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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*
Profile of a low vision clinic population

Mohidin N, Yusoff S

Clin Exp Optom, 2002 12 17;81(5):198-202.
PMID: 12482319

BACKGROUND: Causes of low vision and types of low vision devices (LVDs) prescribed in other low vision clinics have been studied extensively. Similar studies have not been conducted in Malaysia. This paper reports the results of a retrospective study of 573 patients seen at the Universiti Kebangsaan Malaysia-Malaysian Association for the Blind (UKM-MAB) low vision clinic in Kuala Lumpur. METHODS: The record cards of 573 patients seen at the UKM-MAB clinic over 10 years were examined and the following information extracted: date of first consultation, age, sex, cause of visual impairment as diagnosed by an ophthalmologist and types of low vision devices (LVDs) prescribed. RESULTS: The majority of patients were from the younger age groups with 423 (73.8 per cent) less than 50 years of age. Three hundred and ninety-five (68.9 per cent) of the subjects were males and 178 (31.1 per cent) female. The main causes of low vision were congenital structural defects including nystagmus among patients in the zero to 29 years age group, retinitis pigmentosa among the 30 to 59 years age group and age-related macular degeneration (ARM) among those over 60 years of age. CONCLUSIONS: Since the majority of the patients were from the younger age group the main causes of low vision were congenital and hereditary diseases. Three hundred and forty-one (59.5 per cent) patients seen at the low vision clinic accepted the use of LVDs.

Matched MeSH terms: Vision, Low
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
Fulltext Oral hygiene practices among the visually impaired adolescents

Azrina, A.N., Norzuliza, G., R. Saub, R.

Ann Dent, 2007;14(1):1-6.
MyJurnal

The purpose of this study was to gather information on the oral hygiene behaviour among the visually impaired adolescents. Interview and observation methods were used to collect data. A total of 114 visually impaired adolescents were interviewed and 10 of the interviewees were selected for observation on the actual oral hygiene practices. The mean age of the sample was 16 years old. The sample comprised of 53.5% female, majority were Malays (86.8%) and most of them were from the lower income group. Fifty four percent of the sample had low vision and 45.6% were blind. All of the participants reported that they brushed their teeth daily and most of them brushed twice a day or more. Flossing (6.1%) was not common practice among this group. It was observed that they encountered some difficulties, especially when putting the toothpaste on the toothbrush and also the way that they brushed their teeth could cause detrimental effect to the oral cavity. Thus, they need to be taught on proper oral hygiene care so that they can practice safe oral hygiene care and maintain their own oral health.

Matched MeSH terms: Vision, Low
Prevalence and causes of functional low vision in school-age children: results from standardized population surveys in Asia, Africa, and Latin America

Gilbert CE, Ellwein LB, Refractive Error Study in Children Study Group

Invest Ophthalmol Vis Sci, 2008 Mar;49(3):877-81.
PMID: 18326706 DOI: 10.1167/iovs.07-0973

Data on the prevalence and causes of functional low vision (FLV) in adults and children are lacking but are important for planning low-vision services. This study was conducted to determine the prevalence and causes of FLV among children recruited in eight population-based prevalence surveys of visual impairment and refractive error from six countries (India [2 locations]; China [2 locations]; Malaysia, Chile, Nepal, and South Africa).

Matched MeSH terms: Vision, Low/etiology*; Vision, Low/epidemiology*
Prevalence of refractive error in malay primary school children in suburban area of Kota Bharu, Kelantan, Malaysia

Hashim SE, Tan HK, Wan-Hazabbah WH, Ibrahim M

Ann Acad Med Singap, 2008 Nov;37(11):940-6.
PMID: 19082201

INTRODUCTION: Refractive error remains one of the primary causes of visual impairment in children worldwide, and the prevalence of refractive error varies widely. The objective of this study was to determine the prevalence of refractive error and study the possible associated factors inducing refractive error among primary school children of Malay ethnicity in the suburban area of Kota Bharu, Kelantan, Malaysia.
MATERIALS AND METHODS: A school-based cross-sectional study was performed from January to July 2006 by random selection on Standard 1 to Standard 6 students of 10 primary schools in the Kota Bharu district. Visual acuity assessment was measured using logMAR ETDRS chart. Positive predictive value of uncorrected visual acuity equal or worse than 20/40, was used as a cut-off point for further evaluation by automated refraction and retinoscopic refraction.
RESULTS: A total of 840 students were enumerated but only 705 were examined. The prevalence of uncorrected visual impairment was seen in 54 (7.7%) children. The main cause of the uncorrected visual impairment was refractive error which contributed to 90.7% of the total, and with 7.0% prevalence for the studied population. Myopia is the most common type of refractive error among children aged 6 to 12 years with prevalence of 5.4%, followed by hyperopia at 1.0% and astigmatism at 0.6%. A significant positive correlation was noted between myopia development with increasing age (P <0.005), more hours spent on reading books (P <0.005) and background history of siblings with glasses (P <0.005) and whose parents are of higher educational level (P <0.005). Malays in suburban Kelantan (5.4%) have the lowest prevalence of myopia compared with Malays in the metropolitan cities of Kuala Lumpur (9.2%) and Singapore (22.1%).
CONCLUSION: The ethnicity-specific prevalence rate of myopia was the lowest among Malays in Kota Bharu, followed by Kuala Lumpur, and is the highest among Singaporean Malays. Better socio-economic factors could have contributed to higher myopia rates in the cities, since the genetic background of these ethnic Malays are similar.

Matched MeSH terms: Vision, Low/etiology; Vision, Low/epidemiology; Vision, Low/physiopathology
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 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
Severity of visual impairment and depression among elderly Malaysians

Noran NH, Izzuna MG, Bulgiba AM, Mimiwati Z, Ayu SM

Asia Pac J Public Health, 2009 Jan;21(1):43-50.
PMID: 19124335 DOI: 10.1177/1010539508327353

OBJECTIVE: This study aimed at evaluating the relationship between severity of visual impairment and depression among elderly Malaysians attending an eye clinic.
METHODS: This was a cross-sectional study. The study population included patients, aged>or=60 years who attended the Eye Clinic in University Malaya Medical Centre. Exposure measurement was based on ophthalmologic examinations by an ophthalmologist. Data on outcome were measured using the Geriatric Depression Scale.
RESULTS: After adjusting for important confounders, severity of visual impairment either having low vision or blind were independent risk factors of depression. The odds of developing depression among elderly with low vision were 2 times more than those with normal vision, and elderly who were blind had almost 5 times the odds to be depressed compared with those having normal vision.
CONCLUSION: Findings from this study suggest a positive relationship between the severity of visual impairment and depression among elderly Malaysians.
Study site: Eye Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-15)

Matched MeSH terms: Vision, Low/ethnology; Vision, Low/psychology*
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 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
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*
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
Fulltext Childhood blindness and severe visual impairment in Malaysia: a nationwide study

Patel DK, Tajunisah I, Gilbert C, Subrayan V

Eye (Lond), 2011 Apr;25(4):436-42.
PMID: 21350565 DOI: 10.1038/eye.2011.19

To determine the causes of childhood blindness and severe visual impairment (BL/SVI) in schools for the blind in Malaysia.

Matched MeSH terms: Vision, Low/etiology*
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*
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
Fulltext Topical cyclosporin as an alternative treatment for vision threatening blepharokeratoconjunctivitis: a case report

Ismail AS, Taharin R, Embong Z

Int Med Case Rep J, 2012;5:33-7.
PMID: 23754920 DOI: 10.2147/IMCRJ.S29960

Here, a case of vision threatening blepharokeratoconjunctivitis that responded well to topical cyclosporin is reported. A 9-year-old Malay girl with a history of bilateral blepharokeratoconjunctivitis was regularly treated with lid scrubbing using diluted baby shampoo, fusidic acid gel, and topical steroids as well as an intermittent course of oral doxycycline for the past year. She developed acute onset bilateral eye redness associated with poor vision in her right eye. Both eyes showed marked diffuse hyperemic conjunctiva with corneal vascularization. The presence of corneal vascularization obscured the visual axis in the right eye. The condition did not improve with regular intensive lid hygiene using diluted baby shampoo, fusidic acid gel, and topical steroids. She was started on topical cyclosporin A 0.5% every 6 hours. There was a dramatic regression of corneal vascularization after 3 days on topical cyclosporin, with marked improvement in visual acuity. This is a single case in which cyclosporin improved the status of the ocular surface. A large cohort study is required to justify its effectiveness in treating blepharokeratoconjunctivitis and to test its potential as an alternative immunosuppressive agent in comparison to conventional corticosteroids.

Matched MeSH terms: Vision, Low
Impact of glaucoma severity and laterality on vision-specific functioning: the Singapore Malay eye study

Chan EW, Chiang PP, Wong TY, Saw SM, Loon SC, Aung T, et al.

Invest Ophthalmol Vis Sci, 2013 Feb;54(2):1169-75.
PMID: 23341009 DOI: 10.1167/iovs.12-10258

We determined the impact of glaucoma severity and laterality on vision-specific functioning (VF) in an Asian population.

Matched MeSH terms: Vision, Low/diagnosis; Vision, Low/ethnology; Vision, Low/physiopathology
Fulltext Arteriovenous malformation in temporal lobe presenting as contralateral ocular symptoms mimicking carotid-cavernous fistula

Mohd-Tahir F, Siti-Raihan I, Wan Hazabbah WH

Case Rep Ophthalmol Med, 2013;2013:158961.
PMID: 23533876 DOI: 10.1155/2013/158961

Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

Matched MeSH terms: Vision, Low
Fulltext Mental health state and quality of life questionnaire in low vision assessment: a case report

Omar R, Rahman MH, Knight VF, Mustaphal M, Mohammed Z

BMC Res Notes, 2014;7:667.
PMID: 25245590 DOI: 10.1186/1756-0500-7-667

BACKGROUND: Vision impairment associated with diabetic retinopathy, is well known and low vision rehabilitation is always recommended. In this report, the importance of objective measure of mental health and quality of life screening in diabetic retinopathy low-vision assessment is discussed.
CASE PRESENTATION: We describe the case of a 43-year-old Asian female who has mild vision impairment due to tractional retinal detachment secondary to diabetic retinopathy and how mental health screening and quality of life screening during low vision rehabilitation can improve in the management of this patient.
CONCLUSION: Although vision impairment was mild, the psychological impact was enormous and affected her quality of life substantially. This case report illustrates that recognition of the mental health and quality of life impact on visual impairment is critical to the rehabilitation management of low vision patients with diabetic retinopathy.

Matched MeSH terms: Vision, Low/physiopathology*

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