The purpose of this study was to derive a modified equation for contact lens method (CLM) in calculating post myopic laser refractive surgery corneal power. Methods: A total of 93 subjects who underwent myopic laser refractive surgery at IIUM Eye Specialist Clinic were recruited. The accuracy of postoperative corneal power using the standard CLM and newly-derived contact lens modified method (CLMmod) were compared to the standard comparison method ; the historical method (HM). The CLMmod equation was derived by adjusting postoperative corneal power of CLM according to amount of refractive change. Results: The mean postoperative corneal power using standard CLM was significantly higher than HM (mean difference: -0.24 D, p < 0.001). Fifty seven percent (n = 53 eyes) of the standard CLM results were within ±0.50 D of HM results. The difference between postoperative corneal power using standard CLM and HM increased significantly with the amount of refractive change (r = 0.835; p < 0.001). The mean postoperative corneal power of CLMmod showed that there was no statistical significant difference compared to the HM results (mean difference: 0.00 D, p= 0.964). Eighty eight percent (n = 82 eyes) of the CLMmod results were within ±0.50 D of HM results with improvement of 31% from the standard CLM results. Conclusion: The CLMmod equation provides more accurate calculation in determining post myopic laser refractive surgery corneal power. In near future, this modified equation can be used as an alternative equation to calculate postoperative corneal power when the preoperative data is unavailable.

Purpose: The objective of this study was to determine the prevalence of poor visual acuity, colour blindness and visual field defect of new Malaysian drivers. Methods: A total of 3717 new drivers (50.2% males and 49.8% females) age 19±6 years, voluntarily participated in this study. Standard optometric apparatus such as LogMAR Charts, Ishihara plates and HandHeld Bernell Perimeter were used and standard procedures were applied. Results: The visual examination showed 6.7% (n=250) of subjects achieved less than 0.3 LogMAR with better eye whilst 2.2% (n=83) had failed the Ishihara Test (2.1% males and 0.1% females). Most of the affected drivers were deutranopia. Only 2094 subjects had their visual field using a mobile Handheld Bernell Perimeter. 1.72% (n=36) subjects have less than 120 degrees of peripheral field of vision. Conclusions: The visual status among new Malaysian drivers needs to be taken seriously to ensure safe driving. Other factors such as colour vision and visual field screening have to be considered seriously when evaluating the visual performance of a driver. Good visual performance is indispensible for safe driving

The purpose of this study was to evaluate inter-session repeatability, inter-examiner reproducibility and inter-device agreement of corneal power measurements from manual keratometer, autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods: Two sets of mean corneal power measurements (n=40) were compared for inter-session repeatability and inter-examiner reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A oneway repeated measures analysis of variance was conducted to compare differences in the corneal power between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to assess agreement and determine strength of relationship between measurements. Results: There were no significant differences in mean corneal power measurements between 2 different visits (p > 0.05). The Sw and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements between 2 different examiners were also insignificant (p > 0.05). The Sw and COV values between 2 examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments. The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r-values were stronger than 0.84. Conclusion: The corneal power measurements using these 5 instruments were repeatable and reproducible. These instruments can also be used interchangeably, however the topographer should be used with caution.

Purpose: A survey on new Malaysian drivers was conducted in Malaysia between year 2006-2009. The objective of this study was to look at the effectiveness of the present computerized visual screening tool and to compare it with the conventional testing method. Methods: A total of 3717 drivers aged 19±6 years, who had passed in the computerized visual screening, participated in this study. Results: 250 subjects achieved less than 0.3 LogMAR with their best eye and 83 subjects failed the Ishihara Test after retested using the conventional tool. Conclusion: These finding showed the computerized visual screening test failed to filter some subjects according to the standards set.

Introduction: This study aimed to evaluate the correlation between Quality of Life Impact of Refractive Correction (QIRC) score with visual disturbances and contrast sensitivity in spectacle wearers. Methods: A total of 21 spectacle-corrected moderate myopes was recruited. Subjects completed the QIRC questionnaire for quality of life assessment. The functional and emotional QIRC scores were analysed separately. Visual disturbances were evaluated using the Halo and Glare Simulator, and contrast sensitivity was measured by the M&S Smart System II. All measurements were taken binocularly in 1 lux illumination. Spearman’s test was employed to evaluate the correlations. Results: The most common visual disturbance was diffuse glare. The functional QIRC score was significantly correlated with glare intensity (r = -0.54, P = 0.01). Whereas, the emotional QIRC score was significantly correlated with contrast sensitivity (r = 0.45, P = 0.04). Conclusion: The functional QIRC score is lower when the glare intensity is greater, and the emotional QIRC score is higher in person with greater contrast sensitivity. Hence, glare intensity and contrast sensitivity measurements are suggested to predetermine spectacle wearers’ functional vision and well-being, respectively

Introduction: Erosive tooth wear (ETW) is an emerging dental condition worldwide. However, most dental practitioners overlooked the early stages of the condition due to vague clinical appearance of tooth surface loss. Therefore, this study was aimed to determine the knowledge of ETW and treatment given amongst dental professionals in private clinics in Kuantan, Pahang. Method: Several private dental clinics in Kuantan, Pahang, involved in this cross-sectional study. Dental practitioners were volunteering to participate in this research. A validated self-administered questionnaire was distributed, and a descriptive analysis was conducted. Results: The overall response rate was 75%. Results revealed that most participants obtained a structured education on ETW (79.2%). Through continuous dental education, about half of the participants learnt further. All participants agreed that carbonated drink caused ETW, and most reported that gastroesophageal reflux diseases and pickles had related to the ETW. The majority of participants favoured case note (79%) with regards to ETW records. Nevertheless, 40.9% and 36.4% are recorded at the tooth surface and individual level, respectively. Surprisingly, 79% of them did not know about special scores when assessing ETW. Most participants prefer to give instruction on oral hygiene and diet counselling as preventive measures, but the use of fluoride was not given priority. 77% have not ever referred the case to a dental specialist and preferred to treat the patient on their own. Conclusion: ETW knowledge among recruited PDPs is adequate; however, no specific indices were used for ETW scoring and insufficient treatment strategies..

Introduction: Dental surgeon exposes to numerous occupational hazards include the bloodborne pathogens, pharmaceuticals, ergonomic hazards, noise, vibration and workplace violence. It causes prolonged health effects on short or long term exposure include musculoskeletal disorder, back pain and other health issues. This study aimed to identify the awareness level of occupational hazards and experiences among dental surgeons and to determine whether preventive measures are employed. Methods: A cross-sectional study design and convenience sampling method had been used in this study. The Occupational Hazards in Dentistry questionnaire was self-administered by 39 dental surgeons in International Islamic University Malaysia, Kuantan. The data were analysed using descriptive, chi-square and thematic analysis. Results: The overall response rate was good (78%). Among the participants, 59% were female, and 41% were male. Half of the participants (59%) had worked for 11-20 years. The majority of the participants (82%) practised a correct posture while providing dental treatment. The most-reported pain areas were at the shoulder and neck and followed by the lower back. Approximately, 10% of the participants had been diagnosed with cervical spondylitis/ degenerative cervical discs. Most participants have taken preventive measures to reduce exposure to these occupational hazards. Conclusion: Work-related pain is common among dental surgeons. The most affected pain area is the shoulder and neck, followed by back and wrist pain. Occupational hazards can be alleviated effectively using a comprehensive approach. It is essential for dentistry to incorporate comprehensive strategies into practice to improve productivity and enhance occupational safety.

An age-related ocular disease such as cataract that causes reduction of visual functions would affect the individual driving performance. The aim of this study was to compare driving difficulties between Malaysian drivers with bilateral cataracts and without cataract. This cross-sectional study involved measurement of visual functions [visual acuity (VA) and contrast sensitivity (CS)] and driving difficulty of 61 subjects who are actively driving with valid driving license. Subjects were divided into bilateral cataract group (n=30) and non-cataracts group as control group (n=31); which age and gender matched. Results showed that the mean±SD for composite driving difficulty score in the bilateral cataract group and in the control group were 72.08±15.95 and 87.50±12.60 respectively. It showed that both groups had lower mean composite score which indicates difficulty in driving. Results also showed significant mean difference composite driving difficulty score between cataract and control group (p<0.001). Drivers with bilateral cataracts were also found to have significant difficulty when driving the rain (p=0.034), at night (p=0.013) and when driving on local or highway (p=0.005) compared to drivers without cataract. Subsequent Spearman’s Rho showed significant moderate positive correlation between driving difficulty and binocular CS (rs =0.404, p=0.027). This study showed that drivers with cataract would experience driving difficulties compared to the drivers without cataract.

Introduction: Precise pupillometry is crucial to determine ablation optical zone (OZ) size selection in LASIK. Significant difference in the selection induces unwanted postoperative night visual disturbance. Placido-disc topographer and Hartmann-Shack aberrometer are commonly used in LASIK preoperative assessment. However, little is known on the precision and agreement of these devices in pupillometry. Hence, this study aimed to evaluate the precision (repeatability and reproducibility) and inter-device agreement of a Placido-disc topographer and Hartmann-Shack aberrometer in measuring mesopic pupil size in pre-LASIK patients. Methods: Mesopic pupillometry on 38 pre-LASIK patients were performed using both devices by two masked operators, on two separate sessions. Intra-session repeatability, inter-operator reproducibility and inter-device agreement were analysed. A disagreement value of ±0.5 mm and 95% limits of agreement (LoA) were determined. Results: Hartmann-Shack aberrometer demonstrated higher repeatability and reproducibility than Placido-disc topographer in mesopic pupillometry. Ninety-seven percent and all of Hartmann-Shack wavefront aberrometer pupillometry were within ±0.5 mm in repeated sessions and between the operators, respectively. The mesopic pupil size obtained from Placido-disc topographer was significantly larger than Hartmann-Shack aberrometer results (P = 0.02). The agreement between devices was low (LoA > ±1 mm) and only 53% of Placido-disc topographer pupillometry were within ±0.5 mm of Hartmann-Shack aberrometer pupillometry. Conclusion: Hartmann-Shack aberrometer has higher precision within sessions and between operators, and it provides smaller mesopic pupillometry than Placido-disc topographer. Precise mesopic pupillometry could assist refractive surgeons in choosing a correct ablation OZ size during LASIK surgery to improve postoperative outcome.

Introduction: Short-term fasting may influence intraocular pressure (IOP) due to alteration of fluid (total body water; TBW, and water intake) and fat (total body fat; TBF). This study aimed: i) to compare IOP values within and between, fasting and non-fasting periods; and ii) to assess the association between IOP and, TBW and TBF. Methods: Thirty healthy participants aged 21.8±1.1 years were assessed on two different periods (fasting vs. non-fasting). During each period, the IOP, TBW and TBF values were assessed for four times (morning, afternoon, evening, late-evening). The IOP was measured using AccuPen® tonopen, while TBW and TBF were assessed by using a Tanita body composition analyser. Results: During fasting, the IOP value in the afternoon (14.53±2.33 mmHg) was significantly higher than in the evening (12.43±2.73 mmHg, p=0.009) and late-evening (12.60±2.44 mmHg, p=0.003). No significant difference in IOP was observed during non-fasting period. The mean of IOP in the evening was significantly lower during fasting compared to non-fasting (12.43±2.73 mmHg vs 13.75±2.53 mmHg, p=0.044). The IOP and TBW were negatively correlated (r=-0.268; p=0.011) during non-fasting and showed no association during fasting period. There was no significant correlation between IOP and TBF during both fasting and non-fasting periods. Conclusion: IOP reduction during short-term fasting, together with the no association with TBF and TBW suggested that IOP is an independent factor that reduces during fasting in healthy population.