Preface

This book has a proud history. It has served as a guide for treating patients with glaucoma to ophthalmologists and other eye care providers throughout the world for more than four decades.The book was originally conceived and written by Drs Bernard Becker and Robert N Shaffer. It was later revised through multiple editions by Allan Kolker and John Hetherington Jr and, more recently, by H Dunbar Hoskins Jr and Michael A Kass. This eighth edition, as well as the seventh edition, is the product of the second and third generation of glaucoma specialists who trained and/or practiced in St Louis or San Francisco, and thus were privileged to be mentored by the original authors as well as their second generation students.

We have followed the lead of our mentors to summarize our clinical experience with glaucoma and to interpret in a practical way the current, voluminous literature about glaucoma and its management. Our understanding of glaucoma and its treatment have undergone significant change in the last two decades. In the last decade alone, significant advances have been made in epidemiology, genetics, and pathophysiology. Diagnosis has been augmented by more sophisticated intraocular pressure measurement, psychophysical testing, and optic nerve analysis. Imaging of the optic nerve and the anterior segment has become widely utilized. The classification of the glaucomas has been updated to reflect the new findings in genetics, diagnostic modalities and epidemiology, compelling us all to reassess risk factors and to entertain the diverse influences on glaucoma’s manifestations. Treatment has undergone a major change due to new pharmaceutical agents and innovative surgical options. Therefore, the book has undergone an extensive updating with expanded text, bibliography and illustrations. Our overarching goal in writing has been to provide the reader

guidance in conceptualizing the sciences of diagnosis and in individualizing the choices for treatment. Glimpses into the possible intervention of the future are given. We hope that the reader, like us authors, will come to humbly understand what we do and still do not know about the glaucomas.

In one major aspect, this edition differs from previous editions. Because of the exponentially expanding knowledge base related to glaucoma, we three principal authors recognized our individual limitations of expertise and called on our colleagues for assistance in specific areas. We wish to gratefully acknowledge and thank Drs Murray A Johnstone, Michael S Berlin, John Samples, Jeanette Hyer, Robert J Noecker and Larissa Camejo for their contributions, respectively, on aqueous outflow physiology, laser treatment, genetics, and optic nerve imaging. They have graciously authored or reviewed the respective chapters of their expertise. However, we have tried to maintain what has always made the Becker-Shaffer texts so appealing: the coherence of an authored, rather than an edited, text, explicating how we three glaucoma consultants apply the literature and our experience to the management of patients.

As in previous editions, our emphasis has been to provide, in one comprehensive volume, information from the clinician’s viewpoint, to enable an individual engaged in the management of the glaucomas to do so effectively and with understanding. Ultimately, our goal is to reduce vision loss and improve the quality of life for our patients.

Robert L Stamper, MD

Marc F Lieberman, MD

Michael V Drake, MD