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Endophthalmitis: diagnosis and management

GA Peyman, PJ Lee and DV Seal

Taylor & Francis, London, 2004 Price £85.00,

ISBN 1841842788

Endophthalmitis is a rare but potentially devastating infection likely to produce irreversible visual loss if not managed correctly. Current management has evolved over the last few years and the authors of this book have achieved their goal of neatly and comprehensively summarising the present situation.

The book is divided into chapters that take in the mechanisms of intraocular inflammation and basic microbiology, to molecular biological diagnostic techniques and pharmacokinetics. Clinical aspects of the condition are also well covered and include a chapter on endogenous endophthalmitis.

There are unexpected gems such as an excellent chapter on epidemiology. This is rare in books of this nature and the subjects covered range from the validity of questionnaire surveys to the use of Bayesian theorem for the calculation of postoperative endophthalmitis risk. The chapter on pharmacokinetics contains handy tables on likely antibiotic resistance and important information on the calculation of dose for intraocular injections according to globe size. In the chapter on management and treatment, there is an excellent critique on the Endophthalmitis Vitrectomy Study, pointing out the drawbacks of the study and the interpretation of its results. The use of corticosteroids is a contentious area. While it is generally accepted that the intraocular delivery of steroids in postoperative endophthalmitis is beneficial, their use in endogenous endophthalmitis is more controversial and the authors fall on the side of usage without any real evidence to support this approach.

Any book will be out of date from the moment it is published (and often long before) and it is gratifying to discover that the reference lists are up to date with a sprinkling of references from 2004 and the inclusion of key papers from earlier years. The layout is clear and concise with a large body of information marshalled into tabular form. The publishers have done an excellent job of reproducing the clinical photographs as well as the figures and diagrams.

Who will benefit from reading this book? Everyone likely to be engaged in the management of this sight-threatening condition. Trainees will find a wealth of information not available in other formats and experienced surgeons will benefit from the precise synopses of current thinking about the subject. It should form part of the library of all ophthalmic departments as it is also an excellent reference volume. This reviewer will be certainly keeping his complimentary copy under lock and key.

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Stanford, M. Endophthalmitis: diagnosis and management. Eye 20, 632 (2006).

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