BackgroundLASIK (Laser in Situ Keratomileusis) is a very popular combined surgical and laser procedure, which is used to correct myopia (shortsightedness) and hyperopia (farsightedness). There is concern that the public is being misled regarding the safety of the procedure. very popular combined surgical and laser procedure, which is used to correct myopia (shortsightedness) and hyperopia (farsightedness). There is concern that the public is being misled regarding the safety of the procedure.ObjectivesTo assess the quality and quantity of the information on complications on LASIK Web sites. information on complications on LASIK Web sites.MethodSerial analysis and evaluation of the authorship, content, and technical quality of the information on the complications of LASIK on 21 Web sites. content, and technical quality of the information on the complications of LASIK on 21 Web sites.ResultsOf the 21 LASIK Web sites visited, 17 were commercial. Of the 21 Web sites, 5 (24%) had no information on complications. Of the 16 sites that had information on complications the author of the information was clearly identified in 5 (31%), the content was only referenced in 2 (12.5%), and evidence of the information having been updated was only seen in 2 (12.5%). The quantity of information is generally minimal and the information itself is generally difficult to understand and locate. commercial. Of the 21 Web sites, 5 (24%) had no information on complications. Of the 16 sites that had information on complications the author of the information was clearly identified in 5 (31%), the content was only referenced in 2 (12.5%), and evidence of the information having been updated was only seen in 2 (12.5%). The quantity of information is generally minimal and the information itself is generally difficult to understand and locate.ConclusionsThe quality and quantity of the information on the Web on the complications of LASIK are poor. More work is required to encourage clear, accurate, up-to-date, clearly authored, and well-referenced, balanced ophthalmic information. on the Web on the complications of LASIK are poor. More work is required to encourage clear, accurate, up-to-date, clearly authored, and well-referenced, balanced ophthalmic information.

Sir, Irreversible neurotoxicity with acyclovir treatment of acute retinal necrosisNeurotoxicity is a rare but recognised side-effect of acyclovir, which typically occurs in those with cancer or renal failure. We report a case of hand paraesthesia in a man who received intravenous acyclovir for acute retinal necrosis. This case is unusual in that it occurred in a healthy man and its effects did not completely reverse. Case reportA previously healthy right-handed 50-year-old toolmaker presented to us with a 10 day history of blurred vision in his right eye. Visual acuity in this eye was 6/18 unaided, improving to 6/9 with a pinhole, and there was a granulomatous anterior uveitis, papillitis, retinal necrosis, localised retinal detachment and vasculitis. The left eye was never involved. He had no history of neurological disease, previous hand trauma and was on no medication. Acute retinal necrosis was diagnosed and the patient was admitted and received a week's course of intravenous acyclovir 850 mg t.d.s. (32 mg/kg/ day) plus 80 mg prednisolone orally. The intravenous cannula was placed in a vein in the antecubital fossa of his left hand. Approximately 3 days later he developed numbness and tingling over the palmar surface and fingers of his right hand. The patient did not inform the staff of these symptoms and the acyclovir was continued. His ocular condition improved and he was discharged on va1cyclovir 1 g t.d.s. (which was continued for 6 weeks) and prednisolone 60 mg for the right eye. Having stopped the acyclovir his neurological symptoms improved over 3-4 months but currently, 2 years later, he still suffers residual stable paraesthesia. Current neurological assessment indicates reduced pinprick sensation over the ulnar region of the right palmar surface but no muscle weakness. Unaided visual acuity in his right eye is counting fingers improving to 3/60 with a pinhole. Comment Acyclovir selectively inhibits viral DNA polmerase. Its side-effects include neurotoxicity,l-7 nephrotoxocitys and hypotension.9 Neurological effects include alterations in mental status (commonest), myoclonic jerks, action tremors, hallucinations, convulsions, ataxia, dysarthria and hemiparaesthesia.l In Haefeli et al.'s4 review of 24 patients only 13% of the reported

A 21-year-old man presented with severe corneal cystinosis and steroid-related cataract bilaterally. Rather than combined cataract surgery and penetrating keratoplasty, the patient had uneventful phacoemulsification and intraocular lens implantation after which visual acuity improved to 66 in both eyes. The outcome indicates that conventional phacoemulsification is sufficient in these cases. A guarded prognosis is advised in patients with cystinosis having cataract surgery as the fundal view is often impaired and there may be associated maculopathy.