2nd Ophthalmology Research Day 2019

Ophthalmology

Research Day

PROGRAMME BOOK Pusat Kecemerlangan
& Kejuruteraan &
Teknologi JKR
ABSTRACTS
CREaTE, Melaka

16th -18th Oct 2019

Organized by:

Ophthalmology Department
Hospital Melaka
Persatuan Perubatan Oftalmologi
Hospital Melaka

2nd Ophthalmology Research Day- 2019

KEYNOTE ADDRESS

Dato’ Dr. Goh Pik Pin

Director,
National Clinical Research Centre

PLENARY LECTURE

Dr. Hajah Nor Fariza bt Ngah

National Head of Ophthalmology Services
Ministry of Health, Malaysia

PANEL OF JUDGES

Dr. Zaharidah Binti Abdul Kadir

Ophthalmologist,
Hospital Sultan Abdul Halim, Kedah

Dr. Mohd Aziz Bin Husni

Head of Ophthalmology Department,
Hospital Selayang, Selangor

Dr. Francesca Martina Vendargon

Head of Ophthalmology Department,
Hospital Sultanah Aminah, Johor

Dr. Tengku Norina Binti Tuan Jaffar

Ophthalmologist,
Hospital Raja Perempuan Zainab II, Kelantan

Dr. Zalifa Zakiah Binti Asnir

Head of Ophthalmology Department,
Hospital Ampang, Selangor

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2nd Ophthalmology Research Day- 2019

Advisor
Datuk Dr Raja Norliza Raja Omar

Chairperson
Dr. Nor Fadzillah bt Abd Jalil

Secretary
Dr. Noorlaila Baharuddin

Dr. Ang Wen Jeat

Treasurer
Pn. Nor Emalina Suleiman

Scientific Preparation and Technical
Dr. Ang Wen Jeat Dr. Tan Tser Chin
Dr. Ting Xiao Wei
Dr. Sangeetha a/p Subramaniam En. Zakaria Bin Hashim

Promotion and Publicity Opening Gimmick/ Decoration/
Dr. Ang Wen Jeat Multimedia/ Audio/ Visual
Dr Romadonazikri Bin Aslim
Pn. Nurul Hafizah Mohd Norizan Dr. Jon Goh Yi Kinn

Catering Souvenirs
En. Shahazrie Bin Sulor Pn. Nurulfaiz Rahmat
Pn. Zaini Binti Sulaiman Pn. Hartati Binti Hashim
Pn. Anis Azlah binti Aziz Pn. Norazamimah Binti Jaafar
Cik Nur Fadzilah Binti Abdul Rahman
Pn. Jamaliah Binti Ahmad Goodies
Pn. Noorazlinda Binti Saleh Pn. Surainah Binti Hussin
Pn. Suriani Binti Ab Wahab
Transportation
En. Mohd Azri Bin Majid Registration
Dr. Syazwan Izzat Bin Nor Izhar
En. Ilham Bin Basiran
Pn. Norazwati Binti Ramli
Accommodation Pn. Harlyantie Binti Mohamed
Pn. Normaya Binti Halim Cik Nazatul Najuwa Binti Abdul Aidi
Pn.Hazlina Mohd Yusof
Pn. Lizawati Binti Jamil
En. Ilham Bin Basiran
Special Task
Ushers En. Muhamad Salehudin Bin Ramli
Dr Mohammad Fahim Bin Mohd Jais
En. Mohd Noor Hafez Bin Abu Bakar Pn. Kamala Devi A/P RV

Pn. Norshahida Binti Abd Rahim Emcees
Pn. Arbae'yah Binti Zakariya Pn. Fatem Mahanom Binti Shafek
Pn. Rabeah Binti Abdul Rahim
En. Mohd Fitri Bin Sakari
Time Keeper Dr. Kathy Lim Yeen Luan
Dr Mohammad Fahim Bin Mohd Jais Dr Nooramad Abbas bin Ahmad
Dr Durgavashini A/P Govinda Raju

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2nd Ophthalmology Research Day- 2019

Masa Perkara

8:30 – 8:35 pagi Lagu Negaraku & Lagu Kami Sedia Membantu
Bacaan Doa

8:35 - 8:45 pagi Kata kata aluan :
Datuk Dr. Hajah Hatijah binti Hj. Mohd Tan
Pengarah Hospital Melaka

8:45- 8 :55 pagi Ucapan Perasmian:
Dato’ Dr. Goh Pik Pin
Pengarah Pusat Penyelidikan Klinikal Malaysia

8:55- 9:00 pagi Sesi penyampaian cenderamata kepada
Dato’ Dr. Goh Pik Pin dan
Datuk Dr. Hajah Hatijah binti Hj. Mohd Tan

9:00- 9:30 pagi Lawatan ke tapak poster dan jamuan pagi

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2nd Ophthalmology Research Day- 2019

Day Time Agenda

Day 1 4:00 pm onwards Check In
WED Uploading Presentations & Poster Mounting
16/10/19

Day Time Agenda Concurrent
Event
Day 2 8:00 am- Registration
Thursday 8:30 am P
17/10/19 Opening ceremony O
8:30 am-9:00 am Dato’ Dr Goh Pik Pin S
* Breakfast T
9:00 am-9:30 am Keynote Address by E
9:30 am-10:15am by Dato’ Dr Goh Pik Pin R
Free Paper Presentations A
10:15am-12:15pm Lunch Symposium W
12:15pm-12:45 pm Lunch & Prayers A
12:45pm- 2:15 pm Free Paper Presentations B L
2:15 pm-4:30 pm K

4:30 pm Evening Tea T
H
*Rapid fire session for shortlisted posters will be at 2.00 pm till 3:00 pm R
O
Day 3 8:00 am-8:30 am Registration U
Friday G
H
18/10/19

8:30 am- 9:15 am Plenary Lecture

by Dr. Hajah Nor Fariza bt Ngah

9:15 am-9:45 am Breakfast

9:45 am-11:45 am Free Paper Presentations C

11:45 am-12:15pm Lunch Symposium
12:15 pm- 2:30 pm Lunch, Check Out &
Friday Prayers
2:30 pm-3:30 pm Prize Giving & Closing Ceremony
3:30 pm Evening Tea

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2nd Ophthalmology Research Day- 2019

No. Name Presentation Title

A1 Nazrin Nordin Audit - Effectiveness of Eye Screening Program ‘Pusat Perubatan
Universiti Malaya World Sight Day 2018’
A2 Michele Tey Shi
Ying The Rate of Restoration of Ellipsoid Zone and External Limiting
Membrane After Macular Hole Surgery and Their Correlation
A3 Kathy Lim with Visual Outcome

Three Years Retrospective Study on Culture-Proven Keratitis in
Melaka Hospital

A4 Muhammad Correlation between Body Mass Index and Ocular Biometric
Zakwan B Ilias Changes between Premenopausal and Postmenopausal Women

A5 Insyirah Binti Does Cataract Surgery Slows the Visual Field Progression in
Mohd Zuhudi Glaucoma Patients

A6 Kevin Kwan Comparison of Short and Long Duration Burns of Transscleral
Diode Cyclophotocoagulation

A7 Lim Hui Wen Ganglion Cell Layer - Inner Plexiform Layer Thickness and Vision
Loss in Cerebral Palsy

A8 G. Theibban A/L An Audit Care of Ophthalmic Surgical Instruments at
Gopalasamy Ophthalmology Department Hospital Sultan Abdul Halim

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2nd Ophthalmology Research Day- 2019

No. Name Presentation Title

B1 Ivan Chong Jia A Review of Cataract Pre-op Assessment Failure Rate, Reasons
Cherng and Solutions

B2 Normalisa Binti The Status Of Accommodation Before and After Active Near
Muhammad Som Work By Using Smartphone

B3 Rasyiqah Mohd Nurses Perspective In Handling The Multidose of Keratitis
Zamberi Regime

B4 Stephanie Fong Retcam Imaging Screening Examination In Newborns

B5 Muhammad Microbial Profile of Endophthalmitis in a Tertiary Care Hospital
Hayatulrizal Bin Md in Johor Bahru: A 6-Year Retrospective Study
Lailee

B6 Nurul Izza binti A 4 Year Retrospective Review of Infective Keratitis: An
Roslan experience in Hospital Pulau Pinang

B7 Lim Zhi Yiu Hiang Prevalence of Steroid induced high IOP among paediatric in
Weang Hospital Wanita Dan Kanak-kanak Sabah (HWKKS)

B8 Ahmad Nadzirin bin Practice of Solah Among Patients Who had Cataract Surgery In
Yahaya Ophthalmology Department Hospital Sultan Abdul Halim

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2nd Ophthalmology Research Day- 2019

No. Name Presentation Title

C1 Nirna Hazeera Bt Refractive Outcomes in Preterm Baby with and without ROP in
Zahar Hospital Sultanah Nur Zahirah

C2 Nor Emalina The Measurement of Ocular Parameter Using IOL MASTER 700
Suleiman on Cataract patients Before and After Dilatation

C3 Ting Xiao Wei Visual Outcomes of Paediatric Cataract Surgery in Hospital
Melaka, a 6-Year Review

C4 Felicia Foo Diabetes and Diabetic Retinopathy: Knowledge, Attitude,
Practice (KAP) Among Diabetic Patients in Their First Visit to Eye
Clinic, Hospital Melaka

C5 Radtthiga Neovascular Glaucoma: Progression or Regression?
Chelvaraj

C6 Siti Nurul Ashiken ROSE K XL for Irregular Corneal Patient in Ophthalmology
bt Chahar Nordin Department, Hospital Sultanah Aminah, Johor Bahru, Johor:
Benefit to patient

C7 Mohammad Fahim Post-Operative Outcomes of TORIC IOL in Hospital Melaka
Bin Mohd Jais

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No. Joan Marie Palikat
Retinoblastoma in University of Malaya Medical Center, Kuala
1 Lumpur: A Five-Years’ Experience

2 Nabilah binti Mohd Visual Function in Cerebral Palsy Students at Cerebral Palsy
Yussuf Association Johor Bahru

3 Viona Lai Mi Shan Ocular Syphilis – A Retrospective Review of Cases Presented at
Ophthalmology Clinic Hospital Shah Alam
4 Hing Siau Tiak
A Case Series Of Suprachoroidal Hemorrhage

5 Pn. Nazura binti Assessing Agreement Between Manual Keratometer and IOLMaster
Selamat 700 in Measuring Corneal Power

6 Muhassanah Aliah The Screening of Visual Impairment (VI) among Preschool Children

binti Baharum in Kota Kinabalu, Sabah

7 Ummu Salamah I Various Technique of Managing Hypotony Post Filtering Surgery at
HRPZ II

8 Mohd Mustaqim Bin Outcome of Modified Hangback Technique in Strabismus Surgery
Zulkifli Martin

9 Pua Sze Hui Fungal Conjunctivitis: When to Suspect

10 Valarmathy Vaiyavari Elective Cataract Surgery Cancellation In Hospital Sungai Buloh – A
Retrospective Evaluation

11 Khoo Chung Lee An Audit on Cancellation Rate of Ophthalmology Surgical
Procedures in Daycare Operating Theatre in University Malaya
12 Adeeba bt Abd Medical Centre, Malaysia (UMMC)
Rahman
A Case Series of Panuveitis In Hospital Temerloh

13 Nazrin Nordin Case Report - Traumatic Pediatric Cataract: Approach and Surgical
Outcome

14 Hazirah Azhar Case Report: Atypical Presentation of Conjunctival Lymphoma

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No. Tan Chun Loong
Parinaud syndrome
15

16 Komathi Arasu A Rare Case of CRAO with CRVO

17 Muhammad Fadhli Case Series of Central Serous Retinopathy Secondary to
Bin Ab Hamid Supplementary Remedies

18 Mohd Fariz MA Blindness Caused By Onodi Cell Mucocele That Mimics Retrobulbar
Optic Neuritis

19 Shalini Nganasekaran A Bad Sinus For A Good Eye

20 Chiun Pei Rong Conjuctival Myxoid Stromal Tumour – A Rare Ocular Tumour

21 Ho Su Wen An Audit of the Completion of Surgical Consent Forms in the
22 Lau Sui Ching Ophthalmology Day Care Operating Theatre at Universiti Malaya
Medical Centre (UMMC)

Cataract Cancellation Rate in Daycare Hospital Melaka

23 Mohamad Arif bin Retinal Vein Occlusion in A Young Patient: Unusual Complication of
Mustapha Protein Suplementation

24 Muzzaffar Bin Mad Purtscher’s Retinopathy Following Long Bone Fracture

Isa

25 Arwinderjit Kaur Ocular Presentation of Cornelia de Lange Syndrome

Walia

26 Goh Sue Zian A Rare Case Of Endogenous Endophthalmitis With Klebsiella
Pnemumonia Liver Abscess

27 Ng Hui Ruan The Epidemiological Profile of Penetrating Ocular Injuries in a
Tertiary Care Centre

28 Siow Suyi Perfluoro-N-Octane A Surgical Adjunct to Pars Plana Vitrectomy In
Intraocular Foreign Body Removal

29 Prakash Supahiah A Case Series of Endogenous Endophthalmitis in a Diabetic Patient

30 Chiun Pei Rong Optic Disc Haemorrhages as Presenting Feature of Diffuse
Astrocytoma.

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No.
31 Wardati Hanisah Parinaud’s Oculoglandular Syndrome : Not Just Your Everyday 'Red
Jami Eye'

32 Sharifah Izzati The Ocular Sequelae of Syphilis

33 Jesspreet Kaur A Case Series Of Orbital Apex Syndrome: Time is of the Essence

34 Wan Mohd Aiman A Case of IdiopathicInterstitial keratitis Mimicking Cornea Ulcer

bin Wan Abdul

Rahman

35 Patricia Ann John Sight Lost in Space

36 Rasyiqah Mohd The Outcome of Strabismus Surgery in Miri General Hospital-An 7
Zamberi year retrospective study

37 Krystle L. Thompson Bilateral Optic Disc Oedemma Without Hydrocephalus in Acoustic
Schwannoma

38 Andrew Low A Two-year Retrospective Study on Corneal Ulcer in HSAH (Part 2)

39 Andrew Low Cataract Cancellation in Hospital Sultan Abdul Halim in 2018

40 Abdah Adzimah Early Manifestation of Unilateral Retinopathy with Cystoid Macular
41 Sharon Yet Edema in SLE
42 Sharon Yet
Unilateral Choroidal Metastasis Revealing Lung Adenocarcinoma in
a Non-Smoking Lady

An Egg-Yolk Lesion Found at the Macula

43 Sharon Yet An Occupational Welder with Welder's Maculopathy

44 Razan Syazana Bt Orbital Abscess Complicating of Acute Pansinusitis: Avoid Delays in
Zainal Arsad Diagnosis

45 Lai Zhong Yang A Rare Case of Choroidal Melanoma

46 Muhamad Syazni When Herpes Zoster Is Beyong Skin Deep

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No. Amutha Anbazagan
48 A Case of Apparent Trivial Conjunctival Laceration With Enormous
Intraocular Foreign Body

49 Nurul Farhana Ocular Iron Toxicity from Intraocular Foreign Body
Zakaria

50 Nur Aisyah Binti A Rare Ocular Presentation Of Disemminated Cryptococcosis In a
Abdul Rahim Patient With Human Immunodeficiency Virus

51 Abdullah Ashraf Tolosa-Hunt Syndrome With Underlying Latent Tuberculosis: A
Rafique Ali Diagnostic Dilemma

52 Khoirul Barriyah Transient Visual Loss Following Cataract Surgery Under Subtenon
Abdul Aziz Anaesthesia

53 Abd Hadi Mohd Ocular Sporotrichosis
Rasidin

54 Ting Xiao Wei A Retrospective Review of Paediatric Penetrating Ocular Injury in
Hospital Melaka

55 Kunalini Anpalagan Open Globe Injuries in Hilir Perak District - Who’s at Risk and to
What Extent?

56 Pavitra A/P Danapal Bilateral Frozen Eyes in Miller Fisher Syndrome

57 Chai Huei Xian The Incidence and Clinical Pattern of Uveitis in Hospital Raja
Permaisuri Bainun: A Retrospective Review

58 Muhamad Zulhilmi A Study On The Efficacy Of Conjunctival Rotational Autograft In
Akmal bin Zainuddin Primary Pterygium Excision In A Regional Referral Hospital

59 Shubash C.B. A/P A Case of Bilateral Papilloedema in Advanced Medulloblastoma
Veeramohan

60 Patricia Ann John Bump in Brain, Caused Eye in Vain

61 Sai Priyalatha Toxic Optic Neuropathy Secondary to Methanol Poisoning
Mariapan
The Effectiveness of Recombinant Tissue Plasminogen Activator in
62 Ainul Basirah Severe Post-Operative Fibrinous Reaction After Uneventful
Ibramsah Phacoemulsification
A Retrospective Four Years Study On Work Related Eye Hazards
63 Ruhaya Razali Among Foreign Workers In Segamat District-Prevention Better Than
Cure

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No. Chew Chang Feng Doctor, Why Can’t I See Clearly After My Surgery?
64

65 Mohd Faizal Zokri Adulterated Liqour Leading To Blindness: A Case Report

66 Mohd Jamal Bin Pterygium Excision with Autologous Blood Autograft
Ahmad

67 Farah Ibtisam A Rare Case Of Endogenous Fungal Endophthalmitis
Ibrahim

68 Sharifah Azira binti The Clue is in The Vessel: A Case of Unresolving Proptosis and
Syed Mohd Taufik Distorted Vision, and How Interventional Radiology Can Help

69 Khavigpriyaa Clearer Cornea With Folic Acid Supplementation
Kalaichelvam

70 Ainizahidah Ismail Long Cataract Surgery Waiting Time (CSWT) In Hospital Kulim-What
Can We Do

71 Aisyah Amirah MZ Foreign Body In Angle

72 Josephine Lee En Hui Meibomian Gland Dysfunction, An Underdiagnosed and
Undertreated Disease

73 Timothy Liew Khai Bilateral Abducens Nerve Palsy In Dengue Fever: A Case Report
Wing

74 Liow Ying Jie The Use of Topical β-blockers in Infantile Periocular Capillary
Haemangiomas

75 Siva Sathi K Evaluation of Traumatic Hyphema Cases and Management in a
Tertiary Care Center

76 Dheveya Sinnayya Retinopathy of Prematurity : A Two-Year Retrospective Study in a
Tertiary Care Hospital

77 Aqidah K Quality Assurance Project-Daycare Cataract Surgery

78 Nurul Munirah binti TELE Diabetic Retinopathy at Setiu, Terengganu: 5 Years Experience
Mohamad

79 Joseph Jacob Don't Jump The Gun: Bartonella Neuroretinitis Mimicking
Danasamy Tuberculous Neuroretinitis

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2nd Ophthalmology Research Day- 2019

Poster Name Title
No.
Nurnadia Conjugate Gaze Palsy as Isolated or Predominant Manifestation of
80 Kamaruddin Pontine Infarction

81 Siti Sarah Shokri Incidence of ROP and Asscociated Risk Factors of Severe ROP (
Grade 3 and greater) in Hospital Sultan Abdul Halim
82 Kueh YY
Prevalence of Ophthalmia Neonatorum in Miri General Hospital in
83 Aliah Binti Hassan Year 2015 - 2018

Bilateral Primary Vitreoretinal Lymphoma (PVRL)

84 Norazlida Binti A Case of Acanthamoeba Keratitis (AK) With its Complications
Ibrahim Ocular Metastasis as First Presentation of Renal Cell Carcinoma

85 Chan Jinn Shian

86 Tikambari Etthirajan Beauty Turns Nightmare

87 Nurul Huda Md Amin A Case Report On Subluxated Lens in Young Marfan Syndrome

88 Sangeetha Acute Angle Closure Secondary to Polypoidal Choroidal
Subramaniam Vasculopathy – A Devastating Complication

89 Gunavathy A/P Peter’s Brothers: A Case Series of 2 Brothers with Peter’s Anomaly
Nandakumal

90 Kumutha A Rare Case of Traumatic Intraocular Foreign Body at Anterior Lens
Capsule

91 Muhammad Trend of Endogenous Endopthalmitis : Then and Now Our
Hayatulrizal Experience in Hospital Sultanah Aminah

92 Farhana Nabila Bt Case Report: A Rare Case Of Leptospirosis Eyelid Granuloma
Sulaiman

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A1

Audit - Effectiveness of eye screening program ‘Pusat Perubatan Universiti Malaya World Sight
Day 2018’
Nazrin N1, Azida J1
1Department of Ophthalmology, Pusat Perubatan Universiti Malaya, Malaysia
Purpose
1. To gauge the public response to the eye screening program
2. To determine the most effective mechanism for advertisement
3. To evaluate the method of improvement for the future eye screening program
4. To assess the ocular abnormalities pick up rate of the screening program
Methods
Data was collected based on survey and feedback form given to patients who attended World Sight day
eye screening 2018 program in PPUM. During the screening, program patients were screened for visual
acuity, intraocular pressure by using I-care tonometer and posterior segment imaging was done with a
fundus camera. Patients with abnormal findings will be referred to any tertiary center for further
evaluation.
Results
There was a total of 425 participants attended the eye screening program, from which 182 was male and
198 female patients. Based on the survey that was done, most of the participants were aware of the
events through newspaper and social media including Whatsapp, Facebook, and Instagram. 93% of the
responder agree that this eye screening program was beneficial and should be continued annually. Among
the 425 participants, 44 (10.35%) with abnormal findings required referral. The abnormalities including
high cup disc ratio, high intraocular pressure, posterior segment abnormalities, and poor fundus view.
Conclusion
The eye screening program is very important not only to educate the society regarding the importance of
ocular pathology but also to undertake the necessary measure to overcome eye-related diseases in the
community.

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2nd Ophthalmology Research Day- 2019

A2

The rate of restoration of ellipsoid zone and external limiting membrane after macular hole
surgery and their correlation with visual outcome.
Michele Tey Shi Ying1, KP Ling1
1Department of Ophthalmology, Hospital Sultanah Aminah, Johor, Malaysia
Purpose:
To analyse the structural and functional outcomes in patients who underwent macular hole (MH) surgery,
in particularly with regards to the restoration of the ellipsoid zone (EZ) and external limiting membrane
(ELM) and their correlation with visual recovery.
Methods:
A retrospective observational study was conducted on 8 eyes of 8 patients with successful surgical closure
of MH after undergoingsurgical repair over a 14-months period at our institution from June 2018 to July
2019. The main outcomes include the best-corrected visual acuity (BCVA) obtained using the standard
Snellen chart at 6 metres’ distance and the macular microstructure restoration, specifically the EZ and
ELM, determined usingthe Zeiss Cirrus Spectral Domain Optical Coherence Tomography (SD-OCT) pre and
post-operatively.
Results:
The mean age of patients was 67.5 years (range 54-80 years). Preoperative mean logMAR was 1.17. Four
patients underwent combined cataract removal and pars plana vitrectomy (PPV) with internal limiting
membrane (ILM) peeling; while another four underwent PPV and ILM peeling only.EZ was restored in
4(50%) eyes and ELM re-established in 7 (87.5%) eyes.The post-operative mean logMAR was 0.58, with
both the ELM and EZ restoration significantly correlated with BCVA at postoperativeperiod.
Conclusion:
Reconstruction of the foveal microstructures, particularlyEZ and ELMmay be important for visual recovery
after MH repair. Our patients needed to be followed up for the longer term to further determine the long-
term reconstruction of foveal microstructures and their association with visual recovery.

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2nd Ophthalmology Research Day- 2019

A3

3 years Retrospective Study on Culture-Proven Keratitis in Melaka Hospital
Kathy LYL1, Ang WJ1, Norfadzillah AJ1, Raja Norliza RO1
1 Ophthalmology Department Hospital Melaka

Objective:
To discuss the etiology, predisposing factors, microbial profile and clinical outcome of keratitis
Method:
A retrospective study of 160 patients (163 eyes) who was admitted for keratitis in Hospital Melaka over
three-years period from January 2016 until December 2018. This study is discussing on etiology,
predisposing factors, microbial profile and clinical outcome of keratitis.
Result:
One hundred patients (163 eyes) with bacterial keratitis were treated in the Department of
Ophthalmology, Melaka Hospital, over a 3-years duration. Statistic showed that male (61.9 %), Malay (65
%), from Melaka state (93.1%) ad aged between 61-70 years (17.5%). The ocular predisposing factors
were ocular trauma (78%), contact lens users (27%) and bullous keratopathy (17%).The corneal ulcers
were mainly colonized by Gram-negative bacteria (44%). The most frequently isolated microorganisms
was Pseudomonas eruginosa (26 eyes), Staphylococcus aureus ( 5 eyes), Streptococcus pneumoniae ( 3
yes), and Serratia Serratia marcescans( 4 eyes). A good visual outcome occurred in 62.6% of eye analyzed.
Prognosis factors for visual outcome including presenting Snellen visual acuity, time to presentation after
onset of ocular symptom, ocular predisposing factor, corneal ulcer location and corneal ulcer size.
Conclusion:
Keratitis is a potential sight-threatening condition. Public education and awareness regarding importance
of protective eye wear during work, proper contact lens hygiene, optimizing underlying diabetes mellitus
and quit smoking may help decrease visual morbidity.

Keywords: corneal ulcer, bacterial keratitis, fungal keratitis, aetiology

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A4

Correlation between Body Mass Index and Ocular Biometric Changes between
Premenopausal and Postmenopausal Women
M. Zakwan Ilias, M. Firdhaus Zainudin, Pushpa Raman, Khairul Husnaini, Sivagurunathan Premala-Devi
1Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, MALAYSIA

Purpose:
To compare the mean difference and investigate the association between body mass index (BMI) and
ocular biometric parameters between premenopausal and postmenopausal women.
Method:
This is a case control study comprising 50 premenopausal and 50 postmenopausal women whose ocular
biometric parameters (central corneal thickness (CCT), intraocular pressure (IOP), keratometry (K1&K2),
astigmatism, axial length (AXL), lens thickness(LT) and anterior chamber depth(AC)) were measured using
ZEISS IOL Master 700. Participants of both groups met the inclusion and exclusion criteria, had no ocular
co-morbidity and no dry eyes. Statistical analysis was carried out using analysis of co-variance ANCOVA
and Pearson’s correlation.
Results:
The mean age in premeopausal women was 36.3(±4.22) years and 52.8 (±5.43) years in postmenopausal
women(p<0.001) while the mean BMI in premenopause was 25.5 (±4.52) kg/m2 and 28.3 (±6.30) kg/m2 in
the postmenopausal group (p=0.011). There was significant difference between the 2 groups in adjusted
IOP (P=0.015), K1 reading(p=0.002), astigmatism (p=0.001), ACD (p=0.009), AXL(p=0.018) and LT
(p<0.001). However, after age and BMI adjustment, only K1 reading (p=0.023) and CCT (p=0.004) was
statistically significant. There was a negative correlation between BMI and CCT in the premenopausal
women group (r=0.135, p=0.009) while in the postmenopausal women group, there was a positive
correlation between BMI and true IOP (r=0.087, p=0.037).
Conclusion:
There were significant differences in some of the ocular biometric parameters between premenopausal
and postmenopausal women and BMI affected the CCT and IOP differently in the 2 groups of women.

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A5
Does Cataract Surgery Slows the Visual Field Progression in Glaucoma Patients
Insyirah Mohd Zuhudi 1, Puspha Raman1, Khairul Husaini Mohd Khalid1
1Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, MALAYSIA

Purpose:
To explore the effect of cataract extraction on the visual field (VF) progression of open angle
glaucoma patients.
Methods:
This retrospective cohort study included open angle glaucoma patients in Hospital Kuala Pilah
who underwent uncomplicated phacoemulsification surgery and intraocular lens implant.
Standard automated perimetry done every 6 months. We compared the mean results of three
VF examinations immediately before and after the surgery
Results:
We reviewed 39 eyes of 27 patients (mean ± SD age, 66.4 ± 11.7 years). While the intraocular
pressure (IOP) improved significantly by approximately 2mmHg after surgery (P=0.03), the
average change in mean deviation (MD) was 1.7 dB and not significant (P = 0.85). Before surgery
the MD slope was -1.18 ± 0.45 dB/year and after surgery it slightly improved to -1.12 ± 0.53
dB/year with no statistical significance (P=0.78).
Conclusion:
While there was an improvement in IOP after cataract surgery, the changes in the visual field
progression were negligible.

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2nd Ophthalmology Research Day- 2019

A6
Comparison of short and long duration burns of transscleral diode cyclophotocoagulation
Kevin KJE1, Tham ZK2, Ting SL3, Lim CW1
1 Hospital Umum Sarawak, Kementerian Kesihatan Malaysia
2 University Malaya Medical Center
3 Faculty Medicine and Health Sciences, Universiti Malaysia Sarawak

Purpose: to compare the outcomes of transcleral diode cyclophotocoagulation using short duration (SD)
versus longer duration (LD) burn treatment
Methods:
This is a retrospective study reviewing twenty-five eyes with glaucoma of any type who underwent
cyclophotocoagulation with SD (2000ms) and variable power of ≦2000mW versus LD (4000ms)
treatment and variable power ≦1200mW. The outcome measures included intraocular pressure (IOP)
reduction, number of antiglaucoma medications and visual acuity at final visit. The complications between
two techniques were documented.
Results:
There were 5 patients and 20 patients in the SD and LD groups respectively. Both groups were given
topical steroid post treatment. The mean IOP before treatment was 47.2±8.4mmHg and
30.15±7.7SDmmHg for SD and LD group respectively. At final visit, there was a IOP reduction in both
groups (28.0mmHg in SD; p>0.05 and22.15mmHg in the LD; p<0.05). The mean number of eye drops
before treatment was 4.0 and dropped to 2.0 for bothgroup (p< 0.05). The mean logMAR visual acuity
prior to treatment was 2.46 (SD) and 2.10 (LD) and at post treatment, the mean logMAR was 2.70 (SD)
and 2.10 (LD) (p >0.05). Both treatments resulted in complications such as inflammation, hypotony and
hyphaema.
Conclusions:
Both treatments reduce the intraocular pressure and the number of antiglaucoma eye drops needed in
glaucoma patient.

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2nd Ophthalmology Research Day- 2019

A7

Ganglion Cell Layer- Inner Plexiform Layer (Gcl-Ipl) Thickness and Vision Loss In Cerebral
Palsy.
Hui Wen Lim, Mohamad Azlan Zaini, Nora Norzareen Abdul Razak, Mohamad Fathi Ismail, F.M.
Vendargon, Kiet Phang Ling
Ophthalmology Department, Hospital Sultanah Aminah Johor Bahru, Johor

Purpose:
To determine if measures of macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness can
discriminate between cerebral palsy patient with and without vision loss using spectral-domain optical
coherence tomography (SD-OCT).
Methods:
Participants with cerebral palsy enrolled in a prospective study of SD-OCT were included if they were
cooperative for vision acuity (VA) testing and macular SD-OCT images were acquired. Manual
segmentation of the macular GCL-IPL was performed using elliptical annuli with diameters of 4.5 mm.
Difference between subjects’ VA and respective age-based norm was obtained to determine the
magnitude of vision loss. Participants with VA of ≥ 0.2 logMAR below age-based norms were defined as
having abnormal VA. Pearson correlation and independent T- test were used to evaluate the relationship
between VA and GCL-IPL measures. Data were analysed using SPSS version 22.0 software.
Results:
Thirty-eight study eyes (normal vision = 16 eye; abnormal vision = 22) from 20 participants with spastic
cerebral palsy were included. Majority were male participants (65%, n=13) and the mean age was 12.9
years (range from 7 to 29 years). Overall, there was no significant relationship between GCL-IPL thickness
(Mean = 97.3±17.8 μm) with visual acuity (Mean = logMAR 0.3±0.3) from Pearson correlation test.
However, GCL-IPL thickness was significantly different between participants with and without vision loss
[t (24.6) = -2.533, p <0.05].
Conclusions:
Ganglion cell layer thickness could potentially serve as a surrogate marker of vision for cerebral palsy
patients.

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2nd Ophthalmology Research Day- 2019

A8

An Audit Care of Ophthalmic Surgical Instruments At Ophthalmology Department Hospital
Sultan Abdul Halim

G Theibban, G., Zaharidah, A.K., Zakiah, Z., Mohd Rais Afham, M.R., Hasrizal, A., Rosnita, A.

Ophthalmology Department Hospital Sultan Abdul Halim

Introduction: Post-operative endophthalmitis is one of the most devastating post cataract surgery
complications since it may lead to irreversible blindness. Because of this, it is important to ensure proper
handling of ophthalmic surgical instruments starting from cleaning /decontamination, sterilization,
quality control up to sterile storage. Each step is important and essential to prevent infection. Our
department has also been observing this standard practice of care. Paramedics assisting cataract surgery
had in-house training of the standard care with refresher courses on maintaining sterility being held
regularly. However, despite this, there have been reports of surgeons facing some intra-operative
difficulties related to improper cleaning and handling of surgical instruments.

AIM: This audit is to identify the current practice and to identify factors which may cause improper
cleaning and handling of surgical instruments. The outcome of this audit will be used to draw a new
standard practice of care (SOP) for the department.

Methodology: The baseline study was conducted from 1st October until 28 November 2018 while the
second phase was from 7 January 2019 until 12 February 2019. The subjects were all paramedics assisting
in ophthalmology operating theatre. Each subject was observed by independent observers using 5 sets of
standard check list. Check list A for cleaning and decontamination, check list B for sterilization, checklist
C for quality control, check list D for sterile storage and check list E for phacoemulsification hand-piece
probing, irrigation and aspiration . Two sessions of intervention were given to all subjects in between the
two phases. All results were tabulated and analyzed using Microsoft Excel.

Results: A total of 17 subjects enrolled in this audit with 14 females (82%) and 3 males (18%). Seven
subjects (41%) are between 25-35 years old, eight (47%) between 35- 45 years old and only 2 subjects
(12%) between 45-55 years old. Thirteen subjects (76%) were diploma holder either in nursing or medical
assistant with the remaining 4 (24%) has post basic ophthalmology. The overall results for individual
checklist showed a lower achievement for the baseline which improves to satisfactorily level after
intervention before the second phase. In initial checklist A, from cleaning and decontamination where
only 76% are archived at the first result than after some recommendation and innovation the second was
achieve is higher at 96%. In check list B under sterilization, only 70% was achieved and after was up to
90%. Meanwhile, checklist C, under quality control achieves only 51%, than after was up to 94%. In next
stage of this study is sterile storage, where 88% was obtained then increase to 99%. The last stage is
cleaning Phaco hand piece where initial result show 74% and second result shows 97%.

Conclusion: This audit illustrated the importance of human factors in maintaining high standard of care.
Continuous monitoring, assessment and training of personnel is mandatory and should be included the
yearly appraisal for each staff. At the same time, the department should also explore newer techniques
for the whole process in keeping with newer technology while at the same time makes it more cost
effective.

Key Word- Instrument, Phaco hand piece, critical steps, Infection, Inovation

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2nd Ophthalmology Research Day- 2019
c

24

2nd Ophthalmology Research Day- 2019

B1

Audit: A Review of Cataract Pre-op Assessment Failure Rate, Reasons and Solutions
Chong Jia Cherng1,2, Azian binti Adnan2, Hanizasurana binti Hashim2
1Department of Ophthalmology University Malaya
2Department of Ophthalmology Hospital Selayang
Purpose:
To identify the reasons and patient’s failure rate during cataract pre-operative assessment and strategies
to prevent clinic appointment wastage and improve surgical output.
Method:
Retrospective analysis with data extraction from the electronic medical record.
Results:
Two-hundred-and-seventeen medical retina team cataract pre-operative clinic scheduling in the 4th
quarter of 2017 were appointed for 190 patients. A number of 102 (47%) out of these 217 scheduled
appointments failed to pass for surgery for various reasons including defaulters, sub-optimal co-morbidity
controls, change of decisions etc. Twenty-one out of these 190 patients were required to come at least
two to four times to the pre-op clinic within this period yet only 13 (61.9%) out of these 21 patients were
passed for surgery during these 3 months period.
Discussion:
Forty-seven percent of failure rate was a very significant wastage of clinic time. Of these 102 failures,
majority (at least 46%) of them are preventable, e.g. systemic reasons like uncontrolled blood pressure,
blood sugar and IHD, or ocular reasons like uncontrolled glaucoma, corneal issues etc. Repetitively failing
the assessment may have contributed to patient’s no-show, with one-third of defaulters had previously
failed the pre-op assessment. With large RCT studies have shown routine lab investigations or even ECGs
do not reduce perioperative risks in daycare surgeries under local anesthesia for asymptomatic patients,
pre-op clinics scheduling should at least be effective by avoiding patients who are not optimized for
surgery to avoid waste of clinic time, resources, and improve operating theatre utilization as well as
surgical output.

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2nd Ophthalmology Research Day- 2019

B2

The Status of Accommodation Before and After Active Near Work by Using Smartphone
Normalisa Muhammad Som1, Nurul Akimi Abdullah1, Nor Aisyati Ilias1, Nurhidayah Yusuf1, Puspha
R.Raman¹, Khairul Husnaini Khalid1.
1Department of Ophthalmology, Hospital Tuanku Ampuan Najihah
Purpose:
To investigate the effect of active near work by using smartphone on monocular amplitude of
accommodation and lag of accommodation.
Methods:
This is a cross sectional study. 28 normal eyes with bestvisual acuity of 6/6 with normal accommodation
function were enrolled. Subjects were asked to play a pre-selected game on a Samsung j7 Prime Series
smartphone for 30 minutes under standard room illumination. Monocular amplitude of accommodation
(AA) and lag of accommodation (MEM) of subjects were measured before and after the use of
smartphone.
Results:
The mean AA before active near work was 10.53 ± 7.0D and the mean AA after the near work was 9.95 ±
1.90D. For the lag of accommodation, the mean before and after the near work were 0.63 ± 0.19D and
0.70± 0.19D respectively. There was a significant reduction of AA after near work compared to baseline
(z = -2.59, p = 0.012). Besides, the lag of accommodation also significantly became more plus after the
active used of smartphone (z= -2.32, p = 0.020).
Conclusion:
The active near work with a smartphone for 30 minutes significantly affect the changes in amplitude of
accommodation and lag of accommodation.

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2nd Ophthalmology Research Day- 2019

B3
Nurses Perpsective In Handling The Multidose Of Keratitis Regime
Chieng LL, Rasyiqah M.Z
Department of Ophthalmology, Miri General Hospital, Sarawak

Purpose:
1) To assess the difficult level in explaining the eye drop keratitis regime among the nurses
2) To assess the stress level when dealing with multidrop of keratitis regime
Method:
Questionnaire among staff nurse from ward 6 and 7 who are managing eye patient in Miri General
Hospital
Results:
1) 11 out of 15 actually think it is moderately difficult only 2 of them think that is easy
2) The stress level is 6 out of 10
3) Only 11 out of 26 respondents always chart and plan for the whole day, while 6 of them never did it.
4) The difficulty level to explain the regime to patient is 5 to 7.4 out of 10
5) 14 out of 26 respondents wants a simpler and better chart while only 2 of them disagree
Conclusions:
1) There are plenty of opportunity for medication error in the current practice in administration of eye
drop regime
2) It is a timely universal,standardize chart is needed to be designed
3) Introduction of a new chart is to fill the gap for all the stake holders from physician,staff nurse and
most importantly to the patient.

Keywords: eye drop,stress level,staff nurse

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2nd Ophthalmology Research Day- 2019

B4

Retcam Imaging Screening Examination In Newborns

Stephanie F1, Israk I1, JessicaMPT1, ShuaibahAG1
1Department of Paediatric Ophthalmology, Hospital Wanita&Kanak-Kanak Sabah, Kota Kinabalu, Sabah,
Malaysia

Purpose
This study aims to review the prevalence, risk factors, characteristics of retinal hemorrhages (RH)
present in newborns at birth, Sabah Women and Children Hospital (SWACH).
Method
A cross sectional study of healthy term newborns within 24 hours after birth were screened using wide-
angle digital retinal photography (retcam) with the consent of their parents. Maternal and obstetric
factors were obtained from hospital records. The severity, location and laterality of retinal hemorrhages
(RH) were recorded.
Results
A total of 160 infants were enrolled in this study, consist of 47.5% (76) females and 52.5% (84) males.
Birth prevalence of RH was 25% (40). RHlocatedin periphery and posterior pole were 45%(18) and
55%(22) respectively. Majority of RH was bilateral 52.5%(21) of varying severity from mild 29.4%(5),
moderate 47%(8) and severe 47%(8).Vaginal delivery 41.3%(33)was the highest risk compared to
caesarean section 8.8%(7)with p value less than 0.001. There was statistically significant of RH (P=0.029)
among those delivered via instrumentation despite small sample size.
Conclusion
Birth related RH in newborns are common and majority were mild in severity and located at posterior
pole.Instrumental deliveries were highly associated with RH. Infants delivered via cesarean were less
likely to develop RH compared to those delivered by vaginal delivery. The longterm effect of RH on visual
development remainunknown.

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2nd Ophthalmology Research Day- 2019

B5

Microbial Profile of Endophthalmitis at Tertiary Care Hospital in Johor Bahru: A 6-Year
Retrospective Study
Hayatulrizal Muhd. Siow Su Yi, Ling Kiet Phang, Hooi Siew Hong, Francesca Martina Vendargon
Department of Ophthalmology, Hospital Sultanah Aminah, Johor, Malaysia

Purpose:
This study aimed to analyse the microbial profile and visual outcome of culture-positive endophthalmitis
seen in Hospital Sultanah Aminah Johor Bahru.

Method:
Retrospective review of medical and microbiology records was conducted among patients clinically
diagnosed with endophthalmitis in Hospital Sultanah Aminah from January 2014 until August 2019
Results:
Forty-six patients were admitted with endophthalmitis during this study period. Twenty three (50%) cases
were culture-positive, in which twenty-two (95%) cases were vitreous culture-positive and one (5%) was
blood culture-positive. The mean age for culture-positive patients at presentation was ±61 years. The
most common bacterial isolate was Pseudomonas spp., while the most common fungus was Penicillium
sp. Other organisms isolated were Klebsiella sp., Enterococcus sp., Staphylococcus sp., and Aspergillus sp.
The risk factors for culture-positive cases were intraocular surgery, ocular trauma, microbial keratitis,
ocular chemical injury and severe urinary tract infection. There were two patients with bilateral
involvement. Five eyes (20%) underwent pars plana vitrectomy and four eyes (16%) of underwent
evisceration. Only two eyes (8%) had a final Snellen visual acuity of better than 6/60 while thirteen eyes
(52%) were non-perceptive to light.
Conclusion:
In conclusion, culture-positive endophthalmitis in this study were mainly attributed to Pseudomonas spp.
and Klebsiella spp. The visual outcome of culture-positive endophthalmitis was poor.

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2nd Ophthalmology Research Day- 2019

B6

A 4 Year Retrospective Review of Infective Keratitis: An experience in Hospital Pulau Pinang
Nurul Izza Roslan , Ang Ee Ling , Nurliza Khaliddin
Department of Ophthalmology, Hospital Pulau Pinang , University Malaya Medical Center

Introduction :
Corneal blindness is the 4th cause of blindness globally ( 5.1%). Infective keratitis is a significant cause of
corneal blindness in developing country including Malaysia.
Objective:
To determine the demographic characteristics, predisposing factors, microbiological profile and final
visual outcome of infective keratitis in patients admitted from April 2016 to March 2019.
Methods:
Retrospective Observational study. Data was collected by reviewing the medical records. All patients were
examined under slit lamp biomicroscopy, underwent standard corneal scraping technique and sent for
microbiology analysis. Presenting and final visual acuity was taken by using Snellen Chart.
Results:
A total of 70 patients were included. Majority was Chinese 35 (50%) followed by Malay (27,38%). Mean
age was 52.9 year old. The most common predisposing factor was Ocular surface disease (29, 41.42%),
followed by Contact lens wear (14,20%) and trauma (13,18.57%). Corneal scrapping results were positive
in 31 (44.28%) cases. The most common organism was Pseudomonas aeruginosa (18, 58.06%) followed
by Fusarium sp. (4,12.9%). 37 cases (52.85%) were blind on presentation and 18 (28.12%) remain blind
after healed infective keratitis.
Conclusion:
Ocular surface disease was the most common predisposing factor for infective keratitis followed by
contact lens wear. The predisposing risk factor can help to determine the final visual outcome hence
requiring more aggressive therapy.

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2nd Ophthalmology Research Day- 2019

B7

Prevalence of Steroid induced high IOP among paediatric in Hospital Wanita Dan Kanak-kanak
Sabah (HWKKS)
Lim ZYHW1, Israk I2, Shuaibah AG1
1. Department of Ophthalmology, Hospital Wanita Dan Kanak-kanak Sabah
2. Department of Ophthalmoloy, Hospital Queen Elizabeth
Objective:
To evaluate the prevalence of steroid induced high intraocular pressure (IOP) among paediatric patients
who attended paediatric ophthalmology clinic in HWKKS
Method:
A total of 39 patients who have been started on steroid therapy were selected for this retrospective
cohort study from May 2018 until May 2019. IOP was measured with hand held rebound tonometry
(iCare) before steroid was initiated. Patient was diagnosed as steroid induced high IOP if IOP of 2 weeks
post-steroid treatment more than 21mmHg or increment of more than 6mmHg from the baseline. The
patients would be enlisted as study subject if they had a minimum of 2 follow-up. Patients would be
excluded if they had previous traumatic eye injury or co-existing intraocular ocular pathology. Data were
compared and analysed using SPSS version 20.
Results
23.1% (9 patients) had steroid induced high IOP and 79% was treated with dexamethasone 0.1% eye drop
with mean frequency of 5.6hrs (SD 2.9) and mean days of 20 (SD14.9). The mean IOP prior of starting
steroid is 15.5(SD 2.8) and upon follow up is 19.1(SD7.3). The mean change of IOP pre and post steroid is
3.6(SD 7.7).
Conclusions
Our study had a lower prevalence and lower mean increase of IOP after initiation of steroid compared to
other studies.

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2nd Ophthalmology Research Day- 2019

B8

Practice Of Solah Among Patients Who Had Cataract Surgery In Ophthalmology Department
Hospital Sultan Abdul Halim

Ahmad Nadzirin Y, Hasrizal A, MohdRaisAfham MR, Zaharidah AK, MohdNadzri MK, Zahanim S, Zakiah Z,
Nor Hazlina O, UmiKalsum AR, Marzura O, Nor Haslina M, Rokiah H, Wahidah AR, Siti Azura J, Rosnita A,
Siti Hajar MA, Vinuthinee N, Fang SY, Hanisah AH.

Ophthalmology Department Hospital Sultan Abdul Halim

Introduction:

Muslims are required to perform obligatory solah five times a day even during sickness when modification
of solahwhich is known as rukhsah is allowed. In term of cataract surgery, the small surgical incision of
phacoemulsification not only resulted in better visual outcome but also early recovery requiring minimal
post operative restriction. This minimal restriction makes rukhsahunnecessary for most post operative
cases.

Objective:

To assess the knowledge and practise of performing obligatory solah after cataract surgery.

Methodology:

Respondents were Muslim patients who attended Post Operative Clinic at Ophthalmology Department
Hospital Sultan Abdul Halim from 8th March until 6th June 2018. All respondent went through full ocular
examination followed by interview using a standard set of questionnaire assessing their knowledge
performing solah during illness as well as their own practice of solah before, on the day of surgery and
after surgery. Data were analysed using SPSS version 22.0.

Results:

total of 133 Muslim respondents attending Post Operative Clinic Ophthalmology Department Hospital
Sultan Abdul Halim, who agreed to participate were included in the study. The results showed high level
of knowledge performing solah during illness with mean value of 3.90. However, the implementation of
obligatory solah was not satisfactory with only 64.7% performed before surgery, 48.1% on operation day
and 69.2% after surgery. The main barriers were lack of time and sickness. Pearson Chi Square analysis
showed significant relationship only between knowledge and implementation of solah after surgery
(p=0.039). Seventy percent of the respondent who did not modify on how they perform solah post
operatively did not show any ocular sign (such as alteration of surgical wound integrity or decentration of
intra ocular lens) suggestive of possible side effects due to changes of body posture during solah or
wudhu.

Conclusion:

Majority of patients have good knowledge on performing solah during illness. However improved
technique of counselling is required in order to increase their level of understanding towards rukhsah and
subsequent practice of performing solah after cataract surgery.

Key words: Cataract, Solah

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2nd Ophthalmology Research Day- 2019
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2nd Ophthalmology Research Day- 2019

C1

Refractive Outcomes in preterm baby with and without ROP in Hospital SultanahNurZahirah
Nirna Hazeera Zahar, Nurul Munirah Mohamad, Mohd Mustaqim Zulkifli Martin, Ahmad Kamal Ghanimi
Zamli, Siti Nor Zalehawati Sepian
Department of Ophthalmology, Hospital Sultanah Nur Zahirah
Introduction
Retinopathy of prematurity (ROP) is one of leading cause childhood blindness and can be associated with
refractive error such as myopia, astigmatism, and anisometropia. This study was aimed to evaluate the
refractive outcome and the risk factor of visual outcome in preterm babies with or without ROP.
Method
A retrospective review of the electronic medical record from January 2015 to December 2018 of preterm
babies were analysed. Preterm babies were classified into those without ROP, regressed ROP and laser
treated prethreshold ROP. Cycloplegic refraction was taken at 1 year.
Results
Study showed, 128 patients were identified, in which 21 of them had ROP (mean gestational age 27.3
weeks± 2.5). In babies with ROP, both treated and regressed ROP groups tend to get myopia with 25%
and 28% respectively, if compared to those without ROP(6.6%), (p = 0.04). Babies with treated ROP also
tend to get higher astigmatism if compared to babies with regressed ROP or no ROP (mean cylinder -1.21±
1.6, p=0.019).
According to birth weight, there are no significant correlation between extreme birth weight (<1kg) and
extreme preterm (<30 weeks) with refraction errors(sphere p = 0.26, astigmatism p = 0.7, spherical
equivalent p= 0.4).
Based on risk factor intraventricular haemorrhage had 3.4 times risk developing ROP, p = 0.03.
Conclusion
This study showed patient with ROP tend to get myopia .ROP status was a predictive factor for refractive
errors. Therefore, babies with ROP should be screened for refractive error later.

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2nd Ophthalmology Research Day- 2019

C2

The measurement of ocular parameter using IOL MASTER 700 on cataract patient before and
after dilatation
Siti Jalia Jumadi, Nor Emalina Suleiman, Mohamad Farid Othman, Nurul Hafizah Mohd Norizan, Raja
Norliza Raja Omar.
Department of Ophthalmology, Hospital Melaka

Objective:
To measure the ocular parameter among patients with cataract using IOL MASTER 700 before and after
dilated.
Methods:
This study was cross sectional study. Participants 50 years old and above who had cataract were screened
for inclusion criteria via Visual Acuity (VA) and ocular health examination. 79 eyes from the participants
underwent Keratometer reading (K), Anterior Chamber Depth (ACD), Center Cornea Thickness (CCT) and
axial length (AL) measurement using IOL MASTER 700 before dilatation. The same measurements were
repeated after 45 minutes dilatation. Mean of the average K, ACD, CCT, AL and Intraocular Lens (IOL)
power using Sanders/Retzlaff/kraff Theoretical (SKT) formula before and after dilatation were compared
using Paired T-Test.Agreement between measurement modes (with and without dilatation) was assessed
through Intraclass Correlation Coefficients (ICC).
Result:
Mean age 67.11 + 6.96 years (Range 52 – 80). Of the variables determined, ACD and AL varied significantly
according to pupil dilatation. Excellent Intraclass Correlation was observed between measurement made
before and after dilatation.
Conclusion:
The use of pupil dilatation produces no significant impact in all parameters using IOL Master 700.

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2nd Ophthalmology Research Day- 2019

C3

Visual outcomes of Paediatric Cataract Surgery in Hospital Melaka, a 6-year review
Ting Xiao Wei1, Chan Chin Shern1, Nor Fadzillah Abdul Jalil1, Raja Norliza Raja Omar1, Julieana
Muhammed2
1Department of Ophthalmology, Hospital Melaka
2 Hospital Universiti Sains Malaysia, School of Medical Sciences

Objective:
To describe the clinical profile and visual outcome of paediatric patients who underwent cataract surgery
in Hospital Melaka.
Method:
Retrospective review of cases notes of all paediatric patients who underwent cataract surgery in Hospital
Melaka from January 2013 to December 2018. Patients were recruited if they had a minimum of six
months post-operative follow up. Demographic data, indication, target spherical equivalence, post-
operative outcome, including visual acuity, refraction and complications were recorded.
Results:
A total of 37 eyes of 25 patients were reviewed. The mean age of patients at surgery was 10.8 years old.
There were 15 male patients and 10 female patients. The majority of the patients had congenital cataract,
(n=17,46%), followed by subluxated lens secondary to Marfan’s syndrome, (n=10, 27%), (n=9,24%) had
traumatic cataract and (n=1, 2%) had steroid induced cataract. All but 2 patients had intraocular lens
implanted. Among them, all had target refraction aimed at emmetropia. At 1-month post op, 87% patients
achieved target spherical equivalence within 1 dioptres. Eighty percent of patients achieved final
corrected visual acuity of 6/12 and better. Two patients developed amblyopia.
Conclusion:
Cataract is the leading cause of reversible blindness in children. Its management has always been a
challenge among ophthalmologists and requires the involvement of multiple parties, including doctors,
optometrist and the parents. Aside from surgery, visual rehabilitation is important to ensure good long
term visual outcome.

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2nd Ophthalmology Research Day- 2019

C4

Diabetes And Diabetic Retinopathy (Dr): Knowledge, Attitude, Practice (Kap) Among Diabetic
Patients In Their First Visit To Eye Clinic, Hospital Melaka
Felicia FYC, Kathy LYL, Goh YK, Anhar Hafiz, Raja Norliza RO, Nor Fadzillah AJ
Department of Ophthalmology, Hospital Melaka

Introduction:
In Malaysia, diabetic eye disease is the commonest cause of irreversible visual loss in the adult-working-
age-group. This study aims to evaluate the knowledge, attitude, practice (KAP) towards diabetes and
diabetic retinopathy on their first visit to eye clinic. The potential confounding variables and perceived
barriers to come for eye care service were identified.
Methodology:
A prospective, cross sectional study was conducted in the ophthalmology new-case clinic, Hospital Melaka
from September 2018-November 2018(3 months). Total of 460 eligible participants were included in the
study. A validated questionnaire comprised 45-point was used. Patients were classified into good/poor
knowledge; positive /negative attitude and good/poor practice. The associations between the KAP and
demographic data were analyzed using chi square & binary logistic regression. Complete ocular
examination performed and fundus camera were taken.
Results:
This study reported only 9% patients(n=460) had a good knowledge regarding diabetes and DR. The
prevalence of DR was 32% with majority (61%) in adult-working-age-group (18-64 years) and 2% were
blind at diagnosis. The married patients were significantly associated with positive attitude towards
diabetes and good practice towards DR. Patients with retinopathy and good diabetes control were
significantly associated with good practice for DR. (p<0.01) The commonest barriers identified were
patient unaware the need of diabetic eye screening and did not find it necessary as they had good visions.
Conclusion:
It was important to educate the diabetic patients on knowledge of diabetes and DR. Appropriate
measures should be initiated to reinforce on KAP in this group of patients so that early blindness could be
prevented.

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2nd Ophthalmology Research Day- 2019

C5

Neovascular Glaucoma : Progression or regression?
Radtthiga C. Josephine L.E.H.,Chong M.F.,Adil H., Azhany Y., Suresh S.
Hospital Raja Permaisuri Bainun, Ipoh Perak

Purpose :
To describe the demography,ocular comorbidities and clinical outcome of patients with neovascular
glaucoma
Method :
Retrospective study of neovascular glaucoma patients from 1 January 2018 till 30 June 2018
Results:
A total 23 patients presented to HRPB during the period. Among the patients seen in HRPB, majority were
males (61%). Neovascular glaucoma is more prevalent in patients aged less than 50 years old (73.9%).
87% of patients had systemic comorbidities such as Diabetes, hypertension and dyslipidemia. Proliferative
diabetic retinopathy attributes as a cause to neovascular glaucoma in 15 patients (65%),followed by
central retinal vein occlusion(30%).Among diabetic patients with NVG, nearly half were already followed
up since they were in moderate non proliferative diabetic retinopathy(NPDR) stage (46.7%), while the
other half only presented at proliferative diabetic retinopathy stage(53.3%). Almost all patients presented
with a stage 2 NVG to eye department upon diagnosis with 52% had vision worse than 6/60 (52%) About
17.4% of the patients had no perception to light during the first visit. Majority of the patients (87%) were
started on maximum topical antiglaucoma medications to control the intraocular pressure (IOP). Patients
who had pan retinal photo coagulation (PRP) at initial stage appeared to have better visual outcome.
Despite this, one third of the patients had undergone glaucoma drainage device implantation to optimise
the IOP. Poor visual outcome was seen in patients who defaulted treatment and presented late (bilateral
PDR and CRVO). About 3 patients have defaulted follow up.
Conclusion:
Diabetic retinopathy has significant impact in the progression of neovascular glaucoma among our
patients. Early and effective treatment such as PRP and optimisation of comorbidities could halt the
progression of NVG into devastating complications such as blindness.

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2nd Ophthalmology Research Day- 2019

C6

ROSE K XL for irregular corneal patient in Ophthalmology Department, Hospital Sultanah
Aminah,Johor Bahru, Johor : Benefit to patient
Siti Nurul Ashiken Chahar Nordin, Fadhliah Husin, Nur Faiza Jaafar, Norhayati Minhaj, Samsuhaibah
Kasbol, Noorfarina Fadil, Nora Norzareen Abdul Razak, Nabilah Mohd Yussuf
Optometry Unit, Ophthalmology Department, Hospital Sultanah Aminah, Johor Bahru, Johor

Purpose :
To evaluate the benefit of Rose K XL contact lens fitting for irregular corneal patient in Ophthalmology
Department, Hospital Sultanah Aminah,Johor Bahru.
Methods :
Single center retrospective review of 16 eyes successfully fitted with Rose K XL contact lens from
November2017 to August2019. Data were collected during preliminary examination and delivery session,
using standard data collection form.
Results :
16 eyes of 12 patient aged from 16 to 38 years old were fitted with Rose K XL trial lens. 10 (83%) were
male and 2 (17%) were female with majority were Indians (50%), followed by Malays (33%) and Chinese
(17%). 14 eyes were keratoconus and 2 eyes were postpenetrating keratoplasty. 12 (75%) eyes were
never fit with any contact lens, while the other 4 (25%) eyes referred from other hospitals had fitted the
Rose K XL. Average visual acuity without correction were 1.4±0.39 logMAR with average keratometer
reading were 5.79±0.81mm. Average visits required to complete the fitting process were 1.42±0.51 visits.
Out from 14 eyes fitted, 2 eyes needed to refer to others hospital for wider range of trial set fitting, 1 eyes
were prescribed as same as of the trial lens while 13 eyes required parameter adjustment. Average base
curve and diameter prescribed were 6.12±0.2mm and 13.91±0.37mm, respectively. During delivery
session, average visual acuity with contact lens were 0.30±0.21 logMAR. Only 4 lenses need to return for
alteration.
Conclusion :
Rose K XL trial fitting set can give a lot of benefit to patient in Hospital Sultanah Aminah. 14 patients were
successfully fitted with acceptable visual acuity improvement, with minimum trial fitting session.

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2nd Ophthalmology Research Day- 2019

C7

A three-year study of toric intraocular lens implantation in cataract cases with pre-existing
astigmatism
Fahim J1, Woon Tian Qing1,3, Fadzlina AR1, Raja Norliza1, Nor Fadhilah Mohamad2
1Department of Ophthalmogy Hospital Melaka
2Pusat Perubatan University Malaya
3Hospital Canselor Tunku Mukhriz
Purpose:
To evaluate the post-operative visual outcome of toric intraocular lenses (IOL) to correct pre-existing
astigmatism in cataract patient.
Methods:
Phacoemulsification with implantation of a toric IOL (Ankoris, SN6AT and AT Torbi) was performed in
cataract patients with corneal astigmatism. The postoperative follow up was up to 6 months.
Result:
This study enrolled 85 eyes of 63 patient from January 2016 to December 2018 with mean age of patient
age at the time of surgery was 66.32 years ± 14.56 (Range= 22 to 87). The median visual acuity
preoperatively was 0.25 ± 0.3 (Range=0.0052 to 0.8000). 3-month postoperatively the median of visual
acuity 0.8 ± 0.3 (Range=0.3000 to 1.000). There was statistically significant difference between
preoperative and 3-month postoperative visual acuity (Z=-7.925, P<0.001 Wilcoxon signed-rank test). A
wilcoxon signed-rank test indicated that the median post-operative refractive cylinder, median= -0.75 ±
0.50 was statically reduced compared to median pre- operative cornea astigmatism, median= -2.20 ± 1.19.
The median post-operative spherical equivalent (SE) was -0.375D ± 0.56;70.6% of eyes operated were
between ± 0.5D and 90.6% were between ± 1.0D.
Conclusion:
Toric IOL were effective in improving visual acuity by reducing pre- existing cornea astigmatism

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2nd Ophthalmology Research Day- 2019

Guest of Honours
Delegates
Allergan
Novartis
CREaTE
Crews

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2nd Ophthalmology Research Day- 2019
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