Removal of the legislative ban on fireworks in 1996 has had a significant effect on the incidence of eye injuries. These injuries are potentially preventable with stricter control on the availability of fireworks and a greater awareness of the ocular risks they pose.

Aims To report the management and outcomes of sight-threatening diabetic retinopathy in pregnancy. Methods A retrospective review of 8 diabetic females who developed pregnancy related sight-threatening diabetic retinopathy requiring treatment over a 12-year period. Results In total, 16 eyes of eight patients were included in this series. The mean age of the patients at presentation was 30.75 years 73.8 SD and the mean duration of diabetes was 21.0 years 75.1 SD. The mean follow-up period was 46.75 months 747.2 SD. A total of 87.5% of patients showed progression of diabetic retinopathy during pregnancy, 71% of which were in the sight-threatening proliferative category. In the postpartum period, 81% of patients continued to progress to proliferative diabetic retinopathy, requiring panretinal photocoagulation and multiple other surgical procedures. In all, 69% of eyes retained visual acuity equal to or better than 0.3 logMAR units (6/12). Conclusion Sight-threatening diabetic retinopathy in pregnancy is a rare disease, but it can have devastating consequences for mother and child. Laser photocoagulation should be considered for pregnant women with severe preproliferative diabetic retinopathy. Proliferative diabetic retinopathy may not regress postpartum. Close followup should be extended in the postpartum period in this group of patients until the retinopathy is stabilised. The presence of combined rhegmatogenous and tractional retinal detachment and neovascular glaucoma were associated with the worst outcome.

Objective-To evaluate and appraise skin biopsies performed by general practitioners and compare their performance with that of hospital doctors.Design-Retrospective analysis of histology records.Setting Conclusions-The increase in minor surgery has implications for the staffing and finance of histopathology departments. General practitioners must be given proper training in performing skin biopsies, and all specimens should be sent for examination.years. Now increasing in size and itchy, possible malignant change."For comparison we used random number tables to select a similar number of records of skin biopsy specimens from hospital cases during the same period. Cases in which the specimens were more than 3 0 cm in diameter were excluded so that the specimens were similar to those taken in general practice. The same data were recorded for hospital specimens as for the general practitioner specimens, and the data were compared by the X2 test. ResultsWe found a steady rise in the number of skin biopsy specimens received from both hospital surgeons and general practitioners over the past seven years, with a notable increase in specimens from general practitioners mainly since 1988 (table I). General practitioners had excised significantly more specimens from men than had hospital surgeons (x2=5-7, df= 1; p=0 017) and there were significantly more specimens from the head and neck region taken by surgeons than by general practitioners (x2=37, df=2; p<0-00001; table II).Similar numbers of benign naevi and basal cell papillomas were found in both groups, but there was a much higher proportion of basal cell carcinomas in hospital cases and of warts and fibroepithelial polyps in general practitioner cases (table III). The ratio of all

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Background: Glaucoma affects approximately 2% of the population in developed countries and is estimated to affect 67 million people worldwide. The authors investigated the effect of the introduction of new medications on the volume and cost of drugs for glaucoma in two countries, Northern Ireland (NI, population approximately 1.7 million) and the Republic of Ireland (ROI, population approximately 3.9 million) in the 8 years from 1996 to 2003. They also looked at the surgical rates for glaucoma within the same time period for the two countries. Methods: A retrospective analysis was performed of drug costs, prescribing data, and operation rates for glaucoma in Ireland from January 1996 to December 2003. Information regarding costs and volume were obtained for each type of glaucoma drug and these were then grouped into the glaucoma treatment subsections as found in the British National Formulary. The drug information was obtained from the Central Services Agency in NI and IMS Health in the ROI and included both public and private prescriptions. The information on surgical rates for glaucoma was obtained from the Department of Health and Social Services in NI and the Hospital In-patient Enquiry (HIPE) data national files in the ROI. Results: There was a 30% increase in prescription items for glaucoma in NI and a 59% increase in the ROI from 1996 to 2003. The costs increased more rapidly than the number of items: 227% in the ROI and 78% in NI from January 1996 to December 2003. In the ROI, there was an average 19% year on year increase in costs. In NI, new drugs accounted for 40% of the quantity of prescription items for glaucoma and 63% of the market cost in 2003. In the ROI new drugs accounted for 57% of the quantity and 77% of the market cost for glaucoma in 2003; prostaglandin analogue drugs alone accounted for 53% of the cost. The number of trabeculectomies performed decreased by more than 60% in both countries. Conclusion: Volume and cost of glaucoma drugs increased dramatically in both NI and the ROI from 1996 to 2003, probably the result of a combination of changing demographics and a changing approach towards the management of patients with glaucoma and ocular hypertension. In 2003 in the ROI, prostaglandin analogues were the most commonly prescribed class of drug for patients with glaucoma and/or ocular hypertension causing a profound rise in drug expenditure.