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we elected to manage these patients conservatively. In such cases prophylactic laser retinopexy or transscleral retinal cryotherapy around the wounds may be unnecessary, as there is often adequate spontaneous chorioretinal scarring to seal the entry and exit wounds.It is notable that case 1 had retinal oedema secondary to retinal arterial occlusion and that this subsequently resolved without any significant sequelae (visual field testing was normal).The ocular injuries were caused by slender, sharp tipped objects leading to minimal contusional tissue disruption, allowing conservative management. In this respect these injuries are analogous to the penetrating injuries caused by sharp needles as a complication of retrobulbar or peribulbar anaesthesia.9,10 It is notable that Optic disc involvement is a rare complication of herpes zoster ophthalmicus (HZO) occurring typically on the ipsilateral side.! We present a case where the onset of HZO was heralded with contralateral optic disc swelling.To our knowledge, this has not been reported previously in the literature. Case reportA 70-year-old man presented with a 1 week history of intermittent blurred vision in his right eye associated with a ring-shaped floater. He also had a 3-4 day history of a left-sided headache which he described as a piercing pain particularly affecting his temple. There was no jaw claudication, systemic symptoms or other ocular history of note. Relevant medical history included myocardial infarction 11 years previously and hyperlipidaemia.Medications included daily aspirin and allopurinol. The patient was an ex-smoker of 10 years.On examination, visual acuity (VA) was 6/12 in the right eye improving to 6/9-1 with pinhole and 6/6 in the left eye. Anterior segment examination was normal as were the intraocular pressures and there was no relative afferent pupillary defect. Dilated fundal examination revealed a right swollen optic disc with peripapillary haemorrhages (Fig. 1).The right macula was normal and examination of the left fundus was unremarkable. There was no temporal tenderness and the patient had bilateral pulsatile temporal arteries. Neurological and systemic 251

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