Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children’s Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery. Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001). Conclusions Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children’s Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery. Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001). Conclusions Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children’s Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery. Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001). Conclusions Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children’s Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery. Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001). Conclusions Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Methods: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children’s Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery. Results: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001). Conclusions Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Purpose: There has been a lack of data on health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC) from Southeast Asia. This study evaluated the levels (mean total score and subscales score) of HRQoL, comparing the VKC and normal children groups, and within the VKC severity groups. Methods: A cross-sectional study was conducted in two tertiary hospitals, specifically the pediatric ophthalmology services at Hospital Selayang and Universiti Sains Malaysia, spanning from 2019 to 2020. Participants aged between 8 and 15 years were categorized into two groups: those diagnosed with VKC and healthy children serving as the control group. Each participant completed the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire, consisting of 16 questions, divided into two subscales: 12 questions focusing on symptoms and four questions for daily activities. Results: A total of 240 children took part in the study, with 120 children diagnosed with VKC and another 120 in the control group. The mean age of participants with VKC was 11.21 ± 1.91 years, with a male predominance of 4:1 compared to female. Tearing (98.4%) and itchiness (98.3%) emerged as the most prevalent symptoms affecting HRQoL, while the most challenging activities were outdoor play (36.6%) and participation in recreational water activities (34.2%). The mean total score was significantly higher in the VKC group compared to the control group. Additionally, both the mean total score and all subscale scores were significantly higher in the severe type compared to the mild-moderate type. Conclusions VKC significantly reduce the HRQoL among Malaysian children, and the negative impact increases with the disease severity.

Purpose: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patients with nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control group and to correlate it with visual acuity and level of proteinuria. Methods: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome and healthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria, and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus optical coherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. Results: The mean foveal thickness was 238.15 ± 22.98 µm for children with nephrotic syndrome and 237.01 ± 22.60 µm for the control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significant correlation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula (r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between the mean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated a trend towards increased macular thickness. Conclusions The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significant correlation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.

Purpose: The aim of this study is to determine the mean central corneal thickness (CCT) and mean intraocular pressure (IOP) in children with type 1 diabetes mellitus (T1DM) and to determine the relationship between CCT and IOP on the one hand and age, sex, retinopathy hemoglobin A1c (HbA1c), and duration of diabetes on the other. Methods: This is a case-control, hospital-based study conducted at Hospital Universiti Sains Malaysia between January and November 2022. Thirty-eight children with T1DM were recruited as cases, and 38 healthy children were recruited as controls. The cases and controls then underwent ophthalmic examination, IOP measurement, and CCT measurement using optical coherence tomography (OCT) of the right eye. The IOP measurements were adjusted for CCT for further analysis. Results: The means of CCT and IOP values were significantly higher in the T1DM group than in the control group (all p = 0.02). The mean CCT was 542.18 ± 20.40 μm in the T1DM group, and 529.52 ± 26.17 μm in the control group. The mean IOP was 14.68 ± 1.98 mmHg in the T1DM group, and 13.52 ± 1.66 mmHg in the control group. The mean HbA1c was 10.68% ± 2.49% in the T1DM group. Age and duration of DM were found to have a significant association with CCT in children with T1DM. The duration of DM was also found to be significantly associated with the IOP. Sex and HbA1c levels were found to have no significant relationship with either CCT or IOP. Conclusions Children with T1DM have significantly higher CCT and IOP than the average child. The duration of DM is a significant factor that impacts both CCT and IOP. In addition, age is another factor that affects CCT in children with T1DM.

Purpose: The prevalence of retinopathy of prematurity (ROP) is higher in developing countries compared to developed countries. There is limited data on vision-related quality of life (VRQoL) among children with severe type of ROP in developing countries. This study evaluated the influence of threshold and prethreshold ROP on VRQoL in Malaysian children. Methods: Multicenter prospective cross-sectional study conducted in three tertiary hospitals in 2018 to 2019. Children less than 7 years old with previous ROP diagnosis were recruited. Patients with systemic comorbidities that affected vision or daily activities were excluded. A parent or guardian completed the Children’s Visual Function Questionnaire (CVFQ) for the assessment of child’s general health, general vision, competence, personality, family impact, and treatment difficulty. Results: Eight were categorized with threshold ROP, 16 with high-risk prethreshold ROP, and 26 with low-risk prethreshold ROP. Fifty age-matched controls were also included. Mean visual acuity in logarithm of the minimum angle of resolution was 0.46 in the threshold, 0.08 in high-risk prethreshold, and 0.01 in low-risk prethreshold subgroups. Threshold ROP was associated with myopia and strabismus, and associated with poor visual acuity compared to prethreshold ROP. Mean total CVFQ score was significantly lower in the ROP group (p < 0.001) compared to the control group. Mean score and all mean subscale scores were significantly lower in the threshold subgroup compared to high-risk and low-risk prethreshold subgroups, with lowest subscale scores on general vision and general health. There was significant association between gestational age, visual acuity of the better eye, family income, and VRQoL (p < 0.05). Conclusions ROP was associated with lower VRQoL in children born prematurely in Malaysia. The threshold ROP group is the most affected. General vision and health domains are their main difficulties encountered. Gestational age, visual acuity of the better eye, and family income affects the VRQoL.

MicroRNAs (miRNAs) are the small noncoding RNA molecules which regulate target gene expression posttranscriptionally. They are known to regulate key cellular processes like inflammation, cell differentiation, cell proliferation, and cell apoptosis across various ocular diseases. Due to their easier access, recent focus has been laid on the investigation of miRNA expression and their involvement in several conjunctival diseases. The aim of this narrative review is to provide understanding of the miRNAs and describe the current role of miRNAs as the mediators of the various conjunctival diseases. A literature search was made using PubMed, Scopus, and Web of Science databases for studies involving miRNAs in the conjunctival pathological conditions. Original articles in the last 10 years involving both human and animal models were included. Literature search retrieved 27 studies matching our criteria. Pertaining to the numerous literatures, there is a strong correlation between miRNA and the various pathological conditions that occur in the conjunctiva. miRNAs are involved in various physiological processes such as cell differentiation, proliferation, apoptosis, development, and inflammation by regulating various signaling pathways, genes, proteins, and mediators. Pterygium was the most studied conjunctival disease for miRNA involvement, whereas miRNA research in allergic conjunctivitis is still in its early stages. Our review provides deep insights into the various miRNAs playing an important role in the various conjunctival diseases. miRNAs do have the potential to serve as noninvasive biomarkers with diagnostic, prognostic, and therapeutic implications. However, multitudinous studies are required to validate miRNAs as the reliable biomarkers in conjunctival pathologies and its targeted therapy.