Displaying publications 1 - 20 of 56 in total

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  1. Vairavan N, Tajunisah I, Subrayan V, Waran V
    Orbit, 2009;28(6):442-3.
    PMID: 19929682 DOI: 10.3109/01676830903103365
    Surgical approaches are becoming increasingly minimally invasive, without compromising either safety or ease. Penetrating ocular foreign bodies has traditionally been approached either by intraocular or supraorbital access. We successfully attempted a minimally invasive approach to remove a retrobulbar foreign body under computer-assisted image guidance in a 19-year-old man involved in an industrial mishap.
  2. Lee HN, Subrayan V
    Med J Malaysia, 2021 Nov;76(6):950-952.
    PMID: 34806694
    Internuclear Ophthalmoplegia (INO) is an inability of the ipsilateral adduction with a contralateral horizontal abducting saccade on attempted gaze to the contra-lesion side. Injury to the medial longitudinal fasciculus (MLF) will obstruct the signalling pathway between the ipsilateral abducens nucleus and the contralateral medial rectus muscle. Infarction accounts for 38% of INO cases with mostly being unilateral (87%), followed by demyelination (34%), which mostly being bilateral (73%). Lacunar infarct is the most common ischemic stroke. INO can be easily missed due to its subtle presentation with no complaints from the patients. A full cranial nerves assessment, includes the extraocular muscles movement, is important. Ischemic and demyelinating INO typically recover. We present here of a case of INO following right lacunar infarct in a 72-year-old Malay woman. She had hypertensive crisis due to missed medications. Her blood pressure was well controlled throughout the hospital admission and finally she was discharged home with continuation of care at her primary facility.
  3. Patel DK, Tajunisah I, Gilbert C, Subrayan V
    Eye (Lond), 2011 Apr;25(4):436-42.
    PMID: 21350565 DOI: 10.1038/eye.2011.19
    To determine the causes of childhood blindness and severe visual impairment (BL/SVI) in schools for the blind in Malaysia.
  4. Shin HC, Subrayan V, Tajunisah I
    J Cataract Refract Surg, 2010 Aug;36(8):1289-95.
    PMID: 20656150 DOI: 10.1016/j.jcrs.2010.02.024
    PURPOSE: To evaluate changes in anterior chamber depth (ACD) and intraocular pressure (IOP) after phacoemulsification in eyes with occludable angles and compare the results with those in eyes with normal open angles.
    SETTING: Eye Clinic, Ipoh General Hospital, Ipoh, Perak, Malaysia.
    METHODS: Patients with nonglaucomatous eyes with open angles or with occludable angles were recruited. Ocular biometric measurements (ACD, axial length [AL], lens thickness and position) and IOP (tonometry) were performed preoperatively and 1 day and 1, 4, 9, and 12 weeks postoperatively.
    RESULTS: The open-angle group and occludable-angle group each comprised 35 patients. The occludable-angle group had a shallower ACD, shorter AL, thicker and relatively anterior lens position, and higher IOP preoperatively; postoperatively, there was a significant increase in ACD and a significant reduction in IOP (P
  5. Tang IP, Prepageran N, Subrayan V, Tajunisah I
    Med J Malaysia, 2008 Oct;63(4):337-8.
    PMID: 19385499 MyJurnal
    Optic neuropathy, an uncommon manifestation occurs in 5% of patients with Graves' ophthalmopathy. Its outcome is good if early and proper treatment given. We reported a 49 years old male patient of Graves' disease with bilateral optic neuropathy. He underwent bilateral transnasal endoscopic orbital decompression with marked improvement of visual acuity bilaterally. The preoperative visual acuity was 6/36 in his right eye and 6/60 in his left eye. Two days after operation, his visual acuity was 6/12 in his right eye and 6/24 in his left eye. Transnasal endoscopic orbital decompression is a choice of treatment in optic neuropathy in thyroid ophthalmopathy after trial of corticosteroids.
  6. Hassan M, Patel DK, Subrayan V
    Ann Ophthalmol (Skokie), 2009;41(3-4):203-5.
    PMID: 20214058
    We present a case of a newly acquired herpetic infection in the graft after penetrating keratoplasty.
  7. Ang GS, Tey A, Ng WS, Subrayan V
    Med J Malaysia, 2007 Aug;62(3):259-60.
    PMID: 18246923
    Patients with bleeding diatheses can present in a variety of clinical situations. When these patients manifest with ocular complications, their management can be challenging. We describe a case of acute angle closure glaucoma secondary to subretinal haemorrhage, with myelodysplasia as a predisposing factor.
  8. Ooi YL, Tai LY, Subrayan V, Tajunisah I
    Ocul Immunol Inflamm, 2011 Oct;19(5):370-2.
    PMID: 21834697 DOI: 10.3109/09273948.2011.594203
    To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection.
  9. Koay CL, Quo MJ, Subrayan V
    Int Ophthalmol, 2017 Jun;37(3):655-671.
    PMID: 27558260 DOI: 10.1007/s10792-016-0306-4
    The purpose of this study was to investigate the reproducibility of choroidal thickness measurements in normal subjects on 3 spectral domain optical coherence tomography instruments, namely: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA), Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany), and Optovue RTVue (Optovue Inc., Fremont, CA). This cross-sectional non-interventional study was performed in a single institution. Images were obtained in 47 eyes of 47 healthy volunteers which age ranged between 23 and 72 without ocular pathology. All subjects were imaged on the fovea using Cirrus HD 1-line raster, Spectralis enhanced depth imaging, and RTVue retina-cross. The choroid was measured subfoveally and at intervals of 500 µm from the fovea nasally and temporally up to 2500 µm. Paired t test, modified Bland-Altman plot, and Pearson's correlation were used to compare the results. There is no significant difference between the systems for any measurement within 2500 µm either side of the fovea for most points. Inter-observer correlation was strong for RTVue, and moderate in both Cirrus and Spectralis.
  10. See WYN, Sumugam K, Subrayan V
    Allergy Rhinol (Providence), 2016 Jan 01;7(4):223-226.
    PMID: 28683249 DOI: 10.2500/ar.2016.7.0178
    BACKGROUND: To report an unusual case of compressive optic neuropathy secondary to a large onodi air cell.
    METHOD: Case report.
    RESULTS: A 50 year-old gentlemen presented to the eye clinic with left eye painless loss of vision for one day. Visual acuity was counting finger in the left eye with a positive relative afferent pupillary defect (RAPD). Dilated left fundus examination revealed a pale optic disc. A computed tomography of orbit and brain showed a large left sphenoid sinus with onodi-cell-like projection on the left superior margin of left optic canal impinging on the left optic nerve. He was referred to the otorhinolaryngology team and subsequently underwent left optic nerve decompression. Post-operatively, his left visual acuity improved to 6/60 with reversal of RAPD.
    CONCLUSION: There are many causes of optic neuropathy and compressive optic neuropathy due to large onodi air cell is uncommon. Acute unilateral loss of vision heralds from a multitude of sinister causes and junior residents should be vigilant that onodi air cell pneumotisation could be one of them.
  11. Loo AV, Sujaya S, Peyman M, Florence S, Subrayan V
    Int J Ophthalmol, 2011;4(6):641-3.
    PMID: 22553736 DOI: 10.3980/j.issn.2222-3959.2011.06.13
    To investigate the fundus findings of patients infected with human immunodeficiency virus (HIV) in correlation to Highly Active Antiretroviral Therapy (HAART) and CD4 count.
  12. Ismail F, Peyman M, Waran V, Vasudevan S, Subrayan V
    Optom Vis Sci, 2015 Apr;92(4 Suppl 1):S33-5.
    PMID: 25730333 DOI: 10.1097/OPX.0000000000000528
    To report a rare case of nasal chondroma presenting as hypertelorism.
  13. Lee PC, Lam HH, Ghani SA, Subrayan V, Chua KH
    Genet. Mol. Res., 2014;13(2):3553-9.
    PMID: 24737507 DOI: 10.4238/2014.March.24.15
    Mutations in the PAX6 gene that cause aniridia have been identified in various ethnicities but not in the Malaysian population. Therefore, the objective of this study was to investigate the PAX6 mutation in a Malaysian family with congenital aniridia. In this study, a complete ophthalmic examination was performed on a Dusun ethnic family with aniridia. Genomic DNA was extracted from the peripheral blood of the subjects and screened for the PAX6 gene mutation using polymerase chain reaction amplification high-resolution melting curve analysis (PCR-HRM) followed by confirmation via direct DNA sequencing. A heterozygous G deletion (c.857delG) in exon 7 causing a frame shift in PAX6 was identified in all affected family members. Genotype-phenotype correlation analysis revealed congenital cataract and all affected family members showed a similar spectrum of aniridia with no phenotypic variability but with differences in severity that were age-dependent. In summary, by using a PCR-HRM approach, this study is the first to report a PAX6 mutation in a Malaysian family. This mutation is the cause of the aniridia spectra observed in this family and of congenital cataract.
  14. Koay CL, Patel DK, Tajunisah I, Subrayan V, Lansingh VC
    Int Ophthalmol, 2015 Apr;35(2):201-7.
    PMID: 24652461 DOI: 10.1007/s10792-014-9932-x
    To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.
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