Displaying publications 1 - 20 of 28 in total

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  1. Viswalingam A
    Br J Ophthalmol, 1936 Aug;20(8):449-55.
    PMID: 18169380
    In October, 1931, A.L.J., an Anglo-Indian engineer, aged 59 years presented himself for examination on account of sore eyes and photophobia. The visual actuity was R.V. 6/12 with+0.75 sph.=6/6. L.V. 6/18 with+1 sph.=6/6. The pupils at that time were active to light and accommodation, the anterior chamber was slightly shallow and the tension not raised. The filtration atngle was " crowded."
    Kuala Lumpur, Federated Malay States
  2. Sukumaran K
    Br J Ophthalmol, 1991 Mar;75(3):179-80.
    PMID: 2012789
    A case of Norrie's disease in an identical twins is reported. No positive family history was obtained. The couple had no other children. The older of the twins died at the age of 9 months of uncertain cause. To the best of my knowledge this is the first case of Norrie's disease reported in Malaysia. And its occurrence in an identical twins is very rare.
  3. Lim CP, Loo AV, Khaw KW, Sthaneshwar P, Khang TF, Hassan M, et al.
    Br J Ophthalmol, 2012 May;96(5):704-7.
    PMID: 22353698 DOI: 10.1136/bjophthalmol-2011-301044
    To compare homocysteine (Hcy) concentration in the blood plasma, vitreous and aqueous of eyes with proliferative diabetic retinopathy (PDR) against control, and to investigate associations between Hcy concentration in blood plasma with that of aqueous and vitreous in these two groups.
  4. Singh M
    Br J Ophthalmol, 1988 Nov;72(11):820-2.
    PMID: 3207656
    In a prospective study 84 patients with aphakic retinal detachment were treated either by local scleral buckling alone or combined with an encirclement. The rate of surgical reattachment of the retina was found to be similar with either technique over a minimum follow-up period of one year. Simplicity and a low incidence of serious complications of the local procedure merit its application as the initial method of repairing aphakic detachments.
  5. Chen DZ, Wong C, Lam JSH, Sun CH, Lai Y, Koh VTC, et al.
    Br J Ophthalmol, 2023 Sep 19.
    PMID: 37726156 DOI: 10.1136/bjo-2023-323906
    AIMS: To determine axial length (AL) elongation profiles in children aged 3-6 years in an Asian population.

    METHODS: Eligible subjects were recruited from the Growing Up in Singapore Towards Healthy Outcomes birth cohort. AL measurement was performed using IOLMaster (Carl Zeiss Meditec, Jena, Germany) at 3 and 6 years. Anthropometric measurements at birth, cycloplegic refraction at 3 and 6 years, questionnaires on the children's behavioural habits at 2 years and parental spherical equivalent refraction were performed. Multivariable linear regression model with generalised estimating equation was performed to determine factors associated with AL elongation.

    RESULTS: 273 eyes of 194 children were included. The mean AL increased from 21.72±0.59 mm at 3 years to 22.52±0.66 mm at 6 years (p<0.001). Myopic eyes at 6 years had greater AL elongation (1.02±0.34 mm) compared with emmetropic eyes (0.85±0.25 mm, p=0.008) and hyperopic eyes (0.74±0.16 mm, p<0.001). The 95th percentile limit of AL elongation was 1.59 mm in myopes, 1.34 mm in emmetropes and 1.00 mm in hyperopes. Greater birth weight (per 100 g, β=0.010, p=0.02) was significantly associated with greater AL elongation from 3 to 6 years, while parental and other behavioural factors assessed at 2 years were not (all p≥0.08).

    CONCLUSION: In this preschool cohort, AL elongates at an average length of 0.80 mm from 3 to 6 years, with myopes demonstrating the greatest elongation. The differences in 95th percentile limits for AL elongation between myopes, emmetropes and hyperopes can be valuable information in identifying myopia development in preschool children.

  6. Salowi MA, Choong YF, Goh PP, Ismail M, Lim TO
    Br J Ophthalmol, 2010 Apr;94(4):445-9.
    PMID: 19951939 DOI: 10.1136/bjo.2009.163063
    AIMS: To apply cumulative sum (CUSUM) in monitoring performance of surgeons in cataract surgery and to evaluate the response of performance to intervention.
    METHOD: A CUSUM analysis was applied to 80 phacoemulsification performed by three ophthalmic trainees and one consultant, for the occurrence of posterior capsular rupture and postoperative refracted vision of worse than 6/12 among patients without pre-existing ocular comorbidity. The CUSUM score of each consecutive procedure performed by an individual surgeon was calculated and charted on CUSUM chart. When trainees' CUSUM charts showed an unacceptable level of performance, their supervisors would give feedback and impose closer monitoring of subsequent surgeries.
    RESULTS: CUSUM charts of the trainees demonstrated an initial upward followed by flattening trend. This reflects learning curves in their process of acquiring competency in phacoemulsification. In contrast, the consultant showed a flat curve indicating an ongoing maintenance of competence.
    CONCLUSION: The CUSUM analysis is able to monitor and promptly detect adverse events and trends of unacceptable outcomes in cataract surgery. This objective and dynamic monitoring makes CUSUM a useful audit tool for individual surgeons, but more so for busy consultants who need to supervise trainees.
  7. Lai YK
    Br J Ophthalmol, 1990 Apr;74(4):201-2.
    PMID: 2337542
    Seven patients with macular hole retinal detachment were treated by intravitreal gas injection with or without release of subretinal fluid. Macular buckling, diathermy, cryopexy, or vitrectomy were not used. The patients were placed prone for eight hours a day until the gas had absorbed. In five of the seven patients the retina became reattached within three days and remained reattached with follow-up periods of three to 22 months (average nine months). It is believed that such detachments are due to vitreoretinal traction and the intravitreal gas bubble relieves this traction. This technique is simple, safe, and does not require costly or sophisticated instruments. It has an added advantage in preserving macular function.
  8. Lai YK
    Br J Ophthalmol, 1989 Jun;73(6):468-9.
    PMID: 2751981
    The case is reported of a patient who suffered severe acute hypertension, cardiac arrhythmia, and myocardial infarction probably as a direct effect of phenylephrine overdose. Instillation of the drops during surgery probably enhanced the systemic absorption of a significant amount of the drug. Therefore it should be used during surgery with caution, especially in elderly patients and those with cardiovascular disease.
  9. Salowi MA, Chew FLM, Adnan TH, Ismail M, Goh PP
    Br J Ophthalmol, 2017 Nov;101(11):1466-1470.
    PMID: 28292773 DOI: 10.1136/bjophthalmol-2016-309902
    AIM: To identify the risk indicators for posterior capsular rupture (PCR) in the Malaysian Cataract Surgery Registry (CSR).

    METHODS: Data from the web-based CSR were collected for cataract surgery performed from 2008 to 2013. Data was contributed by 36 Malaysian Ministry of Health public hospitals. Information on patient's age, ethnicity, cause of cataract, ocular and systemic comorbidity, type of cataract surgery performed, local anaesthesia and surgeon's status was noted. Combined procedures and type of hospital admission were recorded. PCR risk indicators were identified using logistic regression analysis to produce adjusted OR for the variables of interest.

    RESULTS: A total of 150 213 cataract operations were registered with an overall PCR rate of 3.2%. Risk indicators for PCR from multiple logistic regression were advancing age, male gender (95% CI 1.04 to 1.17; OR 1.11), pseudoexfoliation (95% CI 1.02 to 1.82; OR 1.36), phacomorphic lens (95% CI 1.25 to 3.06; OR 1.96), diabetes mellitus (95% CI 1.13 to 1.29; OR 1.20) and renal failure (95% CI 1.09 to 1.55; OR 1.30). Surgical PCR risk factors were combined vitreoretinal surgery (95% CI 2.29 to 3.63; OR 2.88) and less experienced cataract surgeons. Extracapsular cataract extraction (95% CI 0.76 to 0.91; OR 0.83) and kinetic anaesthesia were associated with lower PCR rates.

    CONCLUSIONS: This study was agreed with other studies for the risk factors of PCR with the exception of local anaesthesia given and type of cataract surgery. Better identification of high-risk patients for PCR decreases intraoperative complications and improves cataract surgical outcomes.

  10. Zainal M, Ismail SM, Ropilah AR, Elias H, Arumugam G, Alias D, et al.
    Br J Ophthalmol, 2002 Sep;86(9):951-6.
    PMID: 12185113
    BACKGROUND: A national eye survey was conducted in 1996 to determine the prevalence of blindness and low vision and their major causes among the Malaysian population of all ages.

    METHODS: A stratified two stage cluster sampling design was used to randomly select primary and secondary sampling units. Interviews, visual acuity tests, and eye examinations on all individuals in the sampled households were performed. Estimates were weighted by factors adjusting for selection probability, non-response, and sampling coverage.

    RESULTS: The overall response rate was 69% (that is, living quarters response rate was 72.8% and household response rate was 95.1%). The age adjusted prevalence of bilateral blindness and low vision was 0.29% (95% CI 0.19 to 0.39%), and 2.44% (95% CI 2.18 to 2.69%) respectively. Females had a higher age adjusted prevalence of low vision compared to males. There was no significant difference in the prevalence of bilateral low vision and blindness among the four ethnic groups, and urban and rural residents. Cataract was the leading cause of blindness (39%) followed by retinal diseases (24%). Uncorrected refractive errors (48%) and cataract (36%) were the major causes of low vision.

    CONCLUSION: Malaysia has blindness and visual impairment rates that are comparable with other countries in the South East Asia region. However, cataract and uncorrected refractive errors, though readily treatable, are still the leading causes of blindness, suggesting the need for an evaluation on accessibility and availability of eye care services and barriers to eye care utilisation in the country.

  11. Thevi T, Godinho MA
    Br J Ophthalmol, 2016 Dec;100(12):1708-1713.
    PMID: 26994109 DOI: 10.1136/bjophthalmol-2015-307785
    BACKGROUND: Cataract surgery has progressed from large incision to smaller incisions, which do not require sutures. Anaesthesia too has progressed from general anaesthesia to local anaesthesia to topical anaesthesia. The ideal anaesthesia for cataract surgery would be one that is easy to administer, provides adequate pain relief during surgery and is associated with fewer complications.

    AIMS: This study was done to find out the most suitable anaesthesia for patients with fewer complications and also to look at the trend of anaesthesia being used.

    METHODS: A retrospective analysis was done of patients who underwent cataract surgery from 2007 to 2014 in Hospital Melaka. Data were obtained from the National Eye Database and analysed using SPSS. Trend of types of anaesthesia used and the associated complications with each were studied.

    RESULTS: The most frequently used anaesthesia was topical anaesthesia, which showed an upward trend followed by subtenon in turn showing a downward trend. Subtenon anaesthesia was associated with more intraoperative and postoperative complications while topical anaesthesia was associated with fewer complications.

    CONCLUSIONS: Topical anaesthesia has shown a steady increase in usage and is the ideal anaesthesia, which has been associated with fewer complications.

  12. Teoh SL, Allan D, Dutton GN, Foulds WS
    Br J Ophthalmol, 1990 Apr;74(4):215-9.
    PMID: 2186795
    The visual acuity, the difference in sensitivity of the two eyes to light (brightness ratio), and contrast sensitivity were assessed in 28 patients with chronic open angle glaucoma and compared with those of 41 normal controls of similar ages and visual acuity. The results obtained were related to the results of Tübingen visual field analysis in patients with glaucoma. Twenty-four of the 28 glaucoma patients (86%) had a significant disparity in brightness ratio between the two eyes. This was found to match the frequency of visual field loss. Moreover, there was a significant relationship between the interocular differences in brightness sense and the difference in the degree of visual field loss between the two eyes. Of the glaucoma patients 39% had sum contrast sensitivities outside the normal range for age-matched normal controls. No significant correlation was found between the interocular difference in brightness sense and the visual acuity or the interocular difference in sum contrast sensitivity. It is concluded that, in the presence of a normal visual acuity, the brightness ratio test warrants evaluation as a potential screening test for chronic open angle glaucoma.
  13. Saw SM, Goh PP, Cheng A, Shankar A, Tan DT, Ellwein LB
    Br J Ophthalmol, 2006 Oct;90(10):1230-5.
    PMID: 16809384
    To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore.
  14. Singh M, Dahalan A
    Br J Ophthalmol, 1987 Nov;71(11):850-3.
    PMID: 3689737
    A total of 94 patients underwent extracapsular cataract extraction and insertion of Sinsky style two-loop posterior chamber intraocular lenses. Forty-six eyes received a standard power IOL and 48 eyes were given a preoperatively calculated IOL. A significant difference was found in the two groups with regard to the postoperative refractive error and uncorrected visual acuity.
  15. Ng ZX, Kuppusamy UR, Tajunisah I, Fong KC, Koay AC, Chua KH
    Br J Ophthalmol, 2012 Feb;96(2):289-92.
    PMID: 22116960 DOI: 10.1136/bjophthalmol-2011-300658
    The receptor for advanced glycation end-products (RAGE) has been implicated in the pathogenesis of diabetic microvascular complications. The aim of this study was to investigate the association between 2245G/A gene polymorphism of the RAGE gene and retinopathy in Malaysian type 2 diabetic patients.
  16. Lukman H, Kiat JE, Ganesan A, Chua WL, Khor KL, Choong YF
    Br J Ophthalmol, 2010 Oct;94(10):1348-51.
    PMID: 20601661 DOI: 10.1136/bjo.2009.173526
    There is a general consensus that individuals with conspicuous strabismus are perceived more negatively with respect to physical appearance, personality and capability. Such social biases can potentially lead to social alienation and negative psychosocial development, particularly when experienced at a young age. This study aims to explore young children's perception of peers with noticeable exotropia.
  17. Wong TY, Foster PJ, Seah SK, Chew PT
    Br J Ophthalmol, 2000 Sep;84(9):990-2.
    PMID: 10966951
    AIM: To estimate the rates of hospital admissions for primary angle closure glaucoma (PACG) in Chinese, Malays, and Indians in Singapore

    METHODS: A population-wide hospital discharge database in Singapore was used to identify all hospital admissions with a primary discharge diagnosis of PACG (International Classification of Disease-CM code: 365.2). The Singapore census was used for denominator data.

    RESULTS: Between 1993 and 1997 there were 894 hospital admissions for PACG. The mean annual rate of PACG admissions was 11.1 per 100 000 (95% confidence interval (CI), 10.4, 11.8) among people aged 30 years and over. The annual rate was highest for Chinese (age and sex adjusted rate: 12.2 per 100 000), which was twice that of Malays (6.0 per 100 000) and Indians (6.3 per 100 000). Females had two times higher rates than males in all three races (age adjusted relative risk: 2.0, 95% CI: 1.7, 2.3).

    CONCLUSION: Malay and Indian people had identical rates of hospital admissions for PACG, which were only half the rates compared with Chinese.

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