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Fulltext Textural analysis in meibomian gland image

Ainun Khalilah Mohamad, Mohd Zulfaezal Che Azemin

International Journal of Allied Health Sciences, 2018;2(1):215-225.
MyJurnal

Meibomian gland is one of the anatomical eye structures to provide oily lipid layer to the anterior part of the eye. Textural analysis by using Mean Histogram Method was proposed as a method of estimating area of Meibomian Gland Loss (MGL). Objective: The main objective of this study was to objectively measure the meibomian gland image by using textural analysis.
Fulltext The effect of daily religious fasting on tear film characteristics and ocular surface

Wan Nur Farhana Ibrahim, Mohd Zulfaezal Che Azemin

International Journal of Allied Health Sciences, 2018;2(1):108-116.
MyJurnal

Religious fasting is an act of refraining oneself from eating and drinking beginning at dawn until sunset. The changes in meal time and long period of meal constraint may influence the tear quality and ocular surface. The purpose of this study was to investigate the effect of daily religious fasting on tear film characteristics and ocular surface integrity. This is a prospective study involving 29 eyes from 29 healthy participants. The tear film characteristics were assessed by measuring the non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), total tear secretion, and
fluorescein ocular surface staining method was used to determine the ocular surface integrity. The measurements were performed in the morning (8.00 to 10.00 a.m.) and evening (4.00 to 6.00 p.m.) during each non-fasting and fasting period. The results showed no statistically significant difference noted for all parameters measured in the morning when comparison was made between non-fasting and fasting periods. Conversely, in the evening, NITBUT value was significantly lower during fasting period, (p = 0.001), but, TMH, total tear secretion and ocular surface staining revealed no significant differences between non-fasting and fasting periods. Our study revealed
that daily religious fasting only significantly reduced the NITBUT value in the evening which possibly due to dehydration; however, it did not affect TMH, total tear secretion and ocular surface integrity. The absence of fluid loading at pre-dawn meal could be the reason of non-noticeable differences noted in the morning
Fulltext The Intra - and inter-grader reliability of meibomian gland loss measurement

Nur Aizzah Hanan Kamarul Zaman, Mohd Zulfaezal Che Azemin

International Journal of Allied Health Sciences, 2018;2(1):226-233.
MyJurnal

Previous work employed digital image analysis using a fully-automated computer software to quantify changes in MG, which is meibomian gland loss. However, semi-automated software is more favorable for clinical applications as it allows clinicians to manually delete undesired noise or artifacts.
Fulltext The evaluation of pinhole glasses as visual therapy in improving refractive error

Fatin Amalina Che Arif, Mohd Zulfaezal Che Azemin

International Journal of Allied Health Sciences, 2018;2(3):408-416.
MyJurnal

Visual therapy or eye exercise, which is widely used in behavioral optometry, has been
successfully helping some visual disorders, especially binocular vision problem. In Bates System of Eye Exercise, it is claimed that eye exercise can restore vision with refractive error by completely relaxing the eyes. One of the ways to relax the eyes is by wearing the pinhole glasses as the pinhole placed before the eyes will help to relax accommodation and temporarily improving vision by reducing the size of blur circle. Pinhole glasses have been marketed as a visual therapy device, with the claim that continuous use of these glasses will improve refractive error. Although only anecdotal evidences have been provided on the efficacy of this product, the society are still interested to use the pinhole glasses and believe that their vision could be improved by simply wearing this device. Aim: The purpose of this study was to compare the refractive error of
myopic participants before and after wearing the pinhole glasses for 3 weeks. Methodology: Fifteen
participants were recruited in this study and all of the participants wore the pinhole glasses while performing near works for 20 minutes/day, anytime from 9 p.m. to 11 p.m. everyday for 3 weeks. Results: The refractive error before and after the intervention was then being compared and the results showed that there was no significant difference in refractive error of both right (p= 0.08) and left eyes (p= 0.09) of myopic participants before and after wearing the pinhole glasses. Conclusion: Our results suggest that pinhole glasses did not improve the refractive error of myopic participants.
Fulltext Voxel-based morphometry analysis of gray matter on Quran memorizers

Iqbal Jamaludin, Mohd Zulfaezal Che Azemin, Abdul Halim Sapuan, Radhiana Hassan

International Medical Journal Malaysia, 2017;16(11):5-5.
MyJurnal

The brain is the most complex organ in the human body. Robust and vigorous daily activities may cause changes to the brain structure. Huffaz, individuals who memorise the Quran undergo intensive memorization training which may lead to structural changes in specific regions of the brain.
Fulltext Eye tracking measurement with headrest in reading aloud study

Nadira Syahira Daman, Mohd Zulfaezal Che Azemin, Ibrahim Adham Taib, Norsham Ahmad

Journal of Optometry, Eye and Health Research, 2019;1(1):1-6.
MyJurnal

Eye tracking is a technology used to track and record what the human eye perceives. It has been applied in detecting visual field loss, determining infant’s preferential looking and virtual reality therapy. In reading tasks, eye tracking needs to be accurate because even a substantial head movement can affect its fixation accuracy; as such, using a headrest can minimise head movements and the associated fixation errors. This experimental study was conducted to determine the effect of headrest usage on eye tracker fixation accuracy during reading aloud activity by comparing a group with headrest and a group without it. The results showed that the difference between the two groups was significant (p=0.004), where the headrest group and non-headrest group introduced a mean fixation error of 30.728 ± 15 mm and 17.671 ± 9 mm respectively. Eye tracking accuracy for the headrest group was then compared with a standard value of 0.6 degrees. The findings showed that the accuracy was significantly different (p
Fulltext Peripheral visual attention superiority in athletes and non-athletes

Muhammad Aiman Ramlan, Mohammad Fitri Fahmi Mohd Arif, Mohd Zulfaezal Che, Azemin Norsham Ahmad

Journal of Optometry, Eye and Health Research, 2019;1(1):7-12.
MyJurnal

Introduction: The purpose of the study was to compare the size of visual field in horizontal and vertical, peripheral retinal sensitivity at mid- and far-peripheral temporal viewing using different sizes of stimuli between football athletes and age-gender matched non-athlete subjects. Methods: The participants comprised 9 experienced male football (23.44 ± 2.74 years) players and the control group comprised 9 age-matched male non-athletes (23.33 ± 2.96 years). The parameters were measured using Oculus Twinfield automated perimeter. Horizontal and vertical size of visual field was measured using manual kinetic strategy. The mid-peripheral (60deg) and far-peripheral (90deg) temporal retinal sensitivity in different sizes of stimuli were measured using manual static strategy. The measurement of each test was repeated three times, and then the most reliable value was taken from the three readings. Results: The results from athletes and non-athletes did not differ in regards to peripheral visual attention in all measured parameters (p>0.05). However, athletes group showed slightly better results than non-athletes group. Conclusions: Improved visual performance in selected parameters among athlete group in this study supports previous studies with hypothesis of visual skill in athletes is better compared to non-athletes.
Fulltext Short term effect of virtual reality on eye accommodative ability

Mohd Syarifuddin Mukhtar, Mohd Zulfaezal Che Azemin, Mohd Hafidz Ithnin, Mohd Izzuddin Mohd Tamrin

Journal of Engineering and Science Research, 2020;4(1):35-39.
MyJurnal

Virtual reality (VR) is a fast-growing technology in the world today. Many countries use virtual reality for many purposes such as education, military and entertainment. Despite the benefits of VR, harmful effects of VR on the users are still inconclusive. With only a few reliable studies that investigate the effect of virtual reality on the users especially on the eyes, yet still there are a lot more things we do not know about the effects of VR. The purpose of this study was to compare the amplitude of accommodation before and after watching 3-dimesional (3D) movie utilizing VR and notebook (control group). Thirty-two participants volunteered in this study and all participants underwent amplitude of accommodation (AA) test using Royal Army Force (RAF) rule before and after watching three-dimensional (3D) movie for 30 minutes using VR and two-dimensional (2D) movie by laptop. The amplitude of accommodation between pre- and post-watching 3D movie on VR was insignificantly changed (p= >0.05). The similar trend was also found after 30 minutes watching movie using laptop (p= >0.05). The utilization of VR and laptop for 30 minutes did insignificantly alter the eye accommodation.
Fulltext Short term effect of virtual reality on tear film stability and ocular discomfort

Mohamad Syarifuddin Sidik Ahmad, Mohd Zulfaezal Che Azemin, Mohd Hafidz Ithnin, Mohd Izzuddin Mohd Tamrin

Journal of Engineering and Science Research, 2020;4(1):40-46.
MyJurnal

: Virtual reality (VR) has been integrated and used with smartphones as one of the digital entertainments such as in gaming and movie streaming. With emergent of various VR brands in the market, it concerns the public on the possible side effects of VR on the ocular performance specifically on tear film stability and ocular discomfort. The purpose of this study was to compare the change on non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH) before and after the use of VR for 30 minutes, and to measure the ocular discomfort after the use of VR quantitatively. Thirty-two subjects were recruited in this study and all the subjects were divided randomly into two groups; VR and laptop (used as a control) groups. Each subject needed to watch a movie for 30 minutes using the respective devices. The changes of tear film stability and ocular discomfort before and after the use of the devices were then compared and the results showed that there was no significant difference (p>0.05) after 30 minutes of the use. Comparison of the ocular parameters between the devices on post-watching activities was also not significant (p>0.05). Use of VR did not give any signs of dryness to the eyes and it can be used without any discomfort even after 30 minutes usage of the devices.
Fulltext Short term effect of virtual reality headset on blink rate and inter-blink interval

Nurul Hafizah Zaini, Mohd Zulfaezal Che Azemin, Mohd Hafidz Ithnin, Mohd Izzuddin Mohd Tamrin

Journal of Engineering and Science Research, 2020;4(1):47-51.
MyJurnal

Virtual reality (VR) headsets are becoming remarkably well-known nowadays, especially in gaming industry. Their ability to immerse users into virtual world makes them captivating. However, there is limited research about the impacts of this technology on our eyes and vision. This study investigated if there is any effect on blink rate (BR) and inter-blink interval (IBI) after 30 minutes of watching 3-dimensional (3D) movie on VR. Besides, this study compares between watching 3D movie on VR headset and 2D movie on laptop. Blinks were recorded over 1 minutes for 32 participants volunteered in this study before and after 30 minutes of watching 3D movie on VR headset and 2D movie on laptop. The result of BR and IBI between pre- and post-watching 3D movie on VR was not significant (p= >0.05). The result between watching movie on laptop and VR also not significant (p= >0.05). Watching 3D movie on VR for 30 minutes resulted in no effects on blink rate and inter-blink interval of the users.
Fulltext Assessment of blurring effect and its associated factors by using imagej: a multiparameter double holes contrast-detail phantom study

Nur Farahana Pauzi, Zafri Azran Abdul Majid, Wan Muhamad Nasuha Wan Hussin, Abdul Halim Sapuan, Mohd Zulfaezal Che Azemin

International Journal of Allied Health Sciences, 2017;1(2):107-119.
MyJurnal

X-ray is produced in form of divergent beam. The beam divergence results to blurring effect that influences image diagnosis. Thus, the blurring effect assessment should be enrolled within the quality control (QC) program of an imaging unit.
Fulltext The influence of blood glucose level on tear break up time among young adults with diabetes

Nur Ain Mat Noh, Aziimah Awang Abd Rahman, Noor Ezailina Badarudin, Mohd Zulfaezal Che Azemin, Aliza Haslinda Hamirudin

International Journal of Allied Health Sciences, 2018;2(3):392-398.
MyJurnal

It has been reported that diabetics are more likely to develop tear film dysfunction compared to non-diabetics. Even so, there has been very little research reported on the correlation between blood glucose level and quality of tears. Objective: The purpose of the study was to investigate the influence of blood glucose level on TBUT among young adults with diabetes. Methods: A cross-sectional study consisting of 37 diabetic patients within the age range of 19-39 years was carried out at International Islamic University Malaysia (IIUM) Optometry Clinic, Kuantan, Pahang, Malaysia. The subjects were tested for random blood glucose level (RBS) and undergone tear
break up time (TBUT) test. Nonparametric test was used namely Spearman correlation to determine the association between RBS and TBUT. Results: TBUT median (interquartile range) value was 7.5 (11.55) seconds. Meanwhile, the negative association was found between (RBS) and TBUT in diabetics (r = -0.126). However, the correlation was not statistically significant (p>0.05). Tear film break up time was not associated with the random blood glucose level. Conclusion: Tear film break up time seems to be not affected by blood glucose level.
Fulltext Changes in apical corneal curvature in unilateral primary pterygium and normal adults using Simulated-K and corneal irregularity measurement

Mohd Radzi Hilmi, Nur Hidayah Musa, Khairidzan Mohd Kamal, Mohd Zulfaezal Che Azemin, Nur Nabilah Maruziki, Nur Ain Norazmar, et al.

International Journal of Allied Health Sciences, 2019;3(2):588-594.
MyJurnal

This paper aimed to describe variation in apical corneal curvature between unilateral primary pterygium and normal adults utilizing simulated-K and corneal irregularity measurement corneal indices. A total of 100 participants comprise 50 unilateral primary pterygium eyes from 50 patients and 50 normal adults were recruited in this study. Diagnosis and classification of primary pterygium were done by a consultant ophthalmologist (KMK). Standard optometric examinations were performed in all participants. Simulated-K (SimK) and corneal irregularity measurement (CIM) was objectively measured using a corneal topographer. Three measurements based on best image quality for SimK and CIM were taken by single operator in a same visit. Difference for both SimK and CIM parameters between primary pterygium and normal groups were determined via independent T-test. Overall mean and standard deviation (n = 120) of SimK and CIM were found higher in primary pterygium group (9.06 ± 4.49 D and 11.48 ± 3.12) compared to normal (1.63 ± 0.67 D and 0.62 ± 0.24) respectively. Independent T-test results showed significance difference in SimK and CIM values between primary pterygium groups and normal (both P< 0.001). Both SimK and CIM corneal indices can be an important tool in describing and predicting changes on the corneal curvature due to pterygium progression. However, it is worth to note that the detectability of changes in anterior corneal curvature is limited to 5 mm of central corneal curvature.
Fulltext Influence of refractive condition on retinal vasculature complexity in younger subjects

Azemin MZ, Daud NM, Ab Hamid F, Zahari I, Sapuan AH

ScientificWorldJournal, 2014;2014:783525.
PMID: 25371914 DOI: 10.1155/2014/783525

The aim of this study was to compare the retinal vasculature complexity between emmetropia, and myopia in younger subjects.
Fulltext Corneo-pterygium total area measurements utilising image analysis method

Mohd Radzi H, Khairidzan MK, Mohd Zulfaezal CA, Azrin EA

J Optom, 2019 05 13;12(4):272-277.
PMID: 31097348 DOI: 10.1016/j.optom.2019.04.001

PURPOSE: To describe an objective method to accurately quantify corneo-pterygium total area (CPTA) by utilising image analysis method and to evaluate its association with corneal astigmatism (CA).
METHODS: 120 primary pterygium participants were selected from patients who visited an ophthalmology clinic. We adopted image analysis software in calculating the size of invading pterygium to the cornea. The marking of the calculated area was done manually, and the total area size was measured in pixel. The computed area is defined as the area from the apex of pterygium to the limbal-corneal border. Then, from the pixel, it was transformed into a percentage (%), which represents the CPTA relative to the entire corneal surface area. Intra- and inter-observer reliability testing were performed by repeating the tracing process twice with a different sequence of images at least one (1) month apart. Intraclass correlation (ICC) and scatter plot were used to describe the reliability of measurement.
RESULTS: The overall mean (N=120) of CPTA was 45.26±13.51% (CI: 42.38-48.36). Reliability for region of interest (ROI) demarcation of CPTA were excellent with intra and inter-agreement of 0.995 (95% CI, 0.994-0.998; P<0.001) and 0.994 (95% CI, 0.992-0.997; P<0.001) respectively. The new method was positively associated with corneal astigmatism (P<0.01). This method was able to predict 37% of the variance in CA compared to 21% using standard method.
CONCLUSIONS: Image analysis method is useful, reliable and practical in the clinical setting to objectively quantify actual pterygium size, shapes and its effects on the anterior corneal curvature.

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