHARLES D. PHELPSIowa City, Iowa

Have you ever wondered how corticosteroids sup­press ocular inflammation, or why epinephrine andtimolol both lower intraocular pressure, or how toselect the appropriate type and dose of antibiotic forthe intravitreal treatment of endophthalmitis, or howto conduct a clinical trial, or how a topically applieddrug is distributed within the eye? 1£ so, you mayfind this book a useful reference. It contains much ofwhat is currently known about how drugs affect theeye.

Each chapter of the book is a long monograph thatdeals with one aspect of ocular pharmacology andprovides a definitive discussion of its subject. Thechapters are written with authority by experiencedinvestigators. The editor requested the authors todescribe the relationship of each drug's basic phar­macology to the eye's natural physiology, usingwhenever possible a quantitative approach. The re­sult is a masterful and instructive summary of mod­ern research in ocular pharmacology.

The book begins with a capsule history of ophthal­mic therapeutics. Just as the reader begins to thinkthat ocular pharmacology is easy reading, the nextchapter plunges into an exhaustive treatment of thecomplex subject of ocular pharmacokinetics. Thischapter quickly discloses to the reader the gaps in hismemory of college calculus, and the following chap­ter on biotransformation and drug metabolism treatsthe reader no more gently with its demands on hisrecollection of biochemistry.

Subsequent chapters are a bit closer to the cli­nician's bailiwick, but contain some unexpectedsurprises. As might be anticipated, the subjectsof cholinergics, adrenergic agonists, adrenergicantagonists, carbonic anhydrase inhibitors, anti­infective agents, antiviral agents, and steroids arediscussed in detail. However, other chapters delveinto the less commonly encountered topics of oxy­gen, autacoids and neuropeptides, vitamin A, ali­pathic alcohols, photosensitizing substances, andtrace elements. Immunosuppresive drugs, nonste-

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roidal anti-inflammatory drugs, and drugs that affectthe blood clotting system are all reviewed thorough­ly. The book concludes with chapters on dyes usedfor diagnosis, especially fluorescein, and on drugsused to test the pupil.

I found myself going back to this hefty volume forfrequent but small doses. It is not light reading. Theclinician will find much about how drugs work andlittle about how they are used in practice. This is nota criticism: the editor clearly states in the preface thatthis was his intent.

What is the place for this book? I believe thatanyone engaged in research on drugs and on the eyeneeds a copy of this book on an easily accessible shelfwhere it can be consulted frequently. I also thinkthoughtful clinicians will find the book challengingand stimulating. Much of the fun and intellectualappeal of medicine is in the application of discoveriesin the laboratory to the care of the patient. This bookbrings together and organizes an immense amount ofinformation from basic pharmacologic research,making it accessible to the clinician.

Ophthalmology In Vienna. An Illustrated Documenta­tion. By Helmut Wyklicky. Vienna, Verlag ChristianBrandstatter, 1984. Softcover, 80 pages, illustrated.(No price available)

Reviewed by FRANK W. NEWELL

This volume commemorates the 100th anniversaryof the founding of the Second University Clinic ofOphthalmology in Vienna that opened Oct. 1, 1883,with Eduard Jaeger as Primarius and Professor extra­ordinaris. The author, a distinguished historian,provides a rich narrative and pictorial history of theclinic between 1883 and 1961.

A major portion of the volume tells of EduardJaeger von [axtthal (1818-1884). Jaeger was thirdchoice for the position after Josef von Hasner, profes­sor at Prague, and Karl Blodig, professor at Graz. Hewas world renowned for his atlases of opthalmo­scopy and for his studies of pathology and physiolo­gy. Alas, he is now most often remembered forrequiring 20 to 50 sittings, at two to three hoursapiece, for each of his fundus drawings. He pub­lished on cataract surgery, ocular physiology andpathology, and refraction, was the teacher of von