Refractive error and amblyopia among primary school children in remote islands of East Coast of Peninsular Malaysia.

INTRODUCTION: Little is known about the prevalence of refractive errors and amblyopia among school children on the islands of East Coast Malaysia. This study aimed to investigate the prevalence of these conditions and their associated factors in this unique and remote geographical location. MATERIALS AND METHODS: This multicentre cross-sectional school-based study included 480 children aged 7 to 12 year from primary schools on the islands of the East Coast of Malaysia. All children underwent visual acuity assessment, orthoptic evaluation, anterior and posterior segment examinations and manifest refraction. Demographic data, history of parental refractive error, parental education level, duration of digital screen time and time spent outdoors were documented in a questionnaire distributed to the parents. RESULTS: The mean age was 9.53 ± 1.69 years, with an equal distribution of genders. The ethnic composition of the subjects was 99.4% Malay and 0.6% Orang Asli. The overall prevalence of refractive errors was 11.9% (95% CI: 9.1 to 15.1%), with myopia at 7.1% (95% CI: 5.0 to 9.8%), hyperopia at 2.5% (95% CI: 1.3 to 4.3%), astigmatism at 2.3% (95% CI: 1.1 to 4.1%) and amblyopia at 2.5% (95% CI: 1.3 to 4.3%). Older age, an absence of parental history of refractive error and reduced daily outdoor time were significantly associated with refractive errors (p < 0.05). CONCLUSION: The prevalence of refractive error is 11.9% and amblyopia is 2.5% among primary school children on the islands of the East Coast of Peninsular Malaysia. Older age, an absence of parental history of refractive error and reduced daily outdoor time are associated with refractive error.

Clinical characteristics and surgical outcomes of acute acquired concomitant esotropia in a tertiary referral centre in Malaysia.

INTRODUCTION: Acute acquired concomitant esotropia (AACE) is an uncommon type of strabismus that occurs due to interruption of fusion. Limited data are available on AACE from Asian countries especially from the Southeast Asian region. We aim to describe the clinical profile and surgical outcomes of AACE patients treated in a tertiary hospital in Malaysia. MATERIALS AND METHODS: We conducted a retrospective study of 20 patients aged 3-26 years who were diagnosed with AACE and attended Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2020 and June 2022 with follow-up periods a minimum of 12 months. Demographic data, clinical features, neuroimaging, surgical intervention, and final ocular alignment outcomes were recorded. RESULTS: The mean age of onset was 9.7±6.6 years. There were equal numbers of males and females in this study. Hypermetropia (45%) was the leading refractive error. Angle of deviation of 50 PD and more was documented in 50% of the patients at distance, and 70% of the patients at near fixation. Fifty per cent had an absence of stereoacuity at presentation. Neuroimaging was performed on 13 patients (65%), and two patients had intracranial pathology. All patients underwent bilateral medial rectus recession during primary surgery. Eighteen patients (90%) experienced excessive near work-related activities for >4 hours per day, and 19 patients (95%) achieved good ocular alignment, restoration of stereoacuity and resolved diplopia after the surgical intervention. CONCLUSION: The mean age of onset was 9.7±6.6 years. Almost half of our patients had uncorrected hypermetropia. Furthermore, 90% of patients had excessive near-work activities, and 95% achieved good post-surgery alignment.