I confess, I’m a huge nerd when it comes to getting new books, especially textbooks.  Though I own a print copy of the 7th Edition, I decided to go ahead and buy the 8th Edition of Kanski’s Clinical Ophthalmology: A Systematic Approach.

The 8th Edition does not list Dr. Jack Kanski as one of the primary editors/authors; instead, the task of updating this work has fallen to one of his colleagues, Dr. Brad Bowling, who did a superb job of maintaining Dr. Kanski’s original vision while inserting his own style to present up-to-date evidence-based information about the essential topics of ophthalmology.  Having personally relied heavily on the 7th edition during residency and through board review, I’ve been very eager to review this new text, which was released earlier this year.

On initial glance, it’s a great update to the already amazing work of the 7th edition.  I don’t know if it’s an accurate claim, but it seems like there are even more images and figures than previous editions.  Though it may not be as revolutionary of a difference between the 7th edition and its predecessors in format and look, the 8th edition is still a sleek upgrade.

Organization

The textbook sections are identical to the 7th edition.  The topics are arranged anatomically from anterior to posterior, as well as sections on ocular side effects of systemic medication and ocular trauma.

Table of Contents (Chapter Titles):

  1. Eyelids
  2. Lacrimal Drainage System
  3. Orbit
  4. Dry Eye
  5. Conjunctiva
  6. Cornea
  7. Corneal and Refractive Surgery
  8. Episclera and Sclera
  9. Lens
  10. Glaucoma
  11. Uveitis
  12. Ocular Tumors
  13. Retinal Vascular Disease
  14. Acquired Macular Disorders
  15. Hereditary Fundus Dystrophies
  16. Retinal Detachment
  17. Vitreous Opacities
  18. Strabismus
  19. Neuro-Ophthalmology
  20. Ocular Side Effects of Systemic Medications
  21. Trauma

Section Organization

As you would expect, each section typically starts with a brief overview of the anatomy, histology, physiology, and other general background information, before diving into the most common pathology.  Each disease has a brief introduction, distinguishing features/differential diagnosis/workup section, and treatment section.  Not too dissimilar from most ophthalmology textbooks.

What makes Kanski so invaluable are the color photos, figures, and diagrams that rival any ophthalmology atlas.  While there are typically detailed descriptors of each key finding, these high-resolution images will often clarify critical concepts.  Each image has a short caption that succinctly explains the image.  Most pages have anywhere from 1 to 6 images surrounding the text, which is an awesome reference for those visual learners.

Presentation Style

Kanski’s text is classically presented in outline form with short sentence descriptors.  In the 8th edition, Bowling preserved the essence of the text, but took away some of the hard-core ordering of the information.  Bullet points are used more liberally, and the letter and numeric ordering (A, B, C, 1, 2, 3, etc.) has been scrapped.

Example of the 7th edition of Kanski's Clinical Ophthalmology.

Example of the 7th edition of Kanski’s Clinical Ophthalmology.

Kanski 8th Ed Sample

Example of the same topic in the 8th edition of Kanski’s Clinical Ophthalmology.

There are a few more paragraphs in the 8th edition, but before anyone panics, the general style of the book remains the same – most of the bullet points remain short and sweet, while the paragraphs are still fairly succinct.

Content

If you’re looking for in-depth explanations diving into the minutiae of ophthalmic basic science, this is not the book for you.  The text is brief in its descriptions but high-yield in its content.  Its breadth of topics covers the essential topics in ophthalmology; its depth is sufficient for the budding ophthalmologist, or for someone doing some moderately-intense review.

Chapter Introductions

Each chapter begins with a brief introduction to the topic.  Anatomy typically begins the section, followed by physiology and histology, terminology, evaluation techniques and interpretation, and basics of treatment.  There is some variation in what is specifically highlighted in the introduction based on the nature of the subject material.  Images in this section are typically of normal anatomy or histology.  Often there are also diagrams illustrating physiology, pictures of instruments and diagnostic data, or tables comparing different clinical findings.

Diseases

The disease topics discuss the essential features of the disease:  epidemiology, pathogenesis/pathophysiology, clinical features (symptoms/signs), differential diagnosis and workup, and treatment.  All of the most common diseases and most of the diseases with notable appearances have images.  There are many histopathology images, which are often directly compared with the corresponding clinical appearance.  In some cases, photographs of surgical treatment are included.

Insets

Throughout the book, there are some insets – these brightly-colored boxes are often descriptions of surgical or clinical techniques.  To me, these are super useful.  When I was first learning how to perform a laser trabeculoplasty, I referenced Kanski’s step-by-step “how to perform an ALT” to make sure I didn’t forget any steps.  They’re great for a quick refresher, or if you’re trying to find a quick guide for various procedures and exam techniques.

Tables

While there are not a lot of tables, the few included tables achieve very directed goals – comparing two similar diseases, listing features of a disease, etc.  Because textbooks can overwhelm the reader with too many tables and figures that most readers probably gloss over, I think the appropriate use and placement of tables can provide some relief in the middle of dense text.  The Kanski text does a decent job of keeping the tables to a minimum.  One critique I have of some of the tables is that some of the information presented in tabular format didn’t stick out as very important to me, but perhaps they may be helpful to someone else.

Images

Like I mentioned above, the high-quality images and figures found in this textbook are very good.  Since ophthalmology is such a highly visual specialty, it’s crucial to see as many good representative images for pattern recognition as possible.  For those people reviewing images in preparation for the oral board exam, these pictures can be very helpful.

Ratings

Organization:  5 out of 5

The book is organized in a very logical fashion.  Each section is presented well, and the book reads from anterior to posterior (as many texts are organized).

Readability:  4.5 out of 5

Kanski’s Clinical Ophthalmology has always been brief and to the point.  This new iteration is no exception; there are no wasted words.  The only reason why it didn’t get a full 5 out of 5 was because stylistically not everyone learns well by bullet point.

Comprehensiveness:  4 out of 5

All of the major topics in ophthalmology are covered.  However, not every single aspect of ophthalmology is covered (which makes sense in a single-volume text).  Bonus points for discussing ophthalmic manifestations of systemic medications (which is a common screening we have to do in clinic).

Citations:  0 out of 5

There are no references to the source journals.  While the information is up-to-date and evidence-based, citations are not included.

Images:  5 out of 5

I don’t think I need to say anything more about this.  😉

Suitability for the Beginning Ophthalmologist:  5 out of 5

For a single-volume textbook, I think Kanski’s Clinical Ophthalmology satisfies the requirements for introducing someone to the field of ophthalmology:  clinically-directed explanations, example images, details on the most common and essential topics in each sub-specialty, etc.  As I’ve previously stated, I think this text is a must-have for every beginning ophthalmologist.

Suitability for Written Board Review:  3.5 out of 5

For some people, Kanski would be sufficient to review the “essentials” and pass the ABO written qualifying exam.  However, there are definitely some knowledge gaps in the text that would require supplemental material (for example, clinical optics).  For this reason, as a stand-alone text, I can’t give it a rating any higher than a 3.5.

Suitability for Oral Board Review:  4.5 out of 5

Studying for the ABO oral exam has to be approached much differently than for the written exam.  Because the oral exam aims to test how well you can articulate a structured approach to common clinical scenarios, it’s important to have texts that are well-organized, full of images, and brief.  While it’s a bit lengthy for a quick review, it’s still a great option for preparing for the oral exam.

Portability:  5 out of 5*

If you buy the book brand new, the 8th edition (U.S.) comes with a code that you can register with ExpertConsult.com to have unlimited online access to the text and images.  There is a free app called Inkling that has partnered with Expert Consult to provide easy-to-navigate access to the book on your mobile devices.  It’s a great bonus feature.  With that access, you can copy/download the images into educational presentations and for offline viewing.  The text is fully searchable, which makes it much easier to hone in on the topics you want to learn.

The textbook itself is a fairly standard size (1.8 x 8.8 x 11 inches, 6.7 pounds), but is still bulky enough that you may not want to lug the physical book around on your clinical rotations.  Although it might not be the most ideal quick-reference book in the clinic, it would be worth taking with you for more in-depth study sessions.

*The reason for the asterisk is that the book’s physical portability would be rated much lower, but because there is high-quality online access for those who purchase the book new, the text can be very portable.

Cost:  $$$

$ = $0.00-$50.00
$$ = $50.00-$150.00
$$$ = $150.00-$250.00
$$$$ = $250.00-$350.00
$$$$$ = $350.00 or more

The listed retail price for the book is $259.99, which seems to me like a pretty fair price for a comprehensive ophthalmology textbook.  Of course, if you shop around online, there are always different deals/discounts available.  I think Elsevier, the publisher, typically runs 20-30% discounts on their textbooks if you purchase directly from them.  Amazon has similar discounts and may offer better deals through their Marketplace.  If you’re not hung up on getting a brand new book so that you can gain online access, purchasing the book used may be a more affordable solution as well.

I ended up finding the book at an incredible deal on Amazon – $155.47 (a 59.8% discount)!  Unfortunately, since I bought the book the price has risen to $180.56 (still a 31% discount), but it makes me that much happier I bought the book when I did.

Overall Rating:  4.5 out of 5

I believe that Kanski’s Clinical Ophthalmology is one of the most popular general ophthalmology textbooks out there.  Its popularity is justified – it covers the basic topics and provides just enough detail to be useful in most situations.  Whether you’re learning ophthalmology for the first time, preparing for OKAP/board exams, or trying to remember some detail years down the road to help one of your patients, this text is a fantastic reference.

I bought the 7th edition during my 2nd year of residency.  Up until then, I had solely been using the AAO’s Basic and Clinical Science Course to study.  While certain topics lack the depth or breadth of the BCSC, there were some aspects of clinical disease that Kanski was able to explain much better, such as the basics of diabetic retinopathy and macular degeneration.  Since I bought the book, I used the 7th edition to study for OKAP my last year of residency, for the written board exam, and for the oral board exam.  Upon first glance, it doesn’t look like there is much change to the actual content, but I look forward to looking through the new layout and using it as a reference to bring you the highest quality content for ophthalmology.


What are your thoughts on Kanski’s Clinical Ophthalmology, 8th Edition?  Leave a comment or e-mail me at ophthreview [at] gmail [dot] com!