| Preface—Clinical Ophthalmology |
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This all started when I stopped at the Harper & Row booth at an Academy meeting in Chicago and asked them why they didn't have a loose-leaf series in ophthalmology. A chain of events began and culminated in proof of the wisdom of that proverb: “Even a fish wouldn't be caught if he kept his mouth shut.” Once committed, it became obvious that I was not one of those few experts who have such an encyclopedic acquaintance with our field to permit him to outline subjects (chapters) required, let alone have an acquaintance with individual authors who had personal authoritative experiences in the subspecialties of ophthalmology. Indeed it was a bit of a task to choose the section headings and the section editors who would carry this ball. The first decision was to choose the proposed audience. Since every man's philosophy depends on the way his bread is buttered, and since I am a teacher, I chose the practicing physician as our target. This includes the resident in training, the candidate for the Boards, and the busy practitioner who will be taking recertifying examinations. The goal is Few of us can recall the multitudinous nuances of ophthalmology and can apply them all day long in a clinical setting. There are too many interruptions and demands on the central nervous system to “put it all together” day in and day out unless one has a system and has the humility to recognize his need to seek help. In this book we try to supply the system and the help. The title means precisely what it says: Clinical Ophthalmology. This is It is our hope that through our assistance the reader will be better able to establish a diagnosis, be conscious of the relevant differential diagnoses, and undertake appropriate therapy as sonn as possible and thus be prepared to modify his program when the results (or lack of same) appear. Hence, the clinician must be able to use the appropriate equipment and must understand the rationale of its use. He must make accurate observations and arrive at conclusions on a logical basis. His decision to act (or not to act, sometimes more difficult) should be built not only on his own experiences but also on those of others. It is the latter we wish to supply. It is hoped that the reader will keep this series handy and that he will be familiar with its contents in general so that he can refer to it for particulars. The computerized index, the numerous tables and figures, the references, and the overall format have been designed to promote instantaneous recall when necessary. If we thus save only a few eyes, the effort will have been worth the candle. If we provide some pleasant reading for leisure hours, our cup runneth over. We (I) are perfectly aware that we are not infallible. Some of our information may be incorrect, especially as time and progress in knowledge continue. Indeed, there is some planned overlap and even disagreement on minor points currently existing in this text. As editor-in-chief I solicit comments from the readers, useful suggestions for future additions or deletions, citations to the literature, and perhaps even better figures to demonstrate clinical problems. Constructive criticism is always welcomed. The reader cannot offend me if he has the facts to substantiate his stand. Any multi-authored text has inborn problems. Not everyones uses the same style, and we have made a few contributors less than happy through intensive editing. The section editors and chapter authors have been most cooperative. Several required more prodding than others. A few, due to outside commitments, withdrew in midstream. This has been disconcerting, delaying, and upsetting to the rest, who were for the most part prompt and diligent from the outset. I told one section editor I felt like an orchestra leader who had a galaxy of virtuoso players but that I had a tough chore making them show up for the performance—to say nothing of the rehearsal. He thought I was more akin to a Broadway entrepreneur who had a group of different shows going concurrently. In any event it has been a challenge, and a stimulating one at that. I personally thank each editor and author for the final product. If there are imperfections, inconsistencies, and annoying variations in style in this text, I assume full blame. The individual authors have done what was asked. Thankfully we can amend our presentations in subsequent revisions at a relatively low cost to the reader. That is what was attractive about the loose-leaf methodology from the outset. An editor incurs many debts. Besides the authors and the editors I wish to especially thank all of Harper & Row. Company policy prevents naming names, but I do thank them personally and collectively; they have been most cooperative, informed, and above all, pleasant. They have taught me much about publishing. In addition I thank my secretary, Ellen H. Kalligonis, who skillfully helped sandwich the editing chore in among my other duties; her assistance is greatly appreciated. I had hoped to perform my end of the editorial chores while on sabbatical leave, but for the greater part this was impossible. As a consequence, all—my wife, my yard, my general reading, and my avocations—have suffered from neglect. I would like to pose as a martyr, but I can't. It has been fun, and as a general practitioner of ophthalmology I have learned much more than I was aware existed. Robert Frost has aptly condensed my sentiments in “Two Tramps in Mud Time”: But yield who will to their separation, November 1976 Thomas D. Duane, MD |