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Ocular leptospirosis in four patients: A diagnostic dilemma

Ng HR, Cheong MY, Mustapha M

Med J Malaysia, 2021 07;76(4):569-572.
PMID: 34305121

Leptospirosis is a zoonotic disease that is caused by the pathogenic spirochetes of the genus Leptospira. The infection occurs worldwide and is particularly more common in the tropics. However, it is becoming a neglected reemerging global health disease due to rapid urbanisation. This disease has a wide range of clinical manifestations from flu-like illness to pneumonia, acute kidney injury, etc. But many uncommon clinical findings are being reported as well. In this paper, we report four patients who presented initially with uveitic features who turned out serologically positive for Leptospira after extensive investigations.
Evaluation of visual outcomes after toric intraocular lens implantation

Ng HR, Goh CH, Ngim YS, Juliana J

Med J Malaysia, 2017 12;72(6):356-359.
PMID: 29308773 MyJurnal

PURPOSE: To evaluate postoperative visual acuity, refractive status and rotational stability of toric intraocular lens (IOL) in correcting pre-existing corneal astigmatism.
METHODS: A total of 69 patients with topographic corneal astigmatism of 1.0 Diopter (D) and above who underwent cataract surgery between June 2015 and December 2016 were included in this retrospective observational study. All preoperative toric IOL calculations were performed using immersion biometry. Appropriate formula to calculate toric IOL power was applied (SRK/T, Holladay 1 or Hoffer Q formula). All patients undergone similar uncomplicated phacoemulsification with implantation of AcrySoft IQ SN6AT toric IOL of different powers. Visual outcome, refractive status and axis of lens were evaluated at six weeks postoperatively. Ethical approval from the Ministry of Health Medical Research Ethics Committee was obtained prior to commencement of study.
RESULTS: The mean refractive astigmatism decreased from 1.69 D ±1.10 (SD) to 0.81 D ± 0.40 (SD) at six weeks postoperatively. The mean postoperative spherical equivalent was at -0.37 D ±0.64 (SD). Mean LogMAR for uncorrected and corrected distance visual acuity in six weeks postoperative patients was at 0.29 ±0.16 (SD) and 0.12 ±0.12 (SD) respectively. Intraoperative to 6 weeks of postoperative comparison of IOL axis alignment showed low levels of rotation (mean 3.21 ±2.52 degrees).
CONCLUSION: Cataract surgery with implantation of toric IOL was stable and effective in improving pre-existing regular corneal astigmatism.
The Epidemiological Profile of Open Globe Injuries and Prognostic Factors in a Tertiary Care Centre

Ng HR, Chee SF, Chai KS, Chong MF, Mustapha M

Cureus, 2021 Jun;13(6):e15846.
PMID: 34327079 DOI: 10.7759/cureus.15846

Purpose To describe the epidemiology of open globe injuries and its prognostic factors from the perspectives of a tertiary care centre in northern Malaysia. Methods A retrospective study of open globe injuries in a period of three years between June 2017 and May 2020. Patients presenting with open globe injuries were identified and recruited from hospital census. Case records were retrieved and analysed after recruitment. Results A total of 114 patients with 118 open globe injuries were included in the study. Four patients had bilateral eye involvement. Men were found to have seven and a half times higher rate of ocular injuries than women. The predominant age group of ocular trauma presentation was in younger adults between the age of 21 and 30 years old. Work-related injuries account for almost half of the globe injuries (48.7%) followed by motor vehicle accident-related, domestic accident-related, and others. The significant factors related to the visual outcome are presenting visual acuity (VA), presence of relative afferent pupillary defect (RAPD) and vitreous loss. Conclusion The factors related to visual outcomes in this study may aid the clinician in determining the visual prognosis of ocular injuries. Young working males were the most susceptible group to sustain penetrating ocular injuries due to their job nature. Health education and safety at workplace are essential to reduce the occurrence of ocular injuries.

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