Editor,—It is well established that early intravitreal antibiotics are the treatment of choice for bacterial endophthalmitis1 but the choice of antibiotics remains controversial.2-5 Most centres rely on combination therapy and aminoglycosides are often used to treat Gram negative organisms. Aminoglycosides have a narrow therapeutic index and therefore a relatively small increase in concentration can cause significant toxicity. Following concerns about the risks of retinal toxicity caused by intravitreal gentamicin many ophthalmologists now use 0.4 mg intravitreal amikacin even though its use has also been associated with retinal toxicity.2 3We report a case of retinal toxicity in a patient treated with intravitreal amikacin for postoperative bacterial endophthalmitis. This case serves to …