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Clinical Ocular Pharmacology (5th ed.)

Article in Optometry and vision science: official publication of the American Academy of Optometry · May 2009
DOI: 10.1097/OPX.0b013e3181a3cebd

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 1040-5488/09/8605-548/0 VOL. 86, NO. 5, P. E548
OPTOMETRY AND VISION SCIENCE
Copyright © 2009 American Academy of Optometry
Clinical Ocular
Pharmacology (5th ed.)
Jimmy D. Bartlett
and Siret D.
Downloaded from http://journals.lww.com/optvissci by FIi7Z8muUyMFvVxMh18knVvyb34jyON2pa8mF7iMlTqU6gvg930bH9TrOaVq542FOyK00vusTSGVo1xDpxbfdArs1biklpbmj8Bnfx6j2WFvF5W1AkMj0kk1QS823inXQ3Vo3Rvl9NFvBaHC5Tnp9A== on 09/13/2021
Jaanus, eds. Boston:
Butterworth-
Heinemann; 2007.
$130.00.
Previous edi-
tions of this text
have rightly be-
come mainstays
of pharmacolog-
ical texts within optometric education.
The goal of the fifth edition is to “pro-
vide ‘one-stop shopping’ for students,
residents, and practicing clinicians who
need a ready source of information re-
garding both the basic pharmacology of
ophthalmic drugs, as well as their utili-
zation in clinical practice.” Considering
the ever-changing landscape of available
pharmaceuticals, there may never be a
single text to provide all the necessary
information on the topic. But if there
were, this text would likely be closest.
This edition has 35 chapters broken
down into four main sections, each man-
aged by a separate section editor. There are
45 contributing authors and coauthors to
the various chapters. Although this may
provoke a concern of discontinuity, credit
must be given to the section editors for
having each author maintain a consistent
content structure that is easy to follow
from one chapter to the next.
Section I is titled “Fundamental Con-
cepts in Ocular Pharmacology” which cov-
ers drug formulations, drug delivery, and
legal and regulatory aspects of drug utiliza-
tion. Section II, “Pharmacology of Ocular
Drugs,” comprises an overview of many
drug categories including mydriatics, cyclople-
gics, anti-infectives, anti-inflammatories,
antiallergy agents, ocular hypotensive agents,
as well as new chapters on drugs for retinal
diseases and nutritional agents for ocular
Optometry and Vision Science, Vol. 86, No. 5, May 2009
View publication stats
BOOK REVIEW
therapy. To underscore the importance of
drug mechanisms of action, each chapter
in this section begins with a physiologi-
cal overview of the systems affected by
the specified drug category. Each drug is in-
troduced in a standardized format reviewing
its pharmacology, clinical uses, side effects,
and contraindications. The combined thor-
oughness and level of detail in this section
provides the most comprehensive contribu-
tion on the topic and is what separates this
text from others.
The largest portion of the book is sec-
tion III, “Ocular Drugs in Clinical Prac-
tice.” Each chapter in this section focuses
on a particular area of disorders and how
they are managed. Relevant anatomy, his-
tology, and examination techniques are
reviewed before covering the etiology, di-
agnosis, and management of numerous
conditions within a given category such as
cornea, conjunctiva and glaucoma to name
a few. Each chapter is easy to follow and
well written but often lacks condition sum-
maries or highly visual reference figures or
tables that make for an ideal clinical “quick
reference” while seeing patients. There are
also ample quality photographs of clinical
conditions. However, the effectiveness of
these photos is severely limited by the lack
of color.
Section IV, “Toxicology,” contains a
single chapter titled “Ocular Adverse
Drug Reactions to Systemic Medica-
tions.” The section is aptly introduced
by a quote by William Penn stating “The
remedy often times proves worse than
the disease.” As such, the recognition of
ocular conditions that are manifestations
of systemic medications is of paramount
importance for proper patient manage-
ment. This chapter nicely outlines the
effects of drugs on the eye by structure.
This includes drugs affecting the cornea,
crystalline lens, conjunctiva, eyelids, lac-
rimal system, episclera, sclera, uvea, pu-
pil, extra-ocular muscles, retina, and
optic nerve. Additional conditions af-
fecting refractive error and intraocular
pressure are also addressed.
For readers of previous editions of
“Clinical Ocular Pharmacology,” the most
striking initial impression is the sleeker
more condensed presentation of the book.
Although the notable reduction in girth
does not come close to making it a pocket
reference, it should also not be mistaken
for a book lacking in content. Although
previous chapters on “Pharmacologic
Management of the Refractive Surgery
Patient” and “Management of Systemic
Emergencies” have been eliminated in this
edition, the biggest reason for the reduc-
tion in page length is a revised formatting
of references. Instead of providing a de-
tailed list of annotated references, selected
references are listed at the end of each
chapter. On the surface, this may appear to
weaken the reference credibility, but a
careful review of the text content and ref-
erence selections shows that they are cur-
rent, relevant, and provide evidence-based
clinical research outcomes.
Beyond the updates of new drug de-
velopments since the last edition, the
depth and breadth of Drs. Bartlett and
Jaanus’s most recent effort continues its
tradition as one of the most comprehen-
sive resources on the topic. One of the
loftiest goals of all educators is for their
students to become lifelong learners. For
this to be accomplished in ocular phar-
macology, a sound understanding of
essential pharmacological principles is
required. The comprehensive nature of
this text provides all the necessary infor-
mation to apply the fundamentals of oc-
ular pharmacology in clinical practice as
well as provide a foundation for lifelong
learning.
Gregory J. Nixon
The Ohio State University
College of Optometry
Columbus, Ohio