Direct costs of myopia in Singapore.

AIMS: To estimate the direct costs of myopia in Singapore children. METHODS: A cross-sectional study of 377 Singaporean school children aged 12-17 years from one school in Singapore Cohort study of the Risk factors for Myopia (SCORM) was conducted. A combination of parent and self-administered questionnaires asked about the cost of each optometrist visit, spectacles, and contact lenses, transport costs, father's educational level, and total family income. RESULTS: A total of 377 subjects participated and cost data were available from 301 subjects. The mean annual direct cost of myopia was S$221.7+/-313.7 (CI, S$186.5-258.1) or US$147.8+/-209.1 (CI, US$124.3-172.1) and median annual direct cost of myopia was S$125.0 or US$83.3. The mean cost per pair of spectacles was S$123.2+/-61.2 (CI, S$116.6-129.8) or US$82.1+/-40.8 (CI, US$77.8-86.5). Sixty subjects (15.9%) wore contact lenses. The mean annual cost of contact lenses was S$567.1+/-565.7 (CI, S$422.2-712.0) or US$378.1+/-377.1 (CI, US$281.4-474.6). Subjects of families with higher total family income and those with fathers with secondary or higher education had higher annual direct expenditure (P=0.03 and P=0.001 respectively). Subjects from families with higher household incomes had higher frequency of change of spectacles (P=0.02) and shorter time since the last change of spectacles (P=0.03). CONCLUSIONS: The mean annual direct cost of myopia for Singapore school children was S$221.68 (US$148) and the median, S$125.00 (US$83.33) per subject. Myopia is associated with significant financial burden in Singapore.

Pseudoretinoblastoma in enucleated eyes of Asian patients.

INTRODUCTION: Retinoblastomas of the eye are a cause of childhood blindness and have a high rate of mortality, as well as a hereditary mode of transmission. Other conditions that mimic retinoblastomas are known as pseudoretinoblastomas, and are managed differently. Although pseudoretinoblastoma and the accuracy of retinoblastoma diagnosis have been reviewed in Caucasian patients, published studies in Asian patients are lacking. The purpose of this article is to report our experience with pseudoretinoblastomas in two major ophthalmological centres in Asia. METHODS: A case series of 28 enucleations carried out for suspected retinoblastoma at the Singapore National Eye Centre and KK Women's and Children's Hospital, Singapore, between January 1991 and December 2002, is reported. All cases were subjected to a detailed history from parents, followed by external ocular examination, slit-lamp biomicroscopy and binocular indirect ophthalmoscopy. Ancillary studies, such as B-scan ultrasonography and computed tomography, were employed as necessary to confirm the diagnosis. Histology was obtained on all cases. RESULTS: Of the 28 cases, 25 (89 percent) were found on histological analysis to be retinoblastomas. Three (11 percent) were pseudoretinoblastomas. There were two cases of Coat's disease and a case of presumed ocular toxocariasis. These three cases were described in detail. CONCLUSION: Although our sample size is small, the percentage of confirmed retinoblastomas was found to be only slightly higher than that found in western countries. Our findings are consistent with their findings that Coat's disease and presumed ocular toxocariasis are the more common causes of pseudoretinoblastoma.