The fishmouth phenomenon in retinal detachment.

a description of routine ocular conditions which can be viewed readily in the outpatient department, but it does not apply to specialised conditions like ocular tumours, and, as stated in the introduction to this book, the relative infrequence of many of these tumours precludes the average eye surgeon from becoming familiar with them, particularly during the various stages of their development. Such knowledge is essential in making an early diagnosis, which is so important in any form of malignant disease. This book fulfils a great need, and the standard of the illustrations is extremely high. The short comments are entirely complementary to the illustrations. There is a fair balance between the roles of surgical treatment and modern methods of irradiation in the management of many of the conditions. Relatively few criticisms need be made, but there is some confusion about the management of surface melanomata. The book indicates that a flat surface malignant melanoma may be treated by beta irradiation whereas a raised lesion should be treated by exenteration, though it is possible that this advice is limited to the fornices and the palpebral surfaces of the eyelids. In fact, however, it is extremely rare for a surface melanoma to assume malignancy without becoming elevated (a possible exception is cancerous melanosis of the eyelidthe lentigo maligna of Hutchinson). Indeed a junctional naevus is elevated in the absence of proved malignant change, so that elevation of a lesion is a doubtful means of determining the precise nature of the lesion and, therefore, the most effective method of its treatment. Exenteration is the essential measure in certain cases, but as a general rule irradiation should be carried out as a primary procedure, and a 'flat' surface which is appropriate for beta irradiation can be achieved when the bulk of the lesion is removed for biopsy. The other criticisms are only trivial. Fig. 13 is to the left (rather than above) Fig. 12, and proper recognition should be made of George Coats, who contributed so much to ophthalmology in the relatively short age span of 39 years, by placing the apostrophe in the correct place, so that Coats's disease is not correctly described as Coat's disease, though to be less pedantic Coats' disease may suffice. This book should be of distinct value to the practising ophthalmologist who sees cases of malignant disease of the eye infrequently. KENNETH WYBAR