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

OBJECTIVE: Memory Impairment has been proposed as the first sign in preclinical and early Alzheimer's disease (AD). This study aims to assess the utility of a new memory test based on Free and Cued Selective Reminding Test using pattern cue that seems useful for detecting memory impairments associated with AD. METHODS: Twenty-six patients with mild cognitive impairment, 24 AD patients at a mild stage, 35 normal controls and 8 Lewybody dementia (LBD) patients at a mild stage took part in the study. A newly devised Pattern Cued Recall Test (PCRT) was compared with established memory test, the word list recall from the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). To assess the ability of the PCRT subtests and CERAD-K to screen dementia, receiver operating characteristic curves were plotted. RESULTS: The distinctive feature of the PCRT was that encoding specificity was increased by adding an immediate cued recall stage at the encoding phase. PCRT was confirmed as having sufficient validity to diagnose dementias. Compared to CERAD-K, the PCRT had similar accuracy of discriminating AD. But the analysis showed better diagnostic validity of PCRT than CERAD-K in LBD. Therefore, this test appears to be, especially, well suited for the diagnosis of mild LBD. CONCLUSION: This study showed that a memory test based on controlled encoding and retrieval condition and especially using pattern cue could be effective methodology for mild AD and LBD from normal control. PCRT could be an alternative to diagnose LBD by testing visual impairments, which is a hallmark symptom of LBD. Therefore, a further clinical study should be promising.
Alzheimer Disease ; Cues* ; Dementia ; Diagnosis ; Humans ; Memory ; Mild Cognitive Impairment ; ROC Curve ; Sensitivity and Specificity ; Vision Disorders

Rapid eye movement sleep behavior disorder (RBD) is currently considered as a prodromal stage of alphasynucleinopathies neurodegeneration. The update data suggested that over 80% patients with idiopathic RBD eventually developed neurodegenerative disease after a mean of 14 years interval from the onset of RBD. A series of potential biomarkers have been identified to predict the development of neurodegeneration in idiopathic RBD, including olfactory loss, color vision deficit, depression, mild cognitive impairment, excessive daytime sleepiness, dopamine dysfunction, and tonic electromyographic activity. Early recognition of the predictive markers of neurodegeneration in idiopathic RBD is essential for development of intervention or prevention strategies at the presymptomatic stage. Nonetheless, the current literature is lacking biomarkers that might reflect the alpha-synuclein neuropathology at the earliest stages. Future studies with large samples and systematic follow-up are needed to confirm more potential markers of neurodegeneration at its early stages.
alpha-Synuclein ; Biomarkers* ; Color Vision ; Depression ; Dopamine ; Follow-Up Studies ; Humans ; Mild Cognitive Impairment ; Neurodegenerative Diseases ; Parkinson Disease ; Prodromal Symptoms ; REM Sleep Behavior Disorder* ; Sleep, REM*