Fire safety in the eye theatre

Recently while doing cataract surgery, I saw a visiting student wandering across our theatre unaware that he was trailing flames from his gown. Deserting my patient, I beat on the back of the unsuspecting student with my surgically gloved hands (!) to put out the flames. The student was not harmed except for a hole in his gown, though my hands were a bit scorched, and the seeds of this article had been sown. Fire in the eye theatre is, fortunately, a rare occurrence. Should there be an outbreak of fire, however, there is serious risk of injury to patients, who because of blindness and age may be less able to make a quick escape, also to staff and students, especially at times of greater risk (e.g. if the theatre is busy and crowded). The three theatre fires of my experience have all been due to the use of a methylated spirit lamp as a low-cost means of heating cautery. Although economical, the method has a number of disadvantages: