MyMedR

Safeguarding against potential injury from an eye drops bottle

Krishnan R, Shamsher S, Adzura S

Med J Malaysia, 2023 Nov;78(6):849-851.

We describe a potential cause of eye injury, its concerns and ways to prevent it. The first author underwent a left cataract operation and was prescribed eye drops postoperatively. While applying one of the eye drops, he felt an object hitting the lower eyelid. A serrated plastic piece had fallen off the bottle. Had it fallen on the operated site, it might have caused serious untoward complications. Nurses, carers and patients need to be educated to remove the serrated piece from the bottle before applying eye drops. Manufacturers of eye drops should design safer bottles without such serrated pieces to prevent such eye injuries.

Fulltext A study of factors influencing eye screening: descriptive findings

Rif'atunnailah Mat Isa, Adzura Salam, Sumaiyah @ Thandar Soe Jamaluddin

International Medical Journal Malaysia, 2017;16(11):13-13.

MyJurnal

Individuals with Diabetes Mellitus (DM) are at increased risk for developing
diabetic ocular complications. This study was carried out to determine factors
influencing eye screening among Diabetes Mellitus patients. The descriptive findings of
participants’ sociodemographic data will be discussed. (Copied from article).

Sphingomonas paucimobilis endophthalmitis postpenetration ocular trauma: A rare case report

Alias NAQ, Bari MA, Jabbari AJ, Salam A

Oman J Ophthalmol, 2023;16(3):555-557.

PMID: 38059095 DOI: 10.4103/ojo.ojo_298_22

Endophthalmitis is an uncommon purulent inflammation of the intraocular fluids secondary to endogenous or exogenous causes. It is known that posttraumatic endophthalmitis had a notably poor visual outcome, and it poses therapeutic challenges. Therefore, early organism detection would be beneficial in therapeutic management and are able to reduce long-term complications. This case report describes a patient with a rare positive culture-proven Sphingomonas paucimobilis endophthalmitis due to penetrating ocular trauma by a metal brush over the right eye. A 36-year-old man presented with progressively worsening right eye redness and blurring of vision with pain for 3 days following ocular penetration by a metal brush during grinding. On initial presentation, his visual acuity was 6/12 over the right eye and 6/6 over the left eye. His visual acuity deteriorated to hand movement 5 days later with worsening of ocular infection over the right eye despite topical and oral antibiotics. B-scan revealed dense vitreous infiltration. A vitreous tap was done, and a combination of intravitreal vancomycin and ceftazidime was administered. Vitreous culture isolated Gram negative S. paucimobilis. The patient was planned for early vitrectomy; however, the patient opted for conservative treatment. Therefore, the patient received intravitreal vancomycin and intravitreal ceftazidime injections every 48-72 h. Published articles on S. paucimobilis endophthalmitis postocular penetration are extremely limited. This case report may provide a better understanding of the presentation and is able to aid with early diagnosis and treatment initiation for future reference.

Fulltext Correlation of serum insulin like growth factor-I with retinopathy in Malaysian pregnant diabetics

Adzura S, Muhaya M, Normalina M, Zaleha AM, Sharifa Ezat WP, Tajunisah I

Int J Ophthalmol, 2011;4(1):69-72.

PMID: 22553613 DOI: 10.3980/j.issn.2222-3959.2011.01.16

AIM: To study the association of serum insulin-like growth factor-I (IGF-I) with diabetic retinopathy.

METHODS: Serum IGF-1 levels were measured in 25 pregnant diabetic patients and 25 pregnant non-diabetic patients who were matched for age, ethnicity, parity and period of gestation. Fundus examination was performed in both groups at 28, 32 and 36 weeks of gestation.

RESULTS: The serum IGF-I level was significantly elevated in pregnant diabetics compared to pregnant non-diabetics (366±199μg/L vs 184±89μg/L, (P=0.0001) at 24 weeks, 535±251μg/L vs 356±89μg/L, (P=0.007) at 32 weeks and 404±166μg/L vs 264±113μg/L, (P=0.003) at 36 weeks of gestation). The pregnant diabetics with established diabetes had significantly higher IGF-1 level than gestational diabetes at 28, 32 and 36 weeks of gestation. The serum IGF-I level in pregnant diabetics with retinopathy was significantly higher than that in those without retinopathy at all periods of gestation.

CONCLUSION: Increased serum IGF-1 in pregnancy may increase the risks for retinopathy.

The impact of image resolution on diagnostic accuracy using fractal dimension in identifying diabetic retinopathy, glaucoma, and age-related macular degeneration

Che Azemin MZ, Mohd Tamrin MI, Yusof F, Salam A

Graefes Arch Clin Exp Ophthalmol, 2024 May 16.

PMID: 38753023 DOI: 10.1007/s00417-024-06521-x

Ocular Hornet Injury: A Case Report on Corneal Microperforation and Endophthalmitis

Mohd Amin MHA, Rosli AH, Salam A

Cureus, 2024 Jul;16(7):e65515.

PMID: 39188476 DOI: 10.7759/cureus.65515

The lesser-banded hornet (Vespa affinis indosinensis) is a prevalent species in tropical and subtropical regions of Asia, including Malaysia. Its stings can result in local reactions, severe anaphylactic shock, and even death. We report a rare case of corneal microperforation and endophthalmitis following an ocular hornet injury. A 76-year-old farmer was attacked by hornets and suffered multiple stings, including one to his right eye. He developed right eye pain, redness, and visual impairment. Ocular examination revealed right corneal haziness with a retained stinger. Attempts to remove the retained stinger were unsuccessful, as the stinger broke and stayed deep in the corneal tissue layer. Corneal microperforation occurred at the site of the retained stinger. Subsequently, he developed endophthalmitis despite extensive topical and systemic antibiotics. He also required a scleral patch procedure for sclerokeratouveitis. This report highlights the importance of quick and vigilant management to prevent severe complications and preserve vision after a hornet sting injury. Retained stingers pose unique challenges that require specialized interventions. There is a need for continuous research and awareness in the management of ocular hornet injuries, aiming to establish standardized treatment guidelines and improve patient outcomes.

A cross-sectional study on factors influencing attendance to eye screening

Isa RM, Saidi S, Salam A, Nurumal MS, Jamaludin TSS

Enferm Clin, 2021 04;31 Suppl 2:S321-S325.

PMID: 33849190 DOI: 10.1016/j.enfcli.2020.12.037

This study aimed to survey the factors influencing attendance to eye screening among Diabetes mellitus (DM) patients. This cross-sectional survey was carried out among 170 DM patients using self-administered questionnaires. Majority of participants, 45.9% (n=78) highlighted that lack of information regarding diabetes and not understanding the significance of eye screening are the barriers to eye screening. Whereas, 10.6% (n=18) reported lack of access to healthcare facilities, 6.5% (n=11) experienced time limitation and 2.9% (n=5) suffered financial issues. However, more than half of the participants (58.2%) have good knowledge related to diabetic eye complications. There was a significant difference between educational level with patients' attendance in yearly eye screening. Lack of information received by the patients on the importance of eye screening and communication issues seems to be prominent and becomes the reason for patients not attending eye screening.

Retinal Vasculature Fractal Dimension Measures Vessel Density

Ab Hamid F, Che Azemin MZ, Salam A, Aminuddin A, Mohd Daud N, Zahari I

Curr Eye Res, 2016 Jun;41(6):823-31.

PMID: 26268475 DOI: 10.3109/02713683.2015.1056375

PURPOSE: The goal of this study was to provide the empirical evidence of fractal dimension as an indirect measure of retinal vasculature density.

MATERIALS AND METHODS: Two hundred retinal samples of right eye [57.0% females (n = 114) and 43.0% males (n = 86)] were selected from baseline visit. A custom-written software was used for vessel segmentation. Vessel segmentation is the process of transforming two-dimensional color images into binary images (i.e. black and white pixels). The circular area of approximately 2.6 optic disc radii surrounding the center of optic disc was cropped. The non-vessels fragments were removed. FracLac was used to measure the fractal dimension and vessel density of retinal vessels.

RESULTS: This study suggested that 14.1% of the region of interest (i.e. approximately 2.6 optic disk radii) comprised retinal vessel structure. Using correlation analysis, vessel density measurement and fractal dimension estimation are linearly and strongly correlated (R = 0.942, R(2) = 0.89, p

Fulltext A mimicry of melioidosis by Klebsiella ozaenae infection

Ng TH, How SH, Kuan YC, Adzura, Aziz AA, Fauzi AR

Malays J Pathol, 2009 Dec;31(2):147-50.

PMID: 20514860 MyJurnal

Klebsiella ozaenae is a Gram negative bacillus. It has been described as a colonizer of oral and nasopharyngeal mucosa and is a cause of atrophic rhinitis. Klebsiella ozaenae has seldom been isolated from serious infections. However, several reports have stated that Klebsiella ozaenae may cause invasive infections and even mortality. We report a 55-year-old man with Klebsiella ozaenae infection causing abscesses involving the right eye and left kidney and possibly also in the brain, lungs and prostate. The isolates were sensitive to ceftazidime, ciprofloxacin, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim but resistant to ampicillin. He responded well to 4 weeks of i.v. ceftazidime and i.v. amoxycillin-clavulanic acid. To our knowledge, such a multiorgan infection has not been reported previously for this organism.

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