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Organized by : In Collaboration with :

3rd SC 2019 E M P O W E R I N G O P T O M E T R Y S E R V I C E T H R O U G H V A L U E B A S E D P R A C T I C E

T H I R D O P T O M E T R Y S C I E N T I F I C C O N F E R E N C E

PERSATUAN PASCASISWAZAH OPTOMETRIS MALAYSIA

OPTOMETRY SERVICE MINISTRY OF HEALTH MALAYSIA

Main Organizing Committee

Advisor Puan Nor’aini Anuar

Chairperson Puan Ramuzha Yaacob Secretary Puan Elmiyana Hasni Treasurer Puan Diana Mohamed

Deputy Chairperson Puan Rossaidah Mustapa Assistant Secretary Puan Syarmilla Che Shamsuddin Assistant Treasurer Puan Sajidah Sulong

Scientific Puan Syarifah Faiza Syed Mohd Dardin Plenary Encik Nazirin Arsad Puan Arifah Nur Yahya Logistic & Banquet Puan Lily Muhanifa Mustafa Puan Noriah Abdullah Registration Puan Ainayanty Adnan Puan Roslinda Rahman Promotion & Publicity Puan Noor Zahirah Husain Puan Eryanti Md Omar Multimedia Puan Normala Sami

Sponsorship Puan Asmah Ahmad Puan Nor Aini Hanafi Exhibition Puan Siti Hamiza Abdul Halim Puan Nor Sharlina Abd Rashid Programme Book & IT Puan Nor Azizah Ismail

Technical Datin Rosmawati Uthman Puan Halijahton Abdul Rahim Souvenirs Puan Fadhliah Husin “Jasamu Dikenang” Puan Narjis Satar Puan Erni Fadhilah Norazmi Protocol Puan Nur Hafizah Mat Jalil Puan Noraini Harith

Scientific Committee Chairperson

Puan Syarifah Faiza Syed Mohd Dardin

Committees Puan Asmah Ahmad Dr Duratul Ain Hussin Dr Naqibah Ghazali Puan Farah Wahidah Hashim Puan Marizah Abdul Rahman

Puan Noor Suriani Mohamad Puan Nur Adnin Razali Cik Norina Abdul Gafor Puan Nurulain Mat Zain Puan Aziimah Awang Abd Rahman@ Jusoh

MESSAGE FROM

DIRECTOR GENERAL OF HEALTH MALAYSIA

Assalamualaikum wbt. and a warm welcome to all.

First and foremost, allow me to extend my heartiest congratulations to the

Organizing Committee of the 3rd Optometry Scientific Conference 2019 for

successfully planning this event, with the theme “Empowering Optometry

Service Through Value Based Practice”.

The need to maintain good eyesight as part of the general wellbeing of one’s

body is the desire of every person. The importance of good vision is adequately stressed and

manifested through several adages and famous saying about the eye. Sight disability is the least

disease condition one can ever wish to have.

In light of this, the theme of the conference is relevant to all healthcare providers, including

optometrists. Value-based practice is a partner to evidence-based practice in supporting clinical

judgement as we peruse individual cases. Values here mean the unique preferences, concerns and

expectations each patient brings to a clinical encounter which must be integrated into clinical

decisions that are at reasonable costs with good clinical outcomes, high patient satisfaction and

improves the quality of life.

I hope that this conference will bring together the best of knowledge-sharing from Ministry of Health

and our academician colleagues from local universities. I have high confidence that this conference

will create a platform for the staging of numerous latest findings and innovations in service delivery

and will strengthen national cooperation and collaboration in optometry learning, training and

research in Malaysia.

Finally, I wish all participants an enjoyable and fruitful conference. May you take home the

knowledge that will improve the care of your patients and make positive changes in the way we

work to achieve the highest productivity and outcomes.

Thank you.

DATUK DR. NOOR HISHAM ABDULLAH

MESSAGE FROM

ORGANISING CHAIRPERSON

Assalamualaikum w.b.t & Salam Sejahtera.

Alhamdulillah, thank you Allah SWT for his blessing. It is my honor and

privilege to host this 3rd Optometry Scientific Conference 2019, from 3 – 4

August, 2019, at Putrajaya Marriott Hotel, Malaysia. This conference is

organized by Persatuan Pascasiswazah Optometris Malaysia in collaboration

with the Optometrist of Ministry of Health Malaysia.

On behalf of the committee members, I would like to welcome all

participants to this conference. The theme “Empowering Optometry Service Through Value Based

Practice” was chosen because it is relevant and significant to the current optometry practices.

This year we invite distinguished speakers who have the expertise and experiences in their field to

share with us their knowledge with the relevant perspective topic. I hope this conference will be a

platform to provide motivation to all optometrist to do research and innovation so as to improve

service delivery to patient, not only through evidence-based practice but also through value-based

practice.

This conference will be one for us to share our thoughts and exchange ideas on how to chart our

journey forward to reach new heights. We have an exciting program at this conference to allow

participants to reflect upon and jointly explore current and future directions. We shall all be proud of

where we are today and excited about where we are headed to.

Congratulations to all committee members who have put a lot of effort to ensure the success of this

conference. A special note of appreciation goes to all involved in this conference especially to all

presenters, invited speakers and sponsors. Without your dedication and sacrifice, this conference

would not have been possible.

Thank you

PUAN RAMUZHA BT. YAACOB

MESSAGE FROM

HEAD OF OPTOMETRIST PROFESSION

Assalamualaikum w.b.t & Salam Sejahtera.

I am honored and delighted to welcome all distinguished speakers and

delegates to the Third Optometry Scientific Conference 2019.

This Conference will provide optometrists the chance to present their

research work and become part of research community. Research often

involves a great deal of cooperation and coordination among different

disciplines and institutions. Ethical standards promote the values that are

essential to collaborative teamwork, such as integrity, good collaboration

and open to criticism, be innovative and empower the culture of knowledge. In conjunction with this

year theme, “Empowering Optometry Through Value-based Practice”, I hope that by positively

embracing this approach, we will strengthen, protect and promote the profession of optometry

service.

To all optometrists I wish everyone of you to have an enriching and best experience during this

conference, where there will be an exchange of ideas and, sharing of knowledge and experiences

with other optometrists from private sectors and universities. This will be an opportunity for us to

work together and enrich our careers whilst strengthening network for future endeavours.

I wish to extend my appreciation to the organizing committee for their dedication and commitment

towards organizing this event. I would also like to express my sincere gratitude and appreciation to

all speakers to share their expertise and to the delegates, thank you for making this event a success

and I wish you to have a fruitful conference.

Thank you.

PUAN HAJAH NOR’AINI BT ANUAR

OPENING CEREMONY

2.30 pm

3.00 pm

3.10 pm

3.15 pm

3.25 pm

3.55 pm

4.00 pm

4.15 pm

4.20 pm

Arrival of Guest Arrival of YBhg. Datuk Dr Noor Hisham Abdullah Director General Of Health Malaysia Official Songs - Negaraku, “Malaysia Bersih” & “ Kami Sedia Membantu” Doa Recital Welcoming Speech by YBrs. Puan Ramuzha Yaacob Organizing Chairperson Third Optometry Scientific Conference Opening Speech by YBhg. Datuk Dr Noor Hisham Abdullah Director General Of Health Malaysia Conference Launching Presentation of Certificate of Appreciation Montage presentation Photo Session Visit Booths Tea Break

DAY 1: 3rd August 2019 (Saturday)

Programme Time

Registration of Participants & Speakers 7.30 am – 8.15 am

Welcoming Remarks 8.15 am – 8.25 am

Doa Recital 8.25 am – 8.30 am

Plenary Lecture 1 :

Crafting Translational Research in Optometry Services

YBhg. Dato’ Dr Goh Pik Pin

Director of Clinical Research Center (CRC)

8.30 am – 9.10 am

Free paper Presentation 9.10 am – 10.00 am

Tea Break / Visit to Poster Exhibition 10.00 am – 10.30 am

Free paper Presentation 10.30 am – 12.00 noon

Invited Talk

Modern Contact Lens Technology & Practice – A South East Asia Perspective

Ms Shirley Loh

Associate Professional Affairs Director,

Johnson & Johnson Vision Care (South East Asia)

12.00 noon – 12.45 pm

Lunch Break 12.45 pm – 2.00 pm

Symposium 1(Public Health)

The Value of Advocacy for Primary Eye Care Service

Dr Duratul Ain Hussin

Hospital Sultanah Nur Zahirah, Kuala Terengganu

2.00 pm – 2.20 pm

Symposium 2 (Visual Field)

Visual Field: The Past, Present and Future

Dr Naqibah Ghazali

Hospital Tengku Ampuan Afzan, Kuantan

2.20 pm – 2.40 pm

Opening Ceremony by Y. Bhg. Datuk Dr. Noor Hisham Abdullah

Director General of Health Malaysia

3.00 pm – 4.30 pm

Symposium 3(Glaucoma)

Optical Coherence Tomography, From Being Lavish To Necessity

Asst Prof Dr Firdaus Yusof @ Alias

Kulliyyah of Allied Health Sciences, IIUM Kuantan

4.30 pm – 4.50 pm

Tea Break & Adjourn 4.50 pm

DAY 2: 4th August 2019 (Sunday)

Programme Time

Registration of Participants & Speakers 8.00 am – 8.30 am

Plenary Lecture 2 :

Breaking The Wall into the World of Paralympics : Low Vision Perspective

YBhg. Prof. Datuk Dr. Rokiah Hj. Omar

Director of University Community Transformation Centre,

Universiti Kebangsaan Malaysia

8.30 am – 9.15 am

Symposium 4 (Cornea & Contact Lens)

Rain in the Desert- Tears, Cornea and Contact Lens

Puan Asmah Ahmad

Hospital Tuanku Ja’afar, Seremban

9.15 am – 9.35 am

Symposium 5 (Pediatric Public Health)

Public Health in Pediatric Optometry

Puan Nurul Farhana Abu Bakar

Hospital Raja Permaisuri Bainun, Ipoh

9.35 am – 9.55 am

Symposium 6 (Research)

Research in Optometry; Chances and Challenges

Puan Syarifah Faiza Syed Mohd Dardin

Hospital Putrajaya

9.55 am – 10.15 am

Tea Break 10.15 am - 10.45 am

Symposium 7 (Low Vision)

Duty or Love? Putting Patients First

Puan Farah Wahidah Hashim

Pusat Pembedahan katarak MAIWP-Hospital Selayang

10.45 am – 11.05 am

Symposium 8 (Binocular Vision)

How a Bunch of Kindred Spirits Help Others Reconnect With the Love of

Binocular Vision

Puan Nur Hafiza Mokhtar

Hospital Selayang

11.05 am – 11.25 am

Prize Giving Ceremony 11.30 am - 12.00 noon

“Jasamu Dikenang” 12.00 noon – 12.15 pm

Closing Ceremony by Head of Optometrist Profession, Ministry of Health

Malaysia

12.15pm - 12.30 pm

Lunch

End of Conference

12.30 pm

YBhg. Dato’ Dr Goh Pik Pin M. Med (NUS), MS (Ophthalmology),

Master in Public Health Director of Clinical Research Center (CRC)

Ministry of Health Malaysia

Dato’ Dr. Goh Pik Pin is the acting director of the National Institutes of Health and Director of Clinical Research Centre, Ministry of Health, Malaysia. Graduated from Universiti Sains Malaysia in 1988, she obtained M. Med (NUS) in 1994, MS (Ophthalmology), Universiti Kebangsaan Malaysia in 1995, Master in Public Health /Public Health Ophthalmology, Bloomberg School of Public Health, Johns Hopkins University in 2001. She contributed to the launch of Entry Point Project on Clinical Research Malaysia, part of the National Key Economic Areas under the Economic Transformation Program and is one of the directors of Clinical Research Malaysia, a government-owned corporatisation established to promote industry sponsored research in Malaysia. She is also a member of MOH Medical Research Ethics Committee.

YBhg. Prof. Datuk Dr. Rokiah Hj. Omar P.S.D., PhD., BOptom., FAAO., FAMO

Director of University Community Transformation Centre,

Universiti Kebangsaan Malaysia

Professor Datuk Dr Rokiah Hj Omar is a leading optometrist, academician and Director at University Community Transformation Centre (UCTC) Universiti Kebangsaan Malaysia. Her area of expertise is Low Vision; research interests include low vision rehabilitation, special population needs, quality of life, Public Health Optometry and Sports Vision. She is the first optometrist in Asia to be inducted as an International Visually Impaired Classifier by the International Blind Sports Federation (IBSA) in 2016 and International Paralympic Committee (IPC) in 2011 where she provides consultation services all over the world. She was the Classification Director/Chairman of the Medical and Sports Science (MSSC) of Asian Paralympic Committee from 2014-2018. She is currently the Classification Director of MSSC for ASEAN Paralympic Sports Federation (APSF) from 2014-2020.

PLENARY SPEAKER’S PROFILE

Ms Shirley Loh Associate Professional Affairs Director

Johnson & Johnson Vision Care (South East Asia)

A clinical optometrist and qualified therapeutic practitioner with more than 10 years of experience, Ms Shirley Loh is the Associate Professional Affairs Director for Johnson and Johnson Vision Care South East Asia. In addition to leading training and education initiatives within the region, Shirley regularly engages the local health & regulatory authorities to work towards raising the professional eye care standards, and is actively involved in raising public awareness in preventable eye conditions. Prior joining Johnson & Johnson, Shirley was the National Professional Services Manager at the Optometrists Association Australia, and is also a former Council Member of the Singapore Optometric Association.Australian-trained in eye disease and contact lens practice, Shirley believes in helping patients achieve their best potential visual clarity and eye comfort, for a lifetime of healthy vision.

INVITED SPEAKER’S PROFILE

Dr Duratul Ain Hussin PhD., MHSc. Optom, B.Optom (Hons.)

Hospital Sultanah Nur Zahirah, Kuala Terengganu Duratul’s career as an optometrist started in 2000 upon graduation. She joined the Ministry of Health Malaysia in the same year and currently working at the Hospital Kuala Lumpur. Duratul has a deep interest in Public Health Optometry. Her Masters project was on pre-school vision screening using Lea Symbols chart. For PhD she developed two optometric service pathways at the primary and tertiary care levels and comprehensively evaluated these pathways. Duratul is currently the Vice Chairperson for the Amblyopia and Visual Impairment Screening (AVISKKM) program and leads the Primary Eye Care Committee of the Ministry of Health Malaysia. In 2016, Duratul also established the Cerebral Visual Impairment Clinic at the Hospital Kuala Lumpur, the first of its kind in Malaysia

Dr Naqibah Ghazali PhD., M.Optom, B.Optom (Hons.)

Hospital Tengku Ampuan Afzan, Kuantan

Dr. Naqibah Ghazali is originally from Perak, and received her undergraduate degree in Optometry from National University of Malaysia in 2003. Dr. Naqibah Ghazali joins Ministry of Health as an optometrist and serve Ophtalmology Department, Hospital Teluk intan, Perak until 2005. A few years after completing her Masters from University Of New South Wales, Australia in 2009, Dr Naqibah embarked on a PhD in Visual Fields in Glaucoma at the University of Manchster UK, supervised by Professor David Henson at Royal Manchester Eye Hospital. Completing her PhD in 2016, Dr Naqibah returned to Malaysia to serve Ophthalmology Department, Hospital Tengku Ampuan Afzan, Kuantan until now. Her expertise and research interest is now on; optimisation of visual field tests and the collation of all visual field tests into a single database that could be queried to answer important questions about the nature of functional loss in glaucoma’s.

Asst Prof Dr Firdaus Yusof @ Alias PhD., M.Optom, B.Optom (Hons.)

Kulliyyah of Allied Health Sciences, IIUM Kuantan Dr Firdaus Yusof receives his optometry training from the University Kebangsaan Malaysia, graduated in 2002. He worked a while in retail, but his true calling is in academia. He joined the International Islamic University Malaysia Kuantan campus, establishing the optometry program in the Kulliyyah (Faculty) of Allied Health Sciences beginning 2003. He pursued Masters of Optometry and graduated in 2006 from the University of New South Wales, Australia. He then went to study in the University of Waterloo, probably the first Malaysian optometrist ever received a PhD from Canada. He was trained in OCT, glaucoma and blood flow, yet his research interest now has diverged into myriad knowledge branches of optometry and vision science.

Puan Asmah Ahmad MHSc. (ClinicalOptom), B.Optom (Hons.) Hospital Tuanku Ja’afar, Seremban

Graduated Bachelor of Optometry from UKM in year 2000. Served as MOH optometrist at Ophthalmology Department HTJS from year 2002 until now. In year 2009 had awarded ‘Hadiah Latihan Persekutuan’ by MOH for programmed master clinical optometry in UKM and in year 2014 for programmed PhD in optometry with research title ‘Kesan perubahan lipid airmata ke atas fungsi penglihatan dan keselesaan di kalangan pemakai kanta sentuh silikon hidrojel’. Presented research at International Conference such as Ophthalmology Optometry Conference in Perak (2018), British Contact Lens Association Conference Singapore (2018), International Scientific Conference (i-Sihat) Kuala Lumpur (2017), World Congress Optometry Hyderabad India 2017, ARVO Brisbane Australia (2017), 10th Asia Cornea & Contact Lens Conference 2016 Hong Kong and International Symposium of Health Sciences, Renaissance Hotel Kuala Lumpur 2010.

SYMPOSIUM SPEAKER’S PROFILE

Puan Nurul Farhana Abu Bakar MHSc., B.Optom (Hons.)

Hospital Raja Permaisuri Bainun, Ipoh

Nurul Farhana Abu Bakar graduated with Bachelor of Optometry from Universiti Kebangsaan Malaysia in 2004. She later obtained her Master of Health Sciences from Universiti Teknologi MARA in 2013 and currently pursuing Doctorate degree at the same university. She served in Hospital Sri Aman, Sarawak from 2005 to 2015. Her research interest is on pediatric optometry and public health.

Puan Syarifah Faiza Syed Mohd Dardin Master in Investigative Ophthalmology & Visual Sciences, B.Optom (Hons.)

Hospital Putrajaya

SYARIFAH FAIZA SYED MOHD DARDIN graduated from Universiti Kebangsaan Malaysia and obtained her M.Sc. in Investigative Ophthalmology & Visual Science from University of Manchester, UK. Her current role encompasses clinical work, research and wide-ranging professional affairs including quality improvement activities and technical contribution for profession development. At present, she heads the optometry service of Hospital Putrajaya and the Chairperson for the Optometry Research Committee, MOH. Currently she involves with Allied Health Sciences Division, MOH-WHO Programme Budget and Sustainable Development Goals - Universal Health Coverage, SDGs-UHC (rehabilitation indicator) as the project team for the profession. She is also a recognized trainer for MOH Quality Assurance Programme and is actively facilitating and evaluating QAP projects nationwide.

Puan Farah Wahidah Hashim MHSc. (Clinical Optom), B.Optom (Hons.)

Pusat Pembedahan Katarak MAIWP-Hospital Selayang

Puan Farah Wahidah Hashim received her B. Optom (Hons) from the Universiti Kebangsaan Malaysia (UKM) in year 2002. After completing her first degree, she joined Ministry of Health (MOH) as an optometrist in Hospital Sultanah Nur Zahirah Kuala Terengganu. Throughout the years, she has served at Malaysian Optical Council and Hospital Kuala Lumpur until she pursued her postgraduate study in 2011. She later obtained her Masters of Health Sciences (Clinical Optometry) from UKM in 2013.

Puan Nur Hafiza Mokhtar M.Orthop, B.Optom (Hons.)

Hospital Selayang

Graduated with a Bachelor of Optometry degree in 2002. Later joined the Ministry of Health Malaysia as an Optometrist in the Department of Ophthalmology, Kuala Lumpur Hospital. Promoted to Sultanah Nur Zahirah Hospital, Kuala Terengganu and subsequently in Selayang Hospital till now. In 2017, she obtained her Master of Orthoptics degree in Melbourne. She was recognized by the Malaysian Government in March 2019 as a Subject Matter Expert in the field of Binocular Vision-Orthoptics. Being a part of the Binocular Vision and Visual Therapy specialty committee member, her passion is in the area of strabismus and ocular motility disorders.

SYMPOSIUM SPEAKER’S PROFILE

PLENARY PL001

Crafting Translational Research in Optometry Services YBhg. Dato’ Dr Goh Pik Pin

Director of Clinical Research Center (CRC) Clinical research is a systematic investigation to test hypotheses that permits conclusion to be drawn and develop generalizable knowledge and best if it is also new knowledge. The ultimate aim of clinical research is to find better ways to prevent, screen, diagnose, or treat a disease so as to improve people’s health. Thus, clinical research is the essence of medical progress as healthcare can only advance with new knowledge to tackle new and emerging diseases. Clinical Research Centre is one of the 6 National Institutes of Health. It is the clinical research arm of the Ministry of health. It has a head quarter based at National Institute of Health Campus at Setia Alam and a network of 33 CRC hospitals located at various hospitals in the 14 states. Its vision is to be the leading research institute in Asia and its mission is improve patients' health outcomes through ethical and quality clinical research CRC's tagline is Research that Matters to Patients and Nation. Its main function is to build research capacity at MOH, to develop data recourses like patient registry and to promote, conduct and monitor research and to publish and help MOH staff to publish research findings. It works closely with other institutions both in MOH and academic institutions like universities to form collaborative research group by clinicians. With the above structure, we hope to assist in crafting translational research in the Optometry services

PL002

Breaking The Wall into the World of Paralympics : Low Vision Perspective YBhg. Prof. Datuk Dr. Rokiah Hj. Omar

Director of University Community Transformation Centre UKM The vision of the Paralympic Movement is “to enable Para‐Athletes to achieve sporting excellence and inspire and excite the world.” This paper will describe how Para-sports can be use as part of low vision rehabilitation. Furthermore to share how optometrist can play an important role to support the realization of this vision. The discussion will cover on topic; who is eligible to compete in Para-sport and consequently have the opportunity to reach their goal of becoming a Paralympic Athlete. The discussion will also cover how to groups the athletes into different sport classes, which are aimed at ensuring, that the impact of their impairment is minimized and their sporting excellence determines which athlete or team is ultimately victorious. It is hope that at the end of this lecture, the important of the competitive structure provided by the Classification Systems are not only important for elite sport but are also essential to promote grassroots participation in Para-sports by all people with vision impairment is understood and can be applied as part of low vision rehabilitation.

SYMPOSIUM OS001

The Value of Advocacy for Primary Eye Care Service Dr Duratul Ain Hussin

Hospital Sultanah Nur Zahirah, Kuala Terengganu Generally advocacy is defined as a planned process of influencing people in order to achieve a specific outcome. Within development of primary eye care context, it involves by representing the needs and interests of disadvantaged and marginalized groups to access eye examination to those with the authority to make or influence a transformation in policy. To realize the success of efforts towards primary eye care in Malaysia, advocacy works need to be carried out with knowledge, conscientious and strategize. There are 5 phases in conducting effective advocacy: identify the problem, identify the strategy, develop action plan, implement action plan, monitor and evaluate progress. Each phase has its own unique approach and need to be executed carefully with considerable amount of planning. Immense understanding and support of stakeholders including policy makers, local health providers, optometrists and/or other health care professional is significant in the advocacy work. It can ensure the strengthening of primary eye health services in Malaysia is achievable in a sustainable and equitable manner.

OS002

Visual Field: The Past, Present and Future Dr Naqibah Ghazali

Hospital Tengku Ampuan Afzan, Kuantan Visual field testing have been used as clinical ophthalmic diagnostic tools and remains one of the most important tools for characterizing and monitoring vision loss in glaucoma. Today, we have many different modalities of visual field testing that are designed to evaluate the visual function within the visual pathways and various and subsets of mechanisms within the visual system. Despite its current mainstream use, new developments continue to emerge on its current use and potentially better methods for its testing and analysis. This presentation summarizes a historical overview of the development of visual field as well as new developments in particular, standard automated perimetry. Evidence-based guidance has recently been provided on the impact of testing frequency on the ability to detect visual field progression. An increasing body of evidence also highlights numerous factors that can impact the interpretation of visual field results currently considered reliable (e.g. the reliability indices themselves, fixation tracking parameters, and cognitive decline). More targeted visual field testing paradigms for central and peripheral visual fields have been explored, although further work is needed to understand their role in clinical care.

SYMPOSIUM OS003

Optical Coherence Tomography, From Being Lavish To Necessity Asst Prof Dr Firdaus Yusof @ Alias

Kulliyyah of Allied Health Sciences, IIUM Kuantan The optical coherence tomography (OCT) technology advances throughout the decades. Stemming from the optical coherence domain reflectometry, OCT has grown to become a powerful imaging modality for the eye. Relative to other imaging methodologies, e.g. scanning laser polarimetry and confocal scanning laser ophthalmoscopy, OCT provides extensive applications to better aid for the diagnosis and management of eye diseases such as glaucoma. This short session will try to cover the evolution of the OCT technology and how its presence has change, for an eyecare specialist, from being lavish machinery to a necessity. This talk will also try to cover the OCT applications for the management of glaucoma. The progress in the engineering and biology promises many more applications of OCT in the future. Without doubt, OCT will remain in the center stage of the eyecare field for many more prospective years.

OS004 Rain in the Desert- Tears, Cornea and Contact Lens

Puan Asmah Ahmad Hospital Tuanku Ja’afar, Seremban

Dry eye definition and classification by subcommittee of the International Dry Eye Workshop (2007) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tears film instability with potential damage to the ocular surface. Moreover, dry eye is the main cause for contact lens discontinuation but there are few available reports about the impact of wearing soft contact lens on tears in Asian eyes. Previous works have shown that tear stability in Asian eyes is lower than Caucasians, which may worsen during contact lens wear. The survey shown that soft contact lens is popular among young adults however few study regarding impact of contact lens had been conducted in Malaysia. The talk will discuss the clinical tears evaluation as well as lab investigation, effects of contact lens toward dry eyes, suitable contact lens and the proper management of dry eyes. If we try to avoid used of contact lens surprisingly contact lens also act as bandage in eye injury and one of the best solution for dry eye treatment. Therefore, wearing contact lens is not the issue but contact lens management is the issue. Hopefully this sharing may help and provide as guidance for optometrist in management of dry eyes especially among contact lens wearer.

SYMPOSIUM OS005

Public Health in Pediatric Optometry Puan Nurul Farhana Abu Bakar

Hospital Raja Permaisuri Bainun, Ipoh The prevalence of children suffering from vision problems is increasing. Despite refractive error has become a global public health issue worldwide, other vision problems such as binocular vision and visual perceptual disorders among children are no less important as the problems might affect learning and quality of life. Providing a comprehensive eyecare is a major role of optometrist encompassing health inequality by social classes. Advocacy to ensure an appropriate eye health preventive and intervention has become a fundamental part of pediatric eyecare. Implementation of a comprehensive pediatric eyecare might be challenging especially in busy clinical-based setting that requires more commitment and engagement. Many factors hindered pediatric eyecare practice in public health that including lack of funding, time constraint and insufficient of skilled and experience clinicians. Enhancement of clinical support structure, development of appropriate mentoring and training system and cultivating the values could catalyse improvement of pediatric eyecare in public health services.

OS006

Research in Optometry; Chances and Challenges Puan Syarifah Faiza Syed Mohd Dardin

Hospital Putrajaya Embedded research in our clinical work is the future of our profession. The importance of doing research upon personal and professional development has been widely acknowledged in the literature. By doing research, it allows us to understand our problem, looking for alternative solutions, improve the way we manage our patients and may improve our clinical procedures and protocols. Research can expand our knowledge and can also be a source of new inspiration and advances. At present, in Malaysia, aside from the work published by academics from institute of higher learning (IHL), the numbers of published researches by our clinical optometrist are relatively small, either in public or private sectors. Profession-specific data exploration from survey conducted by Allied Health Sciences Division, Ministry of Health Malaysia in 2016 found 75.9% (n=214) of optometrists working in government sector do have interest in research. However only 35.5% (n=100) from the respondents had once directly or indirectly involved with the research activities. Heavy clinical workloads, lack of research exposure and skills, and limited time to do research often constitute primary challenges and concerns that hinder our optometrist to undertake research work. This session will discuss the challenges in doing research among our optometrist, and possible ways to overcome it. At the same time this session hope to discuss on chances and opportunity to do research particularly for our clinical optometrist who works on the ground, with abundant of readily available data in the clinic or in the practice.

SYMPOSIUM OS007

Duty or Love? Putting Patients First Puan Farah Wahidah Hashim

Pusat Pembedahan Katarak MAIWP-Hospital Selayang Optometrists’ role in the hospital service has undergone significant development in the recent years to include extended roles and responsibility, which would require the optometrists to undertake a wide range of clinical roles with a transformed scope of practice to ensure the best services to patients. Major changes too have occurred in the area of Low Vision, its assessment and clinical management. Additionally, the concept of Low Vision service has changed considerably, moving away from focusing largely on the provision of optical low vision aids, to a more comprehensive rehabilitation process involving multidisciplinary teams approach, encompassing not only the visually impaired but those with dual sensory loss and multiple disabilities. Hence, effective management of the Low Vision patients requires more than just the ability to perform a long list of low-vision assessment and perform the expected duty, but should include patients’ requirements, psychological state, quality of life and understanding patients’ need for independence and acceptance among the society.

OS008 How A Bunch Of Kindred Spirits Help Others Rediscover Their Love For

Binocular Vision Puan Nur Hafiza Mokhtar

Hospital Selayang The journey to promote Optometric Vision Therapy services in the government hospital was initiated by individuals in 2006. The cumulative effort was realized with the establishment of the Binocular Vision and Vision Therapy Specialty Committee (BVVT) in 2013. The main goal was to ensure that clients would continuously receive sustainable and standardized Orthoptics, Binocular Vision and Optometric Vision Therapy services from Optometrists working in the public hospitals across the country. The greatest challenge was to create awareness amongst the practicing Optometrists to critically think beyond their comfort zone when dealing with clients to overcome their binocular vision problems. The skills acquired by the Optometrists would not only contribute to improving the clients’ quality of life, but has a value-added purpose to their clinical skills thus job satisfaction. The approach to an Optometric Vision Therapy needs to be holistic as it trains the entire visual system which includes eyes, brain and body. It requires a combination of in office treatment and home therapy tailored program. Therefore, to strengthen the delivery of service and ensuring standardized manner, we have been conducting a systematic structured training module with continuous education in the field of Orthoptics, Binocular Vision and Optometric Vision Therapy. The modules were continuously upgraded to be evidence-based and remain relevant to clinicians. The courses conducted from 2014 till now were done in stages, Part I and Part II. Part I mainly focuses on clinical examination in order to derive an exact diagnosis while Part II focuses on further management of the cases. Interesting cases would later be presented in a mini symposium for others to learnt from. Challenges are aplenty- but we are definitely giving it our best shot and are looking forward to share this journey with others.

FREE PAPER FP001

Quality of life status among low vision patients diagnosed with glaucoma. Nur Hidayah Y

1, Zainora M

1, Mohd Harimi AR

1, Jemaima Che Hamzah

2, Nadhrah AB

1

1Optometry & Vision Sciences Programme, Faculty of Health Sciences, UKM Kuala Lumpur.

2Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur.

Aim of Study Glaucoma is an eye disease that could results in low vision and blindness and consequently quality of life (QoL). This research was conducted to determine the status of QoL among low vision patients diagnosed with glaucoma. The study also aimed to determine the correlation between visual field and QoL of the glaucoma patients. Methods This is a cross sectional study. Fifty low vision subjects diagnosed with glaucoma who attended the Ophthalmology Department of Hospital Canselor Tuanku Muhriz were recruited. Visual acuity (VA) was measured in LogMAR by using Good-lite Lea-numbers (3 meter) Logarithm of the Minimum Angle of Resolution (LogMAR) chart while visual field was measured in mean deviation (MD) using a model of HFA 750i Humphrey Visual Field (HVF). Low vision was defined as subjects with VA of 6/18 to 3/60 or HVF MD value of -6dB to -20dB. QoL was measured using Low Vision Quality of Life (LVQoL) questionnaires and it was done face to face. Results -of subjects had reduced QoL. The most affected domains were glare and having problem using tools with 52% subjects scored moderate and less respectively. However, no correlation was found between VF and QoL (rs(50)=-0.041, p=0.776). Conclusion This study showed that the QoL of glaucoma patients could be affected when they became low vision. However, VF is not associated with reduced QoL probably because most of the patients maintained good VA. It is suggested that implementation of LVQoL in assessment of low vision is admissible and should be considered in the management of glaucoma patients who became low vision. Keywords Glaucoma; Low vision; Quality of life; LVQoL

FP002 Myopia prevalence among Ujian Pencapaian Sekolah Rendah (UPSR) candidates in Batu Pahat district 2017.

Noor Aida S1, Syamzariah M

1, Nurulyun S

1, Haryanny K

1, Muhammad Faizal R

1, Nuraini M

1

1Unit of Optometry, Department of Ophthalmology, HSNI, Batu Pahat, Johor.

Aim of study This study aimed to evaluate the prevalence of myopia among Batu Pahat UPSR candidates. Methods All 1652 UPSR candidates (12 years old) were screened at 26 primary school at Batu Pahat district from Blindness Awareness Program. From that, 349 candidates failed and were referred to Eye Clinic, HSNI for further examination. Only 146 candidates (64 males and 82 females) went to eye clinic and underwent assessment of visual acuity testing, binocular vision assessment, objective and subjective refraction, anterior and posterior segment examination. Results A total of 291 eyes were examined and included in this study. Overall, 82.8% (n=241) eyes were myopic, 16.5% (n=48) were emmetropic, and 0.7% (n=2) were hyperopic. The prevalence of mild, moderate and high myopia were 65.3% (n=190), 13.7% (n=40) and 4.1% (n=12), respectively. 111 candidates (76%) need glasses to correct their myopia and 1 candidate (0.7%) need visual therapy due to accommodation insufficiency, and 5 candidates (3.4%) were diagnosed as keratoconus, cornea opacity, cataract, and nerve problem. Conclusions Most of candidates (82.8%) found to have myopia in this study. Near-work load such as schoolwork, syllabus revision, extra classes or tuition and prolonged use of gadget prone to induce myopia among UPSR candidates. Candidates with uncorrected refractive error were prescribed with glasses to increase their visual acuity and help them preparing for examination. Therefore, it is necessary to increase the school health team-optometrist collaboration to improve the quality of vision among school-aged children. Keywords Refractive errors; Prevalence; Myopia

FREE PAPER FP003

The ChromaGen lenses for congenital colour vision deficiency Mahani Mohd Salleh

1, Farah Ismail

1, Zalifa Zakiah Asnir

1

1Department of Ophthalmology, Hospital Ampang, Selangor.

Aim of Study The ChromaGen Lenses may enhance colour perception of people with colour vision deficiency (CVD) by changing the wavelength of each colour going into the eyes. However, there is limited evidence for this. In Malaysia, Ishihara test is commonly used as the gold standard to assess colour vision abnormality. This study was carried out to investigate the number of patients with CVD that could pass Ishihara test using the ChromaGen trial lenses according to CVD types and severity. Method This study was a retrospective, single centre which involved data collections from patient medical records in Ophthalmology Department, Hospital Ampang, Selangor. Patients with congenital CVD and no other abnormality who were seen within 1stAugust 2013 until 30th April 2019 were recruited. Ishihara colour vision test was administered with and without ChromaGen lenses on both eyes of 27 male patients with CVD ranging from 11 to 37 years old. The Hardy-Rand-Rittler (HRR) pseudoisochromatic test was conducted to determine the types and severity of CVD. Data were analyzed using SPSS version 17.0. Results Among the total of 27 patients, 74% (20) have passed the Ishihara test using the ChromaGen lenses. Out of 16 patients categorized as Deutan, 88% (14) passed the Ishihara test compared to 55% (6) from 11 patients diagnosed as Protan. Comparison based on CVD severity between mild, medium and strong showed no significant difference (p > 0.05; Fisher’s exact test). Conclusion Patients with CVD are more likely to pass Ishihara colour vision test upon wearing ChromaGen lenses, particularly patients with Deutan. Those graded as strong CVD may also benefit from ChromaGen lenses. Keywords ChromaGen, Colour vision de¬ficiency, Ishihara test

FP004 Validation of Ocular Surface Disease Index (OSDI) in Bahasa Malaysia

Aziimah Awang Abd Rahman1,2

, Noor Ezailina Badarudin2, Mohd Zulfaezal Che Azemin

2, Azrin Esmady Ariffin

3

1Department of Ophtalmology Hospital Kemaman, Terengganu.

2Department of Optometry and Visual Science, International Islamic University Malaysia, Kuantan, Pahang.

3 Faculty of Optometry and Vision Sciences, SEGi University, Selangor.

Aim of study This study is planned to validate the same structure of OSDI in Bahasa Malaysia, to remove language barrier in assessing the dry eye disease (DED) symptoms. Methods Translation process was conducted via five phases; forward translation, synthesis of translation, backward translation, refine of translation and lastly translation scrutinization. The result from translation process was transformed into an online questionnaire using JotForm program. It was distributed to 230 bilingual participants to answer both English and Bahasa Malaysia version. The responses was automatically calculated and replied via online. SPSS software was used to analyse the results, using Cronbach’s alpha coefficients test to determine the reliability of the translated version. Results The reliability of the scores of all items in OSDI-Bahasa were satisfactory with the Cronbach’s Alpha range from 0.88 to 0.94, which were considered acceptable. Conclusion Thus, OSDI in Bahasa Malaysia is valid as an instrument to assess symptoms of DED. Keywords Dry eye disease (DED); Symptom; OSDI; Translate; Validate

FREE PAPER FP005

Visual acuity demand of modern primary school classrooms in Klang Valley Narayanasamy Sumithira¹, Azizan Izzah Azreena¹, Kaur Sharanjeet¹.

¹Optometry & Vision Science Programme, Faculty of Health Sciences, UKM Kuala Lumpur.

Aim of Study Good visual acuity is important for children’s learning but the actual visual acuity demands of classrooms are poorly understood. Method 61 classrooms from 8 primary schools (SK, SKC, SKT) in Klang Valley were included in this study. The classrooms were divided into lower and upper primary. A range of measurements were conducted in each of the classroom: dimensions, maximum distance a student is seated and vertical height of the distance and near target. Near working distance of 28cm was assumed. Distance and near visual acuity demand (VA) were then calculated. Results This study involved 31 lower and 30 upper primary classrooms. The distance and near VA demands were 0.11 ± 0.26 logMAR and 0.24 ± 0.10 logMAR for lower primary and 0.09 ± 0.20 logMAR and 0.24 ± 0.09 logMAR for upper primary classrooms respectively. Distance and near VA demand between both levels were not significantly different (p>0.05). The distance and near VA demand for Sekolah Kebangsaan were 0.24 ± 0.17 logMAR and 0.31 ± 0.04 logMAR , Sekolah Kebangsaan Cina (SKC) were 0.16 ± 0.11 logMAR and 0.13 ± 0.03 logMAR, Sekolah Kebangsaan Tamil (SKT) were 0.09 ± 0.10 logMAR and 0.12 ± 0.03 logMAR respectively. There were significant differences for both distance and near VA demand between types of schools, F (2, 58) 42.19, p = 0.00; F (2, 58) 208.35, p = 0.00. Conclusion The study shows that relatively high levels of visual acuity demand for distance and near are required to meet the requirements of modern classroom environments. These findings provide an evidence base to inform prescribing guidelines and develop paediatric vision screening protocols and referral criteria. Keywords Visual acuity; Children’s vision; Learning; Vision

FP006 Correlation between variation in phacoemulsification surgical techniques and predictability of surgically induced astigmatism

Md Muziman Syah M.M1, Nazaryna M

1,4, Khairidzan M.K

2, Noorhazayti A.H

3

1Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, IIUM Kuantan, Pahang.

2Department of Ophthalmology, Kulliyyah of Medicine, IIUM Kuantan, Pahang.

3Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, IIUM Kuantan, Pahang.

4 Department of Ophthalmology, Sarawak General Hospital, Kuching, Sarawak.

Aim of Study To evaluate the correlation between variation in phacoemulsification surgical techniques and predictability of surgically induced astigmatism (SIA). Methods This study involved four ophthalmic surgeons (Surgeon A, B, C and D). A self-administered Phacoemulsification Technique Related SIA (PTechSIA) Questionnaire (patency number: LY2018002935) was conducted to document the surgeons’ phacoemulsification surgical techniques. The technique variation score (TVS) for each surgeon was calculated. Score 0 has been given for the surgeons who consistently applied the same surgical technique. Whereas, score 1 has been given if the surgeons used two different surgical techniques, score 2 has been given if the surgeons used three surgical techniques and so on. Twenty patients who had undergone uneventful phacoemulsification with intraocular lens (IOL) implantation by each surgeon were recruited. Preoperative and postoperative K-readings were retrieved from medical records for the SIA analysis. Centroid and coherence of SIA were calculated using SIA Calculator Version 2.1 (SIA2.1). The centroid value represented the surgeon’s SIA and the coherence value represented the measure of the SIA predictability. Correlation between the variation of phacoemulsification surgical techniques and predictability of SIA was determined by the TVS and SIA coherence. Results The TVS and coherence values for Surgeon A, B, C and D were 1, 52%; 1, 48%; 0, 90% and 3, 11% respectively. There was a significant and strong negative correlation between the TVS and SIA coherence (Spearman's r = -0.95, p = 0.05). Conclusion Surgical technique consistency in phacoemulsification cataract surgery contributes to higher predictability of SIA outcome. Keywords Surgically induced astigmatism; Phacoemulsification surgical technique; SIA predictability; Coherence.

FREE PAPER FP007

Outcomes of a statewide refractive error services program in Terengganu Sajidah S

1, Shahidah I1, Rusmiza A

1, Mohd Fazuan AN

1, Duratul Ain H

2.

1 Department of Ophthalmology, HSNZ Kuala Terengganu, Terengganu. 2 Department of Ophthalmology, Hospital Kuala Lumpur.

Aim of Study The purpose of this study was to assess the impact of a statewide Refractive Error Services Program conducted by School Health Team, teachers and optometrists at 502 schools in Terengganu throughout 2018. Method Children who failed vision screening were referred to optometrists at respective District Health Centers (visiting/out-reach optometrists) or nearby hospitals (resident optometrists) for a full eye examination including refraction, squint assessment, red reflex and colour vision test. Children who have been diagnosed with refractive error were prescribed and dispensed a pair of spectacle delivered through the School Health Team or teacher. Screening and optometric examination data were sent to the Program Coordinator at the Hospital Sultanah Nur Zahirah for evaluation using descriptive analysis. Results A total of 45,462 school children were screened through the program in 2018. Of these, 2783 children (6%) had been referred to the optometrists through 66 outreach visit to the districts and hospitals. Only 1,467 school children (53%) turned up for the full eye examination. Of these, 993 children (68%) had refractive error and requires spectacle. Other diagnosis were strabismus (N=29, 2.0%), colour vision defect (N=80, 5.5%) and cataract (N=11, 0.7%). Out of 993 prescriptions dispensed, 591 spectacles (60%) were dispensed from the Unit Dispensing Cermin Mata Hospital Sultanah Nur Zahirah. Conclusion The Statewide Refractive Error Services Program School has shown to be a comprehensive and effectived vision screening programs through a comprehensive and collective effort of School Health Team, teachers and optometrists. The program should be further empowered to enhance its effectiveness in eliminating avoidable visual impairments due to refractive error among school children. Keywords Refractive error; Outreach; Unit Dispensing Cermin Mata

FP008 Effectiveness of computerized visual screening tool used in driving schools in Malaysia: A study on candidates who had

failed the test and have been referred to the Eye Clinic Hospital Sultanah Nora Ismail (HSNI), Batu Pahat. Haryanny K

1, Nurulyun S

1, Syamzariah M

1, Muhammad Faizal R

1, Noor Aida S

1, Nuraini M

1

1Unit of Optometry, HSNI, Batu Pahat, Johor.

Aim of study This study aimed to look at the effectiveness of computerized visual screening tool used by road transport department in driving schools in Malaysia by comparing it with conventional testing method. Methods 141 adults aged range 17-60 years (24±7 years), who had failed in computerized visual screening (comprise of visual acuity test and colour vision test) were referred to eye clinic HSNI from 1st January 2014 to 31st December 2018. They were all re-examined using conventional testing method that is visual acuity test using Snellen chart and colour vision test using Ishihara 24 plate edition. Results 125 candidates were referred after failed their colour vision test at driving school. After re-examine, 27% (n=34) were found failed their colour vision, 70%(n=87) were found having normal colour vision, 3% (n=4) were found having normal colour vision but failed their visual acuity test.16 candidates referred after failed their visual acuity test were re-examined, and found 94% (n=15) passed the visual acuity test, 6% (n=1) failed the test. Conclusions These findings conclude that the current visual screening method used for Malaysian drivers is not effective as a visual screening tool for driving schools. False positive referral has caused burden to driving test candidates especially on the cost incurred and time spent. As for clinicians, it increased the number of outpatients and lengthened overall waiting time. Keywords Visual acuity; Driving; Colour vision.

POSTER PP001

Keratometry changes in pre and post phacoemulsification cataract operation patients in Hospital Raja Perempuan Zainab II

Norhafizah AR1, Najmah CA

1, Tengku Aida TAA

1, Syahidatul Akmal MS

1,Nur Mizan H

1, Nor Fadilawati MY

1, Rahayu AH

1,

Rossaidah M1.

1Department of Ophthalmology, HRPZ II, Kota Bharu, Kelantan.

Aim of study Over the years, cataract operation has been proven to improve vision for patients who has cataract, however many patients still have dependency to glasses due to suboptimal vision quality from residual astigmatism postoperatively. By understanding the changes to the corneal astigmatism post operatively, surgeon can manipulate and reduce the astigmatism during operation. The study was done to determine changes in corneal astigmatism in patients who had phacoemulsification cataract operation in HRPZ II. Method Data was retrospectively collected and analyzed from 54 samples of patients who met the inclusion and exclusion criteria of the study. All patients selected had phacoemulsification cataract surgery in HRPZ II Eye Department with non toric, monofocal acrylic intraocular lens (IOL) implanted during the operation. Pre-operative and post-operative keratometric data was analyzed according to the flattest (flat K) and the steepest (steep K) meridian. Results Mean pre operation data for both meridian is 44.201 D ± 1.25 (flat K) and 45.122 D ± 1.383 (steep K) with pre op corneal astigmatism -0.921 ± 0.319. Post-operative mean data was 44.023 ± 1.33(flat K) and 45.310 ± 1.43 (steep K) with corneal astigmatism -1.287±0.113. There was a significant difference (p<0.05) for both meridian pre and post operatively with mean corneal astigmatism difference 0.35± 0.59 (p<0.05) with majority of post-operative axis towards ATR. Conclusion Phacoemulsification cataract operation does affect the corneal curvature in both flat and steep meridian. Therefore manipulating corneal astigmatism intraoperatively or using toric IOL in patient with significant preoperative corneal astigmatism will reduce residual astigmatism postoperatively. Keywords Cataract; Cataract surgery; Keratometry; Corneal astigmatism.

PP002 Compliance and basic knowledge in two different groups of contact lens wearers

Ishak B1, Azizan ANA

1

1Program of Optometry and Vision Science, Universiti Kebangsaan Malaysia, Kuala Lumpur.

Aim of Study To compare the level of compliance and knowledge related to lens wear between two groups of contact lens wearers. Method A total of 60 female subjects aged 18 to 30 years old participated in this study (30 subjects fitted from UKM Optometry Clinic and 30 subjects from private practices). The subjects were interviewed by using a structured questionnaire which consists of 15 questions about compliance and 14 questions of basic knowledge related to lens wear. Results All subjects wore disposable contact lens with 53.33% (n=32) of them preferred monthly disposable lenses. The purposes of lens wear were to correct refractive error and look good (53.33%). More than 40% subject experienced general discomfort during lens wear. Almost all subjects from both groups practiced safe lens care and good handling of contact lenses. There were no significant differences between both groups in level of compliance of cleaning process (p=0.83), disinfecting (p=0.725), accessories care (p=0.865) and replacement schedule (p=0.699). Both groups have the same level of knowledge and only differ in the knowledge of the effects of eye makeup (p < 0.05) and the duration of the solution used for cleaning (p=0.01). Conclusion Good compliance and knowledge related to lens wear are known to be vital in order to be a success contact lens wearer. Contact lens practitioners should play their role in delivering all the information so that wearers are equipped to handle their contact lenses in a correct way and definitely will minimize the risk of eye complications. Keywords Contact lens wearers; Compliance; Knowledge related to contact lens

POSTER PP003

Vision-related quality of life impact in moderate to severe primary open-angle glaucoma patients: a pilot study Marizah AR

1, Syarifah Faiza SMD

2, Maryam Jameelah N

3, Nurfadhilah AH

3, Sharifah Suzaini SK

5, Nor Emalina S

6

1Hospital Seri Manjung, Perak.

2Hospital Putrajaya, WP Putrajaya.

3Hospital Segamat, Johor.

4Hospital Tunku Jaafar, Seremban, Negeri Sembilan.

5Hospital Melaka.

Aim of Study To assess vision-related quality of life (VRQoL) in moderate and severe primary open-angle glaucoma (POAG) patients. Methods Sixteen patients with moderate to severe POAG were included in this study. VRQoL was assessed using the validated Malay or English versions of 25-items National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Subjects were classified by mean deviation (MD) of the better eye SITA Standard 24-2 test into moderate and severe damage groups. Other visual function tests including visual acuity (VA) and binocular Esterman visual field test were obtained. Results There were statistically significant difference between the moderate and severe POAG patients’ VRQoL score (U=5, p=0.007) with severe glaucoma elicited significantly lower VRQoL score than the moderate POAG patients. Strong positive correlation was observed among binocular Esterman visual field efficiency score and VRQoL score (rs=0.727, p=0.001). Patients exhibited the greatest difficulty in activities involving driving 58.33 (41.67-91.66) followed by role difficulties 68.75 (50-100) and ocular pain 75 (65.63-87.5). However, no significant correlation between better eye VA and VRQoL score (rs=-0.027, p=0.921) observed. The correlation between MD of the better eye and VRQoL score were statistically significant (rs=0.553, p=0.026). Conclusion This study showed that VRQoL decreased with advancing disease severity. Quality of life is therefore one of the important parameter to be monitored in ensuring a successful long term patient management. Keywords Vision-related quality of life; Glaucoma; Primary Open-Angle Glaucoma

PP004 The effect of wearing soft contact lenses on corneal thickness.

Nurul Fara Idayu I1, Fatin Nur Najwa N

1

1 Center of Optometry, Faculty of Health Sciences, UiTM Puncak Alam Campus, Selangor.

Aim of Study This study was conducted to see changes in corneal thickness with contact lens wear of two different water content among dry eye and non-dry eye patients. Method A total of 48 eyes of 24 participant age 19-30 years participated in this study. They were divided into dry eye and non-dry eye group based on inclusion criteria. Twelve subjects for dry eye and twelve subjects for non-dry eye were fitted with two types of daily disposable soft contact lens that have different water content on two different days: low water content (33%) and high water content (59%). Central corneal thickness (CCT) was measured using specular microscope twice a day: one before putting the lens on and one after 6 hours of contact lens wear. Results There were significant changes of corneal thickness before and after lens wear among dry eye and non-dry eye patients (p<0.05). High water content contact lens Hilafilcon B (59%) cause increase (3.000,5.083) in corneal thickness while low water content contact lens Delefilcon A (33%) cause decrease (-3.125, -2.625) in corneal thickness among dry eye and non-dry eye patient. In comparing the corneal thickness changes between dry eye and non-dry eye groups, no significant difference was found (p=0.877). Conclusion Soft contact lens wear can cause changes in corneal thickness among dry eye and non-dry eye patients. The magnitude of changes with high water content lens (59%) was higher in dry eye group. Variations of corneal thickness depend on the type of contact lens used. Keywords Daily disposable soft contact lens; Central corneal thickness; Water content; Dry eye

POSTER PP005

Strabismus and visual impairment among new patient attending Ophthalmology Clinic in Hospital Pulau Pinang Siti Nursyuhada M.S

1., Ruwaidah S.

1, Fazrul Azwan J.S.

1, Nur Molizawatie B.

1, Normaisarah M. S.

1, Siti Noor Aznira Y.

1,

Kew F. H., Effendy H.1

1Hospital Pulau Pinang

Aim of Study 1) To identify new cases of strabismus, (Esotropia and Exotropia) 2) To identify new cases of visual impairment among strabismus population Methods A cross-sectional study was conducted among new patients referred to the Ophthalmology Clinic Hospital Pulau Pinang from 1st August 2017 to 31st August 2018. New patients who fulfilled the inclusion and exclusion criteria aged between 6 month to 18 years old were identified from the medical records where routine eye assessment were conducted by the optometrist. Data from those identified subjects transferred into a Microsoft EXCEL format and analyzed with SPSS version 22. Results 317 new patients were identified as subjects where 177 (55.8%) were males and 140 (44.2%) were females. Among those subjects, 191/317 (60.3%) are Malay, 87/317 (27.4%) are Chinese, 35/317 (11%) Indians and 4 (1.3%) Others. Visual Impairment counted for 186/317 (58.7%) among those subjects. 72/317 (22.7%) of the subjects had strabismus where 21/317 (6.6%) were Esotropia and 51/317 (16.1%) were Exotropia. Vision impairment counted for 51/72 (70.8%) out of those subjects with strabismus. Conclusion This study shows that among the study population, there are higher percentages of Exotropia as compared to Esotropia and more subjects with strabismus has visual impairment. More than half of the subject identified had visual impairment. Keywords Strabismus; Visual Impairment; Esotropia; Exotropia

PP006 IOL Master: Keratometer measurement with and without eye drops

Nurulfaiz Rahmat1, Nurul Hafizah Mohd Norizan

1, Eryanti Md Omar

1, Raja Norliza Raja Omar

1.

1Department of Ophthalmology, Hospital Melaka

Aim of Study To evaluate the keratometer measurement with and without eye drop (normal saline) especially in dry eyes patients using IOL Master 700. Methods This study was a cross sectional study. All subjects were screened for inclusion criteria via Visual Acuity (VA) and ocular health examination. 31 dry eyes (age 51-73) with 30 normal eyes (age 50-71) were classified based on Non-Invasive Tear Break Up Times (NIBUT). All participants in both groups underwent corneal curvature measurement using IOL MASTER 700 without instillation eye drop for both eyes. The same measurement will be repeated after instilling 1 drop of normal saline. NIBUT remeasured after completed the eye curvature measurement using eye drops. Mean of the average corneal curvature before and after instillation of eye drop were compared using Paired T-Test and reliability assessment using Intra-class correlation (ICC). Results There is no significant mean difference between mean average corneal curvature before instillation eye drop (Mean: 44.53D, SD: 1.55D) and after instillation eye drop (Mean: 44.51D, SD: 1.59D) in dry eyes group, t (30) = 0.362, p=0.720. Result showed that there is no significant mean difference between mean average corneal curvature before instillation eye drop (Mean: 43.93D, SD: 1.48D) and after instillation eye drop (Mean: 44.04D, SD: 1.48D) in normal eyes group as well, t (29) = -1.270, p=0.214. High reliability between corneal measurement before and after instillation of eye drop in both groups (Dry eyes: ICC, 0.983, Normal: ICC, 0.988). Conclusion In conclusion, it is recommended to use normal saline in measuring corneal curvature using IOL Master for dry eyes patient as it able to produce reliable results. Key Words Corneal curvature; Dry eyes; IOL Master

POSTER PP007

Prediction of dry eye symptoms in young adult diabetics Aziimah AAR

1, Noor Ezailina B

2, Norsham A

2, Mohd Zulfaezal CA

2

1Department of Ophthalmology Hospital Kemaman, Terengganu.

2Department of Optometry and Visual Science, IIUM Kuantan, Pahang.

Aim of Study This study aimed to determine the predictor of dry eye symptoms in the diabetic population. Methods Thirty-five young adults (19 to 39 years old) with diabetes mellitus (NPDR) and without ocular comorbidity participated in this study. Dry eye symptoms scores (as determined by the OSDI-Bahasa Malaysia), Phenol red thread, tear break up time, corneal staining, Marx line displacement, Meibomian gland count, and quality; visual acuity, contrast sensitivity (Pelly Robson) and colour vision (FM 100-Hue) were measured. For the univariate analysis, associations between all study parameters were simultaneously assessed with Spearman bivariate correlation test. For multivariate analysis, determination of independent parameters that predict dry eye symptoms was performed using a general linear model of multiple regression analysis. Results Among the parameters, contrast sensitivity and phenol red thread showed significant associations with OSDI score. The final model formed in multivariate analysis was statistically significant (p<0.05). With a lower contrast sensitivity value, the OSDI score was expected to be higher (more symptoms) after controlling for the other variables in the model. The model predicted that with 0.1 log decrease of contrast sensitivity, OSDI was expected to increase in score by 7.011 units. Conclusion This study showed that contrast sensitivity is suggested as a predictor of dry eye symptoms in young adult diabetics. Keywords Dry eye symptoms; Contrast sensitivity; Predictor; Diabetics

PP008 Incidence of visual impairment due to uncorrected refractive error in optometry clinic, Hospital Kuala Lumpur Ilyana Rosli

1, Nor Bahiyah Tahar

1, Intan Khursiah Abdul Rahman

1, Farah Wahidah Hashim

2, Nurul Aini Yusoff

2,

Khairul Hasniza Khamis3

1Department of Ophthalmology, Hospital Kuala Lumpur, Malaysia

2Department of Ophthalmology, Hospital Selayang, Malaysia 3Department of Ophthalmology, Hospital Kangar, Malaysia

Aim of Study This study aimed to determine the incidence of visual impairment due to uncorrected refractive error amongst new patients presented at Optometry Clinic Methods Two hundred eighty eight consented subjects referred to Optometry Clinic Hospital Kuala Lumpur (May to July 2018) aged 4 years old and above recruited in this study. Habitual distance visual acuity was determined using a Snellen letter projector chart for the literates and matching Snellen chart for the illiterate patients. Objective and subjective refraction were carried out and the best corrected visual acuity was recorded based on subjective refraction. The data was analyzed using descriptive statistic of the Statistical Package for Social Sciences (SPSS) version 21. Results Upon measuring habitual visual acuity, results showed that 144 eyes (25.22%) had normal vision, 251 eyes (43.96%) had mild visual impairment, 85 eyes (14.89%) had moderate visual impairment, 48 eyes (8.41%) had severe visual impairment, 9 eyes (1.58%) had profound visual impairment, 17 eyes (2.98%) were near blindness and 17 eyes (2.98%) were totally blind. Refraction assessment revealed that 121 eyes (68.75%) had visual impairment due to uncorrected refractive error. Conclusion This study found that high percentage of uncorrected refractive error referral, therefore this data can be used as guidance in managing types of referral to optometry clinic HKL. Keywords Visual impairment; Uncorrected refractive error; Refractive error; Kuala Lumpur

POSTER PP009

A retrospective cohort study to assess the post- operative ocular alignment at one month for lateral rectus recession surgery in the patients with intermittent exotropia

Khatijah Mustapa1, Fiona LM Chew

1

1Department of Ophthalmology, Selayang Hospital, Selangor, Malaysia

Aim of Study This study aimed to assess post-operative ocular alignment for lateral rectus recession surgery in the first month. Methods Retrospective review of the medical records of consecutive patients, who underwent lateral rectus recession for intermittent exotropia by a single surgeon between from March 2017 to March 2019. All subjects completed one-month follow-up. Exclusion criteria were a pre-operative angle of more than 50 prism diopters, re-operation, sensory exotropia, convergence insufficiency, true divergence excess, dense amblyopia, ocular abnormalities other than refractive error, previous ocular trauma, neurological disorders and prematurity. Demographic details were recorded. Preoperative and post-operative measurements for distance and near were noted. Subjects were assigned to the success group if they had phoria, or had post-operative deviation of 10 prism diopters of exotropia or esotropia on prism cover test. The remaining subjects were assigned to the failure group. Results A total of 61 subjects were recruited. Majority of the subjects were female (55.7%, 34/61). Mean subject age was 14.03 years (standard deviation, SD: 16.084). Mean pre-operative angle for distance and near was 35.33(SD: 9.525). 31.1% (19/61) were combination surgeries. For distant angle analysis, success rate was 82% (50/61). Of the patients with residual exotropia, the mean angle was 18.91PD (SD: 4.01). For near angle analysis, 88.5% (54/61) of subjects were in the success group. The mean residual near angle was 19.71PD (SD: 4.19).Pre-operative angles affected postoperative success for distance (P: 0.048) but not near angles (P: 0.246). Conclusion Our study success rate of 82 to 88.5% was comparable to other studies. Further research is required to increase the success of this procedure. Keywords Intermittent exotropia; Lateral rectus recession; Ocular alignment; Success rate

PP010 The profile of patients in Pediatric Optometry Clinic, Universiti Kebangsaan Malaysia from 2010 to 2016

Khoo Zheng Yuan1, Norlaila Mat Daud

1

1Optometry and Vision Sciences Programme, Faculty of Health Sciences, UKM Kuala Lumpur.

Aim of Study This study was conducted to determine the profile of patients in Pediatric Optometry Clinic, National University of Malaysia (UKM) from 2010 to 2016. Methods A total of 309 patient files were analyzed in this study. The parameter involved in this study are patient’s age during the first visit, gender, race, birth history, Orang Kurang Upaya (OKU) status, optometric diagnosis, treatment and management on patients. Results The results showed the majority of patients came to Pediatric Optometry Clinic are male (61.2%), Malay (71.8%) and aged between 4 to 6 years old (45.6%). Among 309 patients in this study, 82.5% were born full term and 13.3% registered as OKU. The common eye problems can be found among patients in Pediatric Optometry Clinic were refractive error (57%) and strabismus (18.1%). The most frequent optometric diagnosis in this study was low hyperopia (46.6%). The most frequent treatment and management given were follow up appointment (48.9%), followed by giving prescription with follow up (18.4%). As a conclusion, majority patients in Pediatric Optometry Clinic were having refractive error and the most frequent treatment and management was follow up appointment. The numbers of cases in the Pediatric Optometry Clinic were fluctuated from 2010 to 2016. Conclusion Malay, male, age between 4 to 6 years and refractive error were the majority of all the pediatric patients from year 2010 to 2016. Keywords Pediatric; Diagnosis; Treatment; Management; Profile

POSTER PP011

A demographic review of binocular vision anomaly cases seen at Hospital Serdang Optometry Clinic in 2015 Fadhilah MH

1, Siti Hamiza AH

1, Nur Syazwani AR

1, Muhsonat MZ

2 Rini Roslina A

1

1 Department of Ophthalmology, Hospital Serdang. 2 Department of Ophthalmology, Hospital Pengajar UPM

Aim of Study To report a demographic of binocular vision anomaly cases seen in Hospital Serdang in 2015. Methods This is a survey study and the data was collected retrospectively from Health Information System (HIS). All patients attended to binocular vision clinic at Hospital Serdang in year 2015 (1st January 2015 to 31st December 2015) were reviewed. Data collection were patients’ age in 2015, onset of the binocular vision problem, gender, diagnosis, refractive error, treatment given and person who detect the sign of binocular vision problem. Data were analyzed using SPSS version 24 and Microsoft Excel 2010. Results Hundred (100) data were scrutinized from HIS. Among the hundreds subjects, children was the majority with 72%. Onset of the problem varies from birth to 71 year old. Gender distribution showed female 69% while the rest were male. The most binocular vision anomalies found were exotropia 29 %, esotropia 27%, convergence insufficiency 11% and accommodation weakness 10%. Refractive error distribution showed 57% were classified into low hyperopia, 20% low myopia while only small percentage were high and moderate level. Treatment given were orthoptic exercise 40%, refractive correction with glasses 34%, occlusion therapy 11%, squint surgery 1% while the rest 14% were not need any treatment. Detection of the problem was made mostly by the optometrist (43%) followed by the parent (26%). Percentage of strabismic and non-strabismic binocular vision anomaly was about equal. Most of the subjects were low level hyperopia. Most of the patients were managed with orthoptic exercise. Conclusion The demography of the binocular vision anomalies seen in this clinic showed that optometrist play an important role in managing the problem. Keywords Binocular vision anomaly; Strabismic and non-strabismic; Accommodation; Convergence

P012 Keratoconus detection using image processing and machine learning

Marizuana M. Daud1, W. Mimi Diyana W. Zaki

1, Aini Hussain

1, Haliza Mutalib

2, Safira Zainal

3

1Centre of Integrated Systems Engineering and Advanced Technologies, Faculty of Engineering and Built

Environment,

UKM Bangi.

2Optometry and Vision Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, UKM Kuala Lumpur.

3Department of Ophthalmology, Kuala Lumpur Hospital.

Keratoconus is one of the diseases that has yearly increased. Early diagnosis is needed to control the progression of Keratoconus (KC). Due to lack of optometrist with ratio of 1:17,580 patient to optometrist reported by Ministry of Health Malaysia 2017, a lot of cases found in severe stage because of late diagnosis especially in rural area and not many hospitals equipped with cornea topography. Thus, computer-assisted method has been proposed to detect Keratoconus using anterior segment photographed images. Firstly, the images captured from front view and side view of an eye using smartphone attached with macro lens. After that, corneal region will be segmented as well as some preprocessing steps to enhance the image. Feature extraction has been applied to get the features such as HVID, VVID, major and minor length, eccentricity and solidity for front view while curvature characteristic measured for side-view. All these features have been ranked following the distinctiveness of features. Lastly, the features will be classified using machine learning which random forest method is. The proposed algorithm has successfully classified KC and Normal cases with accuracy of 96.03%, sensitivity of 98.41% and specificity of 93.65%. With the help of the proposed system, it can be used by clinicians without intense training and very useful in a rural area.

POSTER PP013

Psychological impact of low vision patients diagnosed with diabetic retinopathy Nadhrah AB

1, Mohd Harimi AR

1, Zainora M

1, Mushawiahti M

2 and Nur Hidayah Y

1.

1Optometry & Vision Sciences Programme, Faculty of Health Sciences, UKM Kuala Lumpur.

2Department of Ophthalmology, Faculty of Medicine, UKM Cheras, Kuala Lumpur.

Aim of Study Mental status of low vision (LV) patients is not fully understood and it was not a routine evaluation. This study was carried out to determine the depression, anxiety and stress status among LV patients diagnosed with diabetic retinopathy. Methods A total of 50 LV patients diagnosed with diabetic retinopathy were randomly selected in this cross-sectional study. Standard LV assessment and mental health screening using Depression Anxiety Stress Scales (DASS) questionnaires were administered. Results The mean visual acuity was 0.63±0.16 LogMAR. The mean score for depression, anxiety and stress subscale were 6.28±8.05, 4.20±3.86 and 7.20±6.85 respectively. The DASS questionnaire showed that 19 (38%) of the subjects suffered one or more mental health problems. Of the 19 LV patients with diabetic retinopathy, 26% experienced depression, 53% experienced anxiety and 89% experienced stress. Conclusion The above findings have showed and validated the negative impact of the vision impairment on our LV patients' mental health. The DASS questionnaire has been shown to be able to assess and determine the state of our LV patients' mental health, which in turn enables the better management of the patients. Keywords Mental health; Low vision; DASS; Diabetic retinopathy

PP014 Ocular toxicity from Ethambutol: the past, present and future

Naqibah Ghazali1, Norieny Mat Yaacob

1

1Department of Ophthalmology, HTAA, Kuantan, Pahang.

Aim of study To document and to critically review current guidelines and literature on ocular toxicity of ethambutol- its background, clinical presentation, toxicity characteristics, and suitable visual function test in monitoring and management. Data Source Literature search of Medline from 1962 to Jan 2019 Study selection All related literature in English using the search formula: (ethambutol OR myambutol) AND (eye* OR ophthal* OR ocular) AND (adverse OR toxic). Data extraction All information was collected and analysed by authors. Data synthesis Ethambutol hydrochloride is a commonly used first-line anti-tuberculous agent. Although rare, ocular toxicity in the form of optic neuritis (most commonly retrobulbar neuritis) has been well documented since its first use in the 1960s. Several studies evaluated the utility of optical coherence tomography (OCT) in screening for EON. These showed decreased retinal nerve fiber layer (RNFL) thickness in patients with clinically significant EON, but mixed results in their ability to detect such changes in patients taking ethambutol without visual symptoms. Conclusions Ethambutol-induced optic neuropathy is a well-known, potentially irreversible, blinding but largely preventable disease. Clinicians should be aware of the importance of patient and physician education as well as timely and appropriate screening.

POSTER PP015

Prevalence of refractive error among school children referred by Unit Perkhidmatan Kesihatan Sekolah (UPKS) in Kota Belud, Sabah.

Valentinus G¹, Arifah Nur Y.¹ ¹Hospital Queen Elizabeth Kota Kinabalu, Sabah.

Aim of Study This study aimed to determine the prevalence of refractive error among school children referred by UPKS in Kota Belud, Sabah. Methods A retrospective study of clinical records of Program Saringan Penglihatan Perdana Optometris Sabah was conducted in July 2018. All records of referred students who attend the program with uncorrected VA 6/12 and less were collected for the study. Myopia was defined as spherical equivalent (SE) ≥-0.50D, hyperopia ≥ +2.00D, astigmatism ≥0.75DC and anisometropia ≥1.00D. Results From a total of 110 students referred, 91 (82.7%) students attended further eye examination including refraction and fundus examination. Of these, 88 (36 males and 52 females) were falls on inclusion criteria and analyzed for the study. Mean spherical equivalent was -0.98D ±2.28 while mean of referred VA 0.40 + 0.21 Logmar (6/15) ±19.23. 2% cases of visual impairment (VA less than 6/18) were recorded for the study. Myopia (≥0.50DS) is the most common type of refractive error with the prevalence of 56.8%, followed by astigmatism at 46.6% and no cases of hyperopia detected. Anisometropia is less common with only 9.1%. Mean corrected VA was 0.12+ 0.20 Logmar (6/7.5) ±0.25. Conclusion Myopia is the most common refractive error among school children referred by UPKS in Kota Belud. Thus, we emphasize the need of effective and regular school screening programs in the future to ensure better quality of life and to prevent amblyopia. It is important to have regular and simple vision screening for school children at least at the commencement of school so as to detect those who may have the risk of refractive error. Keywords Refractive error; Myopia; Hyperopia; Astigmatism; Anisometropia

PP016 Phacoemulsification techniques related to surgically induced astigmatism questionnaire: content and face validation.

Md Muziman Syah M.M1, Nazaryna M1,4

, Khairidzan M.K2, Noorhazayti A.H

3

1Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, IIUM Kuantan, Pahang.

2Department of Ophthalmology, Kulliyyah of Medicine, IIUM Kuantan, Pahang.

3Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, IIUM Kuantan, Pahang.

4Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak.

Aim of Study To validate the recently-developed Phacoemulsification Techniques Related to Surgically Induced Astigmatism (PTechSIA) questionnaire Methods A set of questionnaire items was generated according to peer-reviewed literatures of related domains to phacoemulsification surgical techniques. Fifteen closed-ended questions were made up the initial version of the self-administered tool. Face validation was conducted by five subject-matter experts (SMEs) using qualitative approach. Then, another five SMEs were recruited for content validation using Lawshe’s method. Modifications on the questionnaire were made according to SMEs’ feedback, and content validation ratio (CVR) was calculated for each item. Items with CVR value less than 1.00 were eliminated, and final content validity index (CVI) of the questionnaire was obtained. Results Fifteen questionnaire items were generated for validation. The questionnaire had an initial CVI of 0.61. Six items with CVR value less than 1.00 were eliminated (Item No.2; 7; 11; 13; 14; 15). Number of items included in the final version of the questionnaire was nine, with overall final CVI score of 1.0. Conclusion Appropriate validity of the finalised PTechSIA was achieved. Therefore, it can be applied for future studies to evaluate phacoemulsification techniques and its relationship with SIA Keywords Face validity; Content validity; Phacoemulsification; Surgically induced astigmatism; Questionnaire

POSTER PP017

A study of computer vision syndrome related symptoms among staff in Hospital Sultan Ismail, Johor Bahru Nur Adilah A¹, Safiahalimah M¹, Nur Salihah A¹, Nor Aida A¹, Azlyn Azwa J

1

¹Department of Ophthalmology, Hospital Sultan Ismail, Johor Bahru.

Aim of study To determine the prevalence of CVS symptoms among management department staff in Hospital Sultan Ismail, Johor Bahru (HSIJB), to know whether the subjects aware that prolonged use of computer has bad effects on their eyes and to evaluate what the staff do to prevent or relieve the CVS symptoms. Method In a descriptive cross sectional, questionnaire survey study, data was collected among management department staff in HSIJB that are using computer or laptop during their working time. The data was collected regarding the demography, use of spectacles, duration of daily continuous use of computer, symptoms of CVS, preventive measures taken to reduce the symptoms, use of radiation filter on the computer screen, and the lighting in the room. Results A total of 82 staffs, aged between 22 and 55 years, from management department staff in HSIJB were surveyed. The prevalence of symptoms of CVS was found to be 96.3%; the most disturbing symptom was eye tiredness (80.5%) followed by headache (58.5%). 97.56% of the staff aware of CVS. Staffs who used computer for more than 2 hours per day (79 subjects) experienced more symptoms of CVS (375 symptoms present). Taking break in between computer use was found to be effective to relieve the CVS related symptoms (82.9%). The use of radiation filters on the screen did not help in reducing the CVS symptoms (6.1%). 84.1% of the staffs use computer at the eye level. While working on the computer, 92.7% staffs used fluorescent light in the room and only 7.3% of the staff use natural lighting. Conclusion 96% of the management department staff in HSIJB experienced symptoms related to CVS, which was seen more often in those who used computer for more than 2 hours continuously per day. Keywords Computer vision syndrome; Eye tiredness; Headache

CASE REPORT CR001

Managing Streff syndrome in optometry clinic: a case report Aznor Azwan AA

1, Nur Liyana I

1, Nurulain MZ

1, Syarmilla CS

1, Mohd Harimi AR

2

1Department of Ophthalmology, Hospital Kuala Krai.

2Optometry & Visual Sciences Program, UKM

Introduction Streff syndrome is a clinically controversial characteristic associated with psychosomatic and conversion vision disorder. Some health provider may misdiagnose Streff syndrome with malingering or hysterical amblyopia. Case Presentation We describe a case of ten years old, Malay, female who was referred from paediatric ward due to a multiple episode of fainting with a normal Computed Tomography (CT) of brain and electroencephalogram (EEG) but an abnormal visual function. This case shows how important it is how to manage Streff syndrome in the optometry clinic. Conclusion Progress of undiagnosed or unmanaged Streff syndrome will result in poor school performance and affects the daily activities. This case report illustrates that recognition of the stressors in the patient’s life is critical in order to reduce that impact as well. Keywords Streff syndrome; Juvenile bilateral functional amblyopia; Non-malingering syndrome

CR002 Goldenhar Syndrome : Limbal Dermoid; Don't Be Shy

Nur Diana MZ1

, Nur H Mokhtar2

1Optometry Clinic, Kuala Kubu Bharu Hospital, Selangor.

2Department of Ophthalmology, Selayang Hospital, Selangor.

Aim of study Goldenhar Syndrome is a complex congenital syndrome characterized by an association of maxillomandibular hypoplasia, deformity of the ear, ocular dermoid and vertebral anomalies. The estimated prevalence of this rare syndrome was 1 in 26,000 live births with a higher prevalence seen in males. We present a case report of Goldenhar Syndrome in a teenager with an unsightly unilateral Limbal Dermoid and pre-auricular skin tag. Case presentation A 15-year-old female Malay presented with right eye (RE) Limbal Dermoid and congenital unilateral pre-auricular skin tag. However, there were no manifestations on the organs, maxillomandibular and vertebral during the initial examination by a private clinic. She was diagnosed with Goldenhar Syndrome. The Limbal Dermoid was left unremoved throughout her childhood life due to high surgical costs in the private sector and the parents were unaware of other options. The patient by coincidence presented to our primary care setting while accompanying her mother for eye examination. The Best Corrected Visual Acuity (BCVA) for the Right Eye was 6/12 and Left Eye was 6/6. Mother also reported that child had been having low self-esteem due to her appearance. She was later referred to the Ophthalmology Department, Sungai Buloh Hospital and the Limbal Dermoid was subsequently removed in a month time. She was seen 3 months post-operatively with RE residual astigmatism of -1.50DC and BCVA of 6/9. Conclusions Limbal dermoid is removable with minimal costs. The outcome of surgery depends on the types of dermoid. Failure to remove the limbal dermoid could possibly lead to visual disturbances such as amblyopia and psychosocial issues towards the patient. We aim to increase the awareness among the medical community towards the management of Goldenhar Syndrome. Keywords Goldenhar syndrome; Limbal dermoid; Amblyopia

CASE REPORT CR003

Bitoric RGP contact lens is better optional for high regular astigmatism: A case report Shara Wahida MS

1

1Department of Ophthalmology, HOSHAS, Temerloh, Pahang

Background Recent study reported astigmatism is the most common refractive error in children and adults population. The most common treatment are spectacles and contact lens. Rigid Gas Permeable Contact (RGP) lens provide better cosmesis and minimize visual aberration. Case presentation A 15 year old female patient was referred for contact lens fitting. Her chief complaints were headache and discomfort using spectacles. Her best corrected visual acuity on right eye and left eye were 6/9 and 6/6 respectively. Subjective refraction was +0.50/-5.50x175 on right eye and +0.50/-0.75x180 on left eye. Cornea topography showed high regular astigmatism of -5.10DC for right eye. Few types of RGP contact lens were fitted and compared on the right eye. Back surface toric RGP provide good fitting but fail to correct full astigmatism. Fitting with Rose K showed poor fitting by persistent high riding. Therefore, bitoric RGP was prescribed using empirical fitting. Fitting with bitoric RGP showed good centration, movement and tear exchange. During after case visit, patient report high satisfaction with bitoric lens. Discussion Bitoric RGP lens can give better acceptance for patient in high astigmatism. Keywords Astigmatism; Bitoric RGP; Empiricial fitting

CR004 Duane syndrome type 3 with convergence insufficiency: A case report

Mohd Afiru SO1, Azlin Azira A

1, Rusmiza A

1

1Department of Ophthalmology, HSNZ, Kuala Terengganu.

Background Duane syndrome is a congenital eye movement disorder characterized by horizontal eye movement limitation (adduction, abduction or both). Case presentation A 12 year old malay girl complained of diplopia for the past 2 months, noted squint by mother at age 8 months, not worsening. Unaided visual acuity in the right eye (OD) was 6/6 and left eye(OS) was 6/9. She presented with abnormal head posture(AHP) of right face turn, cover test showed alternating exotropia at distance and near, prism cover test for near 16 pd BI and distance 8pd BI, ocular movement showed limited OS abduction and adduction with globe retraction and narrowing of palpebral fissure on adduction, stereopsis with Lang II was 600”of arc, positive fusional vergence(PFV) at distance 6pd BO, for near 4pd BO, negative fusional vergence(NFV) at distance 14pd BI and near 18pd BI (normal), near point of convergence(NPC) was 21cm. Hess test showed under-action of OS lateral rectus and medial rectus,OS limitation of abduction and adduction. Both eyes (OU) fundus were normal. Based on examination, patient was diagnosed as Duane Syndrome Type 3 with convergence insufficiency. She was prescribed in office prism therapy and positive 3 cats stereogram 3 times per day at home. After 3 consecutive visits, the headache symptom was relieved. Her NPC improved to 5cm and stereopsis improved to 200’ of arc with Lang II and 240” of arc with TNO. Her OU unaided vision was 6/5, N5, PFV for distance and near was 40pd BO (normal). Patient then was discharged with continuous positive cat stereogram exercise. Conclusions Duane syndrome Type 3 can be found with other eye problems. As Duane syndrome is asymptomatic, full examination needs to be carried out according to patient’s symptoms. Convergence insufficiency also has its own set of problem which needs to be addressed and managed accordingly. Keywords Duane syndrome; Convergence insufficiency; Diplopia

CASE REPORT CR005

Application of The Newcastle Control Score System in management of patient with Convergence Insufficiency-type Intermittent Exotropia: A case report

Ahmad Wafi AA1

1Department of Ophthalmology, HOSHAS, Temerloh, Pahang.

Background Convergence Insufficiency-type Intermittent Exotropia (CIXT) is defined as larger exodeviation measured at near than exodeviation at distance of at least 10 prism dioptres. Patients with CI often complain of headaches, blurred vision, diplopia, loss of concentration and sleepiness when reading. In most of the cases, symptoms could be treated by non-surgical methods, such as orthoptic treatment, base in prism reading glasses and vision therapy. However, surgical intervention is indicated on patients whose deviations are too poorly controlled or too large to be treated with non-surgical means. In this report, the importance of objective measure (The Newcastle Control Score System for Intermittent Exotropia) in determining level of control in patient with CIXT is discussed. Case Presentation Patient is 25 years old Malay lady with underlying Generalized Anxiety Disorder and Tricotillomania. No other remarkable ocular and systemic finding. Her chief complaints were asthenopia as well as diplopia and these conditions were worsening with time. Her vision was 6/6 bilaterally. Worth-4-dots test shows Binocular Single Vision. She scores 60” of stereopsis in TNO test. Cover test at near and distance show large exophoria with moderate recovery. Measurement of deviations at distance is ranging from 30 prism dioptres to 40 prism dioptres. Measurement at near is ranging from 45 prism dioptres to 68 prism dioptres. She is diagnosed of having Convergence Insufficiency-type Intermittent Exotropia. Level of control was assessed using The Newcastle Control Score System and patient demonstrated high score, suggesting for surgical intervention. Conclusions Although non-surgical methods are the first choice of treatment in CIXT, some patient may benefited from surgical intervention. This can be determined by using score system. Keywords Intermittent exotropia; Convergence insufficiency; The Newcastle Control Score System for Intermittent Exotropia

CR006 From the eyes’s of a Marfan family: a case series report

Rohaila A¹, Siti Aminah AY¹, Siti Illani S¹, Siti Syahidah MS¹, Anis Suzanna M¹, Arni Rehny AR¹, Noor Suriani M¹. ¹Eye Department, Hospital Sultanah Bahiyah, Alor Setar.

Background Marfan syndrome (MFS) is frequently caused by abnormalities or mutations in the fibrillin-1 gene that leads to weakness of zonules resulting in crystalline lens subluxation. The prevalence of MFS using the 2010 Revised Ghent Nosology diagnostic criteria was 6.5/100000. Visual impairment caused may results from significant refractive error (aphakia), amblyopia and ocular disorders such as glaucoma. Case Presentation Three of a family were diagnosed with MFS; S, 49 years old housewife, her children N, 20 years old daughter and AF, 14 years old son. They were first presented at our clinic in May 2014. Reasons for referral were secondary glaucoma management for S and visual rehabilitation for her children. They all had bilateral supero-temporal subluxated lens, leaving S and AF aphakic bilaterally while N is aphakic only on the RE. Thus, management for all of them was carefully planned according to individual ocular and visual impairment status. Improved vision and comfort for N and AF were achieved as they were prescribed with silicone hydrogel aphakic contact lenses, with visual acuity improved from 1/60 RE and 6/36 LE, to 6/60 RE, 6/24 LE for N while AF, visual acuity improved significantly from 6/60 RE and 6/30 LE, to 6/7.5 RE, 6/6 LE. However S is comfortable and compliance with aphakic glasses of +17.00/-0.50x50 (6/12) and +16.00/-0.75x10 (6/9) for RE and LE respectively. Conclusions The optometric management in MFS is a real challenge. Early diagnosis and intervention of Marfan cases may affect visual impairment status and quality of life of the patients in a long run. As for this family, the mother is already in an advanced Marfan condition while N is having bilateral amblyopia may be due to late diagnosis and visual intervention. Careful after care assessments is crucial to ensure good oculo-visual outcome for this family. Keywords Marfan Syndrome; Lens subluxation; Silicone hydrogel; Aphakic; Visual impairment

CASE REPORT CR007

Accomodation dysfunction due to auto immune deseases: a case report Ayu Hidayati A

1, Nur Adnin R

1

1Department of Ophthalmology, HOSHAS, Temerloh, Pahang.

Background Accommodation dysfunction is a part of binocular vision anomalies that can lead to blur of vision and headache. The most common causes are uncorrected refractive error and prolonged near work and these can be treated by prescribing spectacles and vision therapy. Anemia is also known to have some effect on accommodation. This case report discussed the importance of medical investigation after unsuccessful vision therapy in accommodation dysfunction. Case Presentation 20 years old Malay lady was referred by private optometrist. Her chief complains were blurring of vision and headache. Symptoms worsened with near works activities. She was prescribed with multifocal spectacle. Her best corrected visual acuity was 6/6 bilateral. Dry and cyloplegic refraction was +1.00DS on right and left eye. Assessment on accommodation in several visits showed she had very poor amplitude of accommodation and positive relative accommodation. She was treated as accommodative weakness and vision therapy was initiated. Ocular findings were unremarkable. The next few visits showed vision therapy was unable to relieve her symptoms and subsequently patient developed dry eyes problems. Further medical examination revealed of Anemia with Haemoglobin reading 8.1 and she was referred to general medical. Once her Anemia is treated, her Haemoglobin increases to 12.6. Her symptoms relieved with medication and she no longer wears her multifocal spectacles. Conclusions Anemia can result in accommodative dysfunction and managing Anemia proved to relieve symptoms of accommodative dysfunction. Keywords Accommodation; Anemia; Auto immune diseases; Headache; Accommodation spasm

CR008 Pushing the boundaries in large angle sensory esotropia: a case report.

Nur H Mokhtar1, Fiona LM Chew

1

1Department of Ophthalmology, Selayang Hospital, Selangor.

Background Large angle sensory esotropia is difficult to treat, as it often requires multiple surgeries. Surgical techniques include monocular medial rectus and lateral rectus surgery, transposition procedures and even surgery for the normal eye. Four-muscle surgery in one eye is rare as there is an elevated risk of anterior segment ischaemia. Anterior segment ischaemia occurs as disinsertion of multiple recti muscles reduces blood supply to various ocular anterior segment structures. We present a case of large angle sensory esotropia who underwent four-muscle surgery in the affected eye with a cosmetically acceptable outcome. Case presentation A 33-year-old female presented with a longstanding, large angle, left eye (LE) constant esotropia and dense amblyopia secondary to high myopia. Pre-operatively, she had LE esotropia of more than 133 prism diopters (PD) with LE abduction deficit of -4. In view forced-duction test was positive intra-operatively, she underwent maximum LE medial rectus recession. Post-operatively, her esotropia reduced to 133 PD. Two months later, the patient had LE medial rectus re-recession and modified Nishida’s procedure. The esotropia reduced to 60PD with LE abduction deficit of -3. One year later, LE lateral rectus plication was performed. The patient’s final angle at 6 months follow-up was 25 PD with an abduction deficit of -3. She had no evidence of anterior segment ischaemia and was happy with the final surgical outcome. Conclusions Four-muscle surgery in one eye is an option for large angle sensory esotropia. The surgeries should be performed in stages and muscle-sparing procedures should be used to ensure a successful outcome. Keywords Four-muscle surgery, Large angle sensory esotropia, Anterior segment ischaemia, Strabismus

The Sub-Committee of the 3rd OPTOMETRY SCIENTIFIC CONFERENCE (TOSC) wishes to

express its deep appreciation to the following for their contribution and support:

PLENARY EXHIBITION

1. Encik Ku Hazemie Ku Ismail 2. Puan Filzah Rahilah Hussein 3. Cik Rachel Clarice Linggam 4. Cik Sit Jo Anne

1. Puan Rahmi Mukhtar 2. Puan Hazwani Hassan 3. Puan Fadhilah Mohd Hilmi 4. Puan Siti Nursyuhada Mohamed Salleh 5. Puan Akmarina Rosnan 6. Cik Kew Fui Hsien

LOGISTIC & BANQUET PROGRAMME BOOK & IT

1. Puan Nor Bahiyah Tahar 2. Puan Mahani Mohd Salleh 3. Puan Farah Ismail 4. Puan Marhaini Othman 5. Puan Raja Balqis Raja Hasnan

1. Puan Sulastrey Mohamed 2. Puan Najihah Muhammad Sharif 3. Puan Ilyana Rosli 4. Puan Juhaida Zahri

REGISTRATION TECHNICAL

1. Puan Diana Mohamed 2. Puan Arni Rehny Ahmad Rakhli 3. Puan Rohaila Ariffin 4. Puan Juliana Md Desa 5. Puan Noor Asmah Md Azmi 6. Cik Hasyimah Hamdan 7. Puan Noor Maziah Mohd Zain 8. Puan Nadia Nabillah Hassan Basri 9. Puan Nur Shafiah Khursaid Alam

1. Puan Nur Hafiza Mokhtar 2. Puan Majidah Zainal Abidin 3. Encik Mohamad Effandi Nor Mohamed 4. Puan Nurul Aini Yusoff 5. Puan Rohaliza Enet Ghani 6. Puan Samsia Lattang 7. Puan Nurul Akma Saharuddin 8. Puan Khatijah Mustapa 9. Puan Siti Faeza Hanim Syed Yaziz

PROMOTION & PUBLISITY SOUVENIRS

1. Puan Siti Noorasyikin Abd Rahman 2. Puan Suhaida Shahudin 3. Puan Nursyazillah Samsuden 4. Cik Pua Tian Siew 5. Puan Siti Famira Rosland 6. Encik Mohamad Farid bin Othman 7. Puan Hazliyati Hassan 8. Puan Nurul Faiz Rahmat 9. Puan Nurul Hafizah Mohd Norizan

1. Puan Nur Faiza Jaafar 2. Puan Norhayati Minhaj 3. Puan Samsuhaibah Kasbol 4. Puan Nabilah Mohd Yussuf 5. Puan Noorfarina Fadil 6. Puan Nora Noorzareen Abd Razak 7. Puan Siti Nurul Ashiken Chahar Nordin

MULTIMEDIA “JASAMU DIKENANG”

1. Puan Rossaidah Mustapa 2. Puan Sajidah Sulong 3. Puan Ruwaidah Saidin 4. Puan Nur Amirah Meor Shaharuddin 5. Encik Mohamad Shahril Anwar Mohd Puzi 6. Encik Aznor Azwan Ab Azid

1. Puan Nur Adnin Razali 2. Puan Nurul Najiha Mohamed Khairi 3. Puan Ayu Hidayati Ariffin 4. Cik Hafeezah Nor Amirudin 5. Puan Farawahida Kasmira Fakaruddin

SPONSORSHIP PROTOCOL

1. Puan Nur Azillah Ismail 2. Puan Suzana Ahmad 3. Puan Azlina Abdullah 4. Puan Sharifah Suzaini Syed Kuning 5. Puan Tengku Zalikha Tengku Husin 6. Puan Khurul Ain Mohd Anas

1. Puan Syarifah Faiza Syed Mohd Dardin 2. Cik Wan Rahimah Wan Rahim 3. Puan Nik Mazniah Nik Mohd Zin 4. Puan Norhamima Ali 5. Puan Hayati Isman 6. Puan Siti Noor Aznira Yahya 7. Puan Nursyazwani Mohamad 8. Encik Mohd Faiz Mohd Haseri 9. Cik Nur Amirah Meor Shaharuddin 10. Encik Mohamad Shahril Anwar Mohd Puzi

ACKNOWLEDGEMENT

The Organizing Committee of the 3rd OPTOMETRY SCIENTIFIC

CONFERENCE (TOSC), wishes to express its deep appreciation to

the following for their contribution and support

OPTOMETRY PROFESSION MINISTRY OF HEALTH MALAYSIA

PERSATUAN PASCASISWAZAH OPTOMETRIS MALAYSIA