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Fulltext Profile of low vision children in the special education schools in Malaysia

Omar R, Mohammed Z, Knight VF, Basrul MH

Med J Malaysia, 2009 Dec;64(4):289-93.
PMID: 20954552

This study looked at the causes of vision loss, levels of distance, near vision and the use of low vision devices (LVDs) in children studying at special schools in Malaysia. A total of 139 children from two special education schools took part. Visual acuity was measured with and without LVDs. Those who required further assessment were referred to Low Vision Clinic. Near visual acuity in 71 children ranged from N4 to N64. Sixty eight children could not read the N64 chart or they were totally blind. Only eight students were using LVDs before intervention. Seventy one children were referred for low vision assessment and 48 were found to benefit from the LVDs prescribed. The major cause of visual impairment was cataract (17%). Hand held magnifier was the most preferred LVD. Majority of the children attending the blind schools had residual vision but did not have LVDs. LVDs are able to significantly improve near visual acuity and hence there is a need to prescribe and train the children to use the LVDs.

Matched MeSH terms: Vision, Low/etiology; Vision, Low/epidemiology*
Fulltext Irreversible visual loss and optic nerve dysfunction associated with central retinal vein occlusion in Waldenstrom Macroglobulinemia

Fadilah SA, Muhaya M, Azlin I

Med J Malaysia, 2007 Oct;62(4):349-51.
PMID: 18551947 MyJurnal

Irreversible optic nerve dysfunction associated with central retinal vein occlusion (CRVO) is an unusual but important complication of Waldenstrom Macroglobulinemia (WM). Acute visual loss in CRVO is mainly due the severe macular oedema. However, ischaemic optic neuropathy needs to be considered in patients with CRVO when, (i) there is a relative afferent papillary defect and central scotoma, (ii) the visual acuity is not consistent with the retinal pathology, and (iii) the visual defects persisted despite resolution of macular oedema following treatment of the hyperviscosity state. The ischaemic type of CRVO is associated with a poor visual prognosis and the presenting visual acuity has a prognostic role. We report the first description of irreversible unilateral optic nerve damage associated with CRVO in a patient with WM.

Matched MeSH terms: Vision, Low/etiology*; Vision, Low/therapy
Development and validation of a new vision screening test algorithm for public use mobile application- A pilot study

Siti Nor Aishah AR, Mutalib A, Asma H, Baig AA, Naing NN, Hashim SE, et al.

Med J Malaysia, 2020 11;75(6):685-690.
PMID: 33219178

OBJECTIVES: To design and develop a simple vision test algorithm for mobile application and perform a pilot study to determine its validity and reliability as a tool for vision test in the community.
METHODS: A simple visual acuity test algorithm in the form of a single letter E display was designed as the optotype for development of a mobile application. The standardised optotype is presented at random to test visual acuity for corresponding level of 3/60, 6/60, 6/18, and 6/12. The final result is auto-generated based on the classification of the WHO for visual impairment and blindness. The Snellen chart was used as the gold standard to determine its validity while five different users were involved to determine its inter-rater reliability. A pilot study was performed between April till November 2019, in the Universiti Sultan Zainal Abidin Medical Centre (UMC) at Kuala Nerus and Mooris Optometrist Centre at Marang, Terengganu. A total of 279 participants aged four years old and above were involved in this study.
RESULTS: The highest sensitivity was found at the vision level cut-off point of 6/12 with the percentage of 92.7% and 86.8% for the right and left eye, respectively. The specificity was more than 89% for all vision levels in both eyes. The Krippendorff's alpha value for the inter-rater reliability was 0.87 and 0.83.
CONCLUSION: The relatively high level of validity and reliability obtained indicate the feasibility of using the designed optotype to develop a valid and reliable mobile app for vision test. The app can be used to screen vision by nonmedical persons, at anytime and anywhere to help improve public awareness and capability to correctly determine their visual status.

Matched MeSH terms: Vision, Low
Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study

Chew FLM, Thavaratnam LK, Shukor INC, Ramasamy S, Rahmat J, Reidpath DD, et al.

Med J Malaysia, 2018 02;73(1):25-30.
PMID: 29531199 MyJurnal

INTRODUCTION: Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia.
OBJECTIVE: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children.
METHODOLOGY: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria.
RESULTS: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia.
CONCLUSION: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.

Matched MeSH terms: Vision, Low
Fulltext Comparison of refractive error and visual impairment between Native Iban and Malay in a formal government school vision loss prevention programme

Bakar NF, Chen AH, Noor AR, Goh PP

Malays J Med Sci, 2012 Apr;19(2):48-55.
PMID: 22973137 MyJurnal

The epidemiological study of vision problems is important for developing national strategies for the prevention of visual impairment. There was a lack of information regarding vision problems among school children in East Malaysia. The purpose of this study was to compare the refractive errors and degrees of visual impairment between Native Iban and Malay school children who participated in a formal government vision loss prevention programme conducted in a rural area of Betong Division, Malaysia.

Matched MeSH terms: Vision, Low
Prevalence of blindness and low vision in Malaysian population: results from the National Eye Survey 1996

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.

Matched MeSH terms: Vision, Low/etiology; Vision, Low/epidemiology*
Effects of annealing temperature on the optical properties and device performance of Ag / n-Si / CuPc / Ag solar cell prepared via spin coating method

Hanashriah Hassan, Noor Baa'yah Ibrahim, Zahari Ibarahim

Sains Malaysiana, 2010;39.

Copper phthalocyanine (CuPc) thin films have been prepared using a simple spin coating method. The films were annealed at 5 different temperatures (323, 373, 473, 523 and 573 K) for one hour in air. Optical properties study using the UV-Vis spectrophotometer showed that in the range of wavelength of 300-800 nm, all of the films have identical absorption coefficient patterns and there was no systematic changes with respect to annealing temperature. The film annealed at 373 K showed the highest absorbance while the lowest absorbance was shown by the film annealed at 323 K. The results showed that the optical band gaps depended on the temperature. The film annealed at 373 K has the lowest optical energy gap. Using the five annealed films, solar cell with the configuration of Ag / n-Si / CuPc / Ag were fabricated. Under the 50 W/cm2 light illumination, the current voltage measurements at room temperature were carried out on the device. The device which consists of film annealed at 373 K exhibited the best photovoltaic characteristics. The different annealing temperature also affect the photovoltaic behavior of the devices in a non-systematic way.

Matched MeSH terms: Vision, Low
Effectiveness of low vision devices in a special education school. [Keberkesanan penggunaan alat bantuan penglihatan terhad]

Rokiah Omar, Knight VF, Zainora Mohammed

Sains Malaysiana, 2009;38.

The purpose of this study is to determine the visual status and effectiveness of low vision devices among visually impaired school children. One hundred and thirteen students from the special education schools took part in this study. Distance and near visual acuity were measured both with and without low vision devices. Students needing further assessment were referred to the Low Vision Clinic (LVC) Universiti Kebangsaan Malaysia. On presentation, 31% of the students were catagorised as low vision with distance acuity between 6/18 and 6/95 whereas 67% were blind. 2% were found to have distance acuity better than 6/18. The range of near visual acuity of these students was between N4 and N64. Low vision devices such as hand held magnifier, stand magnifier and telescope, were owned by only 17% of low vision students. This study showed that 85% of the students that were referred to the LVC benefited from low vision devices. Access to visual examinations and eye care for students with needs to be provided so that these students can be identified early and suitable low vision devices prescribed. This study emphasises the importance of the role played by parents, teachers and optometrists in the management of vision impairment in school children so that their visual impairment can be rehabilitated effectively.
Keywords: Low vision assessment; low vision devices

Matched MeSH terms: Vision, Low*
Fulltext Vitreous loss-causes, associations, and outcomes: Eight-year analysis in Melaka Hospital

Thevi T, Abas AL

Oman J Ophthalmol, 2018 6 23;11(2):113-118.
PMID: 29930443 DOI: 10.4103/ojo.OJO_220_2016

BACKGROUND: Cataract surgery is associated with a variety of complications, one of which is vitreous loss. Doctors and policymakers should be aware about the precipitating factors, associations, and expected outcomes of vitreous loss. This study was, therefore, undertaken to set guidelines to improve the visual outcomes of patients.

MATERIALS AND METHODS: A retrospective 8-year analysis was conducted from 2007 to 2014 using the national eye database. Demographic features, ocular comorbidities, grade of surgeon, type of surgery, and the associations with the occurrence of vitreous loss, and the final visual outcomes of these patients were studied.

RESULTS: Out of 12,992 eyes, only 3.2% had vitreous loss, mostly aged <40 years. Pseudoexfoliation was the only ocular comorbidity causing vitreous loss. Medical Officers and Gazetting Specialists got more vitreous loss compared to specialists. Intracapsular cataract extraction, phaco convert to extracapsular cataract extraction (ECCE), ECCE, and phaco all had a significant vitreous loss. Vitreous loss was the most significant intraoperative complication causing poor vision and resulted in impaired or poor visual outcome.

CONCLUSION: Vitreous loss occurred in almost all types of cataract surgeries, especially by junior surgeons, among those aged <40 years and significantly caused poor visual outcome compared to other complications. Pseudoexfoliation had higher occurrence of vitreous loss. Vitreous loss patients had impaired/poor visual outcome due to preexisting comorbidity and astigmatism. Patients at risk and junior surgeons should be closely monitored to improve outcomes. Further studies need to be done to see why and when the vitreous loss occurred.

Matched MeSH terms: Vision, Low
Fulltext Low vision rehabilitation and ocular problems among industrial workers in a developing country

Omar R, Knight VF, Aziz Mohammed MA

Malays Fam Physician, 2014;9(3):27-33.
PMID: 26425302 MyJurnal

Work-related ocular injuries and illnesses were among the major causes of job absenteeism. This study was conducted to determine if low vision rehabilitation was provided following work-related ocular problems among industrial workers in a developing country. This was a retrospective analysis of case records.

Matched MeSH terms: Vision, Low
Fulltext Full thickness macular hole: Early intervention is an important factor in visual prognosis

Ng HK, Yaakub A, Ong LB

Malays Fam Physician, 2014;9(3):42-8.
PMID: 26425305 MyJurnal

Full thickness macular hole is an eye disease, which can cause permanent visual impairment. Current advancement in vitreoretinal surgery has high success rates in repairing them, leading to a significant visual improvement, especially if patient presents early. In this article, three cases of idiopathic full thickness macular hole with different visual outcomes have been presented. All cases were referred by the primary care practitioners and had undergone macular hole surgery with the same vitreoretinal surgeon. The visual outcome was best in the patient who had the earliest presentation and referral. Early detection and referral of these patients is vital so that early surgical intervention can be carried out to improve their vision.

Matched MeSH terms: Vision, Low
Fulltext The importance of ophthalmic signs in the diagnosis of suprasellar meningioma - a case report

Tan AK, Mallika P, Md Aziz S, Asokumaran T, Intan G

Malays Fam Physician, 2009;4(1):26-29.
PMID: 25606155 MyJurnal

A forty-two year old lady presented with gradual, painless, progressive blurring of vision of her left eye for four months. There were no other associated ocular or systemic complaints. Examination showed decreased visual acuity in both eyes and a pale optic disc on the left side. Visual field examination revealed a temporal field defect of the right eye which aroused the suspicion of an intracranial mass lesion. MRI of her brain revealed a suprasellar meningioma. We would like to emphasize the importance of visual field examination of both eyes in patients presenting with unilateral loss of vision.

Matched MeSH terms: Vision, Low
Fulltext Review of elderly driver visual perception simulation system for vehicle design

Ghazilla, R. A. R., Yap, H. J.

Malaysian Journal of Public Health Medicine, 2016;16(20):113-120.
MyJurnal

The number of people above 60 years of age will increases due to the growth of the population in the first half of the 21st century, particularly in Malaysia. This has led to the growing number of older drivers which is often unavoidable as driving is a necessary task that not only achieves mobility but also shows a sign of independence and improves self-esteem, which are essential towards effecting the lifestyle. This paper briefly looks at common elderly related visual impairment, reviews design approaches and tools that tackle or include these issues in the design process and further outlines new research needs. It is the intention of this paper to steer the research direction of the development of future design approach and tools that would enhance the capabilities of designers to be well prepared to cater for inclusive design for the elderly, more specifically for visual impairments issues.

Matched MeSH terms: Vision, Low
Fulltext Oral health status of a group of visually impaired school children in Kuala Lumpur

Afsary Jahan Khan, Mas Suryalis Ahmad, Ahmad Shuhud Irfani Zakaria, Universiti Kebangsaan Malaysia, Tanti Irawati Rosli

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):100-105.
MyJurnal

Introduction: Children with visual impairment are reported to be at higher risk of poor oral health. They faced dif- ficulties in basic skills including oral care. For this reason, they may develop dental caries and periodontal disease. The aim of this study was to assess the oral health status of a group of visually impaired school children in Kuala Lumpur. Methods: A cross-sectional study was carried out on students from a Special Education School in Kuala Lumpur. Oral examination was conducted to determine caries experience and oral hygiene status. Caries was mea- sured using DMFT index and simplified oral hygiene index (OHI-S) for oral hygiene status. Oral examination was based on modified World Health Organization (WHO) oral health assessment criteria for children. Chi-square test was used to determine associations between demographic variables and oral health status. Results: A total of 91 visually impaired students (41 blind, 50 low vision) within the age group of 13 to 17 years old participated in this study. The mean OHI-S score was 1.68 (SD 0.87) with majority of students had fair oral hygiene (39.6%) and 29.7% with poor and very poor oral hygiene. The mean DMFT score of total students were 0.80 (SD 1.62). Male students demonstrated significantly better oral health status than female in relation to prevalence and mean score of dental caries. Conclusion: Most of the visually impaired children in this study showed fair oral health status. Regular oral health education is recommended to improve the oral hygiene especially in the totally blind group.

Matched MeSH terms: Vision, Low
Fulltext The status of Malaysian school children’s visual acuity from year 1990 to 2017

Saidatul Norbaya Buang, Abdul Shukor Salha, Marhaida Mahmood, Noor Haire Sumarlie Nordin

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):100-100.
MyJurnal

Introduction: Refractive error is the most common cause of visual impairment among the school children. The visual acuity screening has long been administered through the school health service in Malaysia. The objective of this study was to examine the status of refractive error in the school health screening from year 1990 to 2017. Methods: Every year an average of 1.2 million students were screened for refractive errors through school health service. Stu-dents with visual acuity reading of 6/9 or worst based on 6-meter Snellen chart ware referred for confirmation of refractive error. Secondary data on school visual acuity screening from the Health Informatics for the period of 1990 to 2017 were used to describe the changing pattern of refractive errors. Results: It was observed that the prevalent of suspected refractive errors amongst the Standard 1 student increased from 7 per 1,000 students examined in 1990 to 44.4 per 1,000 students in the 2000 and further increased to 74 per 1,000 students before slow decline to 55 per 1,000 students from year 2015 to 2017. A higher level of detection was observed for students in standard 6 and form 3 between the period of 1990 to 2009 (78/1,000 and 65/1,000 respectively) and further decline thereafter to lowest level in 2017 (33/1,000 to 21.5/1,000 respectively). Conclusion: The Standard 1 students in the 21st century have higher rate of suspected refractive errors compared to their counterpart that lived in the 20th century. Community awareness program need to be introduce for early detection of visual acuity problem.

Matched MeSH terms: Vision, Low
Fulltext The causes of low vision and pattern of prescribing at UKM low vision clinic

Rokiah Omar, Knight, Victor Feizal, Zainora Mohammed

Jurnal Sains Kesihatan Malaysia, 2008;6(2):55-64.
MyJurnal

When medical and surgical intervention cannot alleviate all of the impairments resulting from diseases of the eye, visual rehabilitation can help reduce the disability and increase the quality of life. Data from 169 patients seen at the UKM Low Vision Clinic (UKM LVC) over the past 2 years were examined and analysed. The age ranged from 6 to 87 years of age. The main cause of ocular pathological categories was conduction (63.9%), media (24.9%) and congenital (11.2%) related problems. The main causes of low vision at UKM LVC were congenital cataract, retinitis pigmentosa, glaucoma, cataract and diabetic retinopathy. 84% of these patients received low vision devices to improve their near or/and distance vision. The most common optical devices dispensed at UKM LVC were near high addition spectacle, hand magnifiers and stand magnifiers. Medical, vision care and rehabilitation professionals working together can offer a comprehensive treatment plan for the visually impaired, offering these patients the very best services to increase their quality of life.

Matched MeSH terms: Vision, Low
Fulltext Isu dan cabaran pelajar kurang upaya penglihatan di institusi pengajian tinggi

Raja Nur Fakhriah Raja Zainal B, Aizan Sofia A

Jurnal Psikologi Malaysia, 2018;32:131-145.

Education is one of the most important aspects for every individual including people with visual impairments. Visually impaired students also have the right to a good educational opportunity to higher education. In this regard, this article explores the issues and challenges of visually impaired students in higher learning institution. This study uses a full qualitative approach, a case study in the Klang Valley. In-depth interviews were used in data collection involving 5 students with visual impairment: four males and one female. The findings showed that among the major issues faced by visually impaired students pursuing higher education in tertiary institution were self-esteem, financial and public stigma. In addition, visually impaired students also faced challenges in accessibility, peer-to-peer acceptance and difficulties in learning at the university. In conclusion, this study emphasises on issues and challenges often faced by students with visual impairments at higher learning institution so that appropriate supports and facilities can be effectively provided by the university.

Matched MeSH terms: Vision, Low
Use of recombinant tissue plasminogen activator for treatment of recalcitrant anterior uveitis: A case series

Patrick S, Hui-Tze C, Wan-Hazabbah WH, Zunaina E, Azhany Y, Liza-Sharmini AT

J Taibah Univ Med Sci, 2018 Oct;13(5):483-487.
PMID: 31435366 DOI: 10.1016/j.jtumed.2018.03.005

Management of inflammation after surgery for recalcitrant anterior uveitis is challenging. Herein, we report successful treatment using intracameral injection of recombinant tissue plasminogen activator (rtPA) in two patients with recalcitrant anterior uveitis, due to infective uveitis and Vogt-Koyanagi-Harada disease, respectively. A 40-year-old woman presented with bilateral redness and vision reduction that had persisted 2 weeks. She also had bilateral anterior uveitis, vasculitis, retinitis, and optic disc swelling. Serology was positive for Bartonella henselae and Toxoplasma gondii. She was treated using long-term systemic corticosteroids and appropriate antibiotics. Our second case; a healthy 30-year-old man with bilateral eye redness and reduced vision without pain, and associated with headache and tinnitus for 1 weeks. He showed bilateral granulomatous inflammation with vitritis, choroiditis, retinitis, and hyperemic optic disc. The patient was diagnosed with Vogt-Koyanagi-Harada disease and treated with systemic corticosteroids. Both patients developed secondary cataracts and glaucoma that necessitated surgical intervention. Persistent chronic inflammation led to the formation of a thick fibrin membrane anterior to the intraocular lens (IOL) after phacoemulsification surgery with IOL implantation. This membrane was removed surgically, and intracameral injection of rtPA (25 μg) was carried out. The persistent inflammation had resolved and visual acuity had significantly improved within 1 week of intracameral rtPA injection. There were no reported ocular or systemic side effects. Intracameral rtPA is beneficial in patients with recalcitrant anterior uveitis who have undergone intraocular surgery. In most cases, surgical intervention improves the patients' vision. Intracameral rtPA should be considered in cases of persistent inflammation of varying etiology.

Matched MeSH terms: Vision, Low
Fulltext Sudden visual loss in acute leukaemia

Tengku Kamalden, T.A., Nurliza, K., Haris, A.R.

JUMMEC, 2008;11(1):30-32.
MyJurnal

The presenting signs of acute leukaemia occur as a result of bone marrow failure and organ infiltration. Increased bleeding tendencies are seen on the skin, gums and mucosal lining. Bleeding in the posterior segment of the eye, namely the retina and vitreous, may occur, but do not usually cause any visual disturbances. This case demonstrates visual loss as a result of premacular subhyaloid haemorrhage in acute leukaemia.

Matched MeSH terms: Vision, Low
Independent impact of area-level socioeconomic measures on visual impairment

Zheng Y, Lamoureux E, Finkelstein E, Wu R, Lavanya R, Chua D, et al.

Invest Ophthalmol Vis Sci, 2011;52(12):8799-805.
PMID: 21969296 DOI: 10.1167/iovs.11-7700

It is known that a person's socioeconomic status (SES; individual-level SES) is closely correlated with his or her degree of visual impairment. Whether there is an independent relationship between area-level measures of SES (e.g., living in a lower SES environment) and visual impairment is unclear. This study describes the associations of area-level SES with visual impairment.

Matched MeSH terms: Vision, Low/diagnosis*; Vision, Low/epidemiology*

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