Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidism is commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic, environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identified as the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cell mediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increase extraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibrotic stage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form of thyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases are managed by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgical decompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.

Introduction: The prevalence of hypertension in Malaysia is increasing and an effectivemanagement of hypertension is important to reduce cardiovascular morbidity and mortality.Objective: To determine the knowledge, awareness and perception towards hypertension amongresidents in nursing homes as well as the roles of caregivers in hypertension management.Method: A face-to-face survey with 200 hypertensive residents and 30 caregivers from 24 nursinghomes in Kuala Lumpur and Selangor, Malaysia was conducted.Result: Of all the hypertensive residents, 90.5% (n = 181) knew that lowering their blood pressure couldimprove their health. Most residents strongly believed that taking antihypertensive drugs is importantfor keeping their high blood pressure under control (n = 162, 81%). Taking medication was perceivedas the most important factor in controlling the high blood pressure (58%, n = 116) compared to lifestyleor diet modification. The majority of the caregivers reported that they played a major role in managinghypertension, especially with regards to medication-taking. task (66.7%, n = 20).Conclusion: The knowledge, attitude and perceptions of hypertension play a relatively major rolein the self-management of hypertension. The role of caregivers also needed to be recognised inmanaging hypertension in nursing homes.