This textbook highlights in its preface to the third edition that considerable research has been undertaken in the fields of orbital and periorbital anatomy since 1994 (first edition) and 2011 (second edition). Various topics have been elucidated, such as the orbital connective tissue fascial systems, the retractor systems of the upper eyelid and the lacrimal drainage and tear pump system.
The textbook is divided into 12 chapters, each focusing on a specific anatomical feature of the orbit, such as the extraocular muscles, the nerves, the arterial and venous systems and the osteology of the orbit. Notably, this edition includes a chapter on the nasal cavity and paranasal sinuses, given their close anatomical links with the orbit and the fact that pathology often arises in the orbit and spreads into these compartments, and vice versa. The final two chapters are dedicated to orbital histology and radiographic correlations respectively.
The chapters follow a structured layout, starting with embryology, followed by detailed information on the topic of the chapter and a short section on clinical correlations. The chapter is concluded with diagrams relevant to the chapter and finally a reference list. The diagrams are unique in that they appear hand-drawn, with a strong use of colour and shading, and are thoroughly and clearly labelled. Therefore, the diagrams are arguably the strongest feature of this textbook and are illustrated by Thomas G Waldrop. There are also some figures which seem to be photos and others of CT imaging, enabling the reader to appreciate the anatomy in a more clinically relevant way.
The histology chapter aptly breaks free from the structure followed by other chapters, and instead begins comprising numerous pages of histological slides labelled in great detail, preceded by two short introductory paragraphs. The radiology chapter similarly contains mostly images.
The text is written in a clear and concise style. Some paragraphs follow a narrative style, for example a chapter under the subheading of ‘The adult lymphatic system’ within the ‘Venous and lymphatic systems’ chapter. Dutton starts by reporting that the lymphatics of the eyelid were divided into two components in 1920 by Dewey, and subsequently takes the reader through a chronological journey during which eyelid lymphatics are elucidated, including findings from various research teams. This makes for an enjoyable read, and also affords the reader an appreciation of all the research that has gone into the level of understanding orbital anatomy that we have today. It also aids in retention, as the reader can understand the sequential discovery of certain parts of anatomy and build an image of the story in their mind.
However, the text in this book is very dense, with the main body of each chapter comprising pages of prose, divided only by subheadings. This is a drawback of this textbook in my opinion, as reading the text can become quite laborious and absorbing the information can be difficult for the average reader. Perhaps integrating images into the text would make the book more visually appealing and easier for readers to focus on and retain the information.
In summary, the main advantages of this textbook are in its comprehensiveness and its high-quality diagrams. An eBook version is also included with purchase of the hardback textbook, which can be very useful for individuals studying for exams, enabling them to search through the textbook quickly and highlight key points. The ‘Clinical correlations’ subsections in each chapter are also highly valuable for budding ophthalmologists, given that they are often brief and contain key information, enabling high-yield study.
I would say that this textbook is most valuable as a supplementary resource for those studying for FRCOpth Part 1. It may contain too much information to be of value to other individuals such as medical students or foundation doctors. Similarly, the textbook would be of limited value to allied health professionals such as optometrists or orthoptists.
