exudates and Eye-Diseases

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.

Topics: Blindness; Child; Child, Preschool; Developed Countries; Developing Countries; Eye Diseases; Female; Humans; Malaysia; Male; Prevalence

The purpose of this cross-sectional study was to assess the legal representatives' perceptions on dental care access of individuals with Down syndrome (DS) compared to their non-DS siblings in Peninsular Malaysia.. This cross-sectional study was conducted throughout community-based rehabilitation centers (CBRC) and the Down Syndrome Organization. Legal representatives of individuals with DS within the criteria were given a structured and validated questionaire.. This study demonstrated that individuals with DS (76.9%) significantly utilized more health services than non-DS siblings (23.1%). The service most regularly used was speech therapy followed by opthalmology and dental services. Twenty-five per cent of respondents reported difficulty in finding dental care services for their DS child and 46.9% admitted that healthcare for their DS child took more time. The majority of DS individuals received less complex dental treatment and none received any orthodontic treatment, despite their severe occlusal problems.. A high proportion of parents appear to be able to access dental and medical care for their DS child. However, some parents perceived difficulty in finding oral healthcare.

Topics: Adult; Aged; Attitude to Health; Cross-Sectional Studies; Dental Care; Down Syndrome; Educational Status; Eye Diseases; Female; Health Services Accessibility; Humans; Income; Malaysia; Male; Middle Aged; Orthodontics, Corrective; Parents; Speech Therapy; Time Factors

To describe the prevalence and causes of low vision and blindness in a Malay population.. A population-based, cross-sectional study of 3280 participants of Malay ethnicity, aged 40 to 79 years, was conducted. Participants underwent standardized ophthalmic assessments to determine (1) presenting and best-corrected visual acuity according to US and modified World Health Organization definitions of blindness and low vision and (2) the primary causes of visual impairment.. Of 4168 eligible individuals, 3280 participated in the study (78.7%). The population-weighted prevalence of bilateral blindness was 0.3% and of bilateral low vision, 4.4% (US definition of presenting visual acuity). After best-corrected visual acuity, the population-weighted prevalence of bilateral blindness was reduced to 0.1% and bilateral low vision to 1.0%. Cataract was the main cause of presenting unilateral (38.9%) and bilateral (65.2%) blindness, whereas undercorrected refractive error was the main cause of presenting unilateral (68.8%) and bilateral (52.2%) low vision. Diabetic retinopathy, age-related macular degeneration, and glaucoma were the other leading causes of blindness and low vision.. The age-standardized prevalences of bilateral blindness and low vision in a Malay population were lower when compared with other Asian studies. Undercorrected refractive error and cataract are the leading causes of visual impairment among the Malay adult population in Singapore.

Topics: Adult; Age Distribution; Aged; Blindness; Cross-Sectional Studies; Eye Diseases; Female; Humans; Malaysia; Male; Middle Aged; Prevalence; Sex Distribution; Singapore; Urban Population; Vision, Low; Visual Acuity

National Eye Database (www.acrm.org.my/ned) is a web based surveillance system which collects data on eye diseases and clinical performance in ophthalmology service. It is a prospective study with online data collection, concurrent descriptive data analysis and real time report. It includes cataract surgery registry, diabetic eye registry, glaucoma registry, contact lens related corneal ulcer surveillance and monthly ophthalmology service census. This article presents the methodology and some registries reports. The web based surveillance system has made dissemination of report prompt, easy and without barrier.

Topics: Databases, Factual; Eye; Eye Diseases; Female; Humans; Internet; Malaysia; Male; Middle Aged; Multicenter Studies as Topic; Population Surveillance; Prospective Studies; Registries

Down syndrome was first described as Mongoloid children with European parentage. Although their facial features resemble Orientals or Asians, ocular findings have not been well-documented in Asians, especially Malaysians. Our aim was to identify the ocular findings of Malaysian children with Down syndrome.. A total of 60 children with Down syndrome, aged between one month and 17 years, were examined for ocular findings from January 1995 to January 2004. Ocular examination, which includes visual acuity assessment, slit lamp biomicroscopy, ocular motility, cycloplegic refraction and ophthalmoscopy were performed whenever possible.. The ocular findings include epicanthic fold in 96.7 percent (58), nystagmus in 33.3 percent (20), and strabismus in 26.7 percent (16) of children with Down syndrome, all of whom were esotropic. Other findings were bilateral congenital cataract in 13.3 percent (8), blepharoconjunctivitis in 10.0 percent (6), eyelid abnormalities in 6.7 percent (4), glaucoma in 6.7 percent (4), nasolacrimal duct obstruction in 3.3 percent (2), bilateral retinoblastoma in 1.7 percent (1), bilateral retinal detachment in 1.7 percent (1), and chronic uveitis in 1.7 percent (1) of children. Visual assessment showed that 47.3 percent of patients achieved good vision (6/12 to 6/6). Cycloplegic refraction was done in 24 patients (41.7 percent). Out of the 24 patients, 29.2 percent (7) were myopic, 25.0 percent (6) were hyperopic, and astigmatism was observed in 8.3 percent (2).. Malaysian children with Down syndrome demonstrated high incidences of epicanthic fold, nystagmus, and strabismus, and absence of Brushfield spots or keratoconus, which are in contrast to the ocular findings in Caucasian patients with Down syndrome. Rare ocular findings, such as bilateral retinoblastoma and retinal detachment, were also observed but their association with Down syndrome is not well-established.

Topics: Adolescent; Asian People; Child; Child, Preschool; Down Syndrome; Eye Abnormalities; Eye Diseases; Eyelids; Female; Humans; Infant; Malaysia; Male; Nystagmus, Congenital; Prospective Studies; Retrospective Studies; Strabismus; Visual Acuity

A Web-based service was set up to link subspecialist ophthalmologists with those seeking advice on particular clinical problems in ophthalmology. The service operated between countries, with centres in Malaysia, Ghana, Tanzania, South Africa and Gambia seeking advice from Moorfields Eye Hospital in the UK. It also operated within country, where a rural clinic in The Gambia sought advice from the central hospital on difficult cases or cases for possible referral. Provision of Web access and training in image capture and manipulation were undertaken in each participating centre. During the first 12 months, 132 cases were posted to the Website from five of the six centres participating. The rate of case referral rose to about 12-14 cases per month by the end of the study. Overall, 24% of referrals did not use images. In the first four months the response time was 13 days, and in the last four months it was three days. Most cases were answered with a single response from the specialist. The main problem was the amount of Internet down-time in each of the locations. The main benefit was safe and reliable access to specialist advice for practitioners.

Topics: England; Eye Diseases; Gambia; Ghana; Humans; Internet; Interprofessional Relations; Malaysia; Medical Audit; Ophthalmology; South Africa; Tanzania; Telemedicine

A cross sectional study was conducted to assess the level of awareness and knowledge of common eye diseases (cataract, glaucoma, diabetic retinopathy and refractive errors) among 473 academic staff (non-medical faculties) of University Malaya. The awareness of cataract was in 88.2%, diabetic retinopathy in 83.5%, refractive errors in 75.3% and glaucoma in 71.5% of the study population. The knowledge about all the above common eye diseases was moderate, except presbyopia which was poor. Multivariate analysis revealed that females, older people, and those having family history of eye diseases were significantly more aware and more knowledgeable about the eye diseases. Health education about eye diseases would be beneficial to seek early treatment and prevent visual impairment in the society.

Topics: Adult; Awareness; Cataract; Cross-Sectional Studies; Diabetic Retinopathy; Eye Diseases; Family Health; Female; Glaucoma; Humans; Knowledge; Malaysia; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Refractive Errors; Surveys and Questionnaires; Universities

A case of giant cell arteritis with systemic and panocular involvement is reported here. This elderly Indian male presented with symptoms of unilateral temporal headache and intermittent jaw claudication for a month followed by diplopia and blurring of vision and later loss of vision in the right eye. The right eye showed some limitation of ocular movements, presence of relative afferent pupil defect, anterior segment ischaemic changes and anterior ischaemic optic neuropathy. Visual evoked potential showed an absent P1 wave while the left eye with normal 6/6 vision sowed a prolonged P1 wave. Fundus fluoresceine angiography showed delay in choroidal perfusion. His erythrocyte sedimentation rate (ESR) was 120 mm/hr and he was started on oral prednisolone. Superficial temporal artery biopsy obtained one week after starting steroids was positive for giant cell arteritis. Steroids led to the resolution of optic disc swelling, disappearance of anterior segment signs, full recovery of right ocular movements and no further deterioration of the fellow eye. On steroids, he developed insomnia and progressive myopathy which resolved and is now symptom free at lower doses of steroids.

Topics: Aged; Eye Diseases; Giant Cell Arteritis; Humans; India; Malaysia; Male

This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine) children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot's spot in 2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with the standard diagnosis procedure using luxometer readings.

Topics: Adolescent; Age Distribution; Child; Child, Preschool; Eye Diseases; Female; Humans; Infant; Malaysia; Male; Native Hawaiian or Other Pacific Islander; Night Blindness; Racial Groups; Sex Distribution; Vitamin A Deficiency

A national study was conducted in children attending six schools for the blind in Malaysia to identify the anatomical site and underlying causes of blindness (BL) and severe visual impairment (SVI), with a view to determine the potentially preventable and treatable causes so that appropriate control measures can be implemented in the future. The standardized clinical examination of eyes was performed and the findings were recorded on the WHO Prevention of Blindness Programme eye examination record form for children with blindness and low vision. A total of 358 children aged between 7 and 17 years were examined, of whom 332 (92.7%) were blind or severely visually impaired. The results relate to these 332 children. Lens was the major anatomical site (22.3%) of visual loss followed by retina (20.8%), whole globe (17.2%), cornea (15.1%), optic nerve (8.7%) and uvea (5.1%). Glaucoma was responsible for BL/SVI in 7.2% and others in 3.6% of cases. Hereditary diseases were responsible for visual loss in 29.5%, intrauterine factors in 4.5%, perinatal factors in 9% and childhood factors in 7.8% of cases. However, the aetiology was unknown in 49.1% of cases which included congenital anomalies of the globe. Childhood cataract and corneal scarring are major treatable causes of BL/SVI that can benefit from future intervention strategies. Perinatal screening for intrauterine factors and hereditary eye diseases, and appropriate interventional therapy will help in reducing the prevalence of childhood blindness.

Topics: Adolescent; Blindness; Child; Eye Diseases; Female; Humans; Malaysia; Male; Schools; Visually Impaired Persons

The aim of the study was to determine the spectrum of clinical ocular involvement in patients with inactive systemic lupus erythematosus (SLE) who have no ocular symptoms. Patients with a diagnosis of SLE based on the 1982 revised American College of Rheumatology criteria and with no ocular complaints were recruited from the SLE clinic. Clinical data regarding their systemic disease and disease activity were recorded and a full ophthalmic examination carried out. 52 patients of mixed ethnicity comprising of 75% Chinese, 19% Malays and 6% Indian patients were recruited. Of these, 51 (98%) were female with a mean age of 34+/-11 (range 16-74 y). 16 (31%) patients had dry eyes while corticosteroid induced glaucoma and cataract was detected in 1 (2%) and 7 (14%) patients, respectively. No patients were found to have sight-threatening ocular conditions such as cotton wool spots, vasculitis, optic neuropathy or uveitis. Patients with clinically inactive disease were found not to have sight-threatening ocular diseases that are known to be associated with SLE. Although they have no ocular complaints, nearly one-third of these patients have dry eyes. Ocular examination may be unnecessary when the disease is clinically inactive and in the absence of ocular symptoms.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Cataract; China; Dry Eye Syndromes; Ethnicity; Eye Diseases; Female; Glaucoma; Humans; India; Lupus Erythematosus, Systemic; Malaysia; Male; Middle Aged

A cross-sectional prevalence study amongst a nursing home elderly population was carried out at Rumah Sri Kenangan, Seremban, Negeri Sembilan between June 1995 until June 1996. A total of 204 cases of 60 years and older were examined in order to determine the ocular morbidity amongst them. It was found that 47.5% had low vision and 19.1% were legally blind. Cataract was found to be the leading cause of low vision and blindness occurring in 81.4% and 74.3% respectively. Glaucoma occurred in 1% of those who had low vision and none due to macular degeneration or diabetic retinopathy. The magnitude of visual impairment and blindness in this nursing home is high but is preventable and avoidable.

Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Eye Diseases; Female; Humans; Malaysia; Male; Middle Aged; Nursing Homes; Prevalence

Topics: Eye Diseases; Humans; Malaysia; Ophthalmology; Prevalence

A study was carried out to determine the health effects of rice husk dust in Malaysian rice millers. The study population consisted of 122 male Malay workers from three rice mills, with 42 controls of similar age, sex, ethnic group, and agricultural work background. Interviews using standardised questionnaires, physical examination, total and differential white cell counts, chest radiographs, and lung function tests were performed on each of the millers and the controls. Environmental dust monitoring was also carried out in the three rice mills. Clinical, haematological, and radiological findings suggest that a distinct clinical syndrome seems to be associated with exposure to rice husk dust. The manifestations of this "rice millers' syndrome" include acute and chronic irritant effects affecting the eyes, skin, and upper respiratory tract; allergic responses such as nasal catarrh, tightness of chest, asthma, and eosinophilia; and radiological opacities in the chest, probably representing early silicosis or extrinsic allergic alveolitis.

Topics: Adolescent; Adult; Dust; Eye Diseases; Food-Processing Industry; Humans; Lung; Lung Diseases; Malaysia; Male; Middle Aged; Occupational Diseases; Oryza; Radiography; Respiratory Hypersensitivity; Syndrome

An active worm was seen in the right eye of a 62-year-old man in Malaysia. The worm was behind the lens and attached at one end to some vitreous fibers. It was tentatively identified as an immature Dirofilaria immitis. There appear to be only five previous authentic reports of filariae in the vitreous.

Topics: Diethylcarbamazine; Dirofilaria immitis; Dirofilariasis; Eye Diseases; Female; Humans; Malaysia; Middle Aged; Vitreous Body

Topics: Accidents, Occupational; Eye Diseases; Humans; Malaysia; Occupational Diseases; Public Health

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Eye Diseases; Female; Humans; Infant; Malaysia; Male; Middle Aged; Ophthalmologic Surgical Procedures

Topics: Aged; Blindness; Eye Diseases; Female; Humans; Leprosy; Malaysia; Male; Middle Aged; Peripheral Nervous System Diseases; Sex Factors

Eleven corneal specimens from nine patients with Salzmann's nodular degeneration of the cornea, together with all available clinical information, were collected for this study. The specimens were examined by light and electron microscopy. An antecedent keratitis was diagnosed by history and microscopic findings in every case. The corneal epithelium showed degenerative changes, its thickness varied, and in nodular areas it often consisted of only a single layer of flattened epithelial cells by light microscopy. Bowman's membrane was missing over the nodules, and in this zone there was excessive secretion of a basement membrane-like material. Hyaline degeneration of collagen, cellular debris, and electron-dense hyaline deposits were seen in the collagen of the nodules. The number of fibrocytes in the nodules varied from many that were active to a few that were degenerating. External irritation because of poor epithelial protection was interpreted as a causative factor, although other tissue repair mechanisms may also have played a role.

Topics: Basement Membrane; Cell Membrane; Chromatin; Cicatrix; Collagen; Cornea; Cytoplasm; Epithelial Cells; Epithelium; Eye Diseases; Female; Fibroblasts; Humans; Hyalin; Keratitis; Malaysia; Male; Philippines; Vacuoles

Topics: Adolescent; Adult; Black or African American; Black People; Child; Ethnicity; Eye Diseases; Eye Injuries; Female; Humans; Malaysia; Male; Vision Disorders

Topics: Adolescent; Adult; Child; Child, Preschool; Ethnicity; Eye Diseases; Eye Injuries; Eye Neoplasms; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Melanoma; Retinoblastoma

Topics: Eye Diseases; Female; Humans; Malaysia; Male; Outpatient Clinics, Hospital