This hardcover book with a provocative title deals with the diseases of the ocular surface which involve tear production and maintenance. The book’s editors, Gerd Geerling and Horst Brewitt, together with 31 well-known experts from related clinical fields, have succeeded in covering this area of knowledge and contributed to a better understanding on how to approach ocular surface diseases.

The book consists of 325 pages divided into three parts and 21 chapters. In part I, anatomy, physiology and medical management of dry eye are comprehensively described. In particular, the chapters on tear film and functional anatomy and immunological interactions of ocular surface and adnexa are particularly worthy, in that they explain the complexity of the ocular surface system in a very clear and clinician-friendly manner. The tests to diagnose dry eye are clearly presented, with numerous figures and helpful tables. A short overview of medical treatment of dry eye is provided, with an extensive review of substitute tears. In the anti-inflammatory chapter, it would perhaps have been helpful to add some data on the current topical treatments used in dry eye, considering that inflammation plays a pivotal role in the pathogenesis of this condition and in almost all ocular surface diseases.

The special feature of this book is certainly part II, with the description and illustration of the surgical techniques used to manage dry eye. A clear table of contents indicates that this part is divided into three categories dedicated to tear distribution, reduction of tear drainage, and tear replacement. The chapters are well-structured, beginning with an abstract, followed by a short introduction describing the relationship between the anatomical changes of each disease affecting the ocular surface and dry eye. A detailed and step-by-step illustration of the different surgical techniques is provided, with numerous high quality figures and diagrams which make the techniques especially accessible to residents and ophthalmic practitioners. Also, the complications of each procedure experienced by the authors and reported in the literature are clearly stated, making this book suitable also for experienced surgeons struggling with dry eye.

The final part is dedicated to scientific studies, and includes two chapters on clinical trials and animal models of dry eye, providing useful information for the researchers in the field of dry eye, and giving stimuli to new research projects.

Each chapter of the book is followed by an extensive bibliography. Unfortunately, the way of presenting references does not follow a single standard throughout the book.

In conclusion, the text is compact and easy to read, with many colour diagrams and photographic images. It certainly accomplishes the original aims of the authors. Its strength lies in the coverage of the correct approach to ocular surface diseases, focusing on surgical techniques, and including medical treatment. I would highly recommend the book to anyone involved in treating ocular surface diseases.