Few sight-threatening complications were detected on the morning after an uncomplicated procedure. First day follow-up may be safely omitted if adequate patient counseling is undertaken and there is provision of adequate access to eye services. Review prior to discharge on the day of surgery would provide an opportunity to detect these few surgical complications and for counseling. A diagnosis of glaucoma or ocular hypertension is a risk factor for significantly raised next day IOP and these patients are more likely to experience postoperative discomfort. They may benefit from prophylactic treatment.

We report a case ofpartial avulsion ofthe optic nerve caused by sudden rotation of the globe due to a snooker cue injury. Minimal direct ocular trauma occurred. This case supports the belief that sudden rotation of the globe is the major mechanism of optic nerve avulsion. We include the first results of ultrasound examination that demonstrate optic nerve injury in such a case and believe that, in conjunction with fluorescein angiography and computerised tomography, it is important in the full evaluation of such cases.

SummaryWhilst an anterior chamber lens implant (AC IOL) can be implanted during extra capsular cataract extraction with vitreous loss managed by anterior vitrectomy, lens implantation as a secondary procedure may avoid complications. We reviewed 47 consecutive cases of vitreous loss, 37 managed with primary and 10 with secondary AC IOLs. There was no significant difference in the level of final visual acuity but, as expected, it was reached earlier in the primary group (p