1.Vision loss in an immunocompetent child post varicella infection: A case report
Lee Shu Chaw ; Emily Ng Ming Choo ; Tan Chai Lee ; Ting Siew Leng
Malaysian Family Physician 2020;15(1):54-57
Chickenpox may lead to several neurological complications. Optic neuritis is one of the
complications which has rarely been described, especially in immunocompetent individuals. We
report a case of an 11-year-old immunocompetent girl who presented with sudden onset bilateral
vision loss three weeks after varicella eruption. Ophthalmic examination revealed bilateral optic disc
edema. Diagnosis of bilateral optic neuritis secondary to varicella was established based upon the
preceding medical history, supported with clinical and radiological fndings.
2.Factors predicting screen time related to physical and behavioural complaints in primary school children
Ting Siew Leng ; Rosalia Saimon ; MD Mizanur Rahman ; Rasitasam @Razitasham bt Safii ; Ho Siat Lian ; Nancy John ; Lim Lik Thai ; Nazirin Arsad
The Medical Journal of Malaysia 2020;75(6):649-654
problems from extended usage of electronic devices areissues among primary school children. This study is aimedto investigate the prevalence of physical and behaviouralcomplaints arising from the electronic device usage and toidentify the potential factors that predicted the complaints.Methods: This was a primary school-based cross-sectionalstudy using multistage cluster sampling, conducted at Baudistrict in Sarawak, Malaysia in 40 primary schools. Aquestionnaire was used to collect information of usagepattern in insufficient lighting, timing and position. Thephysical and behavioural complaints were traced. Dataanalysis was performed using SPSS version 22. A p-value <0.05 with 95% CI was considered as statistically significant. Results: About 52.8% of the 569 students used digitaldevices in a bright room, 69.8% in the day time and 54.4% insitting position. The physical complaints were headache(32.9%), neck, shoulder and back pain (32.9%) followed by byeye strain (31.8%). Regarding behavioural problems, 25.7% ofthe students had loss of interest in study and outdooractivities (20.7%), skipped meals (19.0%) andarguments/disagreements with parents (17.9%). After logisticregression analysis, the lying position (OR=1.71, 95% CI:1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138,4.744) appeared to be potential predictors of the complaint.Conclusion: One-quarter of the students studiedexperienced physical complaints, and one-fifth hadbehavioural problems associated with the use of electronicdevices. Lying position and darkroom lighting are thepotential predictors of complaints. Therefore, we suggestthat the children should use electronic devices in the sittingposition with adequate room lighting.
3.Diagnostic dilemma of kimura disease of eyelids
Ting Siew Leng ; Mohammad Zulkarnaen Ahmad Narihan ; Than Than Aye
The Medical Journal of Malaysia 2020;75(1):83-85
Kimura disease (KD) is a rare benign chronic inflammatory
disease that presents as a nodule mostly involving deep
subcutaneous tissue of the head and neck region with
frequent regional lymphadenopathy and peripheral blood
eosinophilia. KD shares some clinical and histopathological
similarity with angiolymphoid hyperplasia with eosinophilia
(ALHE). Consequently, KD and ALHE were once considered
variants of the same disease spectrum. We present here rare
cases of Kimura disease and ALHE involving the eyelid and
lacrimal gland and discuss their differential features.
4.Myxopapillary ependymoma of cauda equina presented with communicating hydrocephalus and papilloedema: A case report
Ting Siew Leng ; Ahmad Tirmizi Jobli ; Sim Sze Kiat ; Dayangku Norlida Awang Ojep
The Medical Journal of Malaysia 2019;74(4):338-340
We reported a case of cauda equina myxopapillary
ependymoma in a patient who presented with atypical
history of progressive blurring of vision. Ophthalmology
examination revealed relative afferent pupillary defect,
binasal hemianopia and papilloedema. This case report
serves as a reminder that the intraspinal tumour could be a
cause of papilloedema, despite rare, should be considered
in a hydrocephalus patient who presented with no
intracranial pathology and minimal spinal symptoms.
5.Factors determining the outcome of paediatric exotropia surgery
Ivan Lai Yoon Ki ; Ting Siew Leng ; Cheah Whye Lian ; Sunder Ramasamy ; Jamalia Binti Rahmat
The Medical Journal of Malaysia 2019;74(4):266-269
Objective: To determine the socio-demographic and clinical
profile of exotropia surgery outcomes amongst paediatric
patients.
Methods: This is a descriptive, retrospective, clinical study
of surgeries performed between 2014 and 2016 at the
Sarawak Heart Centre, Malaysia. Medical records of patients
with primary and secondary exotropia were reviewed. The
following factors that affected the surgical outcomes were
collected: onset age of squint, age at the time of surgery, the
interval between diagnosis and surgery, the type of
exotropia, visual acuity, presence of amblyopia, previous
patching, anisometropia, refractive error, type of surgery,
preoperative and postoperative deviation, pre-existing
ocular comorbidity and systemic illness.
Result: A total of 15 patients were studied with more than
two thirds being females. Seven patients had primary
exotropia while eight patients had secondary exotropia.
Average interval between diagnosis and surgery was 1.3
years (±0.82) for primary exotropia and 1.2 years (±0.84) for
secondary exotropia. Average pre-operative angle for
primary exotropia was 50.57PD (±10.83) whereas secondary
exotropia was 39.38PD (±8.63). Seven patients had
successful surgical outcomes of within 10 prism dioptres,
five for primary exotropia and two for secondary exotropia.
The response to surgery was 3.0PD/mm (±0.59) for primary
exotropia and 2.2PD/mm (±0.74) for secondary exotropia.
Conclusion: In our study, primary exotropia had larger
preoperative angle than secondary exotropia. The response
to surgery was positively correlated with the preoperative
angle of deviation. Primary exotropia showed better surgical
outcome.