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We share Davis, Wilkins and Elliott's concern for reducing pain and discomfort after vitreoretinal surgeryl and read with interest their conclusion that the topical instillation of 0.5% bupivacaine into the surgical field prior to conjunctival closure was ineffective in reducing post-operative pain and analgesic requirements.We have recently conducted a comparable study We would recommend the infiltration of a total of 4 ml of 0.5% bupivacaine evenly divided between the bellies and external sheaths of all exposed rectus muscles (i.e. 1-2 ml per muscle) at the end of a scleral buckling procedure as a safe, effective and complication-free technique for reducing post-opera tive pain and analgesic requirements in patients following scleral buckling procedures.

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found to be absorbed systemically,1-4 it might be expected that adrenaline infused into the posterior segment may similarly be absorbed.As well as the routes by which topical adrenaline may be absorbed there is the potential for further absorption occurring via the ciliary body, iris and choroidal vasculature.We aimed to find out whether there was significant absorption of administered adrenaline. MethodsThe study followed the tenets of the Helsinki