1.Development of Components for A Glaucoma Screening Programme in Malaysia: A Qualitative Study
Hui WX WX ; Sharanjeet-Kaur S ; Hairol M M ; Abd Rahman MH ; Nasaruddin RA ; Md Isa Z ; Ismail R ; Che Hamzah J
The International Medical Journal Malaysia 2026;25(No. 2):55-63
INTRODUCTION: Glaucoma is a leading cause of permanent blindness, often going
undetected in its early, asymptomatic stages, especially in older age groups. In
Malaysia, glaucoma is a growing public health issue due to an increase in the ageing
population. While screening is essential for early glaucoma detection, the most
suitable strategy for Malaysia's healthcare system remains unclear. This study
explored the perspectives of eye healthcare professionals on the most suitable
glaucoma screening strategies for Malaysia. MATERIAL AND METHODS: This
qualitative study used semi-structured interviews with 19 eye health professionals
(ophthalmologists, optometrists, nurses, ophthalmic technicians, and assistant
medical officers) practicing in the Klang Valley. The interviews were conducted
face-to-face in their workplace or via a video conferencing platform. All interviews
were recorded, transcribed, and analysed using thematic analysis. RESULTS: Six
major themes were identified: types of glaucoma screening programmes, accessible
screening locations, target screening population, instruments and use of digital
technology, trained personnel, and referral criteria. Opportunistic case finding and
population-based programmes were identified as the glaucoma screening
programmes in which trained personnel conducted screening at accessible
locations. Glaucoma screening for high-risk individuals was recommended,
focusing on visual acuity testing, tonometry, anterior chamber angle assessment,
funduscopy, perimetry, and retinal nerve fibre assessment. A lack of clear referral
criteria due to low awareness and poor implementation of existing guidelines was
observed. CONCLUSION: Further investigations are required to identify the best
combination of components for glaucoma screening. This will enable policymakers
to develop an effective glaucoma screening programme in Malaysia.
2.Various Ways of Continuous Intraocular Pressure Monitoring in Glaucoma Patients: A Narrative Review
RAMAKRISHNAN G ; CHE HAMZAH J ; SHARANJEET-KAUR S
Medicine and Health 2019;14(2):17-29
Glaukoma adalah sejenis penyakit neurodegeneratif yang berlaku akibat
ketidakseimbangan dalam peredaran cecair akues yang disebabkan oleh
resistan pada sistem pengaliran keluar cecair tersebut. Ini meningkatkan tekanan
intraokular (TIO) yang menyebabkan kerosakan pada saraf optik dan seterusnya
mengakibatkan kebutaan yang kekal. Oleh kerana TIO adalah satu faktor risiko
glaukoma yang boleh dikawal, ciri-ciri dan variasi tekanan sepanjang 24 jam perlu
dikenalpasti sebelum rawatan dimulakan. Pemantauan TIO adalah satu aspek yang
terpenting dan kritikal dalam pengurusan glaukoma. Pelbagai tindakan kawalan
melalui penggunaan teknologi yang berbeza telah dan sedang dilakukan untuk
pemantauan TIO yang kerap dan berterusan selama 24 jam untuk menentukan
kewujudan TIO yang tinggi (peak) dan fluktuasi tekanan. Artikel ini bertujuan untuk
meninjau pendekatan inovatif yang terkini serta untuk mengulas kepentingan dan
kelemahan setiap teknik bagi memperolehi profil TIO selama 24 jam.
3.Brain Activation Due to Various Visual Stimuli: A Pilot Study using Fixed-effects Analysis on Healthy Participants
N.H. Nasaruddin ; A.N. Yusoff ; Sharanjeet Kaur ; N.F. Nasrudin ; S. Muda
Malaysian Journal of Health Sciences 2015;13(1):57-68
Ocular abnormalities have apparent effects on brain activation. However, neuroimaging data about the ocular
characteristics of healthy participants are still lacking to be compared with data for patients with ocular pathology. The
objective of this multiple participants’ functional magnetic resonance imaging (fMRI) studies was to investigate the brain
activation characteristics of healthy participants when they view stimuli of various shapes, pattern and size. During the
fMRI scans, the participants view the growing ring, rotating wedge, fl ipping hour glass/bow tie, quadrant arc and full
checker board stimuli. All stimuli have elements of black-and-white checkerboard pattern. Statistical parametric mapping
(SPM) was used in generating brain activation via fi xed-effects (FFX) and conjunction analyses. The stimuli of various
shapes, pattern and size produce different brain activation with more activation concentrated in the left hemisphere.
These results are supported by the conjunction analysis which indicated that the left pre-central, post-central, superior
temporal and occipital gyrus as well as the left cingulate cortices were involved when the participants viewed each given
stimulus. Differential activation analysis showed activation with high specifi city in the occipital region due to the stimuli of
various shapes, pattern and size. The activation in the right middle temporal gyrus was found to be signifi cantly higher in
response to moving stimuli as compared to stationary stimuli. This confi rms the involvement of the right middle temporal
gyrus in the observation of movements. The black-and-white checkerboard stimuli of various shapes, pattern and size,
stationary and moving was found to 1) activate visual as well as other cortices in temporal and parietal lobes, 2) cause
asymmetry in brain function and 3) exhibit functional integration characteristics in several brain areas.
Photic Stimulation


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