Despite the proven benefit of cryotherapy in the management of threshold retinopathy of prematurity (ROP), it was shown leading to ocular adverse effects. A male infant was born at 28 week of gestation with a birth weight of 1200 g. Serial examinations revealed worsening ROP in both eyes until he reached a high risk pre-threshold ROP in his right eye and threshold ROP in his left eye. Cryotherapy was performed for the threshold ROP in the left eye while the right eye was subjected to further observation. Subsequently, ROP in both eyes regressed without cicatrisation. The patient was followedup over 8 years and refractions showed that the treated eye developed steadily increasing myopia while the untreated eye remained emmetropic. This case demonstrated the detrimental effect of cryotherapy to the treated eye leading to the progressive myopia as the child grew.
Retinopathy of Prematurity ; Cryotherapy

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.

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
Eye

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.

Background: Diabetic retinopathy (DR) is a microvascular complication of diabetes, which is a cause of visual impairment and blindness. Its development and progression have been linked to dyslipidaemia, although the link remains inconclusive. Aim: This study aimed to determine the prevalence of dyslipidaemia among type 2 diabetic patients with DR in a tertiary setting and to determine the association between dyslipidaemia and DR severity. Materials and methods: This was a cross sectional study using retrospective data of type 2 diabetic patients attending the opthalmology clinic of a tertiary centre from January 2007 to June 2014. Results of their fasting lipid profile and clinical data were retrieved from the hospital information system. Results: A total of 178 patient’s data were collected. 120 (n=67.4%) patients had non-proliferative diabetic retinopathy (NDPR) with moderate NPDR being the most prevalent. Dyslipidaemia was noted in 151 (84.8%) of the patients. Patients had a combination of more than one abnormality in the lipid profile with increased LDL-cholesterol being the main abnormality. Dyslipidaemia was however, not significantly associated with DR severity. Conclusion: Dyslipidaemia was highly prevalent in DR patients. The dyslipidaemia was however not associated with severity of DR.
Diabetic retinopathy

Introduction: Keratitis is an eye-threatening condition, which requires immediate treatment, due to the rapid progression when the infection caused by Pseudomonas aeruginosa. This study aimed to describe the socio-demographic factors and risk factors related to Pseudomonas keratitis in selected six government hospitals in Johor, Malaysia. Methods: An 18 months cross-sectional study was conducted among bacterial keratitis patients from six government hospitals offering ophthalmology services in Johor, Malaysia. The cases were confirmed through a positive culture of Pseudomonas aeruginosa. All data on socio-demographic factors, risk factors, and symptoms were recorded using a data collection form and analysed using the Statistical Package for Social Sciences (SPSS) software version 26. Results: Fifty-five patients were diagnosed with Pseudomonas keratitis in this study. The majority of patients were males (65.5%) with a mean age of 41.22 years old. The majority of patients were of Malay ethnicity (60.0%). More than a quarter of cases are involved in office-oriented jobs (n=14, 25.5%). The major risk factors in this study were contact-lens usage (n=25, 45.5%), trauma (n=20, 36.4%), ophthalmic steroid usage (n=16, 29.1%), ocular surface disease (n=12, 21.8%) and previous eye surgery (n=4, 7.3%). This study found underlying medical illness (p=0.036) and ocular surface disease (p=0.051) are significantly associated with Pseudomonas keratitis. Conclusion: The present study is the first study in Malaysia focusing on Pseudomonas keratitis. This study provides additional information on the epidemiology data of keratitis in Malaysia. Future studies shall be extended to all government hospitals in Malaysia to obtain better insight on the disease burden of keratitis especially on Pseudomonas keratitis.