Peribulbar anesthesia is a safe alternative to retrobulbar anesthesia for ophthalmic surgery. Because the anesthetic is deposited outside the muscle cone, the potential for intraocular or intradural injection is greatly minimized. Furthermore, intraconal hemorrhage and direct optic nerve injury is avoided. We illustrate the details of our technique for posterior peribulbar anesthesia and describe our experience in over 3,000 cases.

The authors have used 2% methylcellulose in 8,000 cases of intraocular lens implant surgery during the last five and a half years. Their surgical experience and investigations have convinced them that methylcellulose is safe and effective besides being convenient and economical. It is easily autoclavable, has very low particulate matter when prepared by the author's technique, and causes minimal secondary rise of intraocular pressure. The endothelial protective function and breakdown of the blood aqueous barrier are comparable to that of Healon. The authors consider methylcellulose to be the better alternative for IOL implant surgery.

The microsurgical instruments should be chosen such that they are less than 10cm long, made of titanium, dulled, have very little closing pressure and the working parts do not open more thanl0mm. They should be cleaned with ultrasonic cleaners and sterilised preferably by Ethylene oxide, though Cidex and dry heat can also be used.

The role of A.C. IOL in modern implant surgery has become somewhat debatable, since, the choice procedure to day is undoubtedly an ECCE with a PC lens implant preferably in the capsular bag. Even so, anterior chamber lens implantation has its definite indications. As such it is necessary for the implant surgeon to be familiar with the latest technique in this modality of surgery as well. Many of the complications of earlier rigid model AC IOLs were mainly due to defective lens design. With the advent of new generation flexible one-piece PMMA AC lenses, many of these complications have been eliminated. A.C. IOL implantation, although less frequently done now, has its own legitimate place in modern IOL surgery.

The first 500 posterior chamber lenses inserted in the cap­sular bag, have been analysed in detail. The cases in­cluded in this study were developmental, traumatic and complicated cataracts in addition to senile cataract. The follow-up ranged from 6 months to 2 years. Although posterior capsule rupture occured in 23 cases, the lens was inserted in 12 cases with a small tear. In general the com­plications were found to be minimal and visual recovery was good in more than 80 % of the cases. The only problems we have been facing were thickening of the posterior capsule (11.6 %), high astigmatism (12.2 %), pupillary capture (5.6 %) and decentering of the lens (2.8 %).

Analysis of complications in 1000 cases of primary posterior chamber intraocular lens implantation done, during a period of one year was undertaken for the study. The cases included uncomplicated as well as those with various associated conditions like diabetes, traumatic cataracts, complicated cataracts, myopia and develop­mental cataracts. The important postoperative complica­tions were uveitis (9%), endophthalmitis (0.5%), malposition of IOL (2.8%) and cystoid macular edema (0.3 %). Posterior capsule opacification was seen in 11.5 % of cases and was treated by YAG laser capsulotomy. More than 80% cases had 6/6-6/12 vision. In our ex­perience posterior chamber IOL implantation has become an extremely successful and satisfying procedure along with the availability of YAG laser facility to manage posterior capsule opacification.

Phakoemulsification as a procedure is only complete with flexible foldable lens Preliminary studies show good ac­ceptace of the procedure though the injector is cumber­some. Phakoemulsification has now become a reality with advanced instrumentation techniques available. Phakoemulsification has to its greatest advantage the ability to remove a cataract though a 3mm opening. Not only does this enhance the safety and the speed of healing, but it reduces postoperative astigmatism significantly. However, the very advantages listed above stand negated if the wound is to be opened to 6mm to accommodate an implant. The extra effort needed as compared to regular extra cap­sular cataract extraction, the enhanced cost of the in­strumentation, the more sophisticated technique needed and the superior magnification devices required were all rendered negative till the flexible lenses made their debut. With foldable lenses, phakoemulsification has come into its own. Thomas Mazaco was first credited with the concept of folding and inserting lenses. The ocular lenses were fol­dable with a forcep (Faulker Folder) and inserted into the eye through a 4 mm incision. It was a tight fit and the com­pression exerted by the forceps often left a bend on the lens. These problems led to the manufacture of a injective inserter which was in essence a single metal syringe with a piston, either longitudinal pressure or screw movement. Of these the Bartel injector was perhaps the earliest. Now virtually every company making flexible lenses has come out with an injector. The Staar Softrans injector has proven in my hands to be the most useful of all these devices. as a procedure is only complete with flexible foldable lens. Preliminary studies show good acceptance of the procedure though the injector is cumbersome. Phakoemulsification has now become a reality with advanced instrumentation techniques available. Phakoemulsification has to its greatest advantage the ability to remove a cataract though a 3mm opening. Not only does this enhance the safety and the speed of healing, but it reduces postoperative astigmatism significantly. However, the very advantages listed above stand negated if the wound is to be opened to 6mm to accommodate an implant. The extra effort needed as compared to regular extra capsular cataract extraction, the enhanced cost of the instrumentation, the more sophisticated technique needed and the superior magnification devices required were all rendered negative till the flexible lenses made their debut. With foldable lenses, phakoemulsification has come into its own. Thomas Mazaco was first credited with the concept of folding and inserting lenses. The ocular lenses were foldable with a forcep (Faulker Folder) and inserted into the eye through a 4 mm incision. It was a tight fit and the compression exerted by the forceps often left a bend on the lens. These problems led to the manufacture of a injective inserter which was in essence a single metal syringe with a piston, either longitudinal pressure or screw movement. Of these the Bartel injector was perhaps the earliest. Now virtually every company making flexible lenses has come out with an injector. The Staar Softrans injector has proven in my hands to be the most useful of all these devices.

I.O.L. either primary or secondary has proved to be use­ful after traumatic cataract extraction. Problem of binocular single vision will be better solved and the traumatic eye becoming divergent and amblyopic can thus be avoided.

Estimation of plasma cortisol by flurometric technique desorbed by Maltingly's was carried out in 56 cases, in­cluding 38 cases of myopia (19 cases of simple myopia and 19 cases of degenerative myopia) and 18 normal in­dividuals.Urinary 17-keto steroids/24 hours was also es­timated by Zimmermann technique in 12 out of the 56 cases, which include 8 cases of myopia (4 cases of simple myopia and 4 cases of degenerative myopia) and 4 normal individuals as control.Plasma cortisol level is lower in simple and degenerative myopia than in normal subjects, but on statistcial analysis the difference was not of much significance. Patients with simple myopia with positive family history showed lower value of plasma cortisol than patients with simple myopia with negative family history, the difference was also statistically insignificant (P-0.1). In degenerative myopia patients, with and without family history, there was very little difference in plasma cortisol level and statistically highly insignificant (P-0.8). Urinary 17 keto steroid/24 hour values are lower in simple and degenerative myopia than in normal subjects.

A total of 102 cases of clinically diagnosed cases of acute conjunctivitis were included in the present study. The sample was collected from the inflamed conjunctiva and was subjected to conventional bacterial and fungal cul­tural studies. The allergic element was found out by studying the smear after Giemsa staining and demonstrat­ing increased number of eosinophils. The data revealed that 32 samples had an evidence of bacterial infection, 14 showed isolation of fungi and one displayed an allergic etiology. Thirty cases showed presence of mixed infection in different combinations while 25 samples were sterile on conventional culture media. Microbiological studies are essential for confirmation of clinical diagnosis' and to in­stitute an appropriate treatment.

This study is aimed at presenting the profile of ocular lesions observed in the inmates of a leprosy rehabilitation centre. Corneal involvement was found to be the highest (52.7%), followed by lesions of the eyebrows (47.3%) and eyelids (30.9%), uveal tract involvement (18.1%) and chronic conjunctivitis (1.8%).

Tuberculosis is a ubiquitous disease and a public health problem of major importance in almost all countries. The disease can involve any part of the body. Eye involvement to tuberculosis is also common. A case of bilateral tuber­cular lid abscess without any active systemic involvement is being reported because of its rare occurance.

A rare case of Hydatid cyst of the orbit causing, unilateral axial proptosis is reported. The presence of gross unilateral papilloedema misled us to the character of the cystic swelling causing axial proptosis.