The Kuala Pilah cluster cataract study: Accessible eye care reduces cataract blindness

@#Objective: The Ministry of Health introduced the cluster hospital project in Kuala Pilah district in 2016 to allow sharing of resources between the hospitals in the same vicinity. The aim of this study is to compare the demographic profile, prevalence of cataract blindness and low vision among patients who presented for cataract surgery before and after the programme. Methodology: This is a retrospective cohort study of patients who underwent cataract surgery in Kuala Pilah Cluster Hospitals between 2010 and 2017. A total of 2539 records of patients were reviewed. Patients were assigned into two groups: Group 1 (2010-2012)- before the programme (2010-2012) and Group 2 (2015-2017) after the introduction of the programme. Results: There was a significant increase in number of cataract cases in the district hospital after the cluster initiative. The mean age of patients undergoing cataract surgery was similar in both groups. The common comorbidities were hypertension (Group 1=57.3%; Group 2=70.8%) and diabetes mellitus (Group 1=40.6%; Group 2=51.1%). In 2010-2012, most of the patients were one eye blind (34.4%), whereas in 2015-2017 majority of patients presented with vision better than 6/18 (43.5%). The proportion of patients with cataract blindness reduced from 6% in 2010-2012 to 4.3% in 2015-2017 (p<0.01). Conclusion: There is a significant decrease in percentage of patients with cataract blindness and low vision after the introduction of Kuala Pilah Cluster Hospital Program. We believe that that cluster hospital system is effective in improving accessibility to eye care and therefore increases the cataract detection rate.

Effect of Honey Cocktail on Macular Thickness, Retinal Nerve Fiber Layer Thickness and Optic Nerve Head Parameters in Post-Menopausal Women

@#Introduction: Honey postulated may have an estrogenic effect on the retinal estrogenic receptors. The aim of the study is to compare the mean macular thickness, retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters with and without honey cocktail supplement in post-menopausal women. Methods: A randomised interventional study was conducted from March 2014 to July 2015. A total of 60 post-menopausal women were selected and randomised into 2 groups: honey cocktail (20 mg/day) and control. Macular thickness, RNFL thickness and ONH parameters were measured using optical coherence tomography at baseline and at 3 months post honey cocktail supplementation. Results: The mean global macular thickness and RNFL thickness were significantly thicker in post-menopausal women with honey cocktail at 3 months post supplement (p = 0.002 and 0.033 respectively). There was a significant increase in the mean change of global macular thickness and RNFL thickness in honey cocktail group at 3 months post supplement (p < 0.001 and < 0.001 respectively). Although there was no significant difference in the ONH parameters at 3 months post supplement between the two groups but there was significant increase in the mean change of rim area (p = 0.003), and significant reduce in the mean change of cup area (p = 0.001) and cup-disc-ratio (p <0.001) in honey cocktail group at 3 months post supplement. Conclusion: Honey cocktail supplement showed structural changes in the macular thickness, RNFL thickness and OHN parameters of post-menopausal women.