Assessing The Agreement Between Smartphone Color Vision Application And The Ishihara Color Vision Plate 1. Color vision test commonly used in clinical practice is Ishihara test. 2. Nowadays, the development of smartphone application have evolved which can allow color vision assessment easier. 3. In Malaysia, those who intended to obtain driving license must pass Kurikulum Pendidikan Pemandu (KPP) test. 4. Smartphone application KPP Test 2023- KPP01 JPJ is an application develop by Apicel which includes color blind test and is 99% similar to the real KPP test(1) 5. The agreement between this application with Ishihara test was never been study in our practice yet. 1. To determine the specificity and sensitivity of smartphone color vision application 2. To determine the agreement of smartphone color vision application with Ishihara color vision plates METHODOLOGY 1. Cross sectional study. 2. Study Procedures (Flow Chart 1). 3. Analysis: Specificity and sensitivity using Crosstab, One Sample Test and agreement assessment using Bland & Altman. Nooraishah Md Yusop1 , ‘Afifah Kamarudin1 ,Nur Hafiza Ab Rahim1 , Hazliyati Hassan1 , Siti Jalia Jumadi1 ,Nor Emalina Suleiman1 , Nurul Hafizah Mohd Norizan1 , Nurulfaiz Rahmat1 , Zafira Khairunnisa Zaman2 , Eryanti Md Omar1 1Ophthalmology Department Hospital Melaka, 2Klinik Kesihatan Peringgit. INTRODUCTION OBJECTIVE Demographic data: n=101, mean age 26.9 + 1.12 years (25 years -28 years) NMRR ID-23-00824-R76 53% female 47% male 82% normal 16% deutan 2% protan Gender Distribution Color Vision Status DISCUSSION & CONCLUSION Our study showed a significant difference between these 2 test. Possible reasons for the discrepancies are: 1. Different in plates design, size, contrast and color saturation. Plate size variation measuring 85mm in the Ishihara booklet and 45mm in the smartphone(2). 2. The test design has a multiple choice and the allowance only one plate-error to be made before diagnosing colour deficiency(2) . 3. Brightness can be controlled in Ishihara booklet by testing with similar lighting conditions, while in smartphone application, different smartphone screens have different brightness setting (3) . In conclusion, smartphone application testing for colour vision test are shows low specificity and high false positive rate, limiting their usefulness for clinical use. Therefore, it may be recommended for software designers to provide evidence of validations performed and users should seek evidence of those validations before using these apps to interpret color vision status. ACKNOWLEGDEMENT 1. Dr. Juliana binti Jalaluddin ( Head of Ophthalmology Department, Hospital Melaka) 2. Dr. Zaharimah binti Abdul Kadir( Director of Hospital Melaka) 3. Dr. Azman bin Othman, (Administerative Medical Officer Klinik Kesihatan Peringgit) 4. Clinical Research Centre (CRC) Hospital Melaka and Medical Research and Ethics Committee (MREC) Flow chart 1: Study method 1. KPP TEST 2023- KPP 01 VERSION 3.3.2 2. Sorkin N et al. Comparison of Ishihara booklet with color vision smartphone applications. Optometry and Vision Science, Vol. 93, No. 7, July 2016. 3. Khizer M.A et al. Smartphone color vision testing as an alternative to the conventional Ishihara booklet. Cureus 14(10),October 27,2022. REFERENCES Figure 1: Bland and Altman plot of mean smartphone color vision application and Ishihara Inferential statistics Sensitivity Specificity Mean difference (SD) P value* 100% 51.8% 7.622 (± 25.71) P= 0.004 RESULT *One Sample Test
The Aetiologies and Current Prescribing Pattern of Patients at Sibu Hospital’s Low Vision Clinic Mohammad Ridzwan Bihem1 , Liong Swee Lee1 , Ilyana Rosli1 , Lim Thiam Hou1 , Akmal Kamaliah Badrulhisham1 & Nazaryna Marzuki2 1Department of Ophthalmology, Sibu Hospital, Sibu, Sarawak 2Department of Ophthalmology, Sarawak General Hospital, Kuching, Sarawak Poster ID (08) Introduction Low vision and blindness can affect an individual's visual system and functions, that can be caused by certain eye diseases[1] . Low vision rehabilitation can help those patients utilise their residual vision in order to improve their quality of life and live independently[2] . One of the management strategies used in low vision rehabilitation involves prescribing low vision devices. Identifying the aetiology and prescribing pattern of low vision devices could contribute to better management of patients with visual impairment. This study aimed to determine the causes of low vision and blindness and the types of low vision devices prescribed among patients in the Low Vision Clinic at Sibu Hospital. Objectives This retrospective study retrieved data from existing medical notes of new patients who attended Low Vision Clinic at Sibu Hospital from January 1 st , 2019 to April 30th , 2022. Information retrieved were age, ethnicity, gender, types of low vision devices prescribed and causes of low vision and blindness. Methodology 1. This study enrolled 40 patients ranging in age from 7 to 75 years old (the mean age was 39.5±17.81 SD). 2. Gender and ethnicity distribution Results 52% 48% Male Female Malay 12% Chinese 30% Iban 45% Melanau 13% 33.30% 19.00% 9.52% 9.52% 4.76% 9.52% 4.76% 4.76% 4.76% Retinitis pigmentosa Diabetic retinopathy Retinal detachment Stargardt's disease Age-related macular degeneration Macular scar Macular hole Choroidal retinal atrophy Myopic degeneration 4. Frequencies of occurrence for different types of retinal diseases 52% 22% 3% 18% 5% Retinal diseases Neurological causes Corneal diseases Glaucoma Albinism 3 (11.1%) 4 (14.8%) 4 (14.8%) 6 (22.2%) 10 (37%) Stand magnifier Spectacle magnifier Telescope Handheld magnifier Video magnifier 5. Types of low vision devices prescribed Retinal diseases (n=21;52%) were the major cause of low vision and blindness; whereby retinitis pigmentosa appeared to be the leading cause of retinal diseases in patients (n=7; 33.2%). The results are similar to previous studies[4,5] yet distinct to a study conducted at a facility without an ophthalmology service which offers cataract surgery service[3] . This implies that cataract surgery is crucial in reducing preventable low vision and blindness. More than half of the patients received low vision device prescriptions (n=23;57.5%). The video magnifier is commonly prescribed, as supported by a recent study[3] , but contradicts an older study in 2008[4] . This indicates increased availability and affordability of good-quality video magnifiers in recent years. Discussion 3. Causes of low vision and blindness To address the hereditary nature of retinitis pigmentosa, it is recommended to conduct eye screening and raise awareness among family members through campaigns. Lastly, third-party involvement and engagement are crucial to ensure easy accessibility and subsidised availability of low vision devices for patients. Conclusion Acknowledgement I would like to express my heartfelt gratitude to my colleagues and the head of Ophthalmology Department, Sibu Hospital for their valuable guidance throughout every step of the process. References 1. World Health Organization. (2019). World report on vision. Switzerland: World Health Organization. 2. Agarwal, R. & Tripathi, A. (2021) Current modalities for low vision rehabilitation. Cureus 13(7): e16561. doi:10.7759/cureus.16561. 3. Amirah, W. N. A. & Razif, N. S. (2022). The etiology and pattern of low vision patients in UiTM. Malaysian Journal of Medicine and Health Sciences, 18(SUPP15), 233-239. 4. Omar, R., Knight, V. F., & Mohammed, Z. (2008). The causes of low vision and pattern of prescribing at UKM low vision clinic. Jurnal Sains Kesihatan Malaysia, 6(2), 55-64. 5. Qutishat, Y., Shublaq, S., Masoud, M., & Anuman, N. (2020). Low vision profile in Jordan: A vision rehabilitation center-based study. Healthcare 2021, 9(20).
CHANGES IN CORNEAL THICKNESS AND KMAX VALUE BEFORE AND AFTER 6 MONTHS UNDERGOING CXL : CASE REPORT Suzana Ahmad* , Normalisa M.Som , Tengku Zalikha T.Husin , Khurul Ain M.Anas , Dr. Asmah Ahmad Department of Ophthalmology, Hospital Tuanku Ja’afar Seremban Keratoconus is a specific type of corneal ectasia in which the cornea thins and weakens1 . Treatment for keratoconus include glasses, contact lenses and corneal cross linking (CXL). CXL is used to strengthen the cornea and halt the progression of keratoconus2,3 . This case report describes the changes in corneal thickness and maximum-K reading (Kmax) value before and after 6 months undergoing CXL. INTRODUCTION DISCUSSION CONCLUSION REFERENCES 1. Santodomingo-Rubido, J., Carracedo, G., Suzaki, A., Villa-Collar, C., Vincent, S. J., & Wolffsohn, J. S. (2022). Keratoconus: An updated review. Contact Lens and Anterior Eye, 45(3), 101559 2. Xu, K., Chan, T. C. Y., Vajpayee, R. B., & Jhanji, V. (2015). Corneal collagen crosslinking: A review of clinical applications. Asia-Pacific Journal of Ophthalmology. 3. Duncan, J., & Gomes, J. A. (2015). A new Tomographic Method of Staging/Classifying Keratoconus: The ABCD Grading System. International Journal of Keratoconus and Ectatic Corneal Diseases, 4(3), 85–93. 4 .Maier, P., Reinhard, T., & Kohlhaas, M. (2019). Corneal Collagen Cross-Linking in the Stabilization of Keratoconus. Deutsches Arzteblatt International, 116(11), 184–190 5. Saraç, Ö., Kars, M. E., Temel, B., & Çağıl, N. (2019). Clinical evaluation of different types of contact lenses in keratoconus management. Contact Lens and Anterior Eye Corneal Topography Before CXL Corneal Topography After CXL Kmax change after CXL: 1.8D Corneal thickness change after CXL: 7.5% (28µm)
Methodology Acknowledgement References EARLY CHANGES IN QUALITY OF LIFE AFTER MONOVISION LASER REFRACTIVE SURGERY Nurul Maisarah Mohd Taha1* , Azuwan Musa2 , Md Mustafa Md-Muziman-Syah1 , Khairidzan Mohd Kamal2 1Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, 2Department of Ophthalmology, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang. ID No: IREC 2022-155 Research and Ethical Approval Prospective Longitudinal Study (n=44) Pass Inclusion & Exclusion Criteria Preoperative visit Monovision Laser Refractive Surgery Postoperative visits Inclusion Criteria ❑ Myopic presbyopes range 35 to 45 years old [1] ❑ Healthy and do not have any active and unstable pathologies [2] Exclusion Criteria ❑ Non-presbyopic individuals ❑ Mentally ill The pre- and presbyopic patients have been treated with photorefractive keratectomy, PRK (n=22) and femtosecond laser in situ keratomileusis, FS-LASIK (n=22). The dominant eye was corrected for distance vision and the non-dominant eye was corrected for near vision by adding +0.50D to +1.50D sphere to the final manifest distance refractive power. Patient satisfaction is the key to vision-correcting surgery; hence apart from objective visual assessments, quality of life (QoL) assessment is an added value that offers a detailed evaluation of patient outcomes. Purpose: To investigate the impact of monovision laser refractive surgery on the quality of life (QoL) of pre- and presbyopic patients during preoperative and three postoperative follow-up visits. • QIRC questionnaires [3] • QIRC questionnaires Within 2-week (Po1) 1-month (Po2) 3-month (Po3) 1. Braun, E. H. P., Lee, J., & Steinert, R. F. (2008). Monovision in LASIK. Ophthalmology, 115(7), 1196–1202. https://doi.org/10.1016/j.ophtha.2007.09.018 2. Kandel, H., Khadka, J., Lundström, M., Goggin, M., & Pesudovs, K. (2017). Questionnaires for measuring refractive surgery outcomes. Journal of Refractive Surgery, 33(6), 416–424. https://doi.org/10.3928/1081597X-20170310-01 3. Garcia-Gonzalez, M., Teus, M. A., & Hernandez-Verdejo, J. L. (2010). Visual outcomes of LASIK-induced monovision in myopic patients with presbyopia. American Journal of Ophthalmology, 150(3), 381–386. https://doi.org/10.1016/j.ajo.2010.03.022 4. Klokova, O. A., Sakhnov, S. N., Geydenrikh, M. S., & Damashauskas, R. O. (2019). Quality of life after refractive surgery: ReLEx smile vs Femto-LASIK. Clinical Ophthalmology, 13, 561–570. https://doi.org/10.2147/OPTH.S170277 Result This study involved 12 males and 32 females with 6 patients from low myopia (<-3.00D), 8 patients from moderate myopia (-3.00D to -5.00D) and 8 patients with high myopia (>-5.00D). The objective visual assessments such as distance visual acuity, contrast sensitivity and stereopsis between pre- and within 2- week postoperative visits were statistically significant with p<0.05. Items Questions Pre vs Po1 Po1 vs Po2 Po2 vs Po3 Q1 Driving* Q2 Tired* Q3 Sunglasses* Q4 Think* Q5 Waking* Q6 Swimming* Q7 Gym* Q8 Cost* Q9 Maintenance* Q10 Rely Q11 Vision* Q12 Complications Q13 UV Q14 Looked best* Q15 Others* Q16 Complimented* Q17 Confident* Q18 Happy* Q19 Able Q20 Eager Table 1: QIRC item scores before and after monovision laser refractive surgery (n=44). Discussion/Conclusion Variable PRK Mean (SD) FS-LASIK Mean (SD) t-statistic (df) p-value Pre 38.57 (4.80) 39.79 (4.08) -0.90 (42) 0.372 Po1 42.78 (7.26) 45.60 (4.84) -1.51 (42) 0.138 Po2 44.17 (5.65) 47.95 (5.88) -2.17 (42) 0.036* Po3 47.31 (8.22) 50.84 (7.57) -1.48 (42) 0.146 Introduction Table 2: The QIRC total scores between PRK (n=22) and FS-LASIK (n=22). Figure 1: The means of QIRC total scores (n=44). p<0.001* p<0.001* p=0.087 p<0.001* p=0.024* p=0.001* Note: *ANOVA: p-value is significant, : Paired t-test, p<0.05 as significant 95% CI Special thanks to the team of laser refractive surgery “ LASIK Team”, IIUM Eye Specialist Clinic for all the support and encouragement during the data collection process. • Every postoperative visit showed an escalation in the overall QIRC score. The higher the total score of Quality of Life Impact of Refractive Correction (QIRC), the lower the level of anxiousness and the better the patient satisfaction as well as QoL after performing the surgery. [4] • Monovision correction by laser refractive surgery improved the patient’s QoL and visual quality in early postoperative visits among pre- and presbyopic patients. • However, there are only two patients (5%) who have a decrement in overall QIRC total scores in 3-month postoperative surgery. Nevertheless, the visual quality remains unchanged, especially within 2-week to 3-month postoperatively.
KPM.600-3/2/3-eras(14628) NMRR ID-23-00109-XEB (IIR) SPECTACLE WEAR AMONG PRIMARY SCHOOLCHILDREN IN MUAR, JOHOR- AFFORDABILITY Ungku Noor Aqilla Ungku Hassan*1 , Roziana Sumardi1 , Rasyida Awang1 , Norhuda Md Yusof1 , Suhada Ahmad Suhaimi1 , Effendy Bin Hashim2 1 Hospital Pakar Sultanah Fatimah, Muar - Johor 2 Ministry of Health Malaysia (Optometry Officer) Poster ID font size (28) NMRR ID-23-00109-XEB (IIR) 1. Pejabat Pendidikan Daerah Muar. 2. Clinical Research Centre, Hospital Muar. Children with refractive error commonly experience changes in their spectacle prescription because eyes and vision continuously change while growing. For schoolgoing children needing frequent changes of refractive correction with spectacles, this may cause additional economic stress to those who belong to families with lowincome status. 1,2 1. A first random-sampling survey (Google Forms) was conducted among public primary school administrators in Muar, Johor to gain access to the parents of the schoolchildren wearing glasses between February to March 2023. 2. A second convenient-sampling survey (Google Forms) was administered among those parents with contacts between March to April 2023 to maximize responses. 3. To improve the response rate, administrators and parents were approached via WhatsApp, telephone, and e-mail with assistance from the District Education Office. Descriptive analysis was performed using Microsoft Excel 2019. 1. To investigate the price of a pair of spectacles in Muar, Johor. 2. To investigate the frequency of spectacles changes among schoolchildren in Muar, Johor. 3. To describe the family income status of the children wearing spectacles in Muar, Johor. Introduction Objectives Methodology 82.7% (182/220) afford to purchase only pair/year Gross Household Monthly Income RM4,958.41 (SD∓ RM4016.34) NMRR ID-23-00109-XEB (IIR) Total: 220 parents from 19 primary schools were included in this study Results 60.50% 19.10% 20.50% once or more times in 1 year once in 2 years once in 3 or more years Spectacl es Change School Children Acknowledgement 1. The price of one pair of spectacles for schoolchildren is higher than the expected affordable price for the majority of respondents in Muar. 2. Only one out of five respondents able to change more than one pair of spectacles per year. 3. The price and frequency of spectacles change for schoolchildren were highly dependent on their family income. 1. Malvankar-mehta, Monali S et al. 2018. “Cost and Quality of Life Overlooked Eye Care Needs of Children.” Dove Press Journal 11: 25-33. 2. Zhang, Xinzhi et al. 2012. “Unmet Eye Care Needs among U.S. 5th-Grade Students.” American Journal of Preventive Medicine 43(1): 55-58. References 0 500 1000 1500 0 500 1000 1500 2000 Expected Affordable Spectacles Price (RM) Actual Spectacles Purchase Price (RM) r= +0.674, p-value =1.9 x 10＾-30 0 10000 20000 30000 40000 0 500 1000 1500 2000 Estimated Gross Monthly Income (RM) Actual Spectacles Purchase Price (RM) r=+0.266, p-value=.000066 VS Actual Spectacles Purchase Price : RM 375.94 (SD∓RM237.19) Expected Affordable Spectacles Price : RM 210.50 (SD∓RM122.55) Discussion/Conclusion SPECTACLES CHANGE FOR SCHOOL CHILDREN
RESEARCH POSTER PRESENTATION DESIGN © 2022 www.PosterPresentations.com Uncorrected refractive error is the predominant cause of reduced vision in children1 . It can affect their daily life, including difficulty in studying and if it is left untreated at an early age, it not only causes amblyopia but also other problems in the future. Based on National Eye Survey (NESSII) that was conducted in 2018, it was reported that Sabah has one of the highest prevalence of visual impairment due to poor access to ophthalmological services3 . Thus, this study is carried out to investigate the common types of refractive error(RE) among students who are referred to HDOK by Health School Service Unit (UPKS). The knowledge of the prevalence refractive error would be helpful in planning of public health strategy. Muhammad Iqbal Basri 1 , Nur Hafizah Mat Jalil 1 , Najwa Munirah Mohd Yussoff 1 , Norina Abd Ghafor 1* 1 Ophthalmology Department, Hospital Duchess of Kent (HDOK) Refractive Error Findings in Students Who Failed School-Based Vision Screenings at Hospital Sandakan (HDOK), Sabah. INTRODUCTION METHODOLOGY CONCLUSIONS OBJECTIVES REFERENCES ACKNOWLEGDEMENT A total of 228 students were analyzed in this study. • Almost 2/3 of the students had clinically significant refractive error and any refractive error with suburban community had higher risk of acquiring myopia. • The detection of refractive error and prescription for glasses provided by the vision program helped a significant percentage of students who might not have accessibility to it. • Thus, this demonstrated that the screening program by UPKS had a significant impact on identifying students with vision problems. • Regular eye screening would also lead to increase awareness of myopia in school age children and may increase the proportion of children seeking care appropriately. • An improved eye care delivery system and public health policies are required in the future. 1. Maul E., Barroso S., Munoz S.R., Sperduto R.D., Ellwein L.B., 2000. Refractive error study in children: results from La Florida, Chile. AM. J. Ophthalmol. 129, 445–454. 2. Guo X, Angeline M.N., Hursuong V, et al (2021). Refractive Error Findings in Students Who Failed Schoolbased Vision Screening. Ophthalmic Epidemiology. https://doi: 10.1080/09286586.2021.1954664. 3. Chew F.L.M, Salowi M.A, Mustari Z, et al. Estimates of visual impairment and its causes from the National Eye Survey in Malaysia (NESII). Plos one. 2018 ;13(6):e0198799. DOI: 10.1371/journal.pone.0198799. PMID: 29944677; PMCID: PMC6019397. • To find out the general types of refractive status among students in Sandakan Division. • To determine the risk factors associated with the refractive error among students in Sandakan Division. We gratefully acknowledge the contributions of the individuals of Health School Service Unit (UPKS). Figure 2: Proportions of students with myopia, hyperopia, astigmatism & anisometropia by age. A student may be classified as having more than one type of refractive error. Clinically Significant Refractive error n (%) Type of Refractive error n (%) Yes No Myopia Hyperopia Astigmatism Aniso Suburban Standard 1 31 (73.8) 11 (26.2) 27 (64.3) 5 (11.9) 30 (71.4) 8 (19.4) Standard 6 57 (85.1) 10 (14.9) 47 (70.1) 6 (9) 26 (38.8) 23 (34.3) Form 3 38 (97.4) 1 (2.6) 36 (92.3) 0 (0) 14 (35.9) 13 (33.3) Total 126 (85.1) 22 (14.9) 110 (74.3) 11 (7.4) 70 (47.2) 44 (29.7) Rural Standard 1 14 (38.9) 22 (61.1) 12 (33.3) 5 (13.9) 14 (38.9) 4 (11.1) Standard 6 22 (50) 22 (50) 20 (45.5) 4 (9.1) 13 (29.5) 6 (13.6) Total 36 (45.0) 44 (55.0) 32 (40) 9 (11.2) 27 (33.8) 10 (12.5) RESULTS Figure 1: Demographic gender and locality of students. Figure 3: Proportions of students with clinically significant refractive error in different localities. Table 1 : Comparison of students in different localities (suburban & rural areas) with clinically significant refractive error & the types of refractive error. 0 10 20 30 40 50 60 70 Male (n) Female (n) Suburban (n) Rural (n) Standard 1 45 33 45 36 Standard 6 57 54 67 44 Form 3 14 25 39 0 Number of students Demographic Gender & Locality of the Students • Clinically significant refractive error and any refractive error were found in 162 (71.1%) and 174 (76.3%) students respectively. • The most prevalent type of refractive error found is myopia; 142 (62.3%) followed by astigmatism; 97 (42.5%), anisometropia; 54 (23.7%) and lastly is hyperopia; 20 (8.8%). • Myopia reported more in Form 3 (89.3%) students compared to the lower age group. • Based on Table 1, suburban district showed a higher incidence of myopia, which is 74 (67.9%) students than rural area which is 32 (40%) students. • Clinically significant refractive error also increased with the increment of age as demonstrated in Figure 3. But the significant increment (p<0.05) only reported for students living in suburban area. • However, students in the same age group in Standard 1 and Standard 6 showed significant differences in clinically significant refractive error in different areas; (p<0.05) & (p<0.001) respectively. • As there had been no screening for Form 3 students in the rural area, there was no comparison between the same age group for Form 3 and the two locations. 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00% MYOPIA HYPEROPIA ASTIGMATISM ANISOMETROPIA Proportions of students with any refractive error by age. Standard 1 (7 years old) Standard 6 (12 years old) Form 3 (15 years old) Cross-sectional analysis Procedures: 1) Visual Acuity Assessment 2) Refraction 3) BV Assessment Students were divided into : 1) Age : Standard 1 (7 years old), Standard 6 (12 years old), Form 3 (15 years old). 2) Locality: Suburban (Sandakan) & Rural (Kinabatangan, Telupid, Beluran, Tongod). Criteria: Any refractive error was identified when there is at least -0.50 diopter (D) sphere equivalent (SE) myopia, +0.50D SE hyperopia, -1.00D astigmatism or 1.00D anisometropia in the right eye. Clinically significant refractive error is defined as decreased VA; 6/12 or less & myopia ≥-0.75D SE, hyperopia without esodeviation ≥+2.00D SE, hyperopia with esodeviation≥+1.00D or astigmatism≥ 1.50D. The data was analyzed using IBM SPSS Statistics version 28. 73.80% 85.10% 97.40% 38.90% 50% STANDARD 1 STANDARD 6 FORM 3 Proportions of students with clinically significant refractive error in different localites. Suburban Rural
An Analytic Hierarchy Process-Based Clinical Decision-Making for Dry Eye Disease Diagnostic Test Selection Yu Ting Chai1 , Pui Juan Woi1* , Jecksin Ooi2 , Narayanasamy Sumithira 1 1Center for Community Health Studies (ReaCH), Optometry and Vision Science Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia 2School of Engineering and Physical Sciences, Heriot-Watt University Malaysia,Precinct 5, 62200 Putrajaya, Malaysia 11 UKM PPI/111/8/JEP -2023-292 Ø Schirmer test is the most preferred DED diagnostic test as it measures tear production directly and is readily available. Ø AHP approach can address the uncertainty of practitioners’ clinical decision-making in selecting DED diagnostic tests. Six optometry experts were recruited to rank 4 criteria in deciding DED diagnostic tests and 7 DED diagnostic tests according to their preferences. Pairwise comparison of multiple criteria and alternatives were performed based on AHP Approach. Saaty’s nine-point scale was used to evaluate the relative importance of criteria and alternatives.The geometric average of experts’ response was obtained AND The weight were calculated. DRY EYE DISEASE There are a lot of diagnostic tests used to diagnose DED.To date, there is no single gold standard clinical sign that correlates perfectly with DED1 . In this study, a systematic framework using analytic hierarchy process (AHP), a decision-making technique developed for the multicriteria evaluation of alternatives for DED diagnostic test selection. 0.06 0.09 0.23 0.62 COSTS TIME NEEDED RELIABILITY ACCURACY 0.07 0.13 0.14 0.14 0.15 0.18 0.20 QUSTIONNAIRE MEIBOMIAN GLAND DYSFUNCTION OSMOLARITY TEST NIBUT CORNEAL AND CONJUNCTIVAL STAINING TBUT SCHIRMER TEST Overall, Schirmer test has the highest weightage because: Accuracy = 1 st Reliability = 1 st Cost = 5 th Time needed = 6 th ACKNOWLEDGEMENT The authors are grateful to the experts for their commitment and cooperation. REFERENCES 1.Savini, G., Prabhawasat, P., Kojima, T., Grueterich, M., Espana, E. & Goto, E. 2008. The Challenge of Dry Eye Diagnosis. Clinical ophthalmology 2(1): 31-55. 2.Saaty, T. L. 2004. Decision Making—the Analytic Hierarchy and Network Processes (Ahp/Anp). Journal of systems science and systems engineering 13(1): 1-35. Figure 1: Structure of AHP Goal Criteria Alternatives
RESEARCH POSTER PRESENTATION DESIGN © 2022 www.PosterPresentations.com Acute acquired concomitant esotropia is a special subtype of esotropia characterised by the acute onset of comitant esotropia with diplopia and equal deviation in all gaze direction which more common in older children and adults.(1). The cause of acute acquired concomitant esotropia seems to be associated with an imbalance between the converging and diverging extraocular muscle of the eye (2). With the advent of Covid 19, universal lockdown and introduction of web based online classes for students, including young children and online professional tasks, there has been a higher incidence of AACE which may be attributable to the stress and accommodation load (3) Tengku Aida AA¹ Syarmilla CS¹ Rossaidah M¹ Aznor Azwan AA² Muhammad Afzam Shah ³ Ophthalmology Department Hospital Raja Perempuan Zainab II¹ Ophthalmology Department Hospital Sultan Ismail Petra² Kulliyah Of Allied Health Sciences, International Islamic University Malaysia³ CASE REPORT : ACUTE ACQUIRED COMITANT ESOTROPIA (AACE) – POST COVID-19 HOME CONFINEMENT INTRODUCTION CASE REPORT 1 DISCUSSION OBJECTIVE CONCLUSION ACKNOWLEDGEMENT A 7-year-old boy presented to the Ophthalmology Department , HRPZ II, Kota Bharu with acute onset of diplopia. Two days before presentation, his parents noted crossed eyes when she woke up and dancing eye. He had no history of recent infections or physical or psychological stress. In the past 2 months, he used a tablet approximately 8 hours a day. All test were done and the findings shown in Table.1. Neurologic evaluation and brain magnetic resonance imaging (MRI) under sedation were unremarkable. Full time glasses was prescribed , although other treatment options such as prisms and topical cycloplegics were discussed. We discussed two instances of acute concurrent acquired esotropia (AACE) that took place during COVID-19 home confinement. Case 1 displayed minor hyperopia, while Case 2 featured a myopic patient who voluntarily used spectacles; both had no history of physical or emotional stress. It's interesting to note that both patients used computers, tablets, and smartphones for 8 to 10 hours per day for gaming, accessing coursework, and using social media. According to Aldo Vagge et al (3) , although the cause of acute acquired concurrent esotropia is yet unknown, excessive use of computers, tablets, and smartphones has been linked to continuous nearpoint demands. The authors hypothesized that excessive smartphone usage would cause accommodation and vergence anomalies that would cause the medial rectus muscles to dynamically contract, resulting in the development of manifest esotropia. Home confinement during covid-19 appeared to cause an increasing total hours of screen time and the number of consecutive minutes/hours without visual breaks, should be recommended to prevent AACE. As preventive measures, limiting screen time, taking periodic breaks, and having a larger screen with higher resolution and a correspondingly longer reading distance should all be taken into consideration suggested by YH Lau et al (4). To present a case of Acute Acquired Comitant Esotropia ( AACE ) encountered in the Ministry of Health Hospital, Malaysia. AACE is a relatively rare form of strabismus characterized by a sudden onset of concomitant esotropia with diplopia. The authors would like to thank the Director of Health Malaysia, Datuk Dr Muhammad Radzi Bin Abu Hassan for permission to publish this poster. REFERENCES 1.Yanfang Meng, Xuemin Hu, Xiaoqi Huang,Yiia Zhao, meihong Ye, Beixi Yi & Lianhong Zhou (2022) Clinical Characteristic and aetiology of acute acquired comitant esotropia, Clinical And Experimental Optometry,105:3,293-297, DOI:10.1080/08164622.2021.1914510. 2 Lekskul A, Chotkajornkiat N, Wuthisiri W, Tangtammaruk P. Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management. Clin Ophthalmol. 2021; 15:1567. https://doi.org/10.2147/OPTH.S307951 PMID: 33883873 3 Aldo Vagge., et al. “Acute Acquired Concomitant Esotropia From Excessive Application of Near Vision During the COVID-19 Lockdown”. Journal of Pediatric Ophthalmology and Strabismus 57 (2020): 6. 4. YH Lau et al. “Acute acquired esotropia during the COVID-19 pandemic : four case reports”. Hong Kong Medical Journal , Volume 29 Number 2, April 2023.www.hkmj.org CASE REPORT 2 A 22-year-old girl presented to the Ophthalmology Department , HRPZ II, Kota Bharu with acute onset of diplopia. She is studying on statistic course and spend many hours on computers. She had no history of recent infections or physical or psychological stress. The patient reported an intense use of the computer for more than 8 hours a day. She had worn any glasses yet. Neurologic evaluation and MRI were normal. All test were done and the findings shown in Table.2. Figure 1: Hirschberg test done on patient RE LE Stereopsis (Lang test) Failed Worth 4 Dots see 5 Lights BCVA 6/12 6/18 Ocular motility SAFE Cover Test LE Esotropia with good recovery at distant & near Prism Cover Test Near : 20 PD BO Distant : 20 PD BO Cycloplegic Refraction +0.75/- 1.00 x 20 (6/7.5) +1.50 / -1.00 x 165 (6/7.5) Table.1: Optometric findings RE LE Stereopsis ( TNO ) Failed Worth 4 Dots See 5 Lights BCVA 6/6 6/6 Ocular motility SAFE Cover Test RE Esotropia with good recovery at near and distant Prism Cover Test Near : 25 PD BO Distant : 25 PD BO Cycloplegic Refraction -2.00/-0.25 X 180 (6/6) +1.00/-1.00 X 180 (6/6) Table.2: Optometric findings RSCH ID-23-03909-KCU