exudates and Glaucoma

Genome-wide association studies have identified several genes associated with glaucoma. However, their roles in the pathogenesis of glaucoma remain unclear, particularly their effects on retinal nerve fiber layer (RNFL) thickness. The aim of this study was to investigate the associations between the identified glaucoma risk genes and RNFL thickness.. A total of 3843 participants (7,020 healthy eyes) were enrolled from the Singapore Epidemiology of Eye Diseases (SEED) study, a population-based study composing of three major ethnic groups-Malay, Indian, and Chinese-in Singapore. Ocular examinations were performed, and spectral-domain optical coherence tomography (SD-OCT) was used to measure circumpapillary RNFL thickness. We selected 35 independent glaucoma-associated genetic loci for analysis. An linear regression model was conducted to determine the association of these variants with circumpapillary RNFL, assuming an additive genetic model. We conducted association analysis in each of the three ethnic groups, followed by a meta-analysis of them.. The mean age of the included participants was 59.4 ± 8.9 years, and the mean RFNL thickesss is 92.3 ± 11.2 µm. In the meta-analyses, of the 35 glacuoma loci, we found that only SIX6 was significantly associated with reduction in global RNFL thickness (rs33912345; β = -1.116 um per risk allele, P = 1.64E-05), and the effect size was larger in the inferior RNFL quadrant (β = -2.015 µm, P = 2.9E-6), and superior RNFL quadrant (β = -1.646 µm, P = 6.54E-5). The SIX6 association were consistently observed across all three ethnic groups. Other than RNFL, we also found several genetic varaints associated with vertical cuo-to-disc ratio (ATOH7, CDKN2B-AS1, and TGFBR3-CDC7), rim area (SIX6 and CDKN2B-AS1), and disc area (SIX6, ATOH7, and TGFBR3-CDC7). The association of SIX6 rs33912345 with NRFL thickness remained similar after further adjusting for disc area and 3 other disc parameter associated SNPs (ATOH7, CDKN2B-AS1, and TGFBR3-CDC7).. Of the 35 glaucoma identified risk loci, only SIX6 is significantly and independently associated with thinner RNFL. Our study further supports the involvement of SIX6 with RNFL thickness and pathogensis of glaucoma.

Topics: Asian People; China; Female; Genetic Predisposition to Disease; Glaucoma; Humans; India; Malaysia; Male; Middle Aged; Nerve Fibers; Polymorphism, Single Nucleotide; Retinal Neurons; Risk Factors; Singapore; Tomography, Optical Coherence

Central corneal thickness (CCT) is a risk factor of glaucoma, the most common cause of irreversible blindness worldwide. The identification of genetic determinants affecting CCT in the normal population will provide insights into the mechanisms underlying the association between CCT and glaucoma, as well as the pathogenesis of glaucoma itself. We conducted two genome-wide association studies for CCT in 5080 individuals drawn from two ethnic populations in Singapore (2538 Indian and 2542 Malays) and identified novel genetic loci significantly associated with CCT (COL8A2 rs96067, p(meta) = 5.40 × 10⁻¹³, interval of RXRA-COL5A1 rs1536478, p(meta) = 3.05 × 10⁻⁹). We confirmed the involvement of a previously reported gene for CCT and brittle cornea syndrome (ZNF469) [rs9938149 (p(meta) = 1.63 × 10⁻¹⁶) and rs12447690 (p(meta) = 1.92 × 10⁻¹⁴)]. Evidence of association exceeding the formal threshold for genome-wide significance was observed at rs7044529, an SNP located within COL5A1 when data from this study (n = 5080, P = 0.0012) were considered together with all published data (reflecting an additional 7349 individuals, p(Fisher) = 1.5 × 10⁻⁹). These findings implicate the involvement of collagen genes influencing CCT and thus, possibly the pathogenesis of glaucoma.

Topics: Adult; Aged; Aged, 80 and over; Asian People; Cohort Studies; Collagen; Collagen Type VIII; Cornea; Female; Genome-Wide Association Study; Glaucoma; Humans; Malaysia; Male; Middle Aged; Polymorphism, Single Nucleotide; Quantitative Trait Loci; Risk Factors; Singapore

Primary Open-Angle Glaucoma (POAG) is an age-related chronic optic neuropathy causing progressive constriction of visual field, which compromised quality of life (QoL) of older adults.. The study aims to determine the QoL according to the severity of visual field using Bahasa Malaysia version of the Glaucoma Quality of Life- 36 (Glau-QoL 36) in older adults with POAG in Malaysia.. A cross-sectional study was conducted in two tertiary hospitals in Malaysia: Hospital Universiti Sains Malaysia, Kelantan, and Hospital Selayang, Selangor. POAG patients who were ≥ 60 years old at the time of recruitment had minimal cataract, underwent cataract or trabeculectomy surgery at least 3 months prior and were on medical and surgical treatment. The severity of POAG was based on the modified Advanced Glaucoma Intervention Study (AGIS) score on two reliable reproducible Humphrey visual field SITA program 24-2 analysis. Face to face, one-on-one interview was conducted using validated Bahasa Malaysia version of GlauQol 36.. A total of 360 older adults with POAG were recruited. Majority were between ages 60-67 (38.3%) with 64 (17.8%) mild, 93 (25.8%) moderate, 115 (31.9%) severe POAG and 88 (24.4%) end-stage severity of POAG. The majority of the recruited patients were not working (88.9%) and live with their families (68.1%). There was a significant association between GlauQoL 36 score of all domains: daily living, driving, physiological well-being, self-image, anxiety, burden of treatment and confidence in healthcare with the severity of POAG (p<0.001). Increased severity of POAG was associated with decreased QoL in all GlauQoL 36 domains except confidence in healthcare. There was also a significant increase in dependency, with a majority of the end-stage were living with their families (p<0.001).. QoL and independency of older adults with POAG decrease with worsening of visual field defect. Addressing the problem of visual-related activities in older adults with POAG may reduce their dependency and improve QoL. Happy living is important to lead to healthy living among older adults with POAG.

Topics: Aged; Cataract; Cross-Sectional Studies; Glaucoma; Glaucoma, Open-Angle; Humans; Malaysia; Quality of Life; Surveys and Questionnaires

This study aims to determine the 5-year visual field progression and identify the prognostic factors for progression in Malay patients with primary glaucoma.. A retrospective cohort record review study was conducted among 222 patients (222 eyes) with primary glaucoma who were selected from a glaucoma research database of a tertiary center in Malaysia. The patients were Malays and diagnosed with primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG). Patients who were followed up regularly for at least 6 months between 1 January 2009 and 31 December 2014 and completed another 1-year follow-up after recruitment (between 1 January 2015 and 31 December 2015) were selected. Multiple prognostic factors that influence visual field progression were identified. Progression of visual field loss was based on the Advanced Glaucoma Intervention Study and Hodapp-Parrish-Anderson scores. Kaplan-Meier survival and Cox proportional hazard regression analyses were performed.. Sixty-three patients (28.4%) developed visual field progression after a mean (SD) follow-up of 6.9 (3.3) years. Those with POAG progressed faster (mean time, 10.6 years; 95% confidence interval [CI], 9.3, 11.9) than those with PACG (17.3 years; 95% CI, 14.8, 19.9) but not statistically significant. Disc hemorrhage and history of eye pain increased the risk of progression by 2.8-folds (95% CI, 1.6, 4.8) and 2.5-folds (1.4, 4.4), respectively.. The 5-year survival of the Malay primary glaucoma patients with visual field progression was similar with that of other Asian populations. However, aggressive management is required for those with disc hemorrhages and eye pain related to increased intraocular pressure.

Topics: Disease Progression; Eye Pain; Glaucoma; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Malaysia; Prognosis; Retrospective Studies; Survival Analysis; Visual Field Tests; Visual Fields

To compare the intraocular pressure (IOP) lowering effect and postoperative complications between primary augmented trabeculectomy and glaucoma drainage device (GDD) implantation as primary surgical intervention in patients with juvenile-onset open angle glaucoma (JOAG).. A retrospective review study involving 20 eyes that underwent primary augmented trabeculectomy with mitomycin (MMC) and 10 eyes GDD implantation in 3 tertiary centres in Malaysia between 1 January 2013 and 31 December 2019. They were followed up for at least 12 months postsurgical intervention. Intraocular pressure (IOP), number of topical IOP lowering medication and complications were evaluated at 1, 3, 6 and 12 months post-intervention. Based on the IOP, the success was divided into complete and partial success, and failure. IOP and postsurgical complications were compared using the Repetitive Measure Analysis of Variance (RM ANOVA) and the Pearson chi-square test.. Both methods were effective in lowering the IOP. Eyes with primary augmented trabeculectomy have significant lower IOP compared to GDD implantation (p = 0.037). There was a higher incidence of postoperative hypotony (30%) in the trabeculectomy group. There was also a significant reduction of mean number of topical pressure-lowering drugs required postoperatively (p = 0.015). Complete success was achieved in 100% of eyes with trabeculectomy and 67% in GDD implantation (p = 0.047).. Primary augmented trabeculectomy and GDD implantation are good surgical options for the treatment of JOAG. Both methods provide IOP lowering at 1 year. However, trabeculectomy provides better pressure lowering, compared to GDD implantation in patients with JOAG.

Topics: Follow-Up Studies; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Malaysia; Retrospective Studies; Tertiary Care Centers; Trabeculectomy; Treatment Outcome

According to the WHO, glaucoma is the second leading cause of blindness worldwide. About 50% of the world's glaucoma cases come from the Asian population, and in Malaysia itself, the prevalence of glaucoma is increasing. However, glaucoma is still a foreign word to our community despite the high prevalence. Therefore, there is an urgent need to determine the awareness of glaucoma among the community and its associated factors.. This study showed that only 25.2% of our respondents were aware of glaucoma and it is associated with ethnicity, religion, education, and household income. Besides, among those who were aware, they fall into the group of poor knowledge of glaucoma. On the other hand, the knowledge of glaucoma was associated with occupation and the awareness of glaucoma by definition. The validated questionnaire was distributed and the data were analyzed by SPSS software using. Awareness and knowledge of glaucoma in this population is low. These findings suggest that there is a need for an efficient information and education strategy to be designed and conducted to increase the awareness and knowledge of glaucoma so that early detection can be made and effective management of individuals with this condition can be delivered.

Topics: Adult; Cross-Sectional Studies; Educational Status; Female; Glaucoma; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Surveys and Questionnaires

This prospective cross-sectional study found that patients with cognitive impairment (CI) are more likely to produce unreliable visual field (VF) tests, especially with higher false-negative (FN) responses and consequent overestimation of mean deviation (MD).. Aging-associated CI can impair the ability of individuals to perform a VF test and compromise the reliability of the results. We evaluated the association between neurocognitive impairment and VF reliability indices in glaucoma patients.. This prospective, cross-sectional study was conducted in the Ophthalmology Department, Hospital Kuala Pilah, Malaysia, and included 113 eyes of 60 glaucoma patients with no prior diagnosis of dementia. Patients were monitored with the Humphrey Visual Field Analyzer using a 30-2 SITA, standard protocol, and CI was assessed using the clock drawing test (CDT). The relationships between the CDT score, MD, pattern standard deviation, Visual Field Index (VFI), fixation loss (FL), false-positive values, and FN values were analyzed using the ordinal regression model.. Glaucoma patients older than 65 years had a higher prevalence of CI. There was a statistically significant correlation between CDT scores and glaucoma severity, FL, FN, and VFI values (rs=-0.20, P=0.03; rs=-0.20, P=0.04; rs=-0.28, P=0.003; rs=0.21, P=0.03, respectively). In a multivariate model adjusted for age and glaucoma severity, patients with lower FN were significantly less likely to have CI (odds ratio, 0.91; 95% confidence interval, 0.89-0.93) and patients with higher MD were more likely to have CI (odds ratio, 1.10; 95% confidence interval, 1.05-1.16); false positive, FL, pattern standard deviation, and VFI showed no significant correlation.. Cognitive decline is associated with reduced VF reliability, especially with higher FN rate and overestimated MD. Screening and monitoring of CI may be important in the assessment of VF progression in glaucoma patients.

Topics: Aged; Aged, 80 and over; Aging; Cognitive Dysfunction; Cross-Sectional Studies; Disease Progression; Female; Glaucoma; Health Status Indicators; Humans; Malaysia; Male; Middle Aged; Predictive Value of Tests; Prevalence; Prospective Studies; Reproducibility of Results; Visual Field Tests; Visual Fields

Obstructive sleep apnea syndrome (OSAS) patients are at risk of glaucoma but the risk increases if they have higher intraocular pressure (IOP) while sleeping. We aim to evaluate the postural effect of upright and prolong supine positions on IOP in these patients.. This is a cross-sectional study involving 27 patients with symptoms of OSAS seen at a tertiary institutional center and 25 normal controls performed between June 2015 and June 2016. All patients and controls underwent a polysomnography (PSG) test and were diagnosed with OSAS based on the apnea-hypopnea index (AHI). Patients are those with OSAS symptoms and had AHI > 5, whereas controls are staffs from the ophthalmology clinic without clinical criteria for OSAS and had PSG result of AHI < 5. IOP was measured 10 min after sitting, immediately and at 30 min on supine position and immediately after resuming sitting position. The main outcome measures were the changes in mean IOP in different positions.. The increase in mean IOP when changing from sitting to supine position was significantly higher in OSAS patients in both the right eye (RE) (1.01 ± 1.14 vs 0.44 ± 0.41 mmHg, p = 0.033) and left eye (LE) (1.20 ± 1.26 vs 0.48 ± 0.62 mmHg, p = 0.044). After 30 min supine, the IOP in OSAS patients showed a further increase in IOP than controls (RE 1.20 ± 1.79 vs 0.12 ± 0.66 mmHg, p = 0.001 and LE 0.59 ± 2.00 vs 0.15 ± 0.78 mmHg, p = 0.246). Higher IOP when sitting post supine is associated with higher IOP on supine position.. IOP increase is significantly more in OSAS patients on prolong supine position.

Topics: Adult; Cross-Sectional Studies; Female; Follow-Up Studies; Glaucoma; Humans; Incidence; Intraocular Pressure; Malaysia; Male; Polysomnography; Retrospective Studies; Risk Factors; Sleep; Sleep Apnea, Obstructive; Supine Position

We determined the impact of glaucoma severity and laterality on vision-specific functioning (VF) in an Asian population.. The Singapore Malay Eye Study (SiMES) was a population-based cross-sectional study of 3280 Malays aged 40 to 80 years. VF was assessed using the VF-11 questionnaire. Associations between VF-11 score and glaucoma clinical indices (glaucoma severity in better and worse eyes, and laterality) were determined by multivariate regression modeling. Glaucoma severity was defined as mild, moderate, advanced, and severe based on the Hodapp-Anderson-Parish system. Rasch analysis was used to validate the VF-11 and determine its psychometric properties.. Of 926 persons analyzed, 123 had glaucoma (13.3% glaucoma prevalence in analyzed sample). The mean ± SD VF score was 3.64 ± 1.05 log of odds units (Logits). In multivariate models adjusting for sociodemographic, ocular, and systemic variables, poorer VF was associated with increasingly worse eye visual field loss (β = 0.016, 95% confidence interval [CI] 0.004-0.029, P < 0.001), but not that of the better eye (P > 0.05). Compared to controls, VF was reduced in individuals with worse eye advanced and severe glaucoma (β = -0.65, 95% CI -1.03 to -0.28, P < 0.05), but not mild or moderate glaucoma (P > 0.05). Compared to controls, VF was reduced in unilateral (β = -0.29, 95% CI -0.54 to -0.04, P < 0.05), but not bilateral glaucoma (P > 0.05). These associations remained significant after adjusting for presenting and best-corrected visual acuity.. Among Singaporean Malays, unilateral, and advanced and severe glaucoma in the worse eye significantly impacts on VF. Identifying early-stage glaucoma, preventing progression, and visual rehabilitation in advanced glaucoma are important aspects of glaucoma management.

Topics: Adult; Aged; Aged, 80 and over; Asian People; Blindness; Cross-Sectional Studies; Disease Progression; Early Diagnosis; Female; Glaucoma; Humans; Malaysia; Male; Middle Aged; Multivariate Analysis; Prevalence; Psychometrics; Severity of Illness Index; Singapore; Surveys and Questionnaires; Vision, Low

To evaluate the functional impairment of glaucoma patients, using a modified Bahasa Malaysia version of VF-14 questionnaire, and to correlate the score with the severity of the disease.. One-to-one interview by trained interviewers was conducted on glaucoma patients seen in the eye clinic of Hospital Universiti Sains Malaysia, using a modified validated Bahasa Malaysia version of VF-14 questionnaire. The severity of glaucoma was determined based on the better-eye Advanced Glaucoma Intervention Study Scale (AGIS) score of visual field analysis on the latest most reliable visual field. The literacy rate, living situation, better-eye visual acuity and lens status were also documented.. A total of 110 glaucoma patients were recruited (54.5% primary open-angle glaucoma, 21.8% primary angle-closure glaucoma, 19.2% normotensive glaucoma and 4.5% pseudoexfoliative glaucoma) and majority with bilateral involvement. Based on the better-eye AGIS score, 41.5% were in advanced stage, 29.1% moderate and 29.1% mild. There was a significant association between VF-14 scoring with the better-eye AGIS score (r =-0. 579, P < 0.001), age (r = -0.313, P = 0.000) and better-eye visual acuity (r = -0.752, P = 0.000). Based on the multivariate analysis, there was a significant association of the questionnaire score and better-eye AGIS score (P < 0.001).. The Bahasa Malaysia version of modified VF-14 questionnaire is a useful tool in quantifying quality of life among glaucoma patients in rural area with high illiteracy rate and provides moderate correlation with severity of the disease. Customization of quality of life questionnaire according to custom and culture of the community will provide better insight to the functional impairment of glaucoma patients.

Topics: Age Factors; Aged; Cross-Sectional Studies; Female; Glaucoma; Humans; Malaysia; Male; Middle Aged; Quality of Life; Rural Population; Severity of Illness Index; Surveys and Questionnaires; Vision Disorders; Visual Acuity

The Prostaglandin F2alpha (PGF2alpha) receptor gene has been found to play an important role in reducing the intraocular pressure of the glaucomatous patients. Variations of the PGF2alpha receptor gene may be responsible for the differences in the response to an antiglaucoma drug, Latanoprost. A combined method of denaturing High Performance Liquid Chromatography (dHPLC) and sequencing was applied to detection of the PGF2alpha receptor gene variant among the 76 Malaysian patients with glaucoma, and a novel single nucleotide polymorphism (SNP), IVS -97A>T, was identified. According to the genotyping analysis, 36.8% of the subjects were heterozygous for the variant allele T, while 9.2% homozygous. The frequency of variant allele T was 0.28. Although with a limited number of samples, our data suggested that this polymorphism is common in the Malaysian patients with glaucoma.

Topics: Gene Frequency; Glaucoma; Humans; Malaysia; Polymorphism, Single Nucleotide; Receptors, Prostaglandin; Sequence Analysis, DNA

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 retrospective study was conducted at the Hospital Sultanah Aminah Johor Bahru to determine the outcome of trabeculectomy surgeries over a period of 4 years. One hundred and two eyes were followed up to a maximum of 63 months (mean 34.2 months). The 2-year survival rates for plain trabeculectomies, 5-Fluorouracil augmented trabeculectomies and Mitomycin-C augmented trabeculectomies were 52.9%, 27.3% and 60.5% respectively. The commonest complications noted were cataract formation (25%) and hyphaema (11%). Mitomycin-C induced complications were rarely seen. At last follow-up, 54% of eyes had intraocular pressures below 21 mmHg without medication, while 34% of eyes had intraocular pressures below 21 mmHg with medication. Vitreous at the trabeculectomy site was a statistically significant predictor of operative failure.

Topics: Adult; Aged; Aged, 80 and over; Antimetabolites; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Fluorouracil; Glaucoma; Hospitals, General; Humans; Malaysia; Male; Middle Aged; Mitomycin; Nucleic Acid Synthesis Inhibitors; Postoperative Complications; Retrospective Studies; Statistics, Nonparametric; Trabeculectomy; Treatment Outcome

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

The records of all the glaucoma patients seen at the General Hospital Kuala Lumpur over a five year period were analysed. The racial, age and sex distribution of patients with primary open angle glaucoma and primary angle closure glaucoma was determined. The causes of secondary glaucoma were analysed. As no previous records of glaucoma statistics are available in Malaysia, it is hoped that these findings will form an initial mosaic to build on in the future.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Female; Glaucoma; Humans; Malaysia; Male; Middle Aged; Time Factors

To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body.. This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed.. Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis.. In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.

Topics: Adult; Aged; China; Ciliary Body; Ethnicity; Female; Glaucoma; Humans; India; Intraocular Pressure; Laser Coagulation; Malaysia; Male; Middle Aged; Postoperative Complications; Prospective Studies; Reoperation; Safety; Sclera; Treatment Outcome; Visual Acuity

Topics: Athletic Injuries; Cataract; Eye Injuries; Glaucoma; Humans; Hyphema; Macula Lutea; Malaysia; Pupil; Sports; Visual Acuity