Clinical profile and visual outcome of traumatic paediatric cataract in suburban Malaysia: a ten-year experience

<p><b>INTRODUCTION</b>Available data on traumatic cataract in Asian children is primarily confined to South Asian countries. We aimed to describe the demographics, nature of injury and visual outcomes of Malaysian children with traumatic cataract from a suburban area, and discuss the literature on Asian children with this condition.</p><p><b>METHODS</b>We conducted a retrospective study of 29 children below 17 years of age who were diagnosed with traumatic paediatric cataract and who attended Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2000 and December 2010. Follow-up periods ranged from 12 to 120 months. Demographic data, clinical features, mechanism and extent of injury, and final visual outcome were recorded.</p><p><b>RESULTS</b>The study population was predominantly male. The right eye was injured in 62.07% of patients. A majority of patients had penetrating injuries, with the most common cause being injury by an organic foreign body (24.14%). Presenting visual acuity worse than 6/60 was observed in 68.97% of patients. Only 34.48% of patients had a final corrected visual acuity of 6/12 and better. 55.18% of patients were operated on within less than one month of their injuries. A majority of children sustained concurrent injuries to the anterior segment structures. Corneal opacity and amblyopia were the most common causes of poor final visual acuity.</p><p><b>CONCLUSION</b>Health education and awareness are essential tools that can prevent avoidable blindness due to traumatic cataract in the paediatric population. The importance of rehabilitation programmes for these patients should be emphasised.</p>

Ultrasonographic Findings in Eyes with Retinopathy of Prematurity in Malaysia

RetCam is an excellent screening tool for the detection of retinopathy of prematurity (ROP). However, affordability is a barrier when adopting the use of RetCam in developing countries. We aimed to describe different stages of ROP using ultrasonographic B-scan and to evaluate the association between funduscopic examinations and ultrasonographic B-scan findings in premature neonates with ROP in Malaysia. A descriptive cross sectional study was conducted in 90 eyes of 47 premature neonates with different stages of ROP in three tertiary hospitals in Malaysia. Experienced ophthalmologists performed detailed funduscopic examinations using binocular indirect ophthalmoscopy (BIO). A masked examiner performed a 10 MHz ultrasonographic B-scan evaluation with 12 meridian position images within 48 hours of clinical diagnosis. Data from the clinical examination and ultrasonographic findings were collected and analysed. We recruited 37 eyes (41.1%) with stage 1 ROP, 29 eyes (32.3%) with stage 2, 18 eyes (20.0%) with stage 3, and 3 eyes (3.3%) with stages 4 and 5 based on the clinical assessment. Ultrasonography correctly identified 3 (8.1%) stage 1 eyes, 17 (58.6%) stage 2 eyes, 13 (72.2%) stage 3 eyes, and 3 each (100%) of the stage 4 and 5 eyes. There was a significant association between the funduscopic signs and the ultrasound findings for stage 2 ROP and above (Fisher’s exact test, p <0.001). In conclusion, all stages of ROP were detected and described with a 10 MHz ultrasonic B-scan system. A significant association was observed between funduscopic signs and ultrasonographic findings in premature Malaysian neonates with stage 2 ROP and above.