BOOK REVIEWS 405

routine addition to cyclodialysis in cases where there is no other peripheral iridec-tomy.

The problem of hypotony is a most serious one and lessens the indications for cyclo­dialysis in the average case of decompensated wide-angle glaucoma, except, perhaps, as a procedure secondary to iridencleisis or tre-phination. For some reason, hypotony in the aphakic eye appears to be less devastating than in the phakic eye. Then, too, in aphakia, we have no real choice as other filtering operations are ineffective.

Bleeding is minimized if one is careful to do the cyclodialysis in an area that, by care­ful gonioscopy, has been proven to be avascular ; and if the technique is gentle ; and if the anterior chamber is filled with air at the end of operation ; and if firm pressure is applied for three or four days.

In cases of unsuccessful operation, the angle is usually more embarrassed by adhe­sions than it was prior to surgery. These ad­hesions do not necessarily preclude a second operation at the same site. Chances of suc­cess are definitely diminished but repetition of the surgery is justified. Cyclodialysis may be repeated in the same area, or a different area, a number of times before being finally successful. One frequently sees patients in whom cyclodialysis has failed to achieve the desired result in the phakic eye and then, after removal of the lens, cyclodialysis was repeated successfully.

In conclusion, three simple investigations might help clarify the contradictory observa­tions and theories with regard to cyclodialy­sis:

1. Data comparing the depth of the cham­ber following successful cyclodialysis, with iridectomy and without iridectomy, to note whether or not iridectomy prevents bowing forward of the iris and delayed valvelike closure of the angle.

2. Tonographic studies on eyes made hy-potensive without visible cyclodialysis cleft, to determine whether or not aqueous secre­tion has been diminished.

3. Construction of models of the irido-corneal angle to demonstrate the role of the ciliary muscle in opening or closing the trabecular spaces. Would not such models make a good exhibit for one of our national meetings ?

S. Rodman Irvine.

BOOK REVIEWS LES CATARACTES CONGÉNITALES. By Jules

François. (Rapport présenté a la So­ciété Française d'Ophtalmologie.) Paris, France, Masson & Cie. A worthy member has been added to the

exemplary series of monographs of the Société Française d'Ophtalmologie by Jules François. His discussion of the congenital cataract is extensive and authoritative. The 853 pages of text are excellently printed and illustrated with 468 figures in halftone. There are also 20 plates in color which are superb. They do not merely decorate the text beautifully; they actually display clini­cal findings so perfectly that they will be easily recognized when seen with slitlamp and ophthalmoscope.

In the first chapter the embryonic develop­ment of the lens itself, its capsule, the peri-lental vascular tunic and the vitreous body are discussed. In the second chapter mac­roscopic, microscopic, as well as ultrami-croscopic phenomena are considered. The biomicroscopic data are related to the ana­tomic facts.

Congenital anomalies of the lens are dealt with in the third chapter. The discussion in­cludes congenital aphakia, microblepharo-phakia, anomalies of form and of position, and remains of the vascular tunics. In the next five chapters the various forms of con­genital cataract are thoroughly discussed. The development of each form as well as its final anatomic and clinical appearance is presented. The clinical manifestations, his­tology, and pathogenesis in the great variety of congenital cataracts, 20 entities, are the

406 BOOK REVIEWS

subjects of these chapters. The character­istics of precocious postnatal cataract are ex­emplified by galactosemic cataracts. The many anomalies and lesions of the eye which are associated with congenital cataract such as, for example, microphthalmos, nystagmus, strabismus and retinopathies, are the subject of the 10th chapter.

Electroretinography and encephalography are often the only means of evaluation of retinal function in an eye in which cataract obscures a direct view of the fundus. This method of examination in its relationship to cataract is presented in detail.

Among the nonocular general affections hyperamino-aciduria is stressed and congeni­tal cataract is one of the several manifesta­tions which constitute a dozen syndromes such as those of Sj0gren, Lowe, and Roth-mund.

A number of chapters are devoted to the etiologic and pathogenetic factors in the de­velopment of congenital cataract. A variety of bacterial infections, rickettsias, helminthia-ses and such parasitic diseases as malaria and torulosis are discussed. The develop­ment of cataract has also been induced in the offspring of experimental animals by de­ficiency of tryphosphane, anoxia, and avit-aminosis in the pregnant mother. Toxic, endocrinologie, ionizing and immunologie factors also play a part in the development of congenital cataract and heredity is an im­portant factor.

Differential diagnosis is the subject of a separate chapter and surgical therapy is de­scribed extensively and in detail in the last five chapters.

Each chapter is provided with an exten­sive bibliography. There is an index of the names of the authors which have been re­corded and an exhaustive one of all the data that have been presented ; these make every­thing in this most admirable book readily accessible.

F. H. Haessler.

FRANCISCUS CORNELIS DONDERS. By F. P. Fischer and G. Ten Doesschate. (With a foreword by H. J. M. Weve.) Assen, Van Gorcum and Company, 1958. 215 pages, six illustrations, three tables, index. Price: H. fl. 17.50. What a pity that so few of us can read

Dutch for here is a fine biography of one of ophthalmology's greats, and a figure to whom American ophthalmologists owe a large debt. Included in this volume is a reprint from the Proceedings of the Royal Society, XLIX, 1891, by Donder's great friend, Sir William Bowman, a memorial to F. C. D. written at the request of Michael Foster, then secre­tary of the Royal Society. This memorial by Bowman (in English) is a beautiful bio­graphical sketch and tribute, worthy of care­ful reading. One should also read Stewart Duke-Elder's paper on Donders (Brit. J. Ophth., 43:65, 1959) for further tribute. It would be good if the work by Fischer and Ten Doesschate were made available to us in English.

Derrick Vail.

T H E USE OF DRUGS IN REFRACTION. By D. W. A. Mitchell, F.B.O.A., F.S.M.C. London, British Optical Association, 1959, second edition. 146 pages, 23 illustrations including five in color, index. Price: $4.70. In Great Britain the nonmedical refrac-

tionist is permitted to use and prescribe whatever drugs are considered necessary for the purpose of his profession, including cy-cloplegics for refraction, tetracaine for to-nometry, and sulfacetamide for prophylactic use after contact-lens fitting. The author is director of education in the optometric clinic named the London Refraction Hospital. Since "hospital" has a different connotation in Europe and America, Europeans are con­fused by our use of this word and vice versa. In Europe, "hospital" refers to a pub­lic, wholly charitable institution dealing with health, while private cases must be taken to