Book Review


System Therapy of Macular Degeneration

by Nadim SRADJ

Macular degeneration (MD) is a multifactorial disturbance of the entire visual system. That is, other senses such as hearing, smelling, tasting and memory may be affected in addition to vision. This requires a simultaneous treatment of the whole perception system such as eyes and head.
The present volume addresses to patients, their families, and friends (part 1) as well as to physicians and ophthalmologists (part 2). The scientifical approach of the system therapy is problem-solving based upon epistemology, biology and modern physics of non-linear dynamics.
The 3rd edition is distinguished by big letters which guarantee a facile legibility. As for the content, there are some interesting new aspects: the chapter "International Standard and Current Bases of Knowledge" shows the development of neural sciences. American researchers recently proved that regeneration of nerves is possible. Therefore, the author comes to the conclusion that treatment is indicated regardless of the stage of the disease and the age of the patient in order to mobilize the few remaining functions of the retina and to prevent deterioration.
Logical analysis of the functional brain-theories provides a distinct survey of the different approaches to the nerveous system (self-organization versus input-output reflex theory).
The author discusses the relation between the observing doctor and the patient observed by him (subjectivity versus objectivity). The current conventional view has its origins in the philosophy of Descartes who consiered the human body as a machine moved by causalities. Thus, the interaction between patient and ophthalmologist is characterized as monologue which should be reconsidered and turned into a dialogue between them. Communication can be a source of cognition and scientifical progress. 'Truth and objectivity exist among human beings, but they are non-existent somewhere else', the author stresses in chapter III "Subjectivity and Objectivity of visual Perception" (see also English summary). The different forms of geometries (Euclid and non-euclid-ones) are demonstrated in correlation to the visual mal-perception of MD-patients (metamorphopsia). By means of fractal geometry, pathological visual sensations like asymmetry, disproportions, mal-positions or distorsions - all of these are not measurable phenomena- can be explained.
The meaning of "space", "time" , "matter" and movement is questioned by the anomalies of perception. Following modern physics, findings of measurement in ophthalmology need to be revisited, because visual perception cannot be reduced to mere numerical data. On the contrary it is an experience or a psychological process.
The book is to be regarded as a bridge between science and philosophy surmounting the frontier of pure mechanics. By this, the author puts a different and modified aspect on ophthalmology.
All together, the 3rd edition is a successful enlargement and addition of the first edition of 1999. Fortunately, latest findings in science and methodology are integrated into this revised edition. One wishes that this book will be widely spread not only among affected people but especially among ophthalmologists. Wilfried Stock Baden-Baden / Germany
(translated from German by Dr. Marion Sradj)