Evaluating Cataract Surgical Rate through Smart Partnership between Ministry of Health, Malaysia and Federal Territory Islamic Religious Council.

INTRODUCTION: Cataract is the leading cause of blindness. About 90% of cataract blindness occurs in low- and middle-income countries. The prevalence of blindness and low vision in any country depends on the socioeconomic status, the availability of medical and healthcare facilities, and the literacy of the population. AIM: This paper aims to estimate the cataract surgery rate (CSR) at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang (Cataract Operation Centre), and provide descriptive assessments of the patients who received eye treatments in the center. METHODS: The data were retrieved from the clinical database from 2013 to 2016. Information on the patient's sociodemographic and clinical and treatment history was collected. RESULTS: The cataract surgery rate for 2013 was about 27 and increased to 37.3 in 2014. However, it declined to 25 in 2015 before it resumed to 36 in 2016. For female patients who received eye treatments at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang, the rate was higher (53.7%) compared to male patients (46.3%). The mean duration of cataract surgery from 2013 to 2016 was 21.25 ± 11.071 min. CONCLUSION: The increased cataract surgery rate for MAIWP-HS through smart partnerships for day care cataract surgery proved that better accessibility makes the short- and long-term strategies for the reduction and prevention of blindness in Malaysia possible to achieve.

Estimates of visual impairment and its causes from the National Eye Survey in Malaysia (NESII).

BACKGROUND: Population-based data on prevalence, causes of blindness and extent of ophthalmological coverage is required for efficient implementation and evaluation of ocular health programs. In view of the scarcity of prevalence data for visual impairment and blindness in Malaysia, this study aims to estimate the prevalence and causes of visual impairment (VI) in the elderly, using Rapid Assessment of Avoidable Blindness (RAAB) survey technique. METHODS: Malaysia was divided into six regions, with each region consisting of 50 clusters. Multistage cluster sampling method was used and each cluster contained 50 residents aged 50 years and above. Eligible subjects were interviewed and pertinent demographic details, barriers to cataract surgery, medical and ocular history was noted. Subjects had visual acuity assessment with tumbling 'E' Snellen optotypes and ocular examination with direct ophthalmoscope. The primary cause of VI was documented. Results were calculated for individual zones and weighted average was used to obtain overall prevalence for the country. Inter-regional and overall prevalence for blindness, severe VI and moderate VI were determined. Causes of VI, cataract surgical coverage and barriers to cataract surgery were assessed. RESULTS: A total of 15,000 subjects were examined with a response rate of 95.3%. The age and gender-adjusted prevalence of blindness, severe visual impairment and moderate visual impairment were 1.2% (95% Confidence Interval: 1.0-1.4%), 1.0% (95%CI: 0.8-1.2%) and 5.9% (5.3-6.5%) respectively. Untreated cataract (58.6%), diabetic retinopathy (10.4%) and glaucoma (6.6%) were the commonest causes of blindness. Overall, 86.3% of the causes of blindness were avoidable. Cataract surgical coverage (CSC) in persons for blindness, severe visual impairment and moderate visual impairment was 90%, 86% and 66% respectively. CONCLUSION: Increased patient education and further expansion of ophthalmological services are required to reduce avoidable blindness even further in Malaysia.

Effect of vitamins C or E supplementation to Tris diluent on the semen quality of Awassi rams preserved at 5 ˚C.

The present study was aimed to test the efficacy of adding vitamins C or E to Tris-fructose-egg yolk diluent to increase Awassi ram sperm storage period at 5 ˚C. Semen samples from six mature Awassi rams were used in this study. The semen samples were diluted by Tris-glucose-egg yolk. Diluted semen sample was divided into three parts. The first part was added with 0.9 mg mL(-1) vitamin C, the second part was added with 1 mg mL(-1) vitamin E and the third part was considered as a control without any addition. The diluted semen samples were cooled gradually and preserved at 5 ˚C for five days. Sperms in cooled diluted semen samples were examined for motility, vitality, abnormalities and acrosomal defects every 24 hr for five days. Results of the present study showed an increase in the viability of spermatozoa diluted in the Tris diluent containing vitamins C or E stored at 5 ˚C for 120 hr compared with the control group. There were significant (p < 0.05) effects of vitamins C and E addition to semen diluents on sperm motility as well as the sperm viability in different times of preservation at 5 ˚C. Significant (p < 0.05) higher sperm abnormalities and acrosomal defects values (37.6 ± 1.3% and 71.5 ± 1.1%, respectively) were found after 120 hr incubation in Tris free vitamin C (Control) at 5 ˚C compared with those of containing vitamin C (18.8 ± 1.8% and 52.8 ± 4.3%, respectively). From the results of the present study, it could be concluded, that the addition of antioxidants such as vitamins C and vitamin E to semen preservation media could improve longevity and quality of cooled sperm in Awassi ram semen.

Prevalence, risk factors, and clinical features of thyroid-associated ophthalmopathy in multiethnic Malaysian patients with Graves' disease.

BACKGROUND: The prevalence of thyroid-associated ophthalmopathy (TAO) has been reported to be lower in several Asian populations than in Caucasians. The risk factors for TAO that have been demonstrated in Caucasians have not been studied in Asian populations. The aim of this study, therefore, was to determine the prevalence, risk factors, and clinical features of TAO in a cohort of multiethnic Malaysian patients with Graves' disease (GD). METHODS: This was a cross-sectional study of 167 consecutive patients with GD who attended two endocrine clinics from October 2003 to September 2004. The patients were classified as Malay, Chinese, and Indian based on their ethnic characteristics as detailed in the national identity card. The patients were examined by a single individual for the presence and characteristics of TAO. Thyroid function tests were performed, and smoking history and the extent of smoking history were recorded. RESULTS: The prevalence rate of TAO using the American Academy of Ophthalmology diagnostic criteria was 34.7%. This increased to 46.7% if lower lid retraction was added as an alternate criterion. The observed prevalence rate was higher than expected in the Chinese patient population based on a comparison with the Malay and Indian patients, but this was not statistically significant. Smokers with GD were at 2.75 times greater risk of TAO than nonsmokers (p = 0.019). Male gender was shown to confer higher risk of TAO on univariate analysis (p = 0.003), but not on multivariate analysis. The percentage of males who smoked in the study group was relatively high (79%). The most common presentation of TAO was exophthalmos, followed by lid retraction. CONCLUSIONS: TAO has relatively high prevalence rate (34.7%) in three populations of Asian patients with GD. This is similar to that reported for Caucasian patients with GD. As in Caucasian patients, smoking increases the risk of TAO. In the Asian populations we studied, exophthalmos was the most common eye sign. However, lower lid retraction was also common and present in 60% of cases with other signs of TAO. In Chinese, Malay, and Indian Asians with GD, lower lid retraction should be a diagnostic criterion for TAO.

A common complication in the treatment of nasopharyngeal carcinoma

OBJECTIVE: To report a case of radiation retinopathy, a common complication in the treatment of nasopharyngeal carcinoma. METHOD:This is a case report. RESULTS:A 59-year-old Chinese man with a history of external beam irradiation for nasopharyngeal carcinoma presented with mild blurring of vision of the left eye.Examination revealed bilateral scattered cotton-wool spots, intraretinal hemorrhages, and microaneurysms.The left eye had peripapillary cotton-wool spots and hemorrhages, disc edema, and semimacular star.Funduscopic findings were similar to those of diabetic retinopathy except for the abundance of cotton-wool spots and the presence of macular star. CONCLUSION:Radiation retinopathy usually develops 6 months to 3 years after exposure.In this patient, it occurred 2 years after radiotherapy.Neovascularization at the disc developed 15 months after initial presentation, which required treatment with panretinal photocoagulation, resulting in regression of the new vessels.As severe late ocular complications frequently occur after radiation therapy, periodic ophthalmologic examinations should be considered.