Aims-This study was designed to assess the relative efficacy of topical ganciclovir 0.15% gel and acyclovir 3/o ointment in the treatment of herpes simplex dendritic keratitis. Methods-Both treatment modalities were administered on a five times daily basis to patients suffering from herpes simplex keratitis. Patients were assigned randomly to one of the two treatment groups for the purpose of the trial. They were then examined on days 2, 7, 10, and 14 to assess the rate of healing of the dendritic ulceration. Results-There was no statistically significant difference detected in the rate of healing between the two treatment groups over the course of the trial. Conclusions-Review of the relative efficacy of topical ganciclovir and acyclovir in the treatment of herpes simplex dendritic keratitis showed that both treatment modalities were equally effective in their ability to heal the viral induced corneal ulceration. There were no significant side effects or adverse effects reported for either treatment modality.

A retrospective analysis was carried out of all patients attending the casualty department of Southampton Eye Hospital during 1 February to 31 July 1983. During the six month period 8092 patients made a total of 13 544 visits. Of these patients, 6178 were attending the hospital for the first time and 1914 had previously been seen in the outpatient clinic; many did not fall into the category of "accident and emergency." Some 37% of patients were managed by the ophthalmic nurse alone.The findings show that the department was providing a service far in excess of its defined function, which suggests that the structure of the acute ophthalmic services may require change. Certainly the value of the ophthalmic nurse was beyond question, her active participation in management allowing the doctor more time with the more complex clinical problems and thus enhancing efficiency. IntroductionThe casualty department at Southampton Eye Hospital provides a 24 hour service for acute ophthalmic conditions in south west

Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

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