1.Tear Stability, Corneal Staining and Dry Eye Symptoms in Contact Lens Wearers
Malaysian Journal of Health Sciences 2019;17(2):35-41
The aim of this study was to examine tear stability of contact lens wearers (CLW) in young Malay adults aged 18 and above and to compare the results with non-contact lens wearers (NCLW). Corneal staining and McMonnies Dry Eye Questionnaires (MDEQ) scores between habitual soft CLW and NCLW were also compared. It also aimed to find correlation between tear stability and MDEQ scores. Quasi-experimental and case control study was conducted among 53 participants (53 right eyes) at UiTM Vision Care, UiTM Puncak Alam Campus. Twenty six participants were habitual soft CLW and twenty seven were NCLW. Tear stability was measured using non-invasive tear break-up time (NIBUT) and invasive tear break-up time (TBUT). Corneal staining was measured using Efron Grading Scale and dry eye symptoms evaluated using MDEQ. Mean scores of NIBUT and TBUT for CLW were 5.23 ± 7.3 sec and 2.19 ± 2.41 sec respectively; for NCLW were 8.71 ± 4.33 sec and 3.00 ± 1.69 sec respectively. There were significant differences in NIBUT (Mann-Whitney U, p=0.0001) and TBUT (Mann-Whitney U, p=0.001) between the CLW and NCLW. There was also significant difference in percentage of corneal staining found between the CLW (22.6%) and NCLW (7.5%), (Chi-square, p=0.013). However no significant difference was found in MDEQ scores between the CLW (7.54 ± 3.62) and the NCLW (8.15 ± 3.38) group, (Mann-Whitney U, p=0.42). There were also no correlations found between tear stability and MDEQ scores in the two groups. The results of this study showed NIBUT and TBUT values were significantly higher in NCLW than in CLW and corneal staining was more extensive in CLW. Contact lens practitioners need to be aware of changes in tear stability as results of contact lens wear and take the necessary action to improve on the management of their patients during aftercare consultation.
2.Optometric Practice in Private Sector Around Kuala Lumpur and Klang Valley: A Preliminary Study
Norhani Mohidin & Anisah Hashim
Malaysian Journal of Health Sciences 2011;9(2):29-34
This survey was carried out to examine the habits of practising optometrists in private practice around Kuala Lumpur and the Klang Valley. A questionnaire survey was prepared that encompassed questions on ophthalmic intruments and appliances, services offered, eye examinations carried out and patient management, failure to carry out comprehensive eye examination, community engagements and their opinion on optometrists as primary eyecare practitioners. The questionnaire was sent to 100 registered optometrists practising in Kuala Lumpur and the Klang Valley. About 64 optometrists responded and returned the questionnaire, but 3 of them were excluded because they were incomplete. The results showed almost all optometric practice has all the equipment related to optometry practice except for tonometer and visual field measurement. Forty-four percent (44%) of optometrists undertook comprehensive eye examinations and if
necessary referred patients for further examinations. Optometrists who did not perform comprehensive eye examinations give reasons of inadequate equipment and clients who want a quick examination. In conclusion optometric practice provide almost all the equipments required for optometrists to practice as primary health care practioners but only 44% of optometrists carried out comprehensive eye examinations. Optometrists in private practice need to practice all the skills they learned and play important roles in educating the public in an effort to improve the primary eyecare of society
3.Survey of Contact Lens Care Among Contact Lens Wearers in Kuala Lumpur
Norhani Mohidin ; Bakyah Lorenza Zaimuri
Malaysian Journal of Health Sciences 2012;10(1):41-48
Contact lenses are optical device that are supposedly safe to be used to correct refractive errors as well as for cosmetic purposes. However problems related to eye health do occur as result of contact lens wearers’ attitude of not following the guidelines prescribed by their eye care practitioners. A clinical survey on lens care was carried out amongst contact lens wearers in Kuala Lumpur. It was based on a set of 22 questions focused on lens care including methods of cleaning and disinfection, enzyme treatments, use of rewetting agents and the frequency of follow-up examinations. In addition there were six questions included to explore wearers’ knowledge related to contact lens care and safety. A total of 104 wearers participated in the survey. About 86% of them were females and their mean age was 24 ± 6 years. More than half of them wore disposable lenses. Almost all of them (98%) use chemical disinfection system. Sixty-eight percent (68%) of wearers surveyed cleaned their lenses prior to and after wearing their lenses. Thirty percent (30%) of wearers used re-wetting agents and 40% used protein tablets. Sixty-one percent (61%) of them said that they never went back for aftercare examinations. The mean correct responses for six questions assessing participants’ knowledge on contact lens care and safety was 61.4%. Our results implied that contact lens wearers were not well informed of the risks and consequences to their eye health as results of not following the strict regimes recommended by their practioners. Contact lens providers should reconsider strategies to ensure wearers’s compliance so that complications can be minimized
4.A Survey of Optometric Contact Lens Prescribing in Malaysia
Norhani Mohidin ; Tee, Lee Fung.
Malaysian Journal of Health Sciences 2009;7(2):59-72
This survey represents an initial examination of contact lens practice in Malaysia. It is based on a questionnaire that was sent to selected members of
the Association of the Malaysian Optometrists to survey the prescribing habits of g contact lenses and care products. Questions included types of lenses
prescribed, care systems frequently recommended and types of complications seen. Optometrists in Malaysia prescribed an average of 90 new pairs of contact lenses per year. Soft lenses made up 84% of the prescription followed
by 14% of rigid gas permeable lenses and 1.5% of polymethymethacrylate lenses. Disposable/frequent replacement lenses accounted for 60% of the soft
lenses prescribed. The most commonly prescribed disinfecting system was chemical disinfection. The most common complication seen during aftercare
consultation was dry eye-related problems.
5.Variation in Measurement of Pattern Electroretinogram (pERG)
Shaznida Ghulam ; Norhani Mohidin ; Rokiah Omar
Malaysian Journal of Health Sciences 2012;10(2):31-36
Pattern electroretinogram (pERG) is a recording of retinal response to a phase reversing pattern stimulus. It gives
information on the integrity of the inner retina specifically the ganglion cells. The recording of pERG in a laboratory
is easily influenced by many factors hence standardization in a laboratory is required to ensure that pERG recorded is
repeatable and reproducible. The objective of this study was to determine the factors that could affect pERG recordings
at the Electrophysiology Laboratory, Optometry Program, Faculty of Health Sciences (FSK), Universiti Kebangsaan
Malaysia (UKM). This study involved forty-five subjects, aged between 20 and 25 years. They were divided into three
groups. The factors being investigated were effects of 1) Alcaine 0.5%, 2) diurnal variation and 3) different size and
shape of fixation target for pERG measurement (amplitude and implicit time). Paired t-test showed no significant
differences between the recording before and after instillation of Alcaine 0.5% for amplitude (p = 0.116) and implicit time
(p = 0.557). Measurements carried out in the morning and afternoon did not show significant differences for amplitude
(p = 0.864) and implicit time (p = 0.174). For different fixation targets, results also showed no significant difference for
amplitude (p = 0.125) and implicit time (p = 0.404). In conclusion, use of Alcaine 0.5%, different time of measurements
and different type of fixation targets do not influence pERG results at the Electrophysiology Laboratory, FSK, UKM. Results
of this study can be used for comparisons in research or in diagnosing diseases of the retina in the future
6.Pattern Visual Evoked Potential (VEP) is Unaffected in the Early Stage of Mild Cognitive Impairment
Lau Chean Ling ; Norhani Mohidin ; Azzatul Ainur Mohd Kamal ; Zainora Mohammed ; Bariah Mohd Ali
Malaysian Journal of Health Sciences 2017;15(1):89-95
The aim of this study was to determine whether pattern-reversal Visual Evoked Potential (PRVEP) is affected in mild cognitive impairment (MCI). Participants aged ≥ 60 years diagnosed as MCI were invited to participate in a study together with a group of controls. PRVEP was measured using A RETI-port/Scan 21 and stimuli of large and small checks sizes, 1° (60 min of arc) and 0.25° (15 min) respectively were used to obtain responses. The amplitude and implicit times of the MCI and control groups were then compared. A total of 18 MCI participants (age 65.7 ± 3.1 years) and 18 controls (65.1 ± 3.8 years) consented to participate in the study. The amplitude and implicit times for the MCI group using the target sizes of 60 min of arc were 9.80 ± 4.06 μV and 108.83 ± 7.63 ms and for 30 min of arc were 11.00 ± 7.44 μV and 123.96 ± 6.18 ms respectively. Consecutively for the control groups the amplitudes and implicit times were 8.96 ± 3.52μV, 105.85 ± 3.60 ms and 11.97± 6.11 μV, 122.57 ± 8.28 ms. PRVEP results did not reveal significant differences in P100-wave amplitude nor implicit time between the two groups under investigation. This study concluded that the visual pathway of MCI participants may be unaffected in the early part of the disease process.
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7.The resin-embedded cornea prepared via rapid processing protocol: A good histomorphometric target for clinical investigation in opthalmology and optometry
Pike See Cheah ; Norhani Mohidin ; Bariah Mohd Ali ; Myint Maung ; Azian Abdul Latif
Malaysian Journal of Medical Sciences 2008;15(3):49-54
This study illustrates and quantifies the changes on corneal tissue between the paraffin-embedded and resin-embedded blocks and thus, selects a better target in
investigational ophthalmology and optometry via light microscopy. Corneas of two cynomolgus monkeys (Macaca fascicularis) were used in this study. The
formalin-fixed cornea was prepared in paraffin block via the conventional tissue processing protocol (4-day protocol) and stained with haematoxylin and eosin.
The glutaraldehyde-fixed cornea was prepared in resin block via the rapid and modified tissue processing procedure (1.2-day protocol) and stained with toluidine
blue. The paraffin-embedded sample exhibits various undesired tissue damage and artifact such as thinner epithelium (due to the substantial volumic extraction
from the tissue), thicker stroma layer (due to the separation of lamellae and the presence of voids) and the distorted endothelium. In contrast, the resin-embedded
corneal tissue has demonstrated satisfactory corneal ultrastructural preservation. The rapid and modified tissue processing method for preparing the resin-embedded
is particularly beneficial to accelerate the microscopic evaluation in ophthalmology and optometry.
8.Custom Made Ocular Prosthesis at Optometry Clinic Universiti Kebangsaan Malaysia (UKM)
Norhani Mohidin ; Chia Jho Yan ; Mohd Norhafizun Mohd Saman ; Nazeem Desai
Malaysian Journal of Health Sciences 2013;11(2):51-54
Patients who lost their eyes as results of accidents or diseases (e.g. retinoblastoma) usually underwent enucleation or
evisceration. They were then fi tted with ocular prosthesis to prevent collapse of the globe and also for cosmetic effects.
Custom made ocular prosthesis is almost unheard of in this country for most hospitals supply ready-made (stock) prosthesis.
The cosmetic results of stock prosthesis are often unsatisfactory. Besides being uncomfortable, stock prosthesis may
also induce allergic reaction that may lead to papillary conjunctivitis. The Optometry Clinic at UKM started its custom
made prosthetic service in 2010. We described here two cases of patients who complained of discomfort with their old
stock prosthesis and re-fi tted with custom made prosthesis. We also highlight the importance of proper hygiene and
maintenance so that ocular prosthesis can be used for as long as possible. This article aims to create awareness among
eye care practitioners and showcase the cosmetic benefi ts of custom made ocular prosthesis
9.Corneal thickness and morphology after orthokeratology of six-month lens wear among young Malay adults
Norhani Mohidin ; Aisyah Mat Yacob ; Fatin Nur Najwa Norazman
The Medical Journal of Malaysia 2020;75(5):538-542
Background: Menicon Z night orthokeratology (OK) lenses
was introduced in Malaysia in 2015 and to date there is no
report on its effects on the cornea. The objective of this
study was to examine short term changes in corneal
thickness and morphology of endothelial cells in young
Malay adults after wearing Menicon Z night OK lenses.
Methods: Corneal thickness was measured at the central
and mid-peripheral locations of 20 participants aged
22.45±1.19 years using Tomey SP-3000 A-scan
ultrasonography. Endothelial images of the central and
peripheral locations captured using Tomey EM-3000
specular microscope were noted. Corneal thickness,
endothelial cell density (ECD), coefficient of variation in cell
size (CV), and hexagonality (HEX) at baseline, 24 hours,
three months and six months after treatment were noted and
analysed using repeated measure analysis of variance.
Results: Central corneal thickness decreased significantly
over a three-month period (p=0.001) and stabilised
thereafter. There were no significant changes in thickness in
all peripheral areas measured (p>0.05), and in ECD, CV and
HEX after the six-month period (p>0.05).
Conclusions: The current study showed that significant
thinning of central cornea and none at the mid-periphery. OK
lens wear with Menicon Z night lenses had no effects on
corneal morphology over the six month period.