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Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in peripheral vision loss and eventually can lead to blindness if left untreated. It is most commonly associated with higher-than-normal intraocular pressure (IOP) although there have been cases reported where optic nerve damaged was observed under normal IOP.

Why does glaucoma screening necessary?

Glaucoma is the second-leading cause of blindness worldwide (behind cataracts). What makes glaucoma dangerous is that it has usually NO SYMPTOMS at all and therefore the chances of having intensive damaged caused by the disease are high.

By the time you notice problems with your sight, intensive damaged has occurred and additional loss may be difficult to stop. This is why half of the people with glaucoma don’t know they have it!

Types of glaucoma

• Primary open-angle glaucoma – the most common type of glaucoma which gradually reduces your peripheral vision without other symptoms. By the time you notice it, permanent damage already has occurred.
• Acute angle-closure glaucoma  – an emergency type of glaucoma which produces sudden symptoms such as eye pain, headaches, halos around lights, dilated pupils, vision loss, red eyes, nausea and vomiting. Each attack can cause progressively more vision loss.
• Normal-tension glaucoma – a type of open-angle glaucoma that can cause optic nerve damage under normal IOP without pain.
• Pigmentary glaucoma – A rare form of glaucoma caused by clogging of the drainage angle of the eye by pigment that has broken loose from the iris, reducing the rate of aqueous outflow from the eye. Over time, an inflammatory response to the blocked angle damages the drainage system.
• Secondary glaucoma – a type of glaucoma happened following an eye injury, infection, inflammation or tumour in the anterior part of the eye (primary diseases).
• Congenital glaucoma – An inherited form of glaucoma which is present at birth with 80 percent of cases diagnosed by age one. Signs of congenital glaucoma include cloudy cornea, enlarged or protruding eye in a child.

Visual field loss due to glaucoma

Who is at risk of having glaucoma?

This includes people who:

• are over age 40
• have family members with glaucoma
• have high eye pressure
• are farsighted or nearsighted
• have had an eye injury
• have corneas that are thin in the centre
• have thinning of the optic nerve
• have diabetes, migraines, poor blood circulation or other health problems affecting the whole body

How to screen for glaucoma?

Measuring your Intraocular Pressure (IOP)

In Eyeplus Optometrist, we are equipped with non-contact type tonometer – Keeler Pulsair tonometer. It is a non-invasive test that neither require instillation of any drugs nor touches your cornea. Therefore, it is safe and friendly to use even on children!

Keeler Pulsair tonometer

Evaluate your optic nerve via Digital Retinal Imaging technique

In addition, we will perform digital retinal imaging by using a retinal camera to photograph your optic nerve to evaluate the Cup-to-Disc ratio (optic nerve thinning indicator).

Any larger-than-normal CD ratio is an alarming sign of glaucoma that may require referral to an eye doctor and periodical monitoring.

Funduscopy to evaluate optic disc

At Eyeplus Optometrist, we pride ourselves in the fact that we possess a wide range of diagnostic machines to make sure that we deliver the highest standard of eye care services in this industry. For more information on eye health and eye conditions or to find your local Eyeplus optometrist, 

Anterior Segment Assessment

The anterior segment of the eye is the front third of the eye that includes the structures in front of the vitreous humour: the eyelid and its surrounding, cornea, iris, ciliary body, and crystalline lens (part where cataract occurs).

How do we test?

Using slit lamp biomicroscopy to focus and enlarge the structure of the anterior segment to look for any anomalies. This test will usually take up roughly 5 minutes.

What to look for?

External Structure:

• Look for any eyelid infection (styles, chalazion, Meibomian gland dysfunction or blepharitis).
• Look for any ptosis (droopy eyelid).
• Look for lagophthalmos (inability to close the eyelids completely).
• Note any unusual growths (tumours) or lesions.

Corneal Surface to Crystalline Lens:

• Look for conjunctival infection or inflammation (redness)
• Look for any corneal infection, lesion, foreign body or dryness.
• Look for any cataract.

At Eyeplus Optometrist, we pride ourselves in the fact that we possess a wide range of diagnostic machines to make sure that we deliver the highest standard of eye care services in this industry.

For more information on eye health and eye conditions or to find your local Eyeplus optometrist, 

          Contact lenses are surely gaining its popularity among Malaysian in recent years due to its convenience and superior aesthetic. It is no longer an uncommon situation to see people wearing contact lenses to avoid chunky glasses on important occasions and even on daily basis.

          As the modern lifestyle pushes youngster to rely heavily on contact lenses more than ever, it had led to a series of problems associated with contact lens wear such as corneal edema, neovascularization, infection, contact lenses related dry eye and so forth.

          All of these have led to the need for better contact lens materials, perhaps a more ‘breathable’ one!

          Subsequently, big players like Acuvue, Alcon and Bausch & Lomb had launched their premium silicone hydrogel (SiHy) contact lenses categories one after another ranging from monthly lenses (Air Optix & PureVision) to daily disposable lenses (1 Day Acuvue TruEye & Dailies Total 1).

          While premium SiHy lenses do offer superior wearing experience for the consumers, it also cost more in the long-term. Looking at this opportunity, Cooper vision had launched an affordable SiHy series to target those who are looking for ‘cheap-but-good’ contact lenses – the Clarity family.

The few members of the Clarity family include:

• Clarity elite (monthly)
• Clarity 1 day (daily)
• Clarity 1 day multifocal (daily) for presbyopia
• Clarity 1 day toric (daily) for combination of myopia and astigmatism.

          Clarity family is feature-packed SiHy lenses that not only offer excellent all-day comfort but also provide UVA and UVB protection. And the secret behind?  Is the WetLoc Technology!

          Basically, what the WetLoc Technology does is that it manipulates the structure of hydrophobic (water-hating) silicone molecules so they become hydrophilic (water-loving) and this creates a lens that naturally attracts and binds water molecules, enabling it to provide continuous wettability throughout the wearing time.

The result – is a lens with high water content that provides excellent all-day comfort for its wearers!

Following the emerge of Clarity family, consumers certainly have more choices when it comes to contact lenses selection. It is a good bargain for those who seek to save some bucks and at the same time do not want to put their eye health at stake.

Now you can even order it from Eyeplus Optometrist Store!

What is Retina?

The human retina is the innermost light-sensitive layer at the back of the eye that covers about 65 percent of its interior surface.

It is approximately 0.5mm thick and contains photosensitive cells called “rods” and “cones” that convert incident light energy into signals that are carried by the ganglion cell axons running to the brain and, additionally, incoming blood vessels that open into the retina to vascularize the retinal layers and neurons.

In the middle of the retina is a small dimple called the fovea. It is the centre of the eye’s sharpest vision and the location of most colour perception.

Why do we check for retina?

In Eyeplus Optometrist, we put your eye health as our top priority – to capture abnormalities of blood vessels, optic nerve and retina background for screening purposes as well as to scrutinize the underlying cause of blurry vision that is not due to refractive error.

Who should have their retina reviewed?

People who are more susceptible to retinal damage include:

• Hypertension patient
• Diabetic patient
• Family history of glaucoma
• Glaucoma suspect
• High myopic
• Elderly (55 years old and above)

How to screen retina?

Conventionally, the retina can be screened using an ophthalmoscope – a portable device that has special illumination and optic system which enable the examiner to observe the retina.

In Eyeplus Optometrist, we possess a more advanced imaging device known as the retinal fundus camera which has the ability to capture a 45-degree angle of the retina.

The coloured retina image enables our optometrist to detect the most subtle changes on your retina, thus, increasing the chances of detecting early stage retina diseases.

At Eyeplus Optometrist, we pride ourselves in the fact that we possess a wide range of diagnostic machines to make sure that we deliver the highest standard of eye care services in this industry.

For more information on eye health and eye conditions or to find your local Eyeplus optometrist, 

Dry Eye 

Dry eye syndrome is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface as defined by the International Dry Eye Work (DEWS) in 2007.

In short, it occurs when the eyes don’t make enough tears or the tears evaporate too quickly leading to the feeling of dryness, redness and irritation. It is usually accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.

Symptoms of dry eyes may include:

• Stinging
• Burning
• Foreign body sensation
• Sensitivity to light
• Tearing
• Tired eyes
• Difficulty wearing contact lenses.

DRY EYE IS BECOMING MORE COMMON THESE DAYS

Dry eye has affected the broad mass and it’s no longer just a problem among elderly. Gradually, our lifestyle had changed as digital products started to dominate our daily life.

We can no longer work without our laptop and communicate without the smartphone!

Consequently, we’re not blinking as often as we constantly looking at the screens. This has led to a decrease in blinking rate and increase in tear film evaporation causing discomfort and likely progression of dry eye syndrome.

HOW TO TEST FOR DRY EYE?

In Eyeplus Optometrist, we use all of the available means of diagnosis.

• Case history and questionnaire:

A series of questions including symptoms, contact lens wear history and artificial tear use will be asked to better understand the problem faced, lifestyle changed and severity of the disease. In addition, the patient is required to complete a SPEED questionnaire, which typically takes less than a minute.

• Slit lamp examination:

We look for abnormal signs like frothing near the lower lid margin, capped meibomian glands and toothpaste-like secretion. Besides that, we will also check for tear break up time (TBUT) by using fluorescein dye to evaluate one’s tear film stability.

• Medmont E300 corneal topographer (*Available @ Eyeplus Optometrist Jelutong, Penang):

This instrument shows Automated Tear Film Surface Quality Breakup Time (TFSQ-BUT) which is an important clinical marker for dry eye disease. It had 82% sensitivity and 94% specificity for diagnosing dry eye.

At Eyeplus Optometrist, we pride ourselves in the fact that we possess a wide range of diagnostic machines to make sure that we deliver the highest standard of eye care services in this industry. For more information on eye health and eye conditions or to find your local Eyeplus optometrist, click here.

What is Amblyopia?

Amblyopia, or commonly known as lazy eye, is decreased vision in one or both eyes due to abnormal development of vision in infancy or childhood.

Such abnormal development of vision occurs because nerve pathways between the brain and the eye aren’t properly stimulated, resulting the brain favours the good eye over the other (the bad eye).

What causes amblyopia?

Amblyopia usually developed when one eye only sees blurry images. As children typically developing their vision centre in their brain as they grew, such blurry images obstruct the normal visual development causing vision to decrease despite the normal appearance of the structures of the eyes.

The common causes of amblyopia include:

• Uncorrected high hyperopia (long-sightedness) in either one or both eyes (refractive amblyopia)
• Uncorrected high myopia (short-sightedness) in either one or both eyes (refractive amblyopia)
• Uncorrected high astigmatism in either one or both eyes (meridional amblyopia)
• Constant strabismus or crossed eyes – the brain will take up the images seen in the fixated eye and suppress the misaligned eye, leading to amblyopia.
• Ocular structure anomaly in childhood – droopy eyelid, cataract or corneal scar (deprivation amblyopia)

How can I know whether my child has amblyopia?

The easiest way is to bring him or her to the optometrist to have a complete vision test before school age to screen for any significant refractive error and eye misalignment even there is no vision compliant because in most cases, a child may not experience blurry vision if only one eye is bad. Therefore, amblyopia may develop unnoticed.

It is worthwhile to take note of any strange behaviour of your child such as:

• Abnormal head posture while viewing television
• Frown their eyes
• Complaining of headache
• Making mistakes while copying notes from the blackboard.

These may indicate blurry distance vision that may need immediate attention.

At Eyeplus Optometrist, we pride ourselves in the fact that we possess a wide range of diagnostic machines to make sure that we deliver the highest standard of eye care services in this industry.

For more information on eye health and eye conditions or to find your local Eyeplus Optometrist, click HERE.

弱视（懒惰眼/懒惰的眼睛/Amblyopia）

          弱视是一种儿童中常见的视力问题，如不治疗将造成永久性的视力下降。弱视就是儿童在眼睛结构可以完全正常的情况下发生视力下降，模糊不清的症状。

          一般上如果单眼或双眼的视力无论如何都无法矫正至0.6或以上可称为“弱视”/“懒惰眼”。（当单眼或双眼向大脑送去的视像是模糊的，视力下降就会发生因大脑“学会”只看模糊视像。即使使用眼镜的情况下亦无法改变。如图1）

          Having your child being diagnosed with myopia (short-sightedness) can be quite depressing and frustrated for most parents. Unfortunately, it is far more common these days to see a child wearing glasses during their preschool age compare to the older days.

           But why? Have you ever imagine that your child can be free from glasses one day? Or, at least wishing his or her power does not change (like… forever) and you will do whatever it takes?

Too Much Time Smartphones, Tablets and Homework!

          Since smartphones and tablets are becoming mainstream, I do notice that we spend more time every day in front of them either browsing webs or playing games.

          Consequently, I have heard many parents complaining that their children spend too much time on the phone and avoid outdoor activities at all. In addition, the hectic curriculum in this country is another reason why children are exposing to excessive near work these days.

          Huang et al did a research in 2015 to find the associations between near work activities and myopia and found that the odds of myopia are higher when more time is spent on near work activities.

           So, this gives rise to the idea of reducing near work to slow down or prevent myopia. Think about it, if this really works, why is that myopia prevalence is still riding high and even increasing over years?

A different strategy to treat myopia…

          While technology advancement and the increasing educational level is an inevitable situation, we could have focused on our work to slow down, or to prevent myopia from occurring at all.

          Conventionally, when a child has been diagnosed with myopia, glasses is almost being prescribed immediately. However, there are a number of approaches that we can employ to tackle myopic children in Eyeplus Optometrist. Below are the 6 ways to slow down myopia progression:

1.    Orthokeratology
2.    Multifocal Contact Lenses
3.    Multifocal Glasses (progressive additional lenses)
4.    Executive Bifocal Lenses
5.    Topical Atropine
6.    Lifestyle Changes

          It is worth noting that each of every strategy comes with pro and cons. Therefore, make sure that you have consulted our optometrist and understand well each of the treatment processes, commitment and budget involved before embarking either one.

source : PMC 

source of pics : Google.com

          弱视（Amblyopia/Lazy eye），亦称为“懒惰眼”，是指单眼或两眼经矫正仍达不到正常水平的视力(>0.8)。

          弱视是一种危害视功能的眼病，如不及时治疗会导致视力永久性低下，甚至失明，对日后的生活造成很大的影响。