When medical and surgical intervention cannot alleviate all of the impairments resulting from diseases of the eye, visual rehabilitation can help reduce the disability and increase the quality of life. Data from 169 patients seen at the UKM Low Vision Clinic (UKM LVC) over the past 2 years were examined and analysed. The age ranged from 6 to 87 years of age. The main cause of ocular pathological categories was conduction (63.9%), media (24.9%) and congenital (11.2%) related problems. The main causes of low vision at UKM LVC were congenital cataract, retinitis pigmentosa, glaucoma, cataract and diabetic retinopathy. 84% of these patients received low vision devices to improve their near or/and distance vision. The most common optical devices dispensed at UKM LVC were near high addition spectacle, hand magnifiers and stand magnifiers. Medical, vision care and rehabilitation professionals working together can offer a comprehensive treatment plan for the visually impaired, offering these patients the very best services to increase their quality of life.

Visual impairment among children can be serious without early intervention. This study was conducted to determine prevalence of visual impairment causes among preschool children. Twenty one kindergartens were randomly selected for vision screening. The screening module consist of visual acuity test, cover test, Hirschberg’s test, exsternal ocular asessment and ophthalmoscopy. Preschool children who failed the vision screening were referred for further assessment. Four hundred and seventy nine preschool children with an average age of 5.30 ± 0.69 years old participated in the vision screening program. Of those 43 children who failed the vision screening, 32 (6.7%) children were confirmed to have some form of visual impairment, while 8 children were normal. Three children were excluded from the study because the children did not cooperate for further assessment. The main cause of visual impairment among preschool children was refractive error (5.8%). Other causes were amblyopia (1.3%), strabismus (1.0%) and ocular abnormalities (0.8%). In conclusion early detection of visual impairment through vision screning and early optometric intervention is very important to be conducted among preschool children so that visual impairment can be reduced.

While the prevalence of visually impaired children constitutes a small portion of the visually impaired population, it is important to determine whether the Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 37-45 38 low vision services available are utilised by these children. This is important as previous studies have shown that children have a very high rate of successful low vision device use compared to adults. This was a cross sectional retrospective study. Fifty nine low vision clinic children records were evaluated. The results showed that 25.4% of the children were categorised as with moderate low vision, 30.5% with severe low vision and 40.7% were categorised as blind. The major causes of low vision were congenital cataract, congenital nystagmus, congenital glaucoma, macular degeneration and retinitis pigmentosa. Low vision rehabilitation for near work using magnifiers improved the vision of 30.5% of the low vision children. This finding suggests that 1/3 of low vision children could benefit from low vision rehabilitation. The low vision devices most commonly prescribed to the children in this study were stand magnifiers, hand-held magnifiers and spectacles. This study illustrates the key role of optometrists in the management of visual impairment in Malaysian children. It would appear that the establishment of low vision services in government hospitals using trained optometrists is a cost effective method of service delivery. Therefore more low vision children would have access to proper low vision rehabilitation and through that rehabilitation, their quality of life can be improved.

A Malay Language Related Reading Text Test was developed to assess reading performance among primary school children. One hundred and twenty normally sighted primary school children were randomly selected from year 2 and 3 (mean age 8.5 ± 0.5 years) and year 4 and 5 (mean age 10.5 ± 0.5 years). Subjects were asked to read all fi ve reading text aloud, correctly and according to their usual reading speed in random order. Time to complete each reading paragraph was recorded and any error or guessing was noted. Reading speed and reading rate were measure as word per minute (wpm). The mean reading speed for grade 1 was 88.81 ± 1.95 (SE) wpm and the reading rate was 87.20 ± 1.98 (SE) wpm. For grade 2, reading speed was 108.12 ± 1.66 (SE) wpm while reading rate was 107.22± 1.67 (SE) wpm. Reading speed and reading rate among subjects were not signifi cantly different (p > 0.05) either for grade 1 or 2 with p value 0.91 and 0.57 respectively. Comparison between each text also showed that there was no signifi cant different (p > 0.05). All texts that were developed were statistically homogenous indicating that the reading texts test can be use in random order and will not affect the reading assessment in primary school children.
Reading

Visual Functions are affected by the aging process and without appropriate intervention eventually will results in diminishing visual acuity. As the situation proceeds difficulty to perform daily life activities ensureand will impact on the quality of life especially in the elderly. The objective of this study was to determine the effect of visual impairment towards daily activities and quality of life among elderly. Measurements that were conducted included visual acuity at distance using the LogMAR Chart to determine the level of visual impairment, quality of life test using the Low Vision Quality of Life (LVQOL) questionnaire and ability to cope with the activities of daily life was measured using the Barthel Index (BI). It was found that visual function progressively worsens with age, as did the BI which declined as visual function worsened. The LVQOL score reduced significantly with worsening visual ability. Thirty five percent of the elderly in this study required some form of optometric and low vision intervention. In conclusion, the deterioration in the functions among elderly can reduce the ability to cope with the daily life activities. Other than that, uncorrected visual acuity will cause reduction in the quality of life among the elderlies

The purpose of this study is to determine the prevalence and causes of visually impairment among children below 4 years old in two public tertiary referral hospitals in Selangor, Malaysia. In this cross-sectional retrospective study, the case files of all children aged below 4 years from the ophthalmology clinics in two separate public hospitals in Selangor, Malaysia were analysed over a 5-year period. The definition of visual impairment was based on the World Health Organization (WHO) classification, i.e. moderate visual impairment: visual acuity <6/18 to 6/60 in the better eye; severe visual impairment: <6/60 to 3/60 in the better eye; and blindness: visual acuity <3/60 in the better eye. Prevalence of visual impairment was based on the presenting visual acuity and then differentiated according to the cause of visual impairment diagnosed. A total of 243 (17.38%) children from a total of 1,398 children were classified as visually impaired. Most of these children (n=119, 49.0%) exhibited moderate visual impairment, 26 (10.7%) had severe visual impairment, while 98 (40.3%) were blind. Refractive errors (n=60, 24.7%) were the most common cause of vision impairment, mostly myopes (n=28, 46.7 %). This was followed by strabismus (n=31, 12.8%) and retinopathy of prematurity (n=29, 11.9%). In conclusion, vision impairment was prevalent in children aged below 4 years old presenting to two ophthalmology clinics in a highly urbanised region in Malaysia. High refractive errors were the major cause of vision impairment seen. Our study highlights the need and utmost importance of an early intervention programme to be implemented for these children since the main cause of vision impairment found in this study is an easily treated problem.
visual impairment ; prevalence ; children ; blindness

Vision impairment when undetected early can affect the social and mental development of a child. Early detection of visual impairment can provide better prognosis and can be conducted through vision screening at pre-school. Vision screening performed using pre-school teachers would allow cost and time savings while providing greater access to perform this screening. The objective of this study was to determine the effectiveness of vision screening conducted by pre-school teachers. A total of sixty pre-school teachers from KEMAS Tabika’s and Taska’s in the Klang Valley were randomly selected and divided into two groups i.e. a Study Group and a Control Group. The Study Group was given participative and handson vision screening training whereas the Control Group was only given brief verbal instructions on conducting the screening. Each of these pre-school teachers was asked to conduct vision screening on 15 pre-school children aged 4 to 6 years old. Trained optometrists then repeated the vision screening on the same children. The results showed that there was a higher validity in the vision screening findings from the Study Group (sensitivity = 79%, specificity = 95%) compared to the Control Group (sensitivity = 26%, specificity = 95%). The level of agreement concurrence between the pre-school teachers in the Study Group and the optometrist was high for all tests (AC1 ≥ 0.89). In conclusion, the vision screening program conducted by pre-school teachers was effective but needed proper training for the screeners. This program is seen to be able to empower pre-school teachers using vison screening techniques to allow them to identify pre-school children with vision impairment who would then require further examination and management by an eye-care professional. This program would be able to reduce the prevalence of vision impairment among pre-school children in Malaysia in the long term.
Pre-schooler ; vision screening ; vision impairment ; early detection ; teachers

An experimental investigation was conducted to explore visual reaction time and visual anticipation time between athletes and non-athletes. These visual perceptual skills form the base for cognitive processes required by the brain to respond instantaneously to a stimulus. A total of 228 adolescents, equally distributed between athletes and non-athletes, aged 13 to 16 years (mean age 14.69 ± 0.99 years) were examined. The visual reaction time and visual anticipation time were measured using a Lafayette Reaction Timer (Model 63035) and Bassin Anticipation Timer (Model 35575) respectively. The visual reaction time results revealed that athletes have faster reaction time scores as compared to non-athletes, whereas with visual anticipation time, athletes had fewer errors and a higher consistency compared to non-athletes. There was, however, no interaction between gender and sports participation noted for both these visual perceptual skills. These research findings indicate that gender was not an obstacle in sports participation, therefore not limiting the potential to excel in sports performance. Knowledge gained from these research findings will benefit the sports industry, specifically in athletic and sports training as well as provide a basis for the identification of an individual’s potential in their sports.
athletes ; non-athletes ; sports ; visual anticipation time ; visual reaction time

The purpose of this study is to determine the prevalence and causes of visually impairment among children below 4 years old in two public tertiary referral hospitals in Selangor, Malaysia. In this cross-sectional retrospective study, the case files of all children aged below 4 years from the ophthalmology clinics in two separate public hospitals in Selangor, Malaysia were analysed over a 5-year period. The definition of visual impairment was based on the World Health Organization (WHO) classification, i.e. moderate visual impairment: visual acuity <6/18 to 6/60 in the better eye; severe visual impairment: <6/60 to 3/60 in the better eye; and blindness: visual acuity <3/60 in the better eye. Prevalence of visual impairment was based on the presenting visual acuity and then differentiated according to the cause of visual impairment diagnosed. A total of 243 (17.38%) children from a total of 1,398 children were classified as visually impaired. Most of these children (n=119, 49.0%) exhibited moderate visual impairment, 26 (10.7%) had severe visual impairment, while 98 (40.3%) were blind. Refractive errors (n=60, 24.7%) were the most common cause of vision impairment, mostly myopes (n=28, 46.7 %). This was followed by strabismus (n=31, 12.8%) and retinopathy of prematurity (n=29, 11.9%). In conclusion, vision impairment was prevalent in children aged below 4 years old presenting to two ophthalmology clinics in a highly urbanised region in Malaysia. High refractive errors were the major cause of vision impairment seen. Our study highlights the need and utmost importance of an early intervention programme to be implemented for these children since the main cause of vision impairment found in this study is an easily treated problem.

The lack of awareness about comprehensive eye examination amongst athletes could impact their eye health, hence it needs to be addressed. The authors hypothesize that a majority of athletes in Malaysia have never undergone a thorough eye examination. The present study aims to determine Malaysian athletes’ awareness of the importance of eye assessment. One hundred and twenty-one junior athletes, aged 13 to 16 years participated in the visual screening programme. A questionnaire consisting of fourteen dichotomous questions was developed in two languages, each being English and Malay language and administered prior to eye examination. The questionnaire was designed to measure self-reported visual function, ocular symptoms, and perceptions towards eye health. Questionnaire analysis showed 67.8% of participants never underwent any eye examination. A majority of participants, 66.9% and 75.2%, complained of visual and ocular symptoms respectively. The critical finding of this study showed that 57.9% of participants had reduced vision which could be visually corrected. Overall 90.9% of the participants agreed that eye examination was important. Almost none of the athletes owned any sports safety eyewear nor had undergone any visual training. The importance of wearing protective eyewear during sports needs to be given emphasis. This study implies that athletes' awareness of eye health, as well as visually related issues, is still at a very low level. Hence, the need for comprehensive eye examination and regular review among athletes’ needs to be emphasized. Athletes should also be educated on the importance of regular eye examinations from a young age.