SummaryIntra-ocular pressure was measured before and throughout airway establishment with either the laryngeal mask airway or tracheal tube. Similar measurements were made on removal of either airway and the amount of coughing noted in thejrst minute after removal. There was a significantly smaller increase in intra-ocular pressure ( p < 0.001) using the laryngeal mask airway, both on placement and removal, than with the tracheal tube. Postoperative coughing was significantly reduced using the laryngeal mask airway ( p < 0.001). There was a significantly greater rise in heart rate using the tracheal tube ( p < 0.01) probably related to an increased cardiovascular response. The laryngeal mask airway is recommended as an alternative to tracheal intubation in routine and emergency intra-ocular surgery.

All the patients (73) in the Rheumatology Department five year study of second line therapy who have taken hydroxychloroquine (Plaquenil) for rheumatoid arthritis for longer than 18 months were reviewed. These patients have their treatment dosage carefully monitored and have been receiving regular ophthalmic examinations. Most patients still taking the drug were assessed with a battery of tests for evidence of retinal toxicity. No retinal toxicity causing visual loss was found. On the basis of these results and a review of the recent literature we no longer routinely screen patients for hydroxychloroquine retinal toxicity in Cardiff.

SUMMARYThirty-three ocular hypertensive patients (21 with primary open angle glaucoma and 12 glaucoma suspects) were randomly assigned to receive either timolol, levobunolol or betaxolol in one eye. Pulsatile ocular blood flow (POBF) was measured before treatment (baseline) and 2 hours after drop adminis tration. After 1 week of regular twice-daily dosage, POBF was measured again both immediately before and 2 hours after drop instillation. All measurements were made by an investigator masked to treatment.POBF increased by 11% (p = 0.09) at week 0 after levobunolol administration, and by 22% (p = 0.20) at week 1 before drop administration compared with baseline. It dropped by 23% and 25% (p = 0.04 and 0.06, respectively) before and after betaxolol adminis tration at week 1. Although POBF was reduced in the timolol group, this change was not significant. These results can not be explained uniformly by changes in intraocular pressure or blood pressure. The relevance of these measurements to visual function in glaucoma is not known.

SUMMARYIn a prospective, randomised, masked trial, 91 patients undergoing intraocular surgery received an anaesthetic mixture containing lignocaine hydrochloride 2 % and bupivacaine hydrochloride 0.5 %. In addition group 1 had hyaluronidase (50 i.u.!ml) and adrenaline(1:200,000), group 2 had hyaluronidase alone, group 3 had adrenaline alone and group 4 had neither. The groups were compared regarding the quality of operating conditions. Hyluronidase had a substantial beneficial effect though there was no significant difference related to the use of adrenaline. Anaesthesia was less effective in patients under the age of 65 years.