exudates and Strabismus

To evaluate parents' performance in using the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) Vision Screening App (application) as a vision screening tool among preschool children and to evaluate the reliability of this app.. A total of 195 5- and 6-year-old preschoolers were recruited from children attending Hospital Selayang, Selangor, Malaysia, to test the app. Uncooperative children and those with visual acuity of >logMAR 0.6 were excluded. Results from parents and the screening doctor using the app (Lea symbols) to test visual acuity were compared to each other and to gold standard vision testing by an optometrist using the Lea symbols chart.. Children 5 years of age represented 46.7% of the study population. The mean age of parents was 37.27 ± 7.68 years. Bland-Altman scatterplot agreement between assessors mainly was within the 95% confidence interval for bilateral eyes screening. Parents obtained a sensitivity of 86.6% (right vision) and 79.5% (left vision) and specificity of 78.9% (right vision) and 71.8% (left vision). Parents took a mean of 191.2 ± 70.82 seconds for bilateral screening. The intraclass correlation coefficient between optometrist and parents in bilateral eyes screening was good (P < 0.001). Cronbach's α for all three assessors was >0.7, indicating high internal reliability of the app. Most parents (178/195 [91.3%]) strongly agreed on the app's acceptability and ease of use.. The AAPOS Vision Screening App used by parents is a promising tool for visual acuity screening among Malaysian preschool children and a reliable app for vision screening.

Topics: Adult; Amblyopia; Asian People; Child; Child, Preschool; Female; Humans; Malaysia; Male; Middle Aged; Mobile Applications; Ophthalmology; Parents; Reproducibility of Results; Societies, Medical; Strabismus; Vision Screening; Visual Acuity

The aims of this study were to review the presenting features, treatment and outcome for Malaysian children with retinoblastoma currently.. This was a prospective study, conducted at the General Hospital Kuala Lumpur from August 2001 until October 2007. Clinical data were collected at presentation and follow-up.. One hundred five children were diagnosed to have retinoblastoma. There were 55 males and 50 females, ranging in age from 1 month to 14 years (median 20 months). Seventy-six children were Malay in ethnic origin (73%), 14 Chinese (13%), 12 Indian (11%), and other races (3%). Sixty-four children presented with leukocoria (61%), followed by 23 with proptosis (22%), 13 with squint (12%), and 3 with orbital cellulitis (3%). Thirty-three children (31%) deferred treatment for 6 months or more. Overall, 56 children had extraocular disease (55%), 52 at presentation, 4 later. Seventy-one children (68%) underwent primary enucleation, 76 received chemotherapy (72%), and 23 radiotherapy (22%). Fifty-seven children are alive (54%), of whom 3 are blind (5%). Twenty-seven children were lost to follow-up (26%) and 21 have died (20%).. Retinoblastoma in Malaysia is still characterized by predominantly extraocular disease due to late presentation and high rates of abandonment.

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Ethnicity; Exophthalmos; Eye Enucleation; Female; Follow-Up Studies; Humans; Infant; Malaysia; Male; Orbital Cellulitis; Prospective Studies; Radiotherapy; Retinoblastoma; Strabismus; Survival Rate

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

Down syndrome is a common chromosomal anomaly. Few reported studies make reference to the ocular status in Asian children with Down syndrome. The purpose of this study was to determine the visual and binocular status of a sample of Down syndrome children in Malaysia.. A total of 73 Malaysian children with Down syndrome (38 boys and 35 girls) in the Kuala Lumpur area aged one to 12 years were examined. Cycloplegic refraction was performed on each eye and binocular visual acuity was assessed using the Cardiff acuity card or the LogMAR chart. Binocular functions were assessed using the cover test and Lang's stereo acuity test.. The mean age of the subjects was 6.01 +/- 3.41 years. Refraction of the right eye showed that 10 per cent of the subjects were myopic, 20 per cent were hyperopic and 70 per cent had no significant refractive error. The mean spherical equivalent was +0.92 +/- 2.32 DS for the right eye and +0.99 +/- 2.21 DS for the left. The mean of binocular LogMAR VA was 0.36 +/- 0.22 (6/12). Cover test revealed that 21 subjects had strabismus (of those, 33 per cent had unilateral esotropia, 52 per cent had alternating esotropia, nine per cent had unilateral exotropia and five per cent had alternating exotropia). Only 22 subjects gave clear positive response to the stereotest. Other ocular findings included ptosis (one per cent), abnormal head posture (seven per cent) and nystagmus (six per cent).. Malaysian children with Down syndrome have a high incidence of refractive error and strabismus. Regular visual examination is important so that corrective lenses can be prescribed to improve vision and to enhance the quality of life of these children in Malaysia.

Topics: Child; Child, Preschool; Down Syndrome; Female; Humans; Incidence; Infant; Malaysia; Male; Refraction, Ocular; Refractive Errors; Strabismus; Vision, Binocular; Visual Acuity

Topics: Child; Female; Humans; Malaysia; Male; Strabismus; Vision Disorders