Despite the proven benefit of cryotherapy in the management of
threshold retinopathy of prematurity (ROP), it was shown
leading to ocular adverse effects. A male infant was born at 28
week of gestation with a birth weight of 1200 g. Serial
examinations revealed worsening ROP in both eyes until he
reached a high risk pre-threshold ROP in his right eye and
threshold ROP in his left eye. Cryotherapy was performed for
the threshold ROP in the left eye while the right eye was
subjected to further observation. Subsequently, ROP in both
eyes regressed without cicatrisation. The patient was followedup
over 8 years and refractions showed that the treated eye
developed steadily increasing myopia while the untreated eye
remained emmetropic. This case demonstrated the detrimental
effect of cryotherapy to the treated eye leading to the progressive
myopia as the child grew.
Introduction: Open globe injury may lead to devastating visual outcome. Urgent management and subsequent follow-up is important to maximise recovery. More data on open globe injury in Malaysia is needed to identify risk groups and prognostic factors. This study was carried out to investigate open globe injury, the socio-epidemic profile, clinical characteristics and outcome of the open globe injury in the Hospital Serdang, Malaysia. Methods: All patients managed for open globe injury to Hospital Serdang from January 2006 to December 2013 were included in this retrospective case review. Student’s T-test was used to determine difference between means and chi-square for categorical data. P value of less than 0.05 was regarded as statistically significant. Results: There were 155 patients managed for open globe injury with three of them had bilateral involvement. As such, there were 158 cases eligible for analysis in this study. The average age was 32.2 ± 16.5 years (mean ± standard deviation, SD). Male was at higher risk for open globe injury. Predictors for poor visual outcome were foreign nationality (p=0.047), lid laceration (0.008), type of injury (p=0.001), site of injury (p=0.008), RAPD (p
Microbial keratitis is one of the most challenging complications of contact lens (CL) wear. Proper CL practice plays an important role to reduce the risk for contact lens related microbial keratitis (CLRMK). Methods: This multi-centre case-control study was conducted from January 2008 until June 2009 to determine the risk factors associated with CLRMK. Cases were defined as respondents who were treated for CLRMK, whilst controls were respondents who were contact lens wearers without microbial keratitis. Ninety four cases were compared to 94 controls to determine the risk factors for
CLRMK. Results: The predictors for CLRMK were: Not washing hands with soap before handling CL (aOR 2.979, CI 1.020, 8.701 p=0.046), not performing rubbing technique whilst cleaning the CL (aOR 3.006, CI 1.198, 7.538 p=0.019) and, not cleaning the lens case with multipurpose solution daily (aOR 3.242 CI 1.463, 7.186 p=0.004). Sleeping overnight with the CL in the eye (aOR 2.864, CI 0.978, 8.386 p=0.049) and overall non-compliance with lens care procedures (aOR 2.590, CI 1.003, 6.689 p=0.049) contributed significantly to CLRMK. Conclusion: Health education and promotion in contact lens care are important and should be conducted by eye care practitioners to reduce the occurrence of CLRMK.
Introduction: A hospital based case control study was
conducted in government hospitals on contact lens patients
diagnosed with microbial keratitis. Methods: The objective of
this study is to determine the visual outcomes of contact lens
related microbial keratitis. The visual outcomes which
comprised of visual acuity, keratometry readings, corneal
topography findings and contrast sensitivity examinations was
determined after three months from the first presentation at the
hospitals. Results: The mean LogMAR visual acuity during
presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76)
and mean LogMAR visual acuity after three months was 0.10 ±
0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant
difference (t=11.22, df=78, p=0.001). Best fit curve for the cases
had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224,
0.447, df=78, p=0.001. The visual acuity in cases and controls
was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154
p=0.001) after three months which showed improvement. There
was a reduction in the corneal uniformity index and corneal
asphericity in the cases. The Corneal Uniformity Index (CU
index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13
± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a
reduction in the contrast sensitivity function at all spatial
frequencies in the cases which was significantly different.
Conclusion: Microbial keratitis reduced the vision, corneal
uniformity index, asphericity and contrast sensitivity after three
months in eyes of patients diagnosed with the condition.
Introduction: Dry eye is a common but under-diagnosed problem in the general population. Lack of standardised diagnostic protocol causes prevalence of dry eye varied widely in different populations. Nevertheless, effective management rests largely on the accurate diagnosis and identification of the contributing risk factors.
Methods: In a cross sectional study, socio-demographic, lifestyle and medical history data were collected from 157 respondents. A validated six-item questionnaire was used to determine the dry eye symptoms. Dry eye was determined by using Schirmer’s test. Fluorescein staining test and tear break up time (TBUT) test were performed to characterise the dry eye.
Results: Using the Schirmer’s test, 33.8% of respondents had dry eyes. The likelihood of dry eye increased among Malay females in the seventh decade. The most frequently reported symptom was sensation of dryness of the eye. Although only 22.6% of dry eye cases were symptomatic, up to 47.2% of them may developed surface changes detectable by fluorescein dye test. Ethnicity (p=0.019) and diabetes mellitus (p=0.049) were significantly associated with dry eye.
Conclusion: Dry eye could be subclinical but clinical tests in potential risk groups can lead to better detection of this condition and allow prescription of appropriate treatment for affected patients.
Study site: Ophthalmology clinic, hospital, Malaysia
Introduction: Microbial keratitis (MK) is an important cause for corneal blindness and understanding its risk factors enable us to improve management and minimise its complications. Methods: In this retrospective case review, medical records of all patients treated for MK from 2006 to 2013 was analysed to know the socio-demography, preceding risk factors, clinical characteristics, causative organisms and final visual outcome. Results: A total of 174 patients (180 eyes) were included in this study. Identifiable ocular risk factors included contact lens (CL) usage (85, 47.2%), ocular trauma (50, 27.8%), ocular surface disease (21, 11.6%), steroid use (6, 3.3%) and immuno-compromy (19, 10.5%). Association factors for presenting uncorrected visual acuity (UCVA) were age group (p=0.013), size (p