Dear Editor, The standard of care for endometrial cancer is a total hysterectomy with bilateral salpingo-oophorectomy, and pelvic lymph node dissection (THBSO-PLND). Obesity is a known risk factor for endometrial cancer, and obese patients are challenging to operate on due to their anatomy and comorbidities. A recent database search showed...

Dear Editor, Endophthalmitis refers to the inflammation of the ocular cavities and their immediate adjacent structures without extension beyond the sclera, usually secondary to infection. Endogenous endophthalmitis (EE) results from haematogenous spread of microorganisms in patients with bacteraemia or fungaemia into the eye and represents 2–15% of endophthalmitis cases.1-3...

Dear Editor, Hysterectomy is one of the most common gynaecological procedures, and various approaches are available such as abdominal, laparoscopic and vaginal.1 Several studies demonstrated that vaginal hysterectomy is preferable to laparotomy for superior surgical safety, less postoperative pain, and shorter hospital stay.2,3 However, its use is limited by...

Glaucoma is a major cause of world blindness in developing and developed nations. The WHO Global data on blindness show that over half of the blind due to glaucoma reside in Asia, the majority being Chinese. This article is available only as a PDF. Please click on “Download PDF” on...

Frontal mucoceles are collections of inspissated mucus which occur when there is obstruction to the outflow of the frontal sinuses. The obstruction may be due to congenital anomalies, infection, trauma, allergy, neoplasms or surgical procedures in the nose. This article is available only as a PDF. Please click on “Download...

Sarcoidosis is an idiopathic, systemic, non-caseating, granulomatous disease with protean clinical manifestations. Although the first description of sarcoidosis was attributed to Hutchinson, its ocular features received little attention until 1936 when Heerfordt’s syndrome of uveitis, salivary gland enlargement and cranial nerve palsies was recognised as a sign of sarcoidosis. This...

Singapore’s population has grown rapidly since 1965, the year in which it gained independence. The total population enumerated at its first census in 1970 was 2 074 507, compared to 3 103 500 in 1997. This article is available only as a PDF. Please click on “Download PDF” on top...

Diabetic retinopathy is the leading cause of blindness in persons between the age of 24 and 64 years both in the US and the UK. Peak fertility and childbearing years correspond to the first half of this period. This article is available only as a PDF. Please click on “Download...

Retinoblastoma is the third most common tumour in childhood. It is inherited genetically. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship between the risk of this disease with birth weight and gestational age had been well-documented, in particular, in infants with birth weight ≤1500 g (very...

Diabetes mellitus affects some 9% of Singaporeans. Studies had shown that virtually all insulin dependent diabetes mellitus (Type 1) and 85% of non-insulin dependent diabetes mellitus (Type 2) patients would develop retinopathy after 20 years of disease. This article is available only as a PDF. Please click on “Download PDF”...

Myopia is the commonest eye disease worldwide, and is especially prevalent in certain Asian countries such as Taiwan, Japan and Hong Kong. Physiologic myopia is thought to be a multifactorial disease with both genetic and environmental factors. This article is available only as a PDF. Please click on “Download PDF”...

Involutional entropion is a frequent cause of ocular irritation in the local elderly patients. The inturning of the lid margin and the eyelashes result in corneal epithelial damage that may predispose to vision-threatening infection and irreversible corneal scarring. This article is available only as a PDF. Please click on “Download...

Myopia affects up to 70% of adults in Singapore, Taiwan, Hong Kong and Japan. The prevalence rates in these Asian countries are higher than those among Caucasians and Blacks in the United States and Europe. This article is available only as a PDF. Please click on “Download PDF” on top...

It is well known that stripping of Descemet’s membrane (DM) occurs not infrequently during cataract surgery. In 1928, Samuels described frequent DM detachments of small dimensions during cataract extraction of minor consequence. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress to what for most patients is already a traumatic event. This article is available only as a PDF. Please click on “Download PDF” on top to...

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of registered blindness. The prevalence of AMD seems to be increasing at a rate not commensurate with the increasing age of the population, although this observation...

Advanced primary corneal ectasia presents a difficult problem in terms of visual rehabilitation. Soft contact lenses do not address the astigmatic aberrations in these conditions and conventional rigid gas-permeable (RGP) corneal contact lenses though useful in less severe disease, are poorly tolerated by those with progressively worsening keratoconus and...

Primary meningococcal arthritis (PMA) and endogenous meningococcal endophthalmitis are both uncommon presentations of meningococcal infection that should be considered in the differential diagnosis of reactive arthritis and acute dermatitis-arthritis syndrome. We describe a case of PMA and meningococcal endophthalmitis occurring together. This article is available only as a PDF. Please...

Gyrate atrophy of the choroid (GA) is a rare choroidal dystrophy. It is an autosomal recessive disorder that results in progressive deterioration in peripheral and night vision. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Choroidal neovascularisation (CNV) is a devastating complication of macular degeneration and a major cause of irreversible vision loss in many developed countries. The most common cause of CNV is age-related macular degeneration but it may also occur secondary to a variety of other aetiologies such as pathological myopia, ocular...

The ocular surface is a complex biological continuum responsible for the maintenance of corneal clarity, elaboration of a stable tear film for clear vision, as well as protection of the eye against microbial and mechanical insults. The ocular surface epithelium comprises corneal, limbal and conjunctival epithelia, of which the...

In the Annals January 2004 theme issue on Myopia, Park and Congdon have disputed the reality of the increases in prevalence of myopia in East Asia for several reasons. In particular, they criticise the 2 best documented sets of cohort data, from Taiwan and Singapore, on methodological grounds. This article...

Topical steroid use in cornea ulcers is still a very contentious issue in ophthalmology. A recent review by Wilhelmus found that the use of topical steroids before the diagnosis of bacterial keratitis significantly predisposed eyes with preexisting corneal disease to ulcerative keratitis. This article is available only as a PDF....

Much has been published on the complications of integrated and non-integrated implants. Most studies on integrated implants pertain to experience with the hydroxyapatite implant, with the coralline (such as the Bio-Eye) {Integrated Orbital Implants, Inc., San Diego, California, USA} type dominating its cancellous bone counterpart (the Molteno M-sphere) {IOP,...

“A properly planned and executed clinical trial is a powerful technique for assessing the effectiveness of an intervention”. While each new clinical trial involves unique issues relevant to a particular condition or disease, overarching common guidelines for all studies provide the framework for obtaining meaningful results. This article is available...

Myopia occurs when the image of distant objects, focused by the cornea and lens, falls in front of the retina. It is the commonest eye problem worldwide. Its prevalence varies in different parts of the world – myopia occurs in 25% of the adult population in the United States,...

Myopia is a refractive condition in which the image of a distant object is formed anterior to the retina of the unaccommodated (relaxed) eye. It occurs when the refractive power of the eye is too great compared to the length of the eyeball and this may occur because the...

Today in Taiwan, with increasing level of educational and living standard, the prevalence and severity of myopia appear to be on an upward trend. This is true elsewhere also, especially in Asia. In Asia, there is currently a high prevalence of myopia, especially among the Chinese and Japanese. This article...

A number of authors have recently proposed that myopia is increasing at an “epidemic” rate, particularly in East Asia, and especially among populations of Chinese descent. It has been reported that the prevalence of myopia among some populations in this area has reached 90%. This article is available only as...

Myopia in humans results from an imbalance between the refractive power of the cornea and lens and the axial length of the eye, such that the image of an object at infinity falls in front of the retina, with the lens at rest. Accommodation, therefore, cannot focus the blurred...

Myopia develops from a mismatch of the eye’s anatomical axial length and its focal length, as determined by the combined optical powers of the cornea and lens. For higher degrees of myopia and myopic progression, this mismatch develops primarily as a consequence of disproportionate ocular growth, chiefly of the...

The rates of myopia, including high myopia , have been reported to be rising to epidemic proportions in Asia and solutions to this huge public health problem are urgently needed. Many researchers agree that myopia is not determined solely by genes and that environment may play a huge role. This...

Myopia is an ocular disorder of major public health and socioeconomic significance in many East Asian urban cities. In Singapore, the prevalence of myopia is one of the highest worldwide, affecting 28% of school children at the start of their primary education and 70% of those completing university education. This...

There is a strong association between myopia and near work, and it has been reported that the rapid rise in the prevalence of myopia in Singaporean children may be related to an increase in near work demands such as reading. Although the mechanism by which near work affects myopia...

Nyctalopia is a subjective sensation of poor vision under dark conditions. It may be clinically associated with retinal diseases affecting the rod photoreceptors or post-receptoral pathways. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Neisseria meningitidis has been reported as a causative organism for conjunctivitis and endogenous endophthalmitis, more commonly in neonates and young children. A search of the literature on Medline revealed very few reports on infective keratitis caused by N. meningitidis. This article is available only as a PDF. Please click on...

Acute retrobulbar haemorrhage is a potentially sight threatening condition that can occur spontaneously or following retrobulbar injections and trauma to the orbit. Visual loss results from central retinal artery occlusion or optic neuropathy from direct compression or from compression of optic nerve venous drainage. This article is available only as...

The macula lutea is an anatomic region of the posterior retina that measures approximately 5.5 mm in diameter, and is exquisitely specialised for sharp central vision. Lutein (L) is a carotenoid, which, along with its stereo isomer zeaxanthin (Z), is concentrated at the macula lutea, to give it its...

Ophthalmologists today depend heavily on various investigative modalities such as fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) for an accurate diagnosis and optimal management of macular disorders. This book is a quick reference guide for common macular disorders encountered in an ophthalmic practice and...

Cataract surgery is one of the most successful surgical procedures performed. However, postoperative endophthalmitis, defined as severe inflammation involving both the anterior and posterior segments of the eye secondary to an infectious agent, is an uncommon but devastating complication. This article is available only as a PDF. Please click on...

Metastatic orbital tumour from gastric cancer is rare. In a Japanese survey of metastatic orbital tumours seen over 95 years, gastric metastases accounted for only 8.6% (11 patients) of cases. A series of orbital tumours from 1976 to 1999 by Rootman et al reported only 2 cases of metastasis...

The issue of ophthalmic trauma is a major cause for concern. An estimated 55 million eye injuries occur each year worldwide, leaving 1.6 million patients blind from their injuries. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Among the variety of paradigms implicated in the pathogenesis of choroidal neovascularisation (CNV), an inflammatory component has been a recent focus of interest. The findings that complement factor H (CFH) polymorphisms are associated with an increased risk in the development of age-related macular degeneration (AMD) and that the histopathology...

Posterior capsule rupture (PCR) is a potentially serious intraoperative complication of cataract surgery. The anecdotal experience of some surgeons suggests that differences in the anatomy of the eyelids, bony orbit, nasal bridge and other facial features, as well as the globe itself among different races may influence such factors...

Changes in corneal curvatures and astigmatism after retinal surgery are well documented. Although some of these changes are mild and transient, some have reported clinically significant irregular and asymmetric corneal changes. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

Paediatric cataract has a low incidence compared with adult cataract. The estimated incidence is about 1 to 6/ 10,000 births. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

LASIK is routinely carried out to correct the refractive errors of myopic patients. A high percentage of patients have good high-contrast visual acuity after undergoing LASIK surgery, with the majority of them having unaided vision that meets the minimum recommended criteria for driving. This article is available only as a...

The presence of an intraocular foreign body (IOFB) is a common complication of ocular trauma. For surgical planning, the localisation of IOFBs has to be accurate. Posterior segment foreign bodies are detected by clinical examination and imaging techniques such as computed tomography (CT) and low-frequency (5 MHz to 10...

The epidemic of type II diabetes mellitus is now recognised worldwide. In India, it has been estimated that the population with type II diabetes would increase by 150% in 2025. As the population with type II diabetes increases, so does the prevalence of diabetic retinopathy and other microvascular complications. This...

The importance of ethics in research was highlighted in the USA when a healthy volunteer subject, 24-year-old Ellen Roche, died in a Johns Hopkins asthma study in 2002. Investigations showed that there had been serious deficiencies in the ethical review and research work was suspended in Johns Hopkins until...

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterised by serous detachment of the macula, retinal pigment epithelial (RPE) detachment and areas of RPE atrophy that may represent sequelae of previous episodes. CSCR can arise secondary to chronic treatment with steroids. This article is available only as a PDF. Please...

Retinitis pigmentosa (RP) is characterised by initial night blindness followed by progressive loss of visual fields and eventually, loss of central vision. RP is the most prevalent group of inherited retinopathies, affecting approximately 1 in 3500 individuals. This article is available only as a PDF. Please click on “Download PDF”...

The shift towards broader health perspectives and the emphasis on patient preferences have led to the development of many health questionnaires and their inclusion as primary and secondary outcome measures in clinical trials. Measurements of health-related quality of life (HRQOL), a multidimensional concept encompassing physical, emotional and social aspects...

Retinal angiomatous proliferation (RAP), initially described as deep retinal vascular anomalous complex in 1992 by Hartnett et al, has been recently defined as a new, distinct form of exudative age-related macular degeneration (AMD). In choroidal neovascularisation (CNV), the choroidal new vessels may proliferate through the retinal pigment epithelium (RPE),...

There are several known risk factors for cataract formation, including older age, lower educational status, smoking, ultraviolet light exposure, trauma, dehydration, diabetes, uveitis and glaucoma. Epidemiological research has been confounded by co-existing risk factors that are difficult to measure. This article is available only as a PDF. Please click on...

Retinitis pigmentosa (RP) is the most prevalent group of inherited retinopathies. This spectrum of diseases affects approximately 1 in 4800 individuals. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Best vitelliform macular dystrophy is an autosomal dominant disorder characterised by an egg yolk-like appearance of the macula. The vitelliform “egg yolk” lesions result from abnormal accumulation of lipofuscin in the retinal pigment epithelium (RPE). This article is available only as a PDF. Please click on “Download PDF” on top...

Over the last few years, with advances in mass spectrometry, there has been increasing interest in exploring the proteome of body fluids such as plasma, urine, cerebrospinal fluid (CSF) and saliva. An important objective is to search for potential biomarkers for the diagnosing and monitoring the progression of disease. This...

Pulmonary tuberculosis is a worldwide disease. In Hong Kong, there are about 7000 new cases of pulmonary tuberculosis each year and the prevalence remains high at about 110/100,000. The male elderly (>60 years) are at the greatest risk. This article is available only as a PDF. Please click on “Download...

Singapore currently has a comprehensive range of tobacco control policies and programmes. It started implementing legislative measures against cigarette smoking in the early 1970s, and since then has been regularly reviewing and revising its laws and their enforcement. This article is available only as a PDF. Please click on “Download...

Cataract surgery is the most commonly performed elective surgery in many countries. As a result of advances in surgical and anaesthetic techniques, most cataract surgeries are currently performed under local anaesthesia. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

Past studies on intervention in myopia progression have given conflicting results. For example, in the past, studies on (PMMA) hard contact lenses took researchers in the past on a roller-coaster ride. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

Tuberculosis (TB) has been present since ancient times. Around 460 BC, Hippocrates identified phthisis, which is the Greek term for consumption (TB seemed to consume people from within with its symptoms of bloody cough, fever, pallor and long relentless wasting) as the most widespread disease of the times, which...

Sarcoidosis remains an enigmatic disease with protean manifestations. It is a multi-system disorder of unknown cause characterised by an accumulation of T-lymphocytes, mononuclear phagocytes and non-caseating epithelioid granulomas in affected organs. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

The management of pain in the orbital region, whether ocular or orbital in origin, is complex and lies at the margins of several subspecialty interests. Because of this, and because of its rarity, it has received little attention in the literature. This article is available only as a PDF. Please...

In Retinal Vascular Disorders, Dr Mohan and co-authors cover common and important retinal vascular disorders in a series of short chapters which are written by one or more of the authors. The text is organised logically, with clear headings and subdivisions, and is generally well-written and quite readable. This article...

This review article considers the universal definition of blindness, the causes of world/global blindness, and ongoing international efforts in blindness prevention. The prospects for Vision 2020 – 20/20 or 6/6 visual acuity for all by year 2020 – worldwide, and for Singapore in particular, and whether it is relevant...

The most recent treatment for severe ocular surface disease is the transplantation of cultivated corneal and conjunctival epithelial stem cells, which makes use of human amniotic membrane (HAM) as a substrate and cell carrier. Although the results are quite promising, this new procedure is still facing some challenges. This article...

Tuberculosis (TB) is an ancient disease that has been detected in 3000-year-old Egyptian mummies. Robert Koch’s discovery of the tubercle bacillus as the aetiologic agent of this disease in 1882 led to the acceptance of “Koch’s postulates,” which remain the gold standard for linking a pathogen to a disease. This...

Photodynamic therapy using verteporfin (Visudyne, Novartis Ophthalmics) has been proven safe and effective for the treatment of predominantly classic, age-related macular degeneration (AMD)-related subfoveal choroidal neovascularisation (CNV), pathologic myopia-related CNV, and subgroups of AMD-related occult CNV. Visual results following verteporfin treatment of subfoveal, non-AMD related CNV have been variable....

In 1982, Mossey and Shapiro first demonstrated that global self-rating of health was a better predictor of 7-year survival than medical records or self-reports of medical conditions in participants of the Manitoba Longitudinal Study. Since then, many population-based longitudinal studies have confirmed that global self-rated health remains an independent...

Corneal infection is the most common cause of profound ocular morbidity leading to blindness worldwide. Corneal infection in children is difficult to diagnose and treat, as they are unwilling and sometimes unable to cooperate during active management. This article is available only as a PDF. Please click on “Download PDF”...

Advances in vitreoretinal surgery have greatly increased the anatomical re-attachment rate in cases with proliferative vitreoretinopathy (PVR). The availability of perfluoro-carbon liquids, indirect viewing systems for surgery, illumination systems allowing bimanual dissection, the use of dyes and the use of retinotomies have all contributed to achieving a complete re-attachment...

Optic nerve sheath meningiomas (ONSMs) account for one-third of primary optic nerve tumours, are the second most common optic nerve tumours after gliomas, and are the most common tumours of the optic nerve sheath. Although ONSMs are said to comprise 1% to 2% of all meningiomas, their reported incidence...

Patient comfort, safety and low complication rates are the essentials of local anaesthesia. The anaesthetic requirements for ophthalmic surgery are dictated by the nature of the proposed surgery, the surgeon’s preference and the patient’s wishes. This article is available only as a PDF. Please click on “Download PDF” on top...

Radiation optic neuropathy (RON) is an infrequent but usually devastating consequence of radiation to the optic pathways. It is almost exclusively an iatrogenic phenomenon, occurring in patients who have undergone radiation therapy for tumours and other lesions in sites near the visual apparatus, such as the choroid, orbit, paranasal...

Choroidal neovascularisation (CNV) is a leading cause of blindness in the western world. It causes 90% of the visual loss in age-related macular degeneration (AMD). This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Each year, thousands of people are afflicted with photoreceptor degenerative diseases that reduce vision to bare light perception or complete blindness. Retinitis pigmentosa (RP) is the leading cause of inherited blindness with 1.5 million people worldwide affected and an incidence of 1/3500 live births. This article is available only as...

Age-related macular degeneration (AMD) is a severe ocular disease characterised by progressive deterioration of the macula, the most sensitive central back portion of the retina. Choroidal neovascularisation (wet AMD) leading to haemorrhage and scar formation beneath the central retina accounts for most cases of legal blindness from AMD (80%...

Focal and grid laser photocoagulation are the primary surgical treatments for diabetic macular oedema. However, laser treatment of eyes with diffuse macular oedema has been disappointing. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Uveal melanoma is the most common primary intraocular malignancy and is diagnosed chiefly in the fifth to seventh decades of life. The choroid is the most common site for its development, and choroidal melanomas grow as dome-shaped or mushroom-shaped tumours. This article is available only as a PDF. Please click...

The surface of the eye is covered by 3 distinct forms of non-keratinising stratified squamous epithelium – transparent corneal epithelium overlying the corneal surface, conjunctival epithelium covering the sclera, and a junctional intervening zone of limbal epithelium overlying the limbal region which lies between the corneal and sclera. To...

Acute central serous chorioretinopathy (CSCR) is a condition of unknown origin characterised by a serous detachment of the macula. It afflicts young healthy adults, mostly men, between the ages of 20 and 50 years. This article is available only as a PDF. Please click on “Download PDF” on top to...

Cataract is one of the most common causes of visual impairment in the elderly and its surgery is the most common major ophthalmic surgery, with over 8 million performed globally every year. The majority of cataract surgeries are performed under regional (retrobulbar, peribulbar or sub-Tenon’s) or topical anaesthesia. This article...

With the increasing demands of contemporary life, higher levels of visual performance are expected. In modern societies such as Singapore, many more adults will join the workforce and perform complex tasks that require perfect visual function. This article is available only as a PDF. Please click on “Download PDF” on...

Fungi are known opportunistic organisms, which potentially invade and infect a host with depressed immunity. Fungal pan-sinusitis complicated with orbital apex syndrome or cavernous sinus syndrome has been described in immunosuppressed patients. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Refractive error remains one of the primary causes of visual impairment in children worldwide. Prevalence of visual impairment in children, is defined as uncorrected vision equal to or worse than 20/40, and it varies from as low as 2.72% in South Africa to as high as 15.8% in Chile. This...

The concept of the modern guide dog first began in Germany after World War I in an effort to support veterans blinded in combat. In 1927, Dorothy Eustis, having gained inspiration from her visit to a guide dog school in Potsdam, Germany, introduced guide dogs into the United States...

Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM) worldwide, with 8.2% of Singapore adults between the ages of 18 and 69 having diabetes and there is little data on the prevalence of diabetic...

Ureteropelvic junction obstruction (UPJO) results in the gradual dilatation of the renal collecting system, and may lead to deterioration of renal function and pain. Although traditional open pyeloplasty remains the gold standard in the treatment of this condition, endoscopic management via endopyelotomy has provided a less invasive option in...

Progressive hemifacial atrophy (Parry-Romberg syndrome, PHA) is characterised by slowly progressive atrophy, usually involving one side of the face, and may be associated with ocular manifestations which include enophthalmos, restrictive strabismus and hypotony. We report a case of keratoconus seen in a patient with PHA after obtaining approval from...

Vascular endothelial growth factor (VEGF) is recognised as an important mediator in the pathogenesis of age-related macular degeneration (AMD) and retinal neovascularisation. Anti-VEGF therapies such as pegaptanib (Macugen, EyeTech/OSI Pharmaceuticals) and ranibizumab (Lucentis, Genentech) are Food and Drug Administration (FDA)-approved in the US for the treatment of neovascular AMD. This...

Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness in Asia and many parts of the world. It is a particularly serious problem in East Asia, where it represents the major form of glaucoma. This article is available only as a PDF. Please click on “Download PDF” on...

Although acute concomitant esotropia following heroin detoxification or withdrawal has been described in a few case reports in Europe and Australia, it has not been reported elsewhere. Given the high prevalence of heroin use, however, this phenomenon may have been overlooked. This article is available only as a PDF. Please...

Neovascularisation of the iris is associated with many ischaemia retinal disorders and elevated levels of the vascular endothelial growth factor is found in patients with neovascular glaucoma. Inhibition of the vascular endothelial growth factor has been shown to prevent retinal ischaemia-associated neovascularisation of the iris. This article is available only...

Diabetes is a major public health problem, and diabetic retinopathy is the leading cause of blindness in working-aged people.1 Previous studies have documented poor attainment of guidelines of glycosylated haemoglobin (HbA1c) and blood pressure control2 and eye care utilisation3-6 in the prevention of diabetic retinopathy. Studies have also documented...

Cysticercosis cellulosae, the larval form of the pork tapeworm Taenia solium, causes cysticercosis, in which humans serve as the intermediate hosts in the parasite life cycle. Cysticercosis is endemic in developing regions such as South America, India and China. This article is available only as a PDF. Please click on “Download PDF” on top...

Optical coherence tomography (OCT) has become an indispensable tool in the management of retinal and optic nerve diseases as well as in clinical trials. In late 1996, the earliest commercially available OCT had an axial resolution of approximately 17 μm. This article is available only as a PDF. Please click...

Myopic choroidal neovascularisation (mCNV) is one of the most common causes of permanent central visual loss in patients with high myopia, and its natural history results in the development of chorioretinal atrophy around the regressed mCNV, causing further progressive central visual loss. This article is available only as a PDF....

The recognition that vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of neovascular age-related macular degeneration (NVAMD) has led to the development of several intravitreal anti-angiogenic therapeutics. Ranibizumab (Lucentis, Genentech, San Francisco, USA) and pegaptanib (Macugen, OSI/Eyetech Pharmaceuticals, New York, USA) have been FDA-approved for...

Central retinal artery occlusion (CRAO) typically presents with a retinal “cherry red spot”. In CRAO, infarction of the retinal nerve fibre layer renders the retina opaque. The fovea, where this layer is absent, retains its normal orange red colour due to perfusion from the underlying choroidal vessels, resulting in...

Dear Editor, Multiple myeloma is a subgroup of plasma cell dyscrasias with neoplastic proliferation of plasma cells or their precursors. Crystalline keratopathy is a well-recognised but rare ocular manifestation of multiple myeloma. We present a rare case of IgG-lambda multiple myeloma that manifested as polychromatic crystals in the cornea—a presentation...

I would like to thank the authors for the reply to our case report. The differential diagnosis of Bartonella neuroretinitis in this patient was considered, but it would definitely not be on the top of my list due to the following reasons. This article is available only as a PDF....

We refer to the letter ‘Lyme Neuroretinitis in Singapore: A Diagnostic Dilemma’ published in the April 2012 Vol. 41 No. 4 issue of the Annals, Academy of Medicine. We propose a differential diagnosis of Bartonella neuroretinitis for the case reported. This article is available only as a PDF. Please click...

Pars plana vitrectomy (PPV) using the 27-gauge transconjunctival approach is the last frontier of small gauge vitrectomy. Only 1 paper has been published so far describing the use of 27-gauge vitrectomy in a limited number of cases, including epiretinal membranes, idiopathic macular holes, diabetic vitreous haemorrhages, a vitreous biopsy...

The year 2014 had marked the 10th anniversary of the nationwide Age-related Macular Degeneration (AMD) Awareness Week in Singapore.1 This public health campaign, organised annually since 2005, aims to generate awareness and understanding of AMD by promoting the importance of education, early detection, and knowledge of treatment and rehabilitation...

Ophthalmic cancers are commonly encountered in clinical practice and are an important cause of morbidity and mortality. Globally, the incidence of ophthalmic cancers have been increasing in the past 2 to 3 decades.3-6 Data on recent incidence of primary ophthalmic cancers, comprising intraocular and extraocular cancers, have not been...

Age-related macular degeneration (AMD) is a severe ocular disease characterised by progressive deterioration of the macula, the most sensitive central part of the retina. It is the most common cause of irreversible vision loss among individuals aged ≥60 years in developed countries, and accounts for about 6% of all...

In the past 2 decades, the management of chronic venous insufficiency (CVI) has been revolutionised by the introduction of minimally invasive endovenous techniques, which have replaced open surgical high tie and stripping as the treatment of choice. CVI is common in the Western population and is reported to affect...

Behçet’s disease (BD) is a chronic multisystem inflammatory disease with a classic triad of painful oral ulcers, genital ulcers and uveitis. Neurological manifestations, though uncommon, can affect both central and peripheral nervous system; producing parenchymal, non-parenchymal and mixed forms of the disease. Ophthalmic findings include ocular inflammation and other...

The World Health Organization declared coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern on 30 January 2020. To control the outbreak, many countries have implemented nationwide lockdowns and social distancing measures, which have brought challenges to accessibility of healthcare services and continuation of long-term medical care,...

Recurrent cornea1 erosion (RCE) syndrome is a commonly encountered clinical condition which may be difficult to treat. Hansen first described it in 1872. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Cataract surgery is performed mainly as day-case surgery, with the majority performed under regional anaesthesia. Retrobulbar block, combined with facial nerve block, provides good operating conditions, with the facial nerve block preventing blepharospasm and providing lid akinesia. This article is available only as a PDF. Please click on “Download PDF”...