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.

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DiscussionIt is unclear why pamidronate should have a selective effect in inducing an inflammatory reaction in the orbital tissues, with no apparent effect on muscle function elsewhere in the body. It is probable that the intraorbital inflammation and consequent oedema involved the recti muscles during both the episodes. If the effects of intraorbital oedema on muscle function were not equal bilaterally, as is evident from Hess chart (Figure 1) recorded during the second episode, then diplopia during conjugate eye movements would be expected. Diplopia in the primary position may have been due to breakdown of a small pre-existing vertical phoria, although none was clinically evident when he was assessed after resolution of the second episode.

Aims To assess the impact of primary injection of intravitreal antibiotics and delayed pars plana vitrectomy with removal of intraocular foreign body (IOFB) in patients with clinical features of bacterial endophthalmitis and retained IOFB. Methods Retrospective review of all patients with clinical features of infective endophthalmitis and a retained IOFB who had immediate injection of intravitreal antibiotics and delayed pars plana vitrectomy with removal of IOFB in two vitreo-retinal centres during 1995-2001. Nine patients were identified and minimum follow-up was 3 months. Results Four of the nine patients had a final visual outcome of 6/18 or better. One patient developed total retinal detachment. Conclusions The current series suggests that immediate injection of intravitreal antibiotics with delayed removal of IOFB in eyes with clinical features of infective endophthalmitis and a retained IOFB is a possible alternative to immediate removal of IOFB. This management may be associated with preservation of the eye and restoration of useful visual acuity.