A cohort of 4,792 infants was observed in order to determine the incidence and natu ral history of epiphora during the first year of life. Evidence of defective lacrimal drainage was present in 964 (20%) at some time during the year. 9S�/o became symp tomatic during the first month of life. Spontaneous remission occurred throughout the year and 96% had resolved before the age of one. This study provides no evidence to support probing before the age of one year.

Aims-To investigate the current causes and outcomes of paediatric ocular trauma. Methods-A prospective observational study of all children admitted to hospital with ocular trauma in Scotland over a 1 year period. Results-The commonest mechanism of injury was blunt trauma, accounting for 65% of the total. 60% of the patients were admitted with a hyphaema. Injuries necessitating admission occurred most frequently at home (51%). Sporting activities were the commonest cause of injury in the 5-14 age group. There were no injuries caused by road traYc accidents or fireworks. Patients were admitted to hospital for a mean of 4.2 days (range 1-25 days). One (1%) child had an acuity in the "visually impaired" range (6/18-6/60) and one (1%) was "blind" (6/60) in the aVected eye. No child was bilaterally blinded by injury and none required blind or partial sight registration. Conclusion-This study has shown that the incidence of eye injuries aVecting children has fallen. The outcome of ocular trauma has improved significantly, and for the first time paediatric injuries appear to have a better prognosis than injuries aVecting adults. (Br J Ophthalmol 1999;83:933-936)

Aim To investigate and correlate the corneal, refractive, topographic and familial characteristics of a large cohort with keratoconus. Methods Prospective observational study of 200 consecutive patients presenting with keratoconus during the 4 year-period 1997-2000. Subjects were examined at enrolment and at a final review. Data were collected on demographic characteristics, referral route, symptoms, refractive correction, eye rubbing, family history, medical history, slit-lamp biomicroscopic corneal signs, and computerized corneal topography. Results Mean age at enrolment was 30.9710.4 (range, 12.2-72) years (N ¼ 200, 62.5% male, 93% white Caucasian) with a 5% family history of keratoconus. Atopic diseases included asthma (23%), eczema (14%), and hay fever (30%). Only 9% wore contact lenses before referral. Mean follow-up was 1004 days 7282 (range, 390-1335) and 9.778.9 (range, 1.1-60) years from diagnosis. The mean simulated K1 corneal power at enrolment was 51.7475.36 (range, 42.59-67.32) D and 88.5% exhibited bilateral keratoconus. Fifty-three (15%) topographically confirmed cones exhibited no clinical corneal signs at presentation. At enrollment, 56% had a pachymetry o0.480 mm increasing to 77% at final review. Forty-eight percent of subjects reported significant eye rubbing and there was a highly statistically significant difference (two sample t-test P ¼ 0.018) between keratoconus and control groups. TMS-2 axial corneal power was strongly associated with corneal scarring and age at diagnosis. The size of the scarring effect was 2.2 D (95% confidence interval (CI) 1.34, 3.06). Conclusions This study provides an overview of a large population with keratoconus highlighting presenting features and clinical and topographic progression over a 4 year-period.

DCR is an effective and safe method for the treatment of nasolacrimal obstruction. Meta-analysis of outcomes was not feasible because of the heterogenous patient groups and outcome measures used. Nonetheless, the literature provides considerable levels 3 and 4 evidence to support DCR surgery in adults. Outcomes after EN-DCR and EX-DCR were comparable. The failure rate for LA-DCR was higher.

SUMMARY 5671 patients with injuries presenting to a busy eye casualty department were examined prospectively to determine the incidence, aetiology, and severity of the injury. Of these cases 69-9% occurred at work, 18-3% during leisure and domestic activities (excluding recognised sport), 2-3% during sport, and 1-9% were due to assaults; contact lens injury occurred in a further 2-3%, and the cause was unknown in 5 3%. One hundred and two (1-8%) patients required admission to hospital, and of their injuries 13-7% occurred at work, 22 The aim of this prospective study was to determine the incidence, aetiology, and severity of eye injuries presenting to a busy eye casualty department in the United Kingdom over a 12-month period.

Ains-To provide epidemiological data on the current burden of serious eye injuries utilising the hospital eye service, to inform the planning and provision of eye health care, and health and safety strategies for the prevention of ocular injuries. Methods-A prospective observational study was carried out of all patients with ocular trauma admitted to hospitals in Scotland, under the care of a consultant ophthalmologist, during a 1 year period. The population of Scotland represented the population at risk ofinjury.Visual outcome (Snellen visual acuity in the injured eye) was measured at-the time of final discharge from ophthalmic care and at follow up.

Purpose To describe the incidence, features, management, and risk factors of postintravitreal anti-VEGF endophthalmitis (PIAE) in patients undergoing treatment for exudative age-related macular degeneration in the United Kingdom. Methods Prospective observational case control study. Forty-seven cases of PIAE were identified through the British Ophthalmological

There have been few studies primarily concerned with the relative frequencies, aetiologies and prognoses of ocular motor palsies. Those published have emanated largely from neurological tertiary referral centres rather than primary ophthalmology departments. We have performed a retrospective study of all patients with acquired III, IV or VI cranial nerve palsy who were seen in the orthoptic department at Ninewells Hospital, Dundee, over the 9 year period from 1984 to 1992. A total of 165 cases were identified. VI nerve palsies accounted for the majority of patients (57%), with IV nerve palsies (21%) occurring more frequently than III nerve palsies (17%) and multiple palsies (5%). Thirty-five per cent of cases were of unknown aetiology and 32% of vascular aetiology. The incidence of sinister pathology-neoplasia (2%) and aneurysm (1%)-was surprisingly low. Fifty-seven per cent of all patients made a total recovery (in a median time of 3 months) and 80% made at least a partial recovery. The results are contrasted with those of previous studies and the value of associated symptoms and of further investigation in the assessment of these patients is discussed.