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It was an absolute pleasure to review this beautifully written textbook. Authorship is from a diverse, international group of experienced and respected oculoplastic surgeons with an interest in orbital disease.

A significant contribution to most of these chapters has been made by authors such as Drs Jack Rootman, William Katowitz, Robert Goldberg, Bita Esmaeli, Mohamed Javed Ali, Dinesh Selva, Alan McNab, Yoon-Duck Kim and Gangadhara Sundar, to name a few. These authors have themselves authored many of the seminal textbooks or research on orbital disease and their sizeable contribution to this book sets it as a future seminal textbook for orbital imaging.

Orbital imaging is an important aspect in the management of oculoplastic and orbital disorders. Correlation of imaging features with clinical presentation, as well as systemic disease, is required. Clinicians cannot rely solely upon the report of a radiologist, who often may not be aware of all symptoms and signs or may not necessarily be experienced in the interpretation of orbital disease. There has been a void in recent textbooks in the teaching of this important art. The authors of this book have painstakingly compiled a comprehensive array of images that provides a systematic and detailed reference source for the state-of-the-art imaging of orbital disease.

It is divided into 96 chapters, covering a wide range of disorders. The photos and images are of an exceptionally high quality. Descriptions are detailed. It is easy to lose oneself, gazing from page to page, becoming increasingly absorbed in the beautiful anatomical detail from chapter 1 onwards. I found this book incredibly appealing.

Part 1 is titled Orbital Anatomy and has 10 sections covering bones, vascular, soft tissue, sinuses, cavernous sinus, Meckel’s cave. What is particularly unique is how four chapters are devoted to the orbital fissures alone. Part 2 comprises nine chapters devoted to orbital imaging modalities: CT, MRI, CTA, CTV, MRA, MRV, intraoperative dynamic imaging, ultrasound of tumours, ultrasound with Doppler, PET CT and lastly, orbital imaging “pearls”. Part 3 comprises eight chapters on congenital malformations and anomalies. There are six chapters on lacrimal gland tumours, three chapters on lacrimal anatomy and disease, seven chapters on primary orbital tumours, 12 chapters on ocular and eyelid tumours that may extend to the orbit, six chapters on osseus and meningeal tumours that affect the orbit, three chapters on optic nerve tumours, six chapters on vascular malformations, nine chapters on orbital inflammatory diseases, nine chapters on orbital infectious diseases, five chapters covering orbital trauma and two chapters covering periocular fillers, now commonplace yet poorly understood by clinicians interpreting orbital or facial imaging. The textbook comprises 742 pages, including index. One really cannot emphasise enough its comprehensive and in-depth coverage of the topic.

Overall, the book was expeditious, succinct and very easy to read, either as a source of reference or for longer reading. It is straightforward, concise, aesthetically pleasing and extremely well presented. Each chapter starts with an abstract, outlining the aims and highlighting key points. Cases are critically organised with high-quality, contemporary imaging technology. Images are of excellent quality and non-ambiguous with precise labelling and use of arrows / asterix to highlight pathology. I was provided an e-copy of the book to review but I am assured that the hard copy version is of an equally high quality of print.

I showed the book to my fellow who also found the book fascinating. She made particular comment regarding the interesting array of cases, to quote: “…especially the more nuanced – e.g. orbital manifestations of GPA, IgG4 related orbital disease, particularly those showing infraorbital nerves involvement, xanthogranulomatous (despite rarity), 23-year-old girl with fistulous tract post trauma in preseptal cellulitis chapter, retinal artery occlusion post dorsum of nose filler, among others….wide array of diseases also covering the developing world, e.g. cysticercosis, tuberculosis and hydatid cysts., as well as the private sector, e.g. fillers…it was remarkable to see scans post fillers.”

Comparison points and how to differentiate from other diseases are very helpful. For example: “While thyroid eye disease could present with this appearance, the patient had loss of function of the levator with ptosis rather than lid retraction.”

There are no real weaknesses whatsoever to this textbook, only minor observations:

When anticipating the next edition, the authors may wish to improve upon formatting and consistency of referencing. For example, some chapters are well referenced with citations, yet others do not provide any references or citations whatsoever. It is useful to direct the reader to more in-depth articles for further reading that support their statements. The formatting switched to bullet points for the cysticercosis and hydatid cysts sections, whereas other chapters are written in standard prose. A minor point. In the chapter covering myositis, the abstract states that fusiform enlargement of the muscle with tendon sparing is typical; however, Figure 1 mentions that “axial contrast-enhanced CT of a young woman with acute onset orbital myositis of the left medial rectus muscle, with relative sparing of the muscle tendon, which is less common than tendon involvement.” This appears to be a typo. My fellow commented: “The idiopathic orbital inflammation chapter is excellent. Perhaps the authors can highlight when to use MRI / CT scans when suspecting the condition?”

The book fills an important niche by comprehensively describing the appearances of orbital pathologies on orbital imaging. It is an excellent and uniquely positioned book for all ophthalmologists and radiologists, whether experienced or in training, that supersedes any past text on this topic.

I would strongly encourage any ophthalmology or radiology trainee or, for that matter, practising consultant, who encounters orbital disease in their practice to consider acquiring this book either for their personal library or for their department.

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Raman Malhotra

Queen Victoria Hospital, East Grinstead, UK.

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