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  1. Yahya AN, Sharanjeet-Kaur S, Akhir SM
    PMID: 31783494 DOI: 10.3390/ijerph16234730
    Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
  2. Allinjawi K, Sharanjeet-Kaur SK, Akhir SM, Mutalib HA
    F1000Res, 2016;5:2742.
    PMID: 28163898 DOI: 10.12688/f1000research.9971.1
    Aim: The purpose of this study was to compare the changes in relative peripheral refractive error produced by two different designs of progressive soft contact lenses in myopic schoolchildren. Methods: Twenty-seven myopic schoolchildren age between 13 to 15 years were included in this study. The measurements of central and peripheral refraction were made using a Grand-Seiko WR-5100K open-field autorefractometer without correction (baseline), and two different designs of progressive contact lenses (PCLs) (Multistage from SEED & Proclear from Cooper Vision) with an addition power of +1.50 D. Refractive power was measured at center and at eccentricities between 35º temporal to 35º nasal visual field (in 5º steps). Results: Both PCLs showed a reduction in hyperopic defocus at periphery. However, this reduction was only significant for the Multistage PCL (p= 0.015), (Proclear PCL p= 0.830).  Conclusion: Multistage PCLs showed greater reduction in peripheral retinal hyperopic defocus among myopic schoolchildren in comparison to Proclear PCLs.
  3. Allinjawi K, Kaur S, Akhir SM, Mutalib HA
    Saudi J Ophthalmol, 2020 12 28;34(2):94-100.
    PMID: 33575529 DOI: 10.4103/1319-4534.305035
    PURPOSE: The purpose was to determine the minimum near-addition power needed using Proclear® multifocal D-Design contact lens (adds: +1.50 D, +2.50 D, +3.00 D, and +3.50 D) to invert the pattern of relative hyperopic defocus in the peripheral retina into relative myopic defocus among the eyes of myopic schoolchildren.

    METHODS: Twenty-seven right eyes (24 females and 3 males) of 27 myopic schoolchildren aged between 13 and 15 years were included in this study. The measurements of central refraction, peripheral refraction (between 35° temporal and 35° nasal visual field in 5° steps), and lag of accommodation were conducted using the Grand-Seiko WR-5100K open-field autorefractometer initially without correction (WC), followed by with correction using four different addition powers of Proclear® multifocal D-Design contact lens in random sequence. Axial length was measured using a handheld probe ultrasound A-scan (Tomey AL-2000).

    RESULTS: The relative peripheral refractive error showed high hyperopic defocus of +1.08 ± 1.24 D at 35° nasal and +1.06 ± 1.06 D at 35° temporal visual field WC. All Proclear multifocal contact lenses (MFCLs) decreased the peripheral hyperopic defocus with increasing addition powers (F [2.938, 47.001] = 13.317, P < 0.001). However, only +3.00 D addition and +3.50 D addition (P = 0.001) could invert the peripheral hyperopic defocus into peripheral myopic defocus. Apart from that, the +3.00 D addition lens showed the lowest lag of accommodation (+1.10 ± 0.83 D) among the other MFCL adds (P = 0.002).

    CONCLUSION: A +3.00 D addition Proclear MFCL is the optimal addition power that can invert the pattern of peripheral hyperopic defocus into myopic defocus.

  4. Azman BZ, Akhir SM, Zilfalil BA, Ankathil R
    Singapore Med J, 2008 Apr;49(4):e98-e100.
    PMID: 18418516
    We report two cases of deletion 5p or cri du chat syndrome (CdCS) with different presentations and risks of transmission: one case with paternal chromosome 5 involvement and another, a de novo case with atypical clinical presentation. Cytogenetic analysis was performed on the two cases and their parents. GTG-banded karyotype analysis of Cases 1 and 2 revealed abnormal 46,XY,del(5)(p13-15) male karyotypes. For Case 1, the mother showed normal female karyotype while the father showed an abnormal karyotype involving a balanced translocation 46,XY,t(5;10)(p13;p15). For Case 2, however, both parents showed a normal karyotype pattern. In Case 1, the clinical features, particularly the distinct facial phenotype in combination with a characteristic cat-like cry and hypotonia, aided in the diagnosis at birth and the karyotype analysis was resolutive. The boy in Case 2 presented with atypical clinical features. Even though this patient had multiple syndromic features, the typical high pitched cat-like cry was not prominent. Instead, the patient manifested persistent stridor (from day three of life), which might have prevented the clinician from suspecting CdCS at birth. However, when this patient was presented at seven months of age for cytogenetic analysis, a confirmatory diagnosis of CdCS was established. For children with congenital abnormalities, an early clinical diagnosis confirmed through cytogenetic and molecular investigations, is important for providing personalised diagnostic and prognostic evaluation, and also for genetic counselling on the reproductive risk, particularly for patients with parental chromosome translocation involvement.
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