We measured the range of equatorial horizontal widths (EHW) in axially myopic eyes and identified the sites of staphyloma using B scan echography. One hundred eyes in 50 patients were studied. The axial lengths (ALs) were sorted into five groups of increasing severity of myopia. The group mean AL, group mean EHW and the ratio of EHW/AL was calculated for each range. The results suggest that the increase in the AL in an axially myopic eye is associated with an increase in the EHW. However, this increase in the group mean EHW is relatively small (2.3 mm) compared with the increase mean AL (8.2 mm) across the entire range. The ratio of EHW/AL decreased with an increase in the group mean AL. Therefore, the increase in EHW in an axially myopic eye is unlikely to be a significant risk factor for inadvertent ocular injury for peribulbar injections if a careful single medial canthal approach is used. There was high incidence of staphylomas in eyes with AL > 29 mm, most were inferior to the posterior pole of the globe, and there were none at the equator.

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Purpose To evaluate the visual experiences of patients during vitreoretinal surgery under local anaesthesia (LA). Methods Prospective questionnaire survey of 80 patients within 30 min of completion of vitreoretinal surgery under LA. Preoperative visual acuity, surgical procedure and its duration, efficacy of the local block, as well as intraoperative perceptions of flashes, colours, movements, and seeing instruments were documented. Results A sub-Tenon's block was performed in 62/80 (77.5%) and a peribulbar block in the remainder. Overall, 72 (90%) of patients perceived light at some stage during their surgery. Of these, 51 (70.83%) observed movements, 45 (62.5%) saw colours, 38 (52.77%) saw instruments, and 24 (33.33%) saw flashes. The commonest observations were colourful swirls, black pipes, and the colour red. Most patients found these experiences pleasant or bearable; two found them frightening, and four would like to have been warned preoperatively about them. Preoperative visual acuity, diagnosis, gender of the patient, degree of akinesia, and the duration of surgery did not associate with visual perceptions. Logistic regression analysis showed that younger people were more likely to experience flashing lights (P ¼ 0.03) and to see instruments (P ¼ 0.04), patients having a sub-Tenon's block to perceive light (P ¼ 0.005), and those who did not receive awake sedation were more likely to see instruments (P ¼ 0.04). Conclusions Visual experiences are common during vitreoretinal surgery undertaken under LA. Where appropriate, patients should be forewarned about these experiences and reassured that they are not normally frightening.

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Power grip and thumb key pinch strength were measured pre- and immediately postoperatively in 30 patients with carpal tunnel syndrome while the wrist was in flexion and extension. The carpal tunnel decompression was performed under local infiltration with 1% lignocaine. Grip strength decreased more in wrist flexion than in wrist extension. No difference was found in thumb pinch strength. The authors conclude that some of the immediate postoperative loss of grip strength in wrist flexion can be attributed to prolapse of flexor tendons out of the carpal tunnel in this position.