An 8-year Retrospective Review of Microbial Keratitis in A Secondary Referral Centre in Malaysia

Introduction: Microbial keratitis (MK) is an important cause for corneal blindness and understanding its risk factors enable us to improve management and minimise its complications. Methods: In this retrospective case review, medical records of all patients treated for MK from 2006 to 2013 was analysed to know the socio-demography, preceding risk factors, clinical characteristics, causative organisms and final visual outcome. Results: A total of 174 patients (180 eyes) were included in this study. Identifiable ocular risk factors included contact lens (CL) usage (85, 47.2%), ocular trauma (50, 27.8%), ocular surface disease (21, 11.6%), steroid use (6, 3.3%) and immuno-compromy (19, 10.5%). Association factors for presenting uncorrected visual acuity (UCVA) were age group (p=0.013), size (p<0.001), location (p<0.001) and hypopyon (p<0.001). The predictors for final best spectacle-corrected visual acuity (BSCVA) were age group (p<0.001), nationality (p=0.020), occupation (p<0.001), CL use (p<0.001), ocular surface disease (p=0.048), size (p<0.001) and location (p<0.044), hospitalisation duration (p=0.002) and presenting UCVA (p<0.001). Conclusions: Contact lens was the most frequent predisposing risk factor for microbial keratitis, followed by ocular trauma. Understanding the association factors for presenting vision and predictors for final vision may help in the patients’ management and improve eventual outcome of microbial keratitis.

Open Globe Injury in Hospital Serdang - An 8-year Retrospective Review

Introduction: Open globe injury may lead to devastating visual outcome. Urgent management and subsequent follow-up is important to maximise recovery. More data on open globe injury in Malaysia is needed to identify risk groups and prognostic factors. This study was carried out to investigate open globe injury, the socio-epidemic profile, clinical characteristics and outcome of the open globe injury in the Hospital Serdang, Malaysia. Methods: All patients managed for open globe injury to Hospital Serdang from January 2006 to December 2013 were included in this retrospective case review. Student’s T-test was used to determine difference between means and chi-square for categorical data. P value of less than 0.05 was regarded as statistically significant. Results: There were 155 patients managed for open globe injury with three of them had bilateral involvement. As such, there were 158 cases eligible for analysis in this study. The average age was 32.2 ± 16.5 years (mean ± standard deviation, SD). Male was at higher risk for open globe injury. Predictors for poor visual outcome were foreign nationality (p=0.047), lid laceration (0.008), type of injury (p=0.001), site of injury (p=0.008), RAPD (p<0.001), uveal prolapse (p<0.001), hyphaema (p=0.008), lens damage (p=0.010), vitreous loss (0.014), retinal detachment (p=0.011), intraocular foreign body (IOFB) (0.014) and poor presenting uncorrected visual acuity (UCVA) (p<0.001). Conclusions: Occupational injury was a main cause of open globe injury in Hospital Serdang. Although in general the visual outcome is good, effort should be put to prevent work-related injury.

Dry Eye Among Patients at the Eye Clinic of A Secondary Referral Hospital

Introduction: Dry eye is a common but under-diagnosed problem in the general population. Lack of standardised diagnostic protocol causes prevalence of dry eye varied widely in different populations. Nevertheless, effective management rests largely on the accurate diagnosis and identification of the contributing risk factors. Methods: In a cross sectional study, socio-demographic, lifestyle and medical history data were collected from 157 respondents. A validated six-item questionnaire was used to determine the dry eye symptoms. Dry eye was determined by using Schirmer’s test. Fluorescein staining test and tear break up time (TBUT) test were performed to characterise the dry eye. Results: Using the Schirmer’s test, 33.8% of respondents had dry eyes. The likelihood of dry eye increased among Malay females in the seventh decade. The most frequently reported symptom was sensation of dryness of the eye. Although only 22.6% of dry eye cases were symptomatic, up to 47.2% of them may developed surface changes detectable by fluorescein dye test. Ethnicity (p=0.019) and diabetes mellitus (p=0.049) were significantly associated with dry eye. Conclusion: Dry eye could be subclinical but clinical tests in potential risk groups can lead to better detection of this condition and allow prescription of appropriate treatment for affected patients. Keywords: Dry eye symptoms; Dry eye syndrome