Introduction: Unequal retinal image size (RIS) or aniseikonia is usually related with anisometropia. Higher dif- ferences of RIS may manifest symptoms such as dizziness, headache or disorientation. In worst case might cause suppression that leads to amblyopia. Current study aims to evaluate the consistency of aniseikonia measurement in Smart Optometry smartphone application among myopic, hyperopic, and astigmatic simulated anisometropia and real anisometropia groups. Methods: Fifteen real anisometropes (refractive error; -0.50 until -6.00 diopters; D) and fifteen emmetropes (refractive error: -0.25 until +0.50D) were recruited. Real anisometropes wore their habitual spectacle correction while each emmetropes were fitted using soft contact lenses of +4.00DS, -4.00DS and -4.00DC with base curve 8.6 and total diameter 14.2mm in random order to mimic myopic-, hyperopic- and astigmat- ic-anisometropia before testing. Participants with any ocular disease and binocular vision problem were excluded. The consistency of aniseikonia measurement was determined in two visits, separated by at least 24-hour interval. Three repetitive measurements were taken in each visit. Results: Independent t-test and paired t-test showed that real and simulated anisometropia gave insignificant aniseikonia percentage, p>0.05. ICC findings revealed moder- ate-to-good agreement for all simulated and real groups. Bland Altman analysis between two visits exhibited good agreement among all simulated group; myopic (mean difference 0.2047; 95%CI:-1.1386-1.549), hyperopic (mean difference 0.2200; 95%CI:-0.9286-1.3686) and astigmatic (mean difference 0.2533; 95%CI:-0.7114-1.2180). Real anisometropes demonstrated good agreement with bias value of 0.2247(95%CI:-0.9162-1.3656) using Bland Altman plot. Conclusion: Smart Optometry application provides consistent measurement of aniseikonia regardless any types of anisometropia.
Amblyopia is one of the most common causes of visual defi cit in children. Presently, in the Ministry of Health Malaysia hospitals, there is no documented data on the characteristic and profi le of amblyopia cases. This study was conducted to scribe the profile of new amblyopia cases seen by optometrists at the Ministry of Health (MOH) Hospitals. This study was a retrospective and multicenter study including all MOH hospitals with optometry clinics. Clinical record data of amblyopic patients aged 3 to 17 years old who were newly diagnosed between 1st August 2010 to 31st January 2011 and who fulfi lled the inclusion criteria were obtained. Data collected included demography, systemic history, ocular history and optometric findings and diagnosis. Thirty eight MOH hospitals participated and a total of 301 patients were diagnosed with functional amblyopia within the study period. Mean age for these amblyopic patients was 7.70 + 0.16 years old. Boys were the predominant gender (57.1%) and Malay preceded the other races with a 65.4% occurrence. Mild amblyopia was found in 51.5% of the patients, 31.6% were with moderate amblyopia and only 16.9% of patients were severe amblyopia. The underlying amblyogenic causes assessed were ametropia (61.5%), anisometropia (25.2%), strabismus (9.3%) and stimulus deprivation (4.0%). Refractive error was discovered as the most common cause of amblyopia in this study. It is crucial for optometrists to detect this type of visual impairment and undertake an early optometric intervention.
Study site: multicenter study including all MOH hospital
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.