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Knowledge of the basic science disciplines (pharmacology of the ocular and local anaesthetic drugs, physiology of the eye, anatomy of the orbit and its contents) is essential for safe practice of orbital regional anaesthesia [10]. Observation of, and subsequent initial supervision by, personnel with wide clinical experience and knowledge is recommended. The goal for each practitioner is to build up an experiential database from which increasingly good judgement can result.The anaesthetist should have a good understanding of the operating ophthalmologist's preferred conditions for surgery. Anaesthesia requirements are dictated by the type and operative technique of the proposed surgery, the surgeon's particular preferences and the wishes of the patient. Current techniquesThe requirements for intraocular surgery using regional anaesthesia, as established in the 1950s and 1960s are threefold: globe and conjunctival anaesthesia; globe, lid and periorbital akinesia; and intraocular hypotonia. Desirable operating conditions are attainable safely using relatively large volumes of hyaluronidase-containing local anaesthetics injected appropriately within the orbit. Mechanical orbital decompression devices are used frequently for efficient production of globe hypotonia [3,6]. APPLIED ANATOMYA matrix of connective tissues, which supports and allows dynamic function of the orbital contents, also controls the mode of injectate spread [17]. Globe and conjunctival anaesthesia (conduction block of the intraorbital sensory divisions of the ophthalmic branch of the trigeminal nerve) are achieved more easily than globe akinesia (conduction block of intraorbital portions of the oculomotor cranial nerves III, IV and VI).The oculomotor nerves enter the muscle bellies of the four rectus muscles from their conal surface, %U -$QDHVWK ±

Topical bupivacaine and lidocaine had a longer anesthetic effect, particularly in buffered solutions. No significant corneal toxicity was observed.

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Background: With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. Methods: Two STI clinic nurses encouraged 37 CT positive heterosexual young people (aged 16–25 years), called index clients, to recruit peers from their social and sexual networks using the web-based screening strategy. Eligible peers (young, living in the study area) could request a home-based CT test and recruit other peers. Results: Twelve (40%) index clients recruited 35 peers. Two of these peers recruited other peers (n = 7). In total, 35 recruited peers were eligible for participation; ten of them (29%) requested a test and eight tested. Seven tested for the first time and one (13%) was positive. Most peers were female friends (80%). Nurses were positive about using the strategy. Conclusions: The screening strategy is feasible for targeting the hidden social network. However, uptake among men and recruitment of sex-partners is low and RDS stopped early. Future studies are needed to explore the sustainability, cost-effectiveness, and impact of strategies that target people at risk who are not effectively reached by regular health care.