MALAYSIAN ; Right ; Heart

Introduction: Microbial keratitis is one of the most challenging complications of contact lens (CL) wear. Proper CL practice plays an important role to reduce the risk for contact lens related microbial keratitis (CLRMK). Methods: This multi-centre case-control study was conducted from January 2008 until June 2009 to determine the risk factors associated with CLRMK. Cases were defined as respondents who were treated for CLRMK, whilst controls were respondents who were contact lens wearers without microbial keratitis. Ninety four cases were compared to 94 controls to determine the risk factors for CLRMK. Results: The predictors for CLRMK were: Not washing hands with soap before handling CL (aOR 2.979, CI 1.020, 8.701 p=0.046), not performing rubbing technique whilst cleaning the CL (aOR 3.006, CI 1.198, 7.538 p=0.019) and, not cleaning the lens case with multipurpose solution daily (aOR 3.242 CI 1.463, 7.186 p=0.004). Sleeping overnight with the CL in the eye (aOR 2.864, CI 0.978, 8.386 p=0.049) and overall non-compliance with lens care procedures (aOR 2.590, CI 1.003, 6.689 p=0.049) contributed significantly to CLRMK. Conclusion: Health education and promotion in contact lens care are important and should be conducted by eye care practitioners to reduce the occurrence of CLRMK.
Contact Lenses

Introduction: A hospital based case control study was conducted in government hospitals on contact lens patients diagnosed with microbial keratitis. Methods: The objective of this study is to determine the visual outcomes of contact lens related microbial keratitis. The visual outcomes which comprised of visual acuity, keratometry readings, corneal topography findings and contrast sensitivity examinations was determined after three months from the first presentation at the hospitals. Results: The mean LogMAR visual acuity during presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76) and mean LogMAR visual acuity after three months was 0.10 ± 0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant difference (t=11.22, df=78, p=0.001). Best fit curve for the cases had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224, 0.447, df=78, p=0.001. The visual acuity in cases and controls was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154 p=0.001) after three months which showed improvement. There was a reduction in the corneal uniformity index and corneal asphericity in the cases. The Corneal Uniformity Index (CU index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13 ± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a reduction in the contrast sensitivity function at all spatial frequencies in the cases which was significantly different. Conclusion: Microbial keratitis reduced the vision, corneal uniformity index, asphericity and contrast sensitivity after three months in eyes of patients diagnosed with the condition.
Keratitis ; Eye

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: To describe the profile and geographical distribution of reported cases of cutaneous leishmaniasis (CL) in the province of Hail, Saudi Arabia from 2010 to 2013. Methods: Human data were collected from the dermatology service of both King Khaled and General Hail hospitals. Results: A total of 483 confirmed CL cases were investigated. Cutaneous leishmaniasis follows a seasonal distribution related to the activity of the phlebotomine sand fly fauna. Both saudi and non saudi patients were almost equally infected. The number of reported cases of CL in men was higher than that in females. The frequency of CL was asoociated with age and increased in teenager and adult group. By analyzing the geographical distribution, the majority of Hail districts were affected with this disease. However it is more prevalent in Hail city. Conclusions: The lack of data concerning the parasite, the sand fly fauna and the existing transmission cycles in Hail province make difficult to interpret the reported results and to follow up the spatio-temporal evolution of the disease.