Clinical procedures in primary eye care, 5th edition

Abstract

David Elliott’s Clinical Procedures in Primary Eye Care continues its growing reputation of being one of the most well-known and trusted procedures textbooks in optometry. The first edition of this book was released in 1997 when we were undergraduate optometry students, and we were very thankful to have used that edition. During subsequent successive versions, this book has evolved substantially. The newly revised 5th edition of this valuable resource continues to be concise and is divided into nine chapters covering a wide range of commonly used clinical techniques in primary care optometry. Each chapter begins with an outline format which makes the pertinent information easy to follow and easy to locate. Optometry students will find this book helpful as they navigate the many potential examination techniques by providing evidence-based eye examination techniques in a very easy-to-read and understandable format. Chapter 2 on communication skills examines the fundamentals of developing rapport with a patient during history taking and how to improve communication skills. A brief discussion on history taking and additional questions is raised with case examples. Electronic and written recording of results including important elements of a well-written referral letter is described. The chapter is concluded with a description of the communication strategies of diagnosis and management principles with the patient. The following chapter of assessment of visual function examines in detail the theory and method of measuring distance and near visual acuity across a series of visual acuity charts for adults and children. Contrast sensitivity function is described, and the procedure outlined for clinical testing. A brief genetic description of colour vision anomalies is discussed followed by procedures for routine colour vision testing in clinic for both congenital and acquired colour vision deficiencies. The chapter ends with a detailed description of visual pathways and the fundamentals of perimetry. The common perimetric testing strategies for screening and threshold measures in a clinical setting are discussed with a guide to interpretation. The fourth chapter takes on refraction and prescribing and is one of the most comprehensive parts of this book covering basic and practical concepts including determining lens powers, objective refraction, and common techniques used for performing subjective refraction. Although concise, the 5th revision now includes a section outlining myopia and strategies for myopia control. Although succinct, chapter 5 provides a robust review of procedures involved in fitting, evaluation, and troubleshooting contact lens procedures. Two sections outlining scleral RGP lenses and myopia control using contact lenses are among the new features of the 5th revision. Although the former is discussed in more detail, the latter has only been briefly reviewed which deserves more attention given the rising numbers of primary care optometrists involved in myopia control, in particular orthokeratology. With the wide variety of procedures and their different approaches to binocular and accommodative anomalies assessment, chapter 6 attempts to identify and introduce the most popular and applicable methods in this context. In this version, topics are rearranged and presented in a clearer and more logical format allowing the reader to quickly locate the desired information. The longest chapter is devoted to the assessment of ocular health. It is an exhaustive description of illumination and examination techniques with biomicroscopy for the assessment of the anterior segment. This edition contributes over ten pages of assessment of ocular surface inflammation and tear film analysis and interpretation. Anterior chamber angle analysis and tonometry are discussed including a neurological assessment of pupil pathways. Strategies for optimal viewing techniques for direct and indirect methods of posterior segment exam are described and the theoretical foundations of optical coherence tomography including interpretation of common retinal imaging results are presented. Chapter 8 discusses normal variations in the appearance of the eye. This is an important chapter for the early career optometrist with minimal experience in clinical presentations of patients by helping the reader to integrate the knowledge gained from the preceding chapters in the context of normal variations in presentations of patients. The authors discuss both anterior and posterior segment presentations that appear pathological but are not clinically significant. This textbook concludes with chapter 9 describing some of the physical examination procedures that could be performed at optometry practices. The colour figures, tables, and diagrams throughout the book are very informative and useful for the reader and complement the text well. An attractive feature of the book is the free accompanying eBook version, which is easy to access on a variety of electronic devices (including iOS and Android) and provides viewing digital images, diagrams, video clips, and additional illustrations not included in the hard copy. Overall, this textbook achieves its objective: ‘a teaching aid for undergraduate optometry students and for practitioners wishing to review their clinical practice’. As an essential companion and useful guide, this book has considerable breadth and adequate depth to allow the intended audience to learn and review basic clinical techniques. As clinicians and educators, we would recommend this book for anyone involved in teaching optometry skills, optometry students, or even the optometric practitioners looking for a quick reference for common clinical procedures.