MyMedR

Displaying publications 1 - 20 of 97 in total

Abstract:

Sort:

Fulltext Optic disc swelling in a patient with tuberculous meningitis: a diagnostic challenge

Zuhaimy H, Leow SN, Vasudevan SK

BMJ Case Rep, 2017 Aug 09;2017.
PMID: 28794092 DOI: 10.1136/bcr-2017-221170

We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection. Her Quantiferon-TB Gold in-tube test was negative. Cerebrospinal fluid analysis revealed a high opening pressure but no biochemical parameters to suggest TBM, hence she was treated as idiopathic intracranial hypertension. A diagnosis of TBM was finally made following a positive PCR for Mycobacterium tuberculosis Her vision improved with reduction in optic disc swelling following antituberculous treatment.

Matched MeSH terms: Vision Disorders/etiology
Fulltext Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

Zuhaimy H, Aziz HA, Vasudevan S, Hui Hui S

GMS Ophthalmol Cases, 2017;7:Doc04.
PMID: 28194321 DOI: 10.3205/oc000055

Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect. The fundus was normal. The extraocular movements were restricted in all directions of gaze. Nasal endoscopy revealed pansinusitis that corresponded with CT scan orbit and paranasal sinuses findings. Despite treatment, he showed no clinical improvement. Ethmoidal sinus biopsies performed revealed extranodal NKTCL. Further imaging showed involvement of the right orbital contents and its adnexa with intracranial extension into the right cavernous sinus and meninges over right temporal fossa. The patient underwent chemotherapy. However he succumbed to his illness two months after the diagnosis. Conclusion: Extranodal NKTCL is a great mimicker. This case demonstrated how an acute initial presentation of extranodal NKTCL can present as orbital cellulitis with pansinusitis.

Matched MeSH terms: Vision Disorders
Fulltext Marital status and its relationship with the risk and pattern of visual impairment in a multi-ethnic Asian population

Zheng Y, Lamoureux EL, Chiang PP, Rahman Anuar A, Wong TY

J Public Health (Oxf), 2014 Mar;36(1):104-10.
PMID: 23658389 DOI: 10.1093/pubmed/fdt044

To examine whether marital status is a significant determinant of visual impairment (VI) in urban multi-ethnic Asian population.

Matched MeSH terms: Vision Disorders/epidemiology*
Fulltext Blindness and visual impairment amongst rural Malays in Kuala Selangor, Selangor

Zainal M, Masran L, Ropilah AR

Med J Malaysia, 1998 Mar;53(1):46-50.
PMID: 10968137

A population-based cross-sectional study was carried out to determine the prevalence of visual impairment and blindness and its causes amongst the adult rural Malay population in the district of Kuala Selangor, Selangor. By simple random sampling 330 samples were selected for the study. All samples underwent complete ophthalmological examination. The crude prevalence of visual impairment and blindness were 0.7% and 5.6% respectively. Age was the most important factor associated with the prevalence; gender, level of education and level of income was not significantly related. Cataract was the commonest cause of visual impairment and blindness while diabetic retinopathy was the second important cause.

Matched MeSH terms: Vision Disorders/epidemiology*
Fulltext The effect of smartphone usage on accommodation status

Wiki Safarina Narawi, Shaz’ Ain Razak, Nahdiyah Azman

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):244-247.
MyJurnal

Introduction: Usage of smartphones have increased rapidly because of its importance in our daily life. This led to an increase in incidence of ocular problems among smartphone users. This research was conducted to determine the effect of smartphone usage on accommodation status. Methods: A cross-sectional study was conducted among young adults aged 19 to 30 years old in Management and Science University, Shah Alam. All subjects were asked to use smartphone for 20 minutes. The symptoms and accommodation status were evaluated before and after the smartphone usage. Results: Total subjects showed the mean age of 23.60 ± 2.77 years, 50% (n = 20) were males and 50% (n = 20) were females. The mean smartphone usage per day was 8.60 ± 2.80) hours. After 20 minutes of smartphone usage, subjects complained of tired eyes (92.50%), dry eyes (90.00%), blurred vision (87.50%), and headache (82.50%). Paired t-test showed significant reduction in amplitude of accommodation, monocularly from 9.9 ± 1.9 D to 8.76 ± 2.50 D (p = 0.00), and binocularly from 12.01 ± 1.95 D to 10.96 ± 2.16 D (p = 0.00); monoc- ular accommodative facility from 13.93 ± 3.13 cpm to 11.10 ± 4.32 cpm (p = 0.00) and binocular accommodative facility from 12.70 ± 3.57 cpm to 9.70 ± 4.21 cpm (p = 0.00); positive relative accommodation from -2.72 ± 0.87 D to -2.13 ± 1.28 D (p = 0.00) and increase in lag of accommodation from 0.4 ± 0.26 D to 0.93 ± 0.48 D (p = 0.00). Conclusion: This study shows that there were significance changes on accommodation status after 20 minutes of smartphone usage which can lead to weakness of accommodation.

Matched MeSH terms: Vision Disorders
Ocular conditions among the Orang Asli, the jungle aborigines of West Malaysia

Weerekoon L

Trans Ophthalmol Soc N Z, 1973;25:30-5.
PMID: 4519227
Matched MeSH terms: Vision Disorders/epidemiology
Health burden associated with visual impairment in Singapore: the Singapore epidemiology of eye disease study

Wang X, Lamoureux E, Zheng Y, Ang M, Wong TY, Luo N

Ophthalmology, 2014 Sep;121(9):1837-42.
PMID: 24768238 DOI: 10.1016/j.ophtha.2014.03.017

To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore.

Matched MeSH terms: Vision Disorders/epidemiology*
Fulltext Granulomatous hypophysitis: a case of severe headache

Wan Muhamad Hatta SF, Hamdan MF, Md Ali SA, Abdul Ghani R

BMJ Case Rep, 2016 Sep 09;2016.
PMID: 27613264 DOI: 10.1136/bcr-2016-216395

Idiopathic granulomatous hypophysitis (GH) is an uncommon inflammatory disease of the pituitary with impairment of pituitary gland function due to infiltration by lymphocytes, plasma cells and macrophages. We report the case of a 39-year-old woman who presented with worsening of headaches for 1 month and blurring of vision over 5 days. An MRI revealed a homogeneous supra-sellar mass evoking a pituitary tumour with bulky pituitary stalk extending into the left and right cavernous sinuses. Hormonal investigations showed anterior pituitary hormone deficiencies; meanwhile histopathological examination revealed an aspect of hypophysitis. Clinical and radiological remission occurred immediately postglucocorticoid therapy with the addition of a steroid-sparing agent later in view of recurrence of symptoms on glucocorticoid dose reduction. GH has important diagnostic and therapeutic implications, as clinical and radiological features ameliorate via medical treatment. With further understanding and recognition of the disease, we hope to highlight a case of GH, in which signs and symptoms improved after initiation of corticosteroids.

Matched MeSH terms: Vision Disorders/diagnosis; Vision Disorders/etiology
Fulltext Corticosteroid Therapy in Optic Neuropathy Secondary to Nasopharyngeal Carcinoma

Wahab Z, Tai E, Wan Hitam WH, Sonny Teo KS

Cureus, 2021 Mar 06;13(3):e13735.
PMID: 33842113 DOI: 10.7759/cureus.13735

INTRODUCTION: Nasopharyngeal carcinoma (NPC) is a tumor arising from the epithelial cells of the nasopharynx. NPC can spread and invade the base of skull, nasal cavity, paranasal sinuses, pterygopalatine fossa, and apex of the orbit. However, the involvement of the optic nerve in NPC is rare. The purpose of this case report is to report the efficacy of corticosteroid therapy in optic neuropathy secondary to NPC.
CLINICAL CASE: A 56-year-old Chinese woman, an active smoker, presented with a hearing deficit, persistent tinnitus and nasal congestion. Examination and investigations revealed the presence of a mass in the nasopharynx. Tissue biopsy revealed nasopharyngeal carcinoma. However, the Epstein-Barr virus was not tested. She was counseled for chemotherapy, but refused and was subsequently lost to follow up. She presented one year later with right eye ptosis associated with progressive worsening of diplopia and blurring of vision. Examination revealed multiple (second, third, fourth and sixth) cranial nerve involvement. Systemic examination and investigations revealed cervical lymphadenopathy and liver metastasis. Repeated imaging showed that the mass had invaded the base of the skull, cavernous sinus and orbital apices. Pulse dosing of corticosteroid therapy was commenced, resulting in dramatic improvement of vision.
CONCLUSION: Optic neuropathy may be the presenting sign of NPC. Corticosteroid therapy can offer immediate visual improvement.

Matched MeSH terms: Vision Disorders
Fulltext Posterior intraorbital metallic foreign body: a case discussion

Vinodh VP, Sellamuthu P, Harun RH, Zenian MS

Med J Malaysia, 2014 Apr;69(2):89-91.
PMID: 25241819 MyJurnal

Intraorbital foreign body (IOFB) has been a rare phenomenon in the cases of gunshot wounds and always represents a dilemma in medical management. In Sabah, this scenario is becoming common as there is still certain population in the interiors who owns self made guns for hunting. They either present with self inflicted gunshot injuries or after being mistakenly shot while hunting. There are very few articles on this topic especially when it is located posteriorly in the orbit and occurs without visual impairment. This case reports the challenges faced in the management of the patient with a posteriorly located metallic IOFB. The appropriate management of the patient is discussed based on several international literatures. Author describes a 37 years old male farmer, who was referred from a nearby district hospital after he sustained gunshot injuries to his face and scalp. Urgent computed tomography (CT) scan showed that bullet pellets were at the left orbital floor, the left mandible and the left frontal bone. All bullet pellets were located extracranially only without intracranial involvement. Patient clinically does not have any neurologic deficit and without any visual impairment, thus he refused any surgical intervention. As there is no proper guideline in managing such cases, decision was made based on evidences from international literatures. It was concluded that metallic IOFB located in the posterior orbit may be conservatively managed with observation and regular follow-ups as they are well-tolerated and does not cause much impact on visual deterioration unless inflammation, infection, optic neuropathy or functional deficit occurs. This avoids unnecessary surgery and prevents risk of iatrogenic injury to the eye.

Matched MeSH terms: Vision Disorders
Fulltext Dengue fever presenting as bilateral dengue maculopathy

Umi Kalthum, M.N.

Medicine & Health, 2012;7(1):57-61.
MyJurnal

Dengue fever is a common pyrexial-viral infection in the Asian region and the incidence is increasing yearly. There are various ocular manifestations of dengue fever such as maculopathy, retinal hemorrhages, retinal lesions and vasculitis. Reduction in visual acuity and other visual disturbances such as metamorphopsia is the most common presentation of dengue-associated maculopathy. We report an interesting case of a young lady with bilateral maculopathy secondary to dengue fever who was managed conservatively with dramatic visual improvements. This case highlights the possibility of bilateral and simultaneous ocular involvements in patients infected with dengue fever. Both ophthalmologists and physicians need to be aware of ocular complications following dengue fever and advice patients regarding the symptoms.

Matched MeSH terms: Vision Disorders
A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society

Tsubota K, Yokoi N, Watanabe H, Dogru M, Kojima T, Yamada M, et al.

Eye Contact Lens, 2020 Jan;46 Suppl 1:S2-S13.
PMID: 31425351 DOI: 10.1097/ICL.0000000000000643

The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eyes described dry eye disease as "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with dry eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of dry eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-dry eye specialists, and which is believed to contribute to an effective diagnosis and treatment of dry eyes.

Matched MeSH terms: Vision Disorders
Fulltext BMI, BP, visual acuity and hearing status of Special Olympics athletes in Sarawak

Toh, Teck Hock, Nurhilda Abdullah, Chua, Soh Yian, Muhamad Rais Abdullah, Islia Nahazatul, Chieng, Lee Ling

Int J Public Health Res, 2011;1(2):66-71.
MyJurnal

Introduction Special Olympics (SO) Inc. is an organization for people with intellectual disability (ID) to actively engaging in Olympic-type sport and participating in competition. Special Olympic Inc. provides Healthy Athletes Programme (HAP®) in screening and providing health education to Special Olympic Athletes. Objective To study the body mass index (BMI), blood pressure (BP), visual acuity and hearing status of children and young adult with ID in Special Olympics Sarawak. Methods Health data were collected by trained health professionals under HAP®held in conjunction with Special Olympics Sarawak State Games on 17th and 18th April 2010 in Sibu. Health data collected were athletes' weight, BMI, BP, ear canal screen and hearing status (oto-acoustic emission, pure tone audiometry), as well as eye health and visual acuity, using guidelines set by HAP®. Results 195 athletes attended the State Games in 2010 of which 138 were screened. Significant number of athletes was considered overweight / obese (31.5% for children and 36.9% for adult). More than 20% of the adult athletes were hypertensive or at risk of hypertension. Sixteen percent of the adult athletes had hearing loss. More than half of the adult and children athletes never had eye checks, and a significant numbers of them had abnormal eye tests results. Conclusions Health screening conducted during the HAP® is a useful screening program in this population. Health data collected can bring awareness to athletes and their family, and corrective measures in hearing and visual impairment can be taken immediately.

Matched MeSH terms: Vision Disorders
Rubella-related intermediate uveitis in pregnancy--a rare presentation

Thirupathy A, Tajunisah I

Ocul Immunol Inflamm, 2011 Jun;19(3):156-7.
PMID: 21595530 DOI: 10.3109/09273948.2011.555593

To report a rare case of intermediate uveitis following rubella infection in pregnancy.

Matched MeSH terms: Vision Disorders/etiology; Vision Disorders/physiopathology
Fulltext Prevalence of eye diseases and visual impairment among the rural population - a case study of Temerloh Hospital

Thevi T, Maslina B, Reddy SC

Malays Fam Physician, 2012;7(1):6-10.
PMID: 25606238

Objective: To determine the prevalence of eye diseases and visual impairment among new patients at the eye clinic of Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang.
Method: In this cross-sectional prospective study, 1081 new patients were examined over a period of six months. Age, gender, ethnicity, visual acuity and diagnosis were noted from the medical records.
Results: Out of 1081 examined, 607 (56.1%) were males, 783 (72.4%) were Malays. The mean age of patients was 45.2 years (ranging from one month to 91 years). Cataract (248, 22.9%) was the most common eye disease, followed by retinal diseases (124, 11.5%) and ocular trauma (106, 9.8%). Majority of the patients (48) suffering from ocular trauma had foreign body cornea. In 85 premature infants screened for retinopathy, 19 showed different stages of retinopathy of prematurity. Visual impairment was noted in 89 (8.2%) patients, severe visual impairment in 12 (1.1%) and blindness in 35 (3.2%); vision could not be determined in 85 premature infants (7.9%). Cataract was singled out as the cause of severe visual impairment in 11 out of 12 patients.
Conclusion: Health education at primary health centres and availability of eye specialists in all the district hospitals will facilitate the rehabilitation of visually impaired and blind persons by providing early treatment for eye problems (specifically prescription for spectacles, medical treatment and cataract surgery with intraocular lens implantation).
Keywords: Visual impairment, cataract, diabetic retinopathy, glaucoma, refractive errors, ocular trauma, conjunctivitis
Study site: Eye clinic, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia

Matched MeSH terms: Vision Disorders
Fulltext Prevalence of squints and visual defects in Malaysian primary one school children

Teoh GH, Yow CS

Med J Malaysia, 1982 Dec;37(4):336-7.
PMID: 7167085

Six hundred and fifty standard one school children in 3 Petaling Jaya schools were examined. 7.1 percent were found to have significant refractive errors and fourteen cases of squints were detected giving a prevalence of 2.2 percent. The majority of squints were of the divergent type. The prevalence and different patterns among the Malaysian and Caucasian populations are discussed.

Matched MeSH terms: Vision Disorders/epidemiology*
Dengue maculopathy: a case report

Tan SY, Kumar G, Surrun SK, Ong YY

Travel Med Infect Dis, 2007 Jan;5(1):62-3.
PMID: 17161325

Dengue fever is endemic in many countries of South East Asia. In spite of the occasional epidemics, dengue maculopathy remains a rare entity.

Matched MeSH terms: Vision Disorders/etiology*
Fulltext Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial

Tan PJ, Khoo EM, Chinna K, Saedon NI, Zakaria MI, Ahmad Zahedi AZ, et al.

PLoS One, 2018;13(8):e0199219.
PMID: 30074996 DOI: 10.1371/journal.pone.0199219

OBJECTIVE: To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia.

DESIGN: Pragmatic, randomized-controlled trial.

SETTING: Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia.

PARTICIPANTS: Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months.

INTERVENTION: Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall.

RESULTS: Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613-1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846-1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782-1.522)] and mortality rate [RR = 0.896 (95% CI 0.335-2.400)] did not differ between groups.

CONCLUSION: Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations.

TRIAL REGISTRATION: ISRCTN Registry no. ISRCTN11674947.

Study site: emergency department, medical outpatients and primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia

Matched MeSH terms: Vision Disorders/diagnosis; Vision Disorders/epidemiology; Vision Disorders/therapy
Intracranial hypertension causing visual failure in cryptococcus meningitis

Tan CT

J Neurol Neurosurg Psychiatry, 1988 Jul;51(7):944-6.
PMID: 3204403

Thirty four patients with cryptococcal meningitis seen in the University of Malaya medical centre since 1980 were reviewed. Eleven patients had bilateral papilloedema and visual impairment but eventually survived. Seven patients had intensive aggressive measures, including shunting to reduce intracranial hypertension irrespective of ventricular size shown in CT scan, and showed substantial improvement in vision. It is concluded that papilloedema and visual failure in cryptococcal meningitis reflects raised intracranial pressure and that this should be treated vigorously.

Matched MeSH terms: Vision Disorders/physiopathology*
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 Disorders

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links