In the presence of epinephrine in the intraocular irrigating solution, both prednisolone 1% and flurbiprofen 0.03% failed to maintain mydriasis at the crucial steps of nuclear emulsification and cortical I/A.

The acute effect of Conclusion Acute application of pilocarpine 2% drops increased POBF to a significant extent in untreated ocular hypertension.

A case of uniocular visual loss secondary to trauma study in Scotland' showed that over 25 % of contestants sustained during a competitive karate bout is reported.in a karate competition sustained some type of injury (Br J Sports Med 1995; 29: 273-274) and 41 % of these injuries were to the head and neck. (Figures 2 and 3). At the time of discharge he had a disciform scar at the left fovea and an acuity of 3/60 with no possibility of improvement. DiscussionTo the best of our knowledge, this is the first blinding eye injury reported in a karateka. However, rather than view this as an interesting but isolated case, we feel this incident should remind all involved in the martial arts of the risks involved. There are numerous published reports detailing both the frequency and severity of injuries sustained." One American study of the Tae Kwon Do national championships, found that 52% of all injuries involved the head and neck region.2 During the first European knockdown karate championships 53% of the competitors were injured and 30 % of these injuries were to the head and neck.3 These previous reports suggest that under tournament conditions the distinction between those martial arts disciplines that permit full contact and those that do not becomes blurred. This is consistent with previous work that has found that injuries tend to be more severe under tournament conditions than when training.4 There have been several recommendations aimed at reducing both the rate and the severity of injury.

Red-free light in applanation tonometryEDITOR,-Goldmann's applanation tonometry is generally performed using cobalt blue filter and fluorescein in order to obtain accurate localisation of the apex of the tear meniscus. 2The peak transmission value of the cobalt blue filter BG12 on the Haag-Streit slit lamp 900 BM is 0.80 at 400 nm, whereas that of the red-free filter BG39 is 0.965 at 490 nm. The peak absorption value of fluorescein in dilute aqueous solution at physiological tear pH is also at 490 nm.3 Greater intensity of fluorescence and better visibility of the tear menisci could therefore, be obtained by the use of redfree filter. We designed a study to compare intraocular pressure (IOP) measurements obtained using red-free light with those taken with the blue light.Fifty six consecutive follow up glaucoma patients attending ophthalmic clinic during February 1998 were the subjects for the study. The order of testing of the two eyes and the order of use of the filters were determined by random permuted block method. After instillation of 4% lignocaine and 0.25% fluorescein with polyvinylpyrrolidone, and with slit lamp illumination at 7.5 V, both eyes were applanated at the same sitting using both cobalt blue and red-free illumination in succession. Three readings were taken for each illumination and the average was used for statistical purpose. The mean value of IOP of 112 eyes obtained using red-free light was 17.19 (SD 5.14) mm Hg whereas using blue light it was 17.17 (6.44) mm Hg. On two tailed paired t test analysis at the 5% level of significance, the diVerence is not significant.The red-free filter does not diminish the overall light intensity as much as the blue filter. Consequently, the ocular structures are seen more clearly in the background during the procedure. At the same time the tear menisci are seen brightly fluorescent as a result of both to greater overall intensity and more appropriate wavelength of the light. Red-free light applanation tonometry, therefore, achieves optimal visualisation of the tear menisci and accurate estimation of IOP.