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Fulltext Refractive error status of orang asli and Malay-Jawa children in Kuala Langat, Selangor

Fairuz Mohd Nordin, Khairun Najah binti Hasrin, Mohd Zaki Awg Isa, Amalina Othman, Zurin Firdawani Yacob

Journal of Optometry, Eye and Health Research, 2020;2(1):28-33.
MyJurnal

This study aims to determine the refractive error status of Orang Asli children and Malay-Jawa children in Kuala Langat, Selangor. Visual acuity was measured using LEA chart, followed by dry static retinoscopy which the testing eye fogged with 2.00D, and the contralateral eye fogged with 6.00D to determine the refractive errors. The inclusion criteria encompassed all children in the selected village. The exclusion criteria included children who were already on ophthalmology follow-up for known ocular conditions and refused visual acuity assessment or eye examination. In total, 103 ‘Orang Asli’ and 107 normal population children aged 3 to 13 years received refractive assessments. Approximately 18% of reported cases were myopia, 43% were hyperopia, while 39% were emmetropia. Results showed that the ‘Orang Asli’ population was more hyperopic than the Malay-Jawa (U = 4893.500, P > 0.05, r = 0.14). However, both groups were found more hyperopic compared to myopic conditions. In conclusion, both Orang Asli and Malay-Jawa in Kuala Langat, Selangor are more hyperopic and less myopic. This study suggests that refractive error screening is important for preventing visual impairment among children in rural areas.

Matched MeSH terms: Vision Disorders
Fulltext An elderly lady with blurring of vision

Azhany Y, Nani D, Zunaina E

Malays Fam Physician, 2012;7(1):43-4.
PMID: 25606247 MyJurnal
Matched MeSH terms: Vision Disorders
Fulltext Neuroretinitis with dual infections

Kiu KH, Hanizasurana H, Zunaina E

Int Med Case Rep J, 2015;8:255-8.
PMID: 26527902 DOI: 10.2147/IMCRJ.S91323

A 22-year-old Malay female presented with left eye floaters for 2 weeks, associated with temporal visual field defect and metamorphopsia for 3 days. She has a guinea pig and a hedgehog at home, but denied being bitten or scratched by them. Her visual acuity at presentation was 6/12 on the left eye and 6/6 on the right eye. Her left eye relative afferent pupillary defect was barely positive with mild anterior chamber reaction. Fundus examination of the left eye showed mild vitritis, swollen optic disc with macular star, crops of active choroidal lesions at superonasal retina with a linear arrangement in the form of migratory track nasally. However, there were no nematodes seen on fundus examination. Investigations showed normal full blood count with no eosinophilia and positive serology test for Bartonella henselae. She was diagnosed to have dual infection - diffuse unilateral subacute neuroretinitis (DUSN), based on the presence of crops of choroidal lesions with migratory track, and cat scratch disease (CSD) based on a positive serological test. She was treated with oral albendazole 400 mg 12 hourly for 6 weeks for DUSN and oral doxycycline 100 mg 12 hourly for 4 weeks for CSD. Focal laser had been applied to the area of migratory track in the left eye. Her left eye vision improved to 6/6 at 1 month after treatment, with resolution of neuroretinitis.

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 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*
The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

Harithasan D, Mukari SZS, Ishak WS, Shahar S, Yeong WL

Int J Geriatr Psychiatry, 2020 04;35(4):358-364.
PMID: 31736109 DOI: 10.1002/gps.5237

OBJECTIVES: The objective of this study was to evaluate the relationship between sensory impairment (hearing loss only, vision loss only, and dual sensory impairment [DSI]) and depression, loneliness, quality of life, and cognitive performance in older adults.
METHODS: A total of 229 community-dwelling older adults aged 60 years or older participated in this study. Variables were measured using the Geriatric Depression Scale (GDS-15), Revised University of California at Los Angeles Loneliness Scale (R-UCLA), Satisfaction with Life Scale (SWLS), and Mini-Mental State Examination (MMSE).
RESULTS: There was an independent association between DSI and quality of life (P < .05) and between DSI and hearing loss alone and cognitive function (P < .05) in older adults. In addition, higher education was associated with better quality of life and cognitive function.
CONCLUSIONS: DSI is a significant factor affecting the quality of life and cognitive function in older adults. Sociodemographic factors such as education play an important role in improving quality of life and cognitive function. Thus, increasing the awareness of this disability is important to ensure that older adults receive the necessary support services and rehabilitation to improve their level of independence.

Matched MeSH terms: Vision Disorders/complications*; Vision Disorders/epidemiology; Vision Disorders/psychology
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*
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
Levels of Visual Stress in Proficient Readers: Effects of Spectral Filtering of Fluorescent Lighting on Reading Discomfort

Loew SJ, Rodríguez C, Marsh NV, Jones GL, Núñez JC, Watson K

Span J Psychol, 2015;18:E58.
PMID: 26255657 DOI: 10.1017/sjp.2015.59

Visual stress (VS) affects reading in 5-12% of the general population and 31-36% of children with reading disorders. Symptoms include print distortions and visual discomfort when reading, and are exacerbated by fluorescent lighting. Prior research has indicated that VS can also affect proficient readers. We therefore examined levels of visual discomfort in a group of expert readers (n = 24) under both standard and spectrally-filtered fluorescent lighting. Participants rated their awareness of six symptoms of VS under each lighting condition. Under the standard condition, 4(16.7%) of the group recorded moderate to high levels of VS. Differences in symptom levels and reading speed between conditions were analysed using the Wilcoxon Signed Rank Test. Under the filter condition, the group reported less discomfort regarding all six symptoms of VS surveyed. The differences were significant with respect to three of the symptoms (p = .029 - p < .001), with a medium effect size in all of them (r = .31 - r = .46) and total score (p = .007; r = .39). Variations in reading proficiency included significantly fewer self-corrections (p = .019) and total errors (p = .004). Here we present evidence that VS-type symptoms of reading discomfort are not confined to populations with reading difficulties and may also occur in proficient readers, and that simple adaptations to fluorescent lighting may alleviate such symptoms.

Matched MeSH terms: Vision Disorders/etiology*
Non-arteritic anterior ischaemic optic neuropathy secondary to menorrhagia in a young healthy woman

Koh KL, Sonny Teo KS, Chong MF, Wan Hitam WH

BMJ Case Rep, 2018 Jun 27;2018.
PMID: 29950366 DOI: 10.1136/bcr-2018-225113

Non-arteritic anterior ischaemic optic neuropathy (NAION) may develop due to severe anaemia and hypotension which is seen in acute blood loss. The devastating visual loss is often irreversible. We report a case of NAION in a 20-year-old healthy woman, who presented on the third day of a heavy menstrual cycle with hypovolaemic shock. On day 2 of admission, she had sudden right eye blurring of vision at the superior field on awakening from sleep. Funduscopy revealed a pale and swollen right optic disc. There was a dense right superior altitudinal visual field defect. Her haemoglobin level was low (3.6 g/dL), but she refused blood transfusion due to her religious belief (Jehovah's Witness) and opted for conservative management. She later developed right optic atrophy with persistent visual field defect despite an improved haemoglobin level of 10.5 g/dL.

Matched MeSH terms: Vision Disorders/etiology*; Vision Disorders/pathology
Fulltext Caecocentral Scotoma: A Rare Presentation of Optic Perineuritis

Mohamad SA, Zunaina E, Wan Hitam WH

Cureus, 2019 Nov 08;11(11):e6101.
PMID: 31886042 DOI: 10.7759/cureus.6101

Optic perineuritis (OPN) is a subtype of optic neuritis (ON) in which the inflammatory process involves meningeal sheath surrounding the optic nerve. Clinically, OPN simulates ON. However, in contrast to ON, patient with OPN shows sparing of central vision, improves dramatically with high-dose corticosteroid, are more likely to experience recurrence after stopping treatment. We report a rare case of caecocentral scotoma observed in a female with typical ON symptoms. Her magnetic resonance imaging showed features in line with OPN. She was treated with intravenous methylprednisolone 1 g/day for five days followed by slow tapering dose of oral prednisolone for one month. Her vision improved dramatically with a resolution of visual field defect. No relapses seen within two years of follow-up.

Matched MeSH terms: Vision Disorders
Fulltext Bilateral Inferior Altitudinal Visual Field Defect in Recurrent Intracranial Meningioma: A Case Report

Ghanimi Zamli AK, Chew-Ean T, Wan Hitam WH

Cureus, 2019 Apr 11;11(4):e4436.
PMID: 31245223 DOI: 10.7759/cureus.4436

Altitudinal visual field defect is a rare presentation of retrochiasmal lesion especially when bilateral visual fields were affected. In fact, bilateral inferior altitudinal visual field defect (BIAVFD) usually occurred in patients who survived a gunshot injury to the occipital lobe or as a direct trauma to the brain. We report a rare case of BIAVFD secondary to occipital meningioma. A high index of suspicion enables timely investigation and diagnosis when dealing with atypical presentation of intracranial meningioma.

Matched MeSH terms: Vision Disorders
Fulltext Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia

Hasan AN, Mustapha M, Wan HAHW

Cesk Slov Oftalmol, 2024;80(Ahead of print):1-5.
PMID: 38413229 DOI: 10.31348/2024/1

AIMS: We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia.
CASE SERIES: There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21-64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impair- ment (6/18-6/60); 35.71% each, followed by mild visual impairment (6/12-6/18), and severe visual impairment (6/60-3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up.
CONCLUSION: VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment and systemic corticosteroids.

Matched MeSH terms: Vision Disorders
Fulltext Multifacet of Cornea Patch Graft in Anterior Segment Diseases

Chendran P, Meng Hsien Y, Wan Abdul Halim WH

Case Rep Ophthalmol Med, 2019;2019:6862487.
PMID: 31885979 DOI: 10.1155/2019/6862487

Incidence of cornea melting or perforation is commonly seen in variety of cornea conditions. It can cause debilitating vision loss and impair patient's daily activity. Several techniques have been described to surgically treat cornea perforation and melting. In this article, a series of corneal diseases treated with corneal patch graft are highlighted to relate different approach of cornea patch graft surgery. Post-operative management and complications are discussed.

Matched MeSH terms: Vision Disorders
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 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 negative waveform in the scotopic response in a patient with phosphoglycerate kinase deficiency: a visual electrophysiology report

Mohd Khialdin S, Grigg J, Rowe N, Crofts S, Wilson M, Troedson C

Documenta ophthalmologica. Advances in ophthalmology, 2015 Dec;131(3):215-20.
PMID: 26396085 DOI: 10.1007/s10633-015-9511-0

Phosphoglycerate kinase (PGK) deficiency is an X-linked neurometabolic genetic disorder with variable systemic manifestations. So far, only one patient with retinal anomalies has been reported, but no visual electrophysiology findings were described. We report the first description of visual electrophysiology in a child with PGK deficiency. This provides further information for the site of involvement in the eye.

Matched MeSH terms: Vision Disorders/diagnosis; Vision Disorders/physiopathology*
Fulltext Characteristics of visually impaired children in Low Vision Clinic in UKM. [Ciri kanak-kanak berpenglihatan terhad di Klinik Penglihatan Terhad UKM]

Omar R, Knight VF, Mohammed Z, Tholasee GM

Jurnal Sains Kesihatan Malaysia, 2007;5(1):37-45.
MyJurnal

While the prevalence of visually impaired children constitutes a small portion of the visually impaired population, it is important to determine whether the low vision services available are utilised by these children. This is important as previous studies have shown that children have a very high rate of successful low vision device use compared to adults. This was a cross sectional retrospective study. Fifty nine low vision clinic children records were evaluated. The results showed that 25.4% of the children were categorised as with moderate low vision, 30.5% with severe low vision and 40.7% were categorised as blind. The major causes of low vision were congenital cataract, congenital nystagmus, congenital glaucoma, macular degeneration and retinitis pigmentosa. Low vision rehabilitation for near work using magnifiers improved the vision of 30.5% of the low vision children. This finding suggests that 1/3 of low vision children could benefit from low vision rehabilitation. The low vision devices most commonly prescribed to the children in this study were stand magnifiers, hand-held magnifiers and spectacles. This study illustrates the key role of optometrists in the management of visual impairment in Malaysian children. It would appear that the establishment of low vision services in government hospitals using trained optometrists is a cost effective method of service delivery. Therefore more low vision children would have access to proper low vision rehabilitation and through that rehabilitation, their quality of life can be improved.
Key words: children, low vision
Study site: Klinik Penglihatan Terhad Pusat Perubatana, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Matched MeSH terms: Vision Disorders
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*

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