The frequency of major and minor complications fell sharply after the first 150 operations and was maintained. This study may provide a guide for beginning phacoemulsification surgeons and a basis for experienced surgeons to compare their performance outcomes.

Primary phacoemulsification with the option of future trabeculectomy should be considered in selected patients with persistent appositional angle closure and uncontrolled IOP after angle-closure glaucoma.

SUMMARY A patient who had been observed to have an iris microhaemangioma (capillary haemangioma), confirmed on fluorescein iris angiography, came to cataract surgery. The lesion was excised at the time of surgery and submitted to light and electron microscopic study. It had the features of a hamartoma of the capillary haemangioma type, with its characteristics being specific for vessels seen in iris tissue.Iris microhaemangiomas (IMHs) (capillary haemangiomas) are vascular tufts usually found at the pupillary margin, but occasionally they are situated in the anterior stroma. Usually they are found in older people (over 60 years) and are better seen with an undilated pupil. Their association with diabetes mellitus, chronic obstructive airways disease, and myotonic dystrophy has been noted. 4

Exophthalmometry, the quantitative assessment of the position of the globe in the orbit, is a clinically useful measurement. The purpose of this study was to examine the performance of a simple exophthalmometer that would lend itself to accurate and convenient use in clinical practice. In this study, two observers independently performed exophthalmometry on 100 eyes using the Hertel and Luedde instruments. The results were compared between instruments and between observers. There was no statistically or clinically significant difference between measurements taken with the Luedde as compared with the Hertel instrument. The Luedde exophthalmometer has a number of advantages over the Hertel exophthalmometer, and represents a simple, inexpensive and equally reliable means of evaluating clinically the anteroposterior position of the eye in the orbit.Key words: Exophthalmometry, exophthalmos, Hertel, Luedde, proptometry, proptosis.Exophthalmometry may be defined as the measurement of the distance between two parallel planes, one tangent to the apex of the cornea with the eye in the primary position, the other passing through the lateral orbital margin.It provides a quantitative clinical measure of the position of the eye in the orbit. Absolute exophthalmometry depends on radiological assessment, the result being compared with a normal value. This method is not clinically applicable because of the many variables which include orbital linear dimensions and volume. In serial exophthalmometry, the clinical measurements are compared over time and in relative exophthalmometry, the results on the two sides are compared.Exophthalmometry provides clinical measurement of proptosis or enophthalmos, which is of value in evaluating patients with orbital disease or abnormal globe size. Apparent proptosis, such as lid retraction, can be distinguished from true proptosis. Quantitative assessment is particularly valuable in serial measurements, for example while monitoring the course of proptosis in management of thyroid orbital disease. Exophthalmometry, as a parameter to assess orbital disease, together with clinical examination, visual field assessment and organ imaging techniques facilitates management and decisionmaking. With this in mind, it is important that any instrument measuring proptosis be portable, readily available, and quick to use. Any result must be reproducible between observers and over time.The terms exophthalmos and proptosis are both derived from Greek, and mean 'protrusion of the eye'. To many clinicians, exophthalmos may have implications of thyroid orbital disease. Although exophthalmometry is currently stan-

A 77-year-old artist having endocapsular phacoemulsification surgery and intraocular lens implantation illustrated her visual impressions of the procedure in 6 stages, from draping to lens implantation. Her illustrations and commentary indicate that she experienced clear visualization of instruments and colorful abstract imagery. These paintings were shown to 30 consecutive patients to assess their usefulness in preoperatively informing and preparing patients for surgery. With the widespread use of local and topical anesthesia, it is pertinent to the ophthalmic surgeon to understand what patients may seen when vision is retained during the procedure.