Development and validation of a novel questionnaire regarding vision screening among preschool teachers in Malaysia

AIM: To develop and evaluate the validity and reliability of a knowledge, attitude, and practice questionnaire related to vision screening (KAP-VST) among preschool teachers in Malaysia. METHODS: The questionnaire was developed through a literature review and discussions with experts. Content and face validation were conducted by a panel of experts (n=10) and preschool teachers (n=10), respectively. A pilot study was conducted for construct validation (n=161) and test-retest reliability (n=60) of the newly developed questionnaire. RESULTS: Based on the content and face validation, 71 items were generated, and 68 items were selected after exploratory factor analysis. The content validity index for items (I-CVI) score ranged from 0.8-1.0, and the content validity index for scale (S-CVI)/Ave was 0.99. Internal consistency was KR20=0.93 for knowledge, Cronbach's alpha=0.758 for attitude, and Cronbach's alpha=0.856 for practice. CONCLUSION: The KAP-VST is a valid and reliable instrument for assessing knowledge, attitude, and practice in relation to vision screening among preschool teachers in Malaysia

Refractive error and visual acuity of elderly Chinese in Selangor and Johor, Malaysia

The first aim of this study was to determine the refractive error and visual acuity of Chinese elderly age 60 and above in Selangor and Johor, Malaysia. The second aim was to determine the percentage of elderly with vision impairment. Participants of this study were from the on-going population-based longitudinal study on neuroprotective model for healthy longevity (TUA) among Malaysian older adults using multistage random sampling. A total of 259 Chinese elderly aged 60 and above from state of Selangor and Johor agreed to participate. Refractive error was determined using autorefractometer Retinomax K-plus followed by subjective refraction. Best corrected visual acuity (VA) was measured using logMAR chart. Analysis was performed on data of 202 participants and the remaining 57 were excluded. Overall percentage of refractive error was higher for hyperopia (54%) compared to myopia (23.2%). High percentage of astigmatism was noted for all age groups (> 50%). Both gender showed similar distribution of refractive status. Mean overall VA was 0.24 ± 0.17 logMAR (≅ 6/9–) and mean VA declined with age. Overall, the percentage of elderly having at least mild vision impairment (> 0.3 logMAR or 6/12) was higher (62.9%) compared to normal vision (≤ 0.3 logMAR). However, percentage of vision impairment (VI) was highest in the mild category compared to others and only one participant had severe VI. This study found a high percentage of Chinese elderly with refractive error. The most common type of refractive error was hyperopia. A high proportion of them had mild vision impairment followed by moderate VI even with best correction. Vision impairment could affect daily life functioning and this effect can be further explored in the future

Soal selidik kendalian kendiri indeks fungsi visual (VF14) dan korelasinya dengan akuiti visual koreksi terbaik pada warga emas

Kajian ini dilakukan untuk menentukan skor kendalian kendiri indeks fungsi visual (VF14) dan korelasinya dengan akuiti visual koreksi terbaik pada warga emas. Subjek kajian ialah warga emas berumur 60 tahun ke atas yang mengambil bahagian dalam kajian yang sedang dijalankan iaitu“Model Perlindungan Neuro Bagi Penuaan Sihat Di Kalangan Warga Emas (TUA). Akuiti visual diukur dengan menggunakan carta logMAR. Penilaian soal selidik kendalian kendiri diukur menggunakan Indeks Fungsi Visual (VF14) berbahasa Melayu yang telah diubah suai. Seramai 482 (93.05%) daripada 518 subjek kajian telah mengambil bahagian dalam kajian ini. Purata umur subjek kajian ialah 69.18 ± 5.67 tahun dan purata akuiti visual koreksi terbaik ialah logMAR 0.21 ± 0.17. Purata skor VF14 ialah 89.65 ± 13.19. Perempuan mempunyai purata skor VF14 yang lebih rendah jika dibandingkan dengan lelaki (skorperempuan89.21 ± 12.76, skorlelaki90.11 ± 13.65) tetapi tidak ada perbezaan secara statistik (z= -1.09, p= 0.277). Terdapat korelasi yang sederhana tetapi signifikan antara skor VF14 dan akuiti visual koreksi terbaik (r = -0.412, p < 0.01). Kesimpulannya, akuiti visual koreksi terbaik sahaja tidak boleh digunakan sebagai indikator untuk menjelaskan perubahan skor VF14. Kajian ini menunjukkan ia hanya menyumbang kepada 17.2% kepada perubahan skor VF14. Gabungan banyak faktor lain seperti faktor sosio demografik (bangsa, status pendidikan dan masalah kesihatan), sensitiviti kontras dan stereopsis perlu diambil kira apabila menilai fungsi visual yang diukur dengan VF14

Definisi miopia menggunakan retinoskopi tanpa sikoplegia dalam kalangan pelajar Melayu

Miopia pada kebiasaannya didefinisi sebagai sfera setara ≥ -0.50 D dalam banyak kajian yang dilaporkan. Namun demikian tidak banyak laporan berkaitan kesensitifan dan kekhususan definisi miopia yang dipilih apabila penyelidik melaporkan prevalen dan taburan miopia dalam populasi yang dikaji. Objektif kajian ini adalah membezakan kesensitifan and kekhususan setiap definisi miopia yang dipilih, iaitu -0.50 D, -0.75 D dan -1.00 D dan untuk mengenal pasti kebolehan definisi tersebut meramalkan ralat refraksi miopia pada akuiti penglihatan kurang daripada log MAR 0.3 (6/12) dalam kalangan pelajar Melayu. Seramai 866 orang pelajar Melayu berumur antara 7-10 tahun mengambil bahagian dalam penyelidikan ini. Akuiti penglihatan diukur menggunakan carta log MAR dan ralat refraksi diukur menggunakan retinoskopi tanpa sikloplegia. Keputusan kami menunjukkan kesensitifan dan kekhususan definisi miopia yang dipilih iaitu ≥ -0.50 D adalah 54.5% dan 97.8%, untuk definisi miopia ≥ - 0.75 D adalah 71.1% and 97.5% dan untuk definisi miopia ≥ -1.00 D adalah 83.3% dan 97.2%. Luas lengkok ROC untuk setiap definisi miopia -0.50 D, -0.75 D dan -1.00 D ialah 0.676, 0.839 and 0.957. Kesimpulannya, kajian ini menunjukkan definisi optimum miopia untuk pelajar sekolah Melayu berumur antara 7-10 tahun ialah ≥ -1.00 D, dengan menggunakan kaedah retinoskopi tanpa sikloplegia. Definisi ini boleh mengenal pasti 95.7% pelajar mempunyai akuiti penglihatan kurang daripada log MAR 0.3 dan ia mempunyai gabungan kesensitifan (83.9%) dan kekhususan (95.7%) terbaik

Peripheral refraction with different designs of progressive soft contact lenses in myopes [version 1; referees: 2 approved]

Aim: The purpose of this study was to compare the changes in relative peripheral refractive error produced by two different designs of progressive soft contact lenses in myopic schoolchildren. Methods: Twenty-seven myopic schoolchildren age between 13 to 15 years were included in this study. The measurements of central and peripheral refraction were made using a Grand-Seiko WR-5100K open-field autorefractometer without correction (baseline), and two different designs of progressive contact lenses (PCLs) (Multistage from SEED & Proclear from Cooper Vision) with an addition power of +1.50 D. Refractive power was measured at center and at eccentricities between 35º temporal to 35º nasal visual field (in 5º steps). Results: Both PCLs showed a reduction in hyperopic defocus at periphery. However, this reduction was only significant for the Multistage PCL (p= 0.015), (Proclear PCL p= 0.830).  Conclusion: Multistage PCLs showed greater reduction in peripheral retinal hyperopic defocus among myopic schoolchildren in comparison to Proclear PCLs