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Editor,—Modern inferior oblique surgery is considered to be a safe procedure with little chance of serious complications.1 2 Monopolar diathermy is known to be a potentially dangerous tool if used inappropriately or injudiciously.3 There have been cases of fires, explosions caused by igniting bowel gas during laparoscopic surgery,3and patient death caused by interference with a cardiac pacemaker.4 Our case demonstrates once again that an inadequate understanding of equipment or its inappropriate use can cause significant injury to the patient.
CASE REPORT
A 22 year old woman presented herself to Moorfields eye casualty department with a 2 day history of seeing a blob in front of her left eye. Her acuity was 6/6 right eye and 6/12 left eye corrected with no improvement with pinhole. Examination revealed left vitreous haemorrhage with bilateral chorioretinal scars in the temporal periphery slightly below the horizontal in each eye (Fig 1, top). The scars roughly corresponded to the possible insertion of the inferior oblique muscles. She had no medical problems, was on no medication, but had a family history of retinal detachment. She had had bilateral inferior oblique myectomy 6 years earlier. Her acuity improved to 6/6 bilaterally when the vitreous haemorrhage had cleared 4 months later but she was left with bilateral scotomas. There …