508 AMERICAN JOURNAL OF OPHTHALMOLOGY MARCH. 1970

phy for diagnostic purposes and suggestions for improvement: e.g., the need for instru­ments with greater sensitivity and resolution, practical problems in positioning of the A-scope, movements of the patient in using the B-scope, spurious and secondary reflections from inclined surfaces and the walls of the eye and orbit (studies using standard models of the eye are planned), difficulty in localiza­tion of foreign bodies, and the need for bet­ter methods of measuring reflections from different tissues quantitatively. Ultrasonic holography seems possible.

The therapeutic use of ultrasonic waves is in its infancy, but the possibilities are inter­esting (e.g., disintegration of cataracts, breaking of vitreous strands, repositioning of retinal detachments and sealing of retinal breaks, or treatment of tumors). Whether the effect of therapeutic ultrasonics is due primarily to vibration, heat, "cavitation," or other modalities is uncertain. The tissue ef­fects of diagnostic ultrasonography are probably minimal, but with new instruments, these effects have not been thoroughly deter­mined.

These transactions have been beautifully assembled and edited. The original contribu­tions from the investigators in the field make this book essential for anyone working with these instruments, and of general interest to other ophthalmologists.

William F. Hughes

CONTRIBUTION A L'ETUDE DE L'ACHROMA-TOPSIE CONGÉNITALE. By Alice Delpech. Toulouse, Imprimerie Castelvi, 1968. Pa-perbound, 116 pages, bibliography, 17 fig. ures. This monograph contains the thorough

studies of three patients with typical total color blindness, or rod monochromatism, and of one patient with cone monochromatism, an unusual type of total color blindness without abnormal vision. In addition, there is a review of the past literature on total color blindness.

Most of the findings from the four pa­tients studied are similar to those reported in the past literature. However, a few new points are presented. The nystagmus of these patients, which was recorded and stud­ied in detail, varied considerably in type, fre­quency, amplitude, and at times, in direction, depending primarily on the position of the eyes and the position of the object of regard. Jerky as well as pendular nystagmus was characteristic. Visual evoked responses, re­corded for the first time in a person with cone monochromatism, were normal. Two findings of questionable value were an ele­vated blood level of nonspecific esterases in three patients, and a structural anomaly of one chromosome 17 in one patient. It is un­likely that these data, particularly the bor­derline chromosomal abnormality, bear any relationship to the ocular problem.

Although the review of the literature was extensive, several important papers were omitted. The author refers only to autosomal recessive inheritance in total color blindness and fails to mention the publications describ­ing sex-linked inheritance in one of the atyp­ical forms (blue monocone monochromacy). The author refers only to two of the three histologie studies which have been published. Reference to past psychophysical and elec-trophysiologic evaluation of such patients is also incomplete. Although the author de­scribes the electroretinogram in her patient with cone monochromatism, she fails to mention three patients with this diagnosis previously tested.

This monograph is definitely worthwhile for those interested in total color blindness, but should not be regarded as a comprehen­sive reference on this subject.

Alex E. Krill

OCULAR SYNDROMES. By Walter J. Geer-aets. 2nd edition. Philadelphia, Lea & Fe-biger, 1969, Clothbound, 289 pages, glos­sary, seven tables. Price :·$9.00. In the second edition of this remarkable

book the ocular syndromes described have