Kanta sentuh merupakan alat optikal yang sepatutnya selamat digunakan untuk pembetulan ralat refraksi atau kosmetik. Namun demikian terdapat permasalahan berkaitan kesihatan mata yang timbul akibat sikap pemakai yang tidak patuh kepada garis panduan penjagaan kanta yang disaran oleh pengamal kesihatan mata. Justeru itu satu soal selidik berkaitan penjagaan kanta sentuh dilakukan di kalangan pemakai kanta sentuh di sekitar Kuala Lumpur. Ia berdasarkan 22 set soalan terfokus kepada penjagaan kanta sentuh termasuklah tatacara pembersihan dan disifeksi, rawatan enzim, penggunaan agen pembasah dan kekerapan menghadiri pemeriksaan lanjutan. Di samping itu, terdapat enam soalan yang diaju untuk meninjau pengetahuan pemakai berkaitan penjagaan kanta sentuh yang selamat. Seramai 104 pemakai kanta sentuh mengambil bahagian dalam kajian ini. Lebih kurang 86% daripada mereka adalah wanita dengan min umur 24 ± 6 tahun. Lebih setengah daripada mereka memakai kanta sentuh jenis pakai buang. Hampir kesemuanya (98%) menggunakan sistem disinfeksi kimia. Hanya 68% pemakai yang dikaji mencuci kanta mereka setiap kali sebelum memakai dan selepas menanggalkannya. Tiga puluh peratus (30%) pemakai kanta sentuh menggunakan agen pembasah dan 40% menggunakan tablet protein. Enam puluh satu peratus (61%) daripada mereka menyatakan tidak membuat temu janji untuk pemeriksaan lanjutan. Enam soalan tertumpu kepada pengetahuan pemakai mengenai penjagaan kanta yang selamat dan min jawapan yang betul ialah 61.4%. Sebahagian pemakai kanta sentuh tidak mengikut arahan penjagaan kanta sentuh seperti yang disaran oleh pengamal kesihatan mata. Ramai yang tidak faham akan garis panduan pemakaian kanta yang selamat. Kajian ini menunjukkan sebahagian daripada pemakai kanta sentuh tidak mempunyai pengetahuan yang cukup mengenai risiko dan bahaya ke atas mata mereka kerana ketidakpatuhan pada arahan yang disaran oleh pengamal kesihatan mata. Pengamal kanta sentuh perlu memikirkan semula strategi untuk memastikan pemakai patuh kepada arahan berkaitan penjagaan kanta sentuh supaya komplikasi dapat dikurangkan.
This survey represents an initial examination of contact lens practice in Malaysia. It is based on a questionnaire that was sent to selected members of the Association of the Malaysian Optometrists to survey the prescribing habits of g contact lenses and care products. Questions included types of lenses prescribed, care systems frequently recommended and types of complications seen. Optometrists in Malaysia prescribed an average of 90 new pairs of contact lenses per year. Soft lenses made up 84% of the prescription followed by 14% of rigid gas permeable lenses and 1.5% of polymethymethacrylate lenses. Disposable/frequent replacement lenses accounted for 60% of the soft lenses prescribed. The most commonly prescribed disinfecting system was chemical disinfection. The most common complication seen during aftercare consultation was dry eye-related problems.
Elektroretinogram paten (pERG) adalah pengrekodan respons retina terhadap stimulus paten yang dipancarkan bersilih ganti. Ia memberi maklumat mengenai integriti sel dalaman retina khasnya sel ganglion. Pengrekodan pERG dalam sesebuah makmal boleh dipengaruhi oleh beberapa faktor, maka piawai makmal perlu ada untuk memastikan bacaan pERG yang diperolehi boleh diulang dan dihasilkan semula. Objektif kajian ini ialah untuk menentusahkan faktor yang mungkin mempengaruhi pengukuran pERG untuk paiwaian Makmal Elektrofisiologi Jabatan Optometri, Fakulti Sains Kesihatan (FSK), Universiti Kebangsaan Malaysia (UKM). Kajian ini melibatkan 45 orang subjek yang berumur di antara 20 hingga 25 tahun yang dibahagikan kepada 3 kumpulan. Faktor yang dikaji adalah 1) kesan penggunaan anestetik Alcaine 0.5%, 2) variasi pengukuran pada waktu pagi dan petang dan 3) saiz dan bentuk target fiksasi yang berbeza terhadap bacaan pERG (amplitud dan tempoh pendam). Ujian-t berpasangan mendapati tiada perbezaan yang signifikan antara pengukuran sebelum dan selepas penggunaan Alcaine 0.5% bagi amplitud (p = 0.116) dan tempoh pendam
(p = 0.557). Pengukuran pada waktu pagi dan petang juga menunjukkan tiada perbezaan signifikan bagi amplitud (p = 0.864) dan tempoh pendam (p = 0.174). Untuk bentuk dan saiz target yang berbeza, didapati tiada perbezaan yang signifikan untuk parameter amplitud (p = 0.125) dan tempoh pendam (p = 0.404). Kesimpulannya, penggunaan Alcaine 0.5%, pengukuran pada waktu pagi dan petang dan target fiksasi yang berbeza tidak mempengaruhi bacaan pERG di Makmal Elektrofisiologi, FSK, UKM. Hasil kajian boleh diguna pakai untuk perbandingan dalam penyelidikan ataupun tujuan pendiagnosan penyakit retina di masa hadapan.
It is well established the efficacy of orthokeratology (OK) treatment in improving refraction and visual acuity (VA) of low myopic subjects. However, limited data is available on high myopes. The purpose of this study was to investigate the changes of refraction, VA and contrast sensitivity (CS) over time in high myopic school children after 1 week of overnight OK treatment. A total of 19 high myopic school children were fitted with OK lenses. Mean refraction at baseline was -6.29±1.25 DS. Refraction was conducted using cross cylinder method and LogMAR chart. CS was evaluated using Pelli-Robson and FACT charts. All measurements were taken at baseline, 1, 2, 3 and 7 days after overnight OK. Data was analyzed using repeated measures of ANOVA. The results showed that refraction and CS were significantly improved throughout the study period (p<0.05). Significant changes in all parameters were noted after the first overnight treatment. Mean refraction and unaided VA after 7 nights of treatment was -0.64±1.17DS and 0.08±0.29, respectively. The results from Pelli-Robson and FACT charts showed improvement comparable to aided baseline values (p>0.05). This study concludes that overnight OK reduces refraction but does not compromise VA and CS in high myopic children within the study period. Further studies are needed to determine the long term impact of OK treatment on visual functions in a larger sample of high myopic children.
The purpose of this study was to compare the performance of four different electrode types in detecting the multifocal electroretinogram (mfERG) using the visual evoked response imaging system (VERIS). Multifocal ERG of 30 healthy subjects aged 17-50 years was recorded. Four different types of electrodes were used (JET contact lens, gold foil, DTL thread and c-glide carbon fiber electrodes) and the trough to peak amplitude response densities of the first order kernels (which approximated to the a and b wave of the full field electroretinogram) were compared. The JET contact lens electrode produced the highest amplitude response which was significantly different from the gold foil, DTL thread and the c-glide electrodes, but there was no significant difference between the gold foil and DTL or between DTL and the c-glide electrodes. In conclusion, contact lens electrode produced the highest response density followed by the gold foil and the DTL thread. There was no significant difference in amplitude response between the gold foil and DTL thread, therefore these two electrodes provide for viable alternatives for recording mfERG especially when there are concerns that contact lens electrode may be uncomfortable for recording periods that may take a long time.
Miopia pada kebiasaannya didefinisi sebagai sfera setara ≥ -0.50 D dalam banyak kajian yang dilaporkan. Namun demikian tidak banyak laporan berkaitan kesensitifan dan kekhususan definisi miopia yang dipilih apabila penyelidik melaporkan prevalen dan taburan miopia dalam populasi yang dikaji. Objektif kajian ini adalah membezakan kesensitifan and kekhususan setiap definisi miopia yang dipilih, iaitu -0.50 D, -0.75 D dan -1.00 D dan untuk mengenal pasti kebolehan definisi tersebut meramalkan ralat refraksi miopia pada akuiti penglihatan kurang daripada log MAR 0.3 (6/12) dalam kalangan pelajar Melayu. Seramai 866 orang pelajar Melayu berumur antara 7-10 tahun mengambil bahagian dalam penyelidikan ini. Akuiti penglihatan diukur menggunakan carta log MAR dan ralat refraksi diukur menggunakan retinoskopi tanpa sikloplegia. Keputusan kami menunjukkan kesensitifan dan kekhususan definisi miopia yang dipilih iaitu ≥ -0.50 D adalah 54.5% dan 97.8%, untuk definisi miopia ≥ - 0.75 D adalah 71.1% and 97.5% dan untuk definisi miopia ≥ -1.00 D adalah 83.3% dan 97.2%. Luas lengkok ROC untuk setiap definisi miopia -0.50 D, -0.75 D dan -1.00 D ialah 0.676, 0.839 and 0.957. Kesimpulannya, kajian ini menunjukkan definisi optimum miopia untuk pelajar sekolah Melayu berumur antara 7-10 tahun ialah ≥ -1.00 D, dengan menggunakan kaedah retinoskopi tanpa sikloplegia. Definisi ini boleh mengenal pasti 95.7% pelajar mempunyai akuiti penglihatan kurang daripada log MAR 0.3 dan ia mempunyai gabungan kesensitifan (83.9%) dan kekhususan (95.7%) terbaik.
The purpose of this study was to examine the effects of mild cognitive impairment on pattern electroretinogram (pERG)
among urban elderly Malays. A total of 36 subjects aged 60 years and above comprising of 18 MCI subjects and 18
normal controls were recruited for this study. The inclusion criteria for both the MCI and normal subjects included best
corrected distance visual acuity ≥ 6/9 (Snellen) with refractive error less than ±4.00 DS and/or ±2.00 DC (astigmatism),
near visual acuity ≥ N8, absence or no previous history of any significant media opacities, retinal disorders and ocular
pathologies. pERG was recorded with the RetiPort/Scan21 system in accordance with the International Society for the
Clinical Electrophysiology of Vision standards. The target presented to subjects through a 19” CRT monitor was a black
and white reversing checkerboard with luminance equal to 80 cd/m2
, contrast 97% and stimulus frequency 2.00 Hz (4
rev/s). Amplitudes and implicit times of P50 and N95 waves generated by the system were noted and compared between
the two groups. The results showed no significant difference in the amplitude and implicit times between the right and left
eyes so only the right eye was used for comparison between the MCI and control groups. The mean amplitude and implicit
times of the right eye of the MCI and control groups were 1.86±0.65 μV, 56.27±6.20 ms and 1.54±0.74 μV, 56.15±4.98 ms,
respectively. T-test showed no significant differences in pERG amplitudes and implicit times between MCI and the control
groups. In conclusion, our results may imply that the inner retina is intact in early MCI elderly subjects.
The first aim of this study was to determine the refractive error and visual acuity of Chinese elderly age 60 and above in Selangor and Johor, Malaysia. The second aim was to determine the percentage of elderly with vision impairment. Participants of this study were from the on-going population-based longitudinal study on neuroprotective model for healthy longevity (TUA) among Malaysian older adults using multistage random sampling. A total of 259 Chinese elderly aged 60 and above from state of Selangor and Johor agreed to participate. Refractive error was determined using autorefractometer Retinomax K-plus followed by subjective refraction. Best corrected visual acuity (VA) was measured using logMAR chart. Analysis was performed on data of 202 participants and the remaining 57 were excluded. Overall percentage of refractive error was higher for hyperopia (54%) compared to myopia (23.2%). High percentage of astigmatism was noted for all age groups (> 50%). Both gender showed similar distribution of refractive status. Mean overall VA was 0.24 ± 0.17 logMAR (≅ 6/9-) and mean VA declined with age. Overall, the percentage of elderly having at least mild vision impairment (> 0.3 logMAR or 6/12) was higher (62.9%) compared to normal vision (≤ 0.3 logMAR). However, percentage of vision impairment (VI) was highest in the mild category compared to others and only one participant had severe VI. This study found a high percentage of Chinese elderly with refractive error. The most common type of refractive error was hyperopia. A high proportion of them had mild vision impairment followed by moderate VI even with best correction. Vision impairment could affect daily life functioning and this effect can be further explored in the future.
A vision screening study was carried out among Indian schoolchildren around Kuala Lumpur to determine whether the prevalence of myopia was higher in boys or girls. Altogether 749 students (49.7% boys and 50.3% girls) aged 7-18 years were screened and their refractive error examined using retinoscopy without cycloplegia. For the right eye 15.1% of the girls' eyes were found to be myopic as compared to 16.9% of the boys, of which chi-square showed no significant difference (p = 0.44). For the left eye 18.8% of the girls' eyes were myopic as compared to 16.4% of the boys. Chi square also showed no significant difference (p = 0.26). When high myopia (> -6.00D) was considered, there was no difference found between boys and girls. The number of students with high myopia greater than -6.00D was also very small (0.3%-0.5%). In conclusion, it was found that there was no significant difference in myopia between girls and boys among Indian schoolchildren.
Patients who lost their eyes as results of accidents or diseases (e.g. retinoblastoma) usually underwent enucleation or evisceration. They were then fi tted with ocular prosthesis to prevent collapse of the globe and also for cosmetic effects. Custom made ocular prosthesis is almost unheard of in this country for most hospitals supply ready-made (stock) prosthesis. The cosmetic results of stock prosthesis are often unsatisfactory. Besides being uncomfortable, stock prosthesis may also induce allergic reaction that may lead to papillary conjunctivitis. The Optometry Clinic at UKM started its custom made prosthetic service in 2010. We described here two cases of patients who complained of discomfort with their old stock prosthesis and re-fitted with custom made prosthesis. We also highlight the importance of proper hygiene and maintenance so that ocular prosthesis can be used for as long as possible. This article aims to create awareness among eye care practitioners and showcase the cosmetic benefi ts of custom made ocular prosthesis.
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Kajian terdahulu banyak menunjukkan perbezaan dalam dimensi okular mengikut kaum. Walau bagaimanapun hanya terdapat sedikit data mengenai dimensi okular bangsa Melayu di Malaysia yang dilaporkan. Kajian ini bertujuan untuk menetapkan nilai normal dimensi okular bangsa Melayu muda di Malaysia. Seramai 584 orang telah diundang untuk menjadi subjek untuk kajian secara sukarela. Pengukuran yang dilakukan meliputi kelengkungan dan ketebalan tengah kornea, nilai esentrisiti kornea (e), diameter iris horizontal dan vertikal yang kelihatan, saiz pupil dan bukaan palpebral. Subjek dibahagikan kepada 3 kumpulan berikut mengikut umur dan dipadankan mengikut jantina dan umur: Kumpulan 1 (7-12 tahun, n = 188), Kumpulan 2 (13 to 18 tahun, n = 196) and Kumpulan 3 (19 to 24 tahun, n = 200). Pengukuran dilakukan menggunakan topografer kornea (CTK 922 dari Haag Streit, Jerman), pakometer ultrasonik (Corneo-Gage Plus 2 dari Sonogage Incorporated) dan auto refraktometer (Auto-Ref R1 dari Canon, Jepun). Dimensi okular bangsa Melayu yang diukur didapati lebih kecil dari bangsa lain di seluruh dunia. Perbezaan yang signifikan juga didapati untuk semua pengukuran dengan peningkatan umur (p < 0.05). Keputusan kajian ini boleh dijadikan rujukan untuk nilai dimensi okular populasi Melayu muda Malaysia di masa hadapan.
The aim of this study was to determine whether pattern-reversal Visual Evoked Potential (PRVEP) is affected in mild
cognitive impairment (MCI). Participants aged ≥ 60 years diagnosed as MCI were invited to participate in a study together
with a group of controls. PRVEP was measured using A RETI-port/Scan 21 and stimuli of large and small checks sizes,
1° (60 min of arc) and 0.25° (15 min) respectively were used to obtain responses. The amplitude and implicit times of
the MCI and control groups were then compared. A total of 18 MCI participants (age 65.7 ± 3.1 years) and 18 controls
(65.1 ± 3.8 years) consented to participate in the study. The amplitude and implicit times for the MCI group using the
target sizes of 60 min of arc were 9.80 ± 4.06 µV and 108.83 ± 7.63 ms and for 30 min of arc were 11.00 ± 7.44 µV
and 123.96 ± 6.18 ms respectively. Consecutively for the control groups the amplitudes and implicit times were 8.96 ±
3.52µV, 105.85 ± 3.60 ms and 11.97± 6.11 µV, 122.57 ± 8.28 ms. PRVEP results did not reveal significant differences in
P100-wave amplitude nor implicit time between the two groups under investigation. This study concluded that the visual
pathway of MCI participants may be unaffected in the early part of the disease process.
This study was conducted to determine the score of self-reported visual function index (VF-14) and its correlation with
best corrected visual acuity (BCVA) in the elderly population. Participants were elderly aged 60 years and above recruited
from the on-going population-based longitudinal study on neuroprotective model for healthy longevity (TUA). Visual
acuity was measured using logMAR chart. A self-reported visual function assessment was measured using modified
Bahasa Malaysia Visual Functioning Index (VF-14). A total of 482 (93.05%) from 518 subjects participated in this study.
Mean age was 69.18 ± 5.67 years old and mean best corrected VA was 0.21 ± 0.17 logMAR. Mean VF-14 score was 89.65
± 13.19. Female had lower mean score of self-reported visual function scores compared to male (meanfemale89.21 ± 12.76,
meanmale90.11 ± 13.65) but it was not statistically significant (z = -1.09,p = 0.277). There was a moderate but significant
correlation between VF-14 score and best corrected VA (r = -0.412, p < 0.01). In conclusion, the best corrected visual
acuity alone was not able to become as an indicator to describe changes in VF14 score. This study showed that it only
contributes 17.2% to changes in VF14 score. The combination of many other factors such as socio-demographic factors
(race, educational status, and health problems), contrast sensitivity and stereopsis should be taken into account when
assessing visual function as measured by VF14.