Merkel cell tumour is a rare primary malignant tumour of the skin that can affect the lids and periocular region. It has a high rate of recurrence and metastasis following surgical excision and an overall mortality rate of 20-33%. Clinically, it is difficult to distinguish from other malignancies and the diagnosis requires careful histological analysis and immunocytochemical staining. A case of Merkel cell tumour affecting the lids and originally misdiagnosed is presented. Correct diagnosis was made only after the appearance of a second Merkel cell tumour on the contralateral lid. The pathogenesis, clinical progression, histology and management of this difficult condition are reviewed.

Primary ocular blast injury is an uncommon and disputed phenomenon. As personal ballistic protection of the head and torso improves for soldiers, increasing numbers of injuries to the unprotected areas such as the face and eyes may be expected; similarly the increase in the use of improvised explosive devices by insurgent terrorists in Iraq is increasing the number of primary blast injuries being seen by the Defence Medical Services. We report a rare case of primary blast injury to the eye and briefly discuss the literature on the subject.

The incidence of endophthalmitis following pars plana vitrectomy remains low.

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We have developed a simple and safe technique to remove extruded Miragel explants, reducing the risk of fragmentation.

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We report a case of a 66-year-old man who had bilateral laser in situ keratomileusis and 6 months later, uneventful simultaneous bilateral cataract surgery. One week postoperatively, the visual acuity was reduced and 4 weeks later, the patient was referred to our clinic with a macular hemorrhage in the right eye and bilateral cystoid macular edema. He was treated with bilateral sub-Tenon's triamcinolone, which had to be repeated in both eyes, and is still being followed.

A 37-year-old Afro-Caribbean woman with Marfan syndrome presented with a history of blurred vision in the right eye for 7 days. Her medical history included cardiomyopathy with congestive heart failure.