Displaying publications 1 - 20 of 250 in total

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  1. Fairuz Mohd Nordin, Khairun Najah binti Hasrin, Mohd Zaki Awg Isa, Amalina Othman, Zurin Firdawani Yacob
    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: Visual Acuity
  2. Azhan, A., Mutasim, H., Abdul-Hadi, R., Khairul-Anwar, I., Zunaina, E.
    MyJurnal
    Macular branch retinal vein occlusion (BRVO), a type of retinal vein occlusion, is rarely recognised as a distinct entity. Macular BRVO has unique clinical features and different natural courses than the major BRVO. We report a case of a young patient with macular BRVO with macular oedema who was successfully treated with intravitreal ranibizumab injection. A 43 year-old Chinese man with no underlying medical illness presented with 2 weeks history of left eye painless reduced central vision which was worsening over time. On examination, his left eye visual acuity was 6/30 and Amsler chart drawing showed a lower central scotoma. Dilated fundus examination found marked flame-shaped retinal hemorrhages with cotton wool spot over the superior macular area bounded superiorly by superior arcade and macular thickening. An optical coherence tomography revealed cystoid macular oedema; and fundus fluorescein angiography showed occlusion of a small venous branch draining a superior part of macula to superior temporal venous arcade. A complete medical investigation found that he has hypertriglyceridemia and he was managed accordingly. His vision had improved to 6/6 after receiving 3 injections of intravitreal ranibizumab with no residual central scotoma and complete resolution of macular oedema.
    Matched MeSH terms: Visual Acuity
  3. Norlaili M, Bakiah S, Zunaina E
    BMC Ophthalmol, 2011;11:36.
    PMID: 22111945 DOI: 10.1186/1471-2415-11-36
    BACKGROUND: Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the risk of visual loss. However recurrences are common and despite laser treatment, patients with diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood retinal barrier introduces a rationale for intravitreal triamcinolone treatment in diabetic macular oedema. This study is intended to compare the best corrected visual acuity (BCVA) and the macular oedema index (MEI) at 3 month of primary treatment for diabetic macular oedema between intravitreal triamcinolone acetonide (IVTA) and laser photocoagulation.
    METHODS: This comparative pilot study consists of 40 diabetic patients with diabetic macular oedema. The patients were randomized into two groups using envelope technique sampling procedure. Treatment for diabetic macular oedema was based on the printed envelope technique selected for every patient. Twenty patients were assigned for IVTA group (one injection of IVTA) and another 20 patients for LASER group (one laser session). Main outcome measures were mean BCVA and mean MEI at three months post treatment. The MEI was quantified using Heidelberg Retinal Tomography II.
    RESULTS: The mean difference for BCVA at baseline [IVTA: 0.935 (0.223), LASER: 0.795 (0.315)] and at three months post treatment [IVTA: 0.405 (0.224), LASER: 0.525 (0.289)] between IVTA and LASER group was not statistically significant (p = 0.113 and p = 0.151 respectively). The mean difference for MEI at baseline [IVTA: 2.539 (0.914), LASER: 2.139 (0.577)] and at three months post treatment [IVTA: 1.753 (0.614), LASER: 1.711 (0.472)] between IVTA and LASER group was also not statistically significant (p = 0.106 and p = 0.811 respectively).
    CONCLUSIONS: IVTA demonstrates good outcome comparable to laser photocoagulation as a primary treatment for diabetic macular oedema at three months post treatment.
    TRIAL REGISTRATION: ISRCTN05040192 (http://www.controlled-trial.com).
    Matched MeSH terms: Visual Acuity
  4. Yusoff M, Alwi AA, Said MM, Zakariah S, Ghani ZA, Zunaina E
    BMC Ophthalmol, 2011;11:15.
    PMID: 21679403 DOI: 10.1186/1471-2415-11-15
    Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue.
    Matched MeSH terms: Visual Acuity
  5. 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: Visual Acuity
  6. Ghanimi Zamli AK, Irma Ngah NS, Chew-Ean T, Muhammed J, Wan Hitam WH, Hussein A, et al.
    Cureus, 2019 Feb 05;11(2):e4015.
    PMID: 31007973 DOI: 10.7759/cureus.4015
    Introduction Ocular syphilis is a sight-threatening condition. It can occur at any stage of syphilis infection, which present either with acute inflammation during the primary, secondary, and early latent stages or with chronic inflammation during tertiary infection, affecting virtually every ocular structure. This study was to report on the clinical presentation of ocular syphilis that presented to eye clinic Hospital Universiti Sains Malaysia. Methodology This was a retrospective study where medical records of ocular syphilis patients who attended eye clinic in Hospital Universiti Sains Malaysia from January 2013 to June 2017 were reviewed. Results A total of 10 patients (13 eyes) with ocular syphilis were identified out of 106 cases that presented with ocular inflammation. The mean age of presentation was 69.8 ± 6.4 years and seven of them (70%) were female. All patients were Malay and human immunodeficiency virus (HIV) was negative. The ocular manifestations included panuveitis (four eyes, 30.8%), anterior uveitis (two eyes, 15.4%), posterior uveitis (seven eyes, 53.8%) and optic neuritis (two eyes, 15.4%). Seven (53.8%) eyes presented with visual acuity of worse than 6/60, five (38.5%) eyes had visual acuity between 6/15 to 6/60, and one (7.7%) eye had visual acuity of 6/12 or better. Nine patients received an intravenous benzylpenicillin regime and one patient received an intramuscular penicillin injection. Out of 13 eyes affected, 11 (84.6%) eyes had improved visual acuity of at least one Snellen line after treatment. Visual acuity of 6/12 or better increased to four (30.8%) eyes. Conclusions Posterior uveitis was the commonest presentation of ocular syphilis in HIV-negative patients. Early detection and treatment of ocular syphilis can result in resolution of inflammation and improvement of vision.
    Matched MeSH terms: Visual Acuity
  7. Guan-Fook N, Hayati AA, Raja-Azmi MN, Liza-Sharmini AT, Wan-Hazabbah WH, Zunaina E
    Clin Ophthalmol, 2012;6:487-90.
    PMID: 22536041 DOI: 10.2147/OPTH.S29806
    We report a case of diffuse unilateral subacute neuroretinitis in a young boy with no clinical visualization of nematode. The diagnosis was made based on clinical findings and detection of Toxocara immunoglobulin G by Western blot test. An 11-year-old Malay boy presented with progressive blurring of vision in the left eye for a duration of 1 year. It was associated with intermittent floaters. Visual acuity in the left eye was 6/45 and improved to 6/24 with pinhole. There was positive relative afferent pupillary defect, impaired color vision, and presence of red desaturation in the left eye. There were occasional cells in the anterior chamber with no conjunctiva injection. Posterior segment examination revealed mild-to-moderate vitritis and generalized pigmentary changes of the retina with attenuated vessels. The optic disk was slightly hyperemic with mild edema. There was presence of multiple, focal, gray-white subretinal lesions at the inferior part of the retina. Full blood picture results showed eosinophilia with detection of Toxocara immunoglobulin G by Western blot test. Investigations for other infective causes and connective tissue diseases were negative. The diagnosis of diffuse unilateral subacute neuroretinitis secondary to Toxocara was made based on clinical findings and laboratory results. He was treated with oral albendazole 400 mg daily for 5 days and oral prednisolone 1 mg/kg with tapering doses over 6 weeks. At 1 month follow-up, the inflammation had reduced, and multiple, focal, gray-white subretinal lesions were resolved; however there was no improvement of vision.
    Matched MeSH terms: Visual Acuity
  8. Suresh S, Nor-Masniwati S, Nor-Idahriani MN, Wan-Hazabbah WH, Zeehaida M, Zunaina E
    Clin Ophthalmol, 2012;6:147-50.
    PMID: 22291456 DOI: 10.2147/OPTH.S26844
    BACKGROUND: The purpose of this study was to evaluate the immunoglobulin (Ig) G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis.

    METHODS: A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed.

    RESULTS: A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6-83) years. Seventy-one patients (54.6%) were found to be seropositive, of whom five (3.8%) were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis) while one (0.8%) showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis) and 65 patients (50.0%) showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection). Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036). Eighteen patients (13.8%) were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing.

    CONCLUSION: Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.

    Matched MeSH terms: Visual Acuity
  9. Nor-Masniwati S, Shatriah I, Zunaina E
    Clin Ophthalmol, 2011;5:1079-82.
    PMID: 21847340 DOI: 10.2147/OPTH.S21057
    We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks' duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.
    Matched MeSH terms: Visual Acuity
  10. Nursyafiqah MT, Siti-Azrin AH, Yaacob NM, Wan-Nor-Asyikeen WA, Zunaina E
    Trop Med Int Health, 2023 Apr;28(4):300-307.
    PMID: 36787961 DOI: 10.1111/tmi.13862
    OBJECTIVE: Intravitreal ranibizumab is one of the anti-vascular endothelial growth factors used for the treatment of diabetic macular oedema, not always successfully. We aimed to identify the factors affecting the changes of central macular thickness after induction treatment with intravitreal ranibizumab, to predict the treatment effect and facilitate early treatment decisions.

    METHODS: Cross-sectional study involving a retrospective record review of diabetic macular oedema patients who received an induction treatment of three monthly 0.5 mg intravitreal ranibizumab injections between 2016 and 2019. Central macular thickness was measured at baseline and 3 months post-treatment. Linear regression was applied to identify the factors associated with the changes of central macular thickness.

    RESULTS: A total of 153 diabetic macular oedema patients were involved in this study. Their mean age was 57.5 ± 7.7 years, 54.9% were female. The mean change of central macular thickness from baseline to 3 months after completed induction treatment of intravitreal ranibizumab was 155.5 ± 137.8 μm. Factors significantly associated with changes of central macular thickness were baseline central macular thickness [b = 0.73; 95% (CI): 0.63, 0.84; p = <0.001] and presence of subretinal fluid [b = 35.43; 95% CI: 3.70, 67.16; p = 0.029].

    CONCLUSION: Thicker baseline central macular thickness and presence of subretinal fluid were the factors significantly associated with greater changes of central macular thickness in diabetic macular oedema patients after receiving three injections of intravitreal ranibizumab.

    Matched MeSH terms: Visual Acuity
  11. Liza-Sharmini AT, Azlan ZN, Zilfalil BA
    Singapore Med J, 2006 Jan;47(1):14-9.
    PMID: 16397715
    Down syndrome was first described as Mongoloid children with European parentage. Although their facial features resemble Orientals or Asians, ocular findings have not been well-documented in Asians, especially Malaysians. Our aim was to identify the ocular findings of Malaysian children with Down syndrome.
    Matched MeSH terms: Visual Acuity
  12. Muhamad-Amin, R., Nur Hasnida Gani, Liza-Sharmini, A.T., Zamli, A.H.
    MyJurnal
    Acute lymphoblastic leukemia (ALL) is the most common
    childhood leukaemia. It is a malignant neoplasm caused by the proliferation of
    poorly differentiated precursors of the lymphoid cells. It is relatively
    uncommon in adult. In adult ALL, central nervous system (CNS) involvement
    is associated with poor prognosis. The incidence of CNS involvement has
    been reported between 7% and 15 %. We report a case of optic nerve
    infiltration in ALL in a 49 years old gentleman. He was diagnosed with
    precursor-B ALL. He was treated with chemotherapy and CNS prophylactic
    regime. He presented with sudden left eye loss of vision for one-day duration
    with history of right eye inferior visual field loss for the past three months. His
    visual acuity was no perception to light on the left eye and 6/9 on the right
    eye. There was marked left relative afferent pupillary defect. The right eye
    showed decreased in optic nerve function with inferior visual field defect.
    Anterior segment examination was unremarkable in both eyes. Left optic disc
    appeared normal but the right optic disc was pale. Blood investigation
    showed no sign of infection or haemoconcentration. Cerebral spinal fluids
    examination revealed abundant of white cells and blast cells. Magnetic
    resonant imaging showed bilateral optic nerve enhancement suggesting of
    bilateral optic nerves infiltration. He was started on a new regime of
    chemotherapy followed by cranial radiotherapy. Unfortunately, he succumbed
    to death due to septicaemia. There are variations in clinical presentation of
    optic nerve infiltration in leukaemic patients. Normal appearance of optic disc
    may not exclude the possibility of infiltration by malignancy. Assessment of
    the optic nerve function and imaging is helpful for the detection of leukaemic
    infiltration. Early detection of optic nerve infiltration is important for initiation or
    change of therapy to prevent mortality.
    Matched MeSH terms: Visual Acuity
  13. Thanigasalam T, Reddy SC, Zaki RA
    J Ophthalmic Vis Res, 2016 4 7;10(4):375-84.
    PMID: 27051481 DOI: 10.4103/2008-322X.158892
    PURPOSE: Cataract surgery is the most common intraocular surgery performed all over the world and has advanced technically in recent years. As in all surgeries, complications are unavoidable. Herein we report factors associated with complications and visual outcomes of cataract surgery.

    METHODS: This retrospective cohort study included data of 1,632 cataract surgeries performed from 2007 to 2010 which was obtained from the cataract registry of the Malaysian National Eye Database. Demographic features, ocular and systemic comorbidites, grade of surgeon expertise and duration of surgery, type of anesthesia, intraoperative and postoperative complications, and the type of intraocular lens were recorded. Best corrected visual acuities were compared before and after the operation.

    RESULTS: Mean patient age was 66.9 years with equal gender distribution. The majority of subjects had age related cataracts. Phacoemulsification was done faster than other surgeries, especially by specialist surgeons. History of prior ocular surgery and operations performed under general anesthesia were associated with greater complications. Phacoemulsification was associated with less complications and better visual outcomes. The age and etiology of cataract did not affect complications. Malays, absence of ocular comorbidities, left eyes and eyes operated under local anesthesia were more likely to experience more visual improvement. Gender, age, cause of cataract, systemic comorbidities and surgeon expertise as well as intra-and postoperative complications did not affect the visual outcomes.

    CONCLUSION: Phacoemulsification had good visual outcomes in cataract surgery. Duration of surgery, expertise of the surgeon and complications did not affect the visual outcomes.

    Matched MeSH terms: Visual Acuity
  14. Amir NN, Kamaruzzaman SB, Effendi-Tenang I, Jamaluddin M, Tan MP, Ramli N, et al.
    Eur Geriatr Med, 2021 Apr;12(2):313-319.
    PMID: 33486745 DOI: 10.1007/s41999-021-00450-2
    PURPOSE: Using data from the Malaysian Elders Longitudinal Research (MELoR), this study investigated the association between visual function (visual acuity and contrast sensitivity) and frailty in a group of urban-dwelling older adults.

    METHODS: This was a cross-sectional study. 1332 participants aged ≥ 55 years were selected by random sampling from the parliamentary electoral register. Only 1274 participants completed the frailty assessment and 1278 participants completed the contrast sensitivity assessment. Impaired vision was defined as a Snellen visual acuity of worse than 6/12 in the better eye. Poor contrast sensitivity was defined as a score on the Pelli Robson chart of lower than 1.65. Frailty was defined with the Fried's phenotype criteria. Inter-group comparisons were determined with the independent T-test for continuous variables and the Pearson's Chi-squared test for categorical variables. The odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the cross-sectional association between frailty and visual function.

    RESULTS: The mean age of participants was 68.8 ± 7.5 years, of which 58.1% (774) were women. Impaired vision and poor contrast sensitivity were present in 187 (14%) and 271 (21.2%) subjects respectively. 73 (5.8%) individuals were classified as frail, 1161 (91.0.%) pre-frail, and 40 (2.8%) non-frail. There was no significant difference in frailty phenotypes between those with good and impaired vision (p = 0.241). Fried's component of handgrip strength, gait speed and exhaustion were significantly better in those with good visual function (p 

    Matched MeSH terms: Visual Acuity
  15. Ameilia A, Shatriah I, Wan-Hitam WH, Yunus R
    Brain Dev, 2015 Jun;37(6):635-7.
    PMID: 25457086 DOI: 10.1016/j.braindev.2014.09.011
    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits.
    Matched MeSH terms: Visual Acuity
  16. Jin-Poi T, Shatriah I, Ng SL, Zurkurnai Y, Yunus R
    JAMA Ophthalmol, 2013 Feb;131(2):263-5.
    PMID: 23411903 DOI: 10.1001/jamaophthalmol.2013.587
    Matched MeSH terms: Visual Acuity/physiology
  17. Teoh GH, Yow CS
    Med J Malaysia, 1982 Mar;37(1):7-10.
    PMID: 7121351
    A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).
    Matched MeSH terms: Visual Acuity
  18. Md Noh UK, Zahidin AZ, Yong TK
    Clin Pract, 2012 Mar 30;2(2):e54.
    PMID: 24765453 DOI: 10.4081/cp.2012.e54
    A 26-year-old woman with a recent flare-up of systemic lupus erythematosus presented with peripheral retinal hemorrhages at a routine check-up. She is on a tapering dose of immunosuppressive agents. Her visual acuity was good. Fluorescein angiogram revealed vasculitic changes with capillary non-perfusion areas. A few weeks later, she developed cerebral lupus with advanced lupus nephritis. Immunosuppressive therapy was restarted and panretinal photocoagulation was delivered. Her visual acuity remained stable, despite development of a cataract from prednisolone therapy.
    Matched MeSH terms: Visual Acuity
  19. Ibrahim M, Yap JY
    BMJ Case Rep, 2018 Apr 25;2018.
    PMID: 29695396 DOI: 10.1136/bcr-2018-224552
    We describe the first clinical case of Burkholderia cepacia keratitis registered in Southeast Asia. A man in his mid-70s with underlying poorly controlled diabetes mellitus came with complaints of painful red left eye for 4 days. This was accompanied with photophobia and blurring of vision after being injured by a wooden particle while cutting grass. Slit-lamp examination showed a paracentral anterior corneal stromal infiltrates with overlying epithelial defect. Culture of the corneal smear isolated B. cepacia that was sensitive to ceftazidime, meropenem and bactrim (trimethorprim and sulfomethoxazole). Topical ceftazidime was given intensively to the patient and the infection resolved after 6 weeks of treatment.
    Matched MeSH terms: Visual Acuity
  20. Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM
    Clin Exp Optom, 2020 05;103(3):278-289.
    PMID: 31441091 DOI: 10.1111/cxo.12953
    The role of visual acuity and refractive errors in the academic performance of children is controversial due to the variable quality of the research in this area and the mixed findings reported. This review aims to provide clarity by reviewing and critiquing relevant peer-reviewed publications and also summarises what is known regarding the visual demands of modern classroom environments. The outcomes of this review suggest that while a number of studies have investigated the role of vision in relation to children's academic performances, the veracity of the evidence obtained from the majority of these studies is undermined by methodological limitations. Comparisons between studies are constrained by differences in experimental designs, instrumentation and sample characteristics. Despite these limitations, the weight of evidence suggests there is an association between academic performance and both visual acuity and refractive error in children. However, well-designed experimental studies are necessary to further understand the relationship between these parameters.
    Matched MeSH terms: Visual Acuity
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