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Child maltreatment is defined as the neglect and abuse of children under 18 years old. It encompasses physical/emotional ill-treatment, sexual abuse, negligence and/or exploitation...

Assessing the impact of frailty in elderly patients undergoing emergency laparotomies in Singapore

The ageing population is a growing global phenomenon. In 2019, 14.4% of the population in Singapore, equivalent to 3.9 million people, were aged 65...

The value of frailty assessments in older surgical patients undergoing emergency laparotomies in Singapore

Mortality in emergency laparotomy (EL) far exceeds that of elective bowel surgery, and standards for the National Emergency Laparotomy Audit (NELA) in the UK...

Treatment outcomes of micropulse cyclophototherapy in uveitic glaucoma

Dear Editor, We present a case series, describing the utility of micropulse cyclophototherapy in the treatment of uveitic glaucoma. Prevalence of glaucoma in patients suffering from...

Emergency department falls interventions improve osteoporosis management in frail older adults

Dear Editor, Singapore’s population is ageing rapidly and by 2030, around 1 in 4 citizens will be aged 65 and above.1 Older adults represent 21–40%...

Transitional care strategies at emergency department for elderly patients: A multicentre study in Singapore

In Singapore, greater efforts are being directed towards developing an integrated health and social ecosystem under the new Healthier SG strategy announced by the...

Through the eyes into the brain, using artificial intelligence

Neurological dysfunction is a leading cause of disability, affecting more than 276 million people worldwide.1 Over the last decades, the prevalence of neurological dysfunction...

The eye as a window to the brain

Over the last 20 years, it has become evident that the age-old expression, “the eye is the window into the soul”, might in fact...

Clinical outcome of bacterial endogenous endophthalmitis in 15 patients

Dear Editor, Endophthalmitis refers to the inflammation of the ocular cavities and their immediate adjacent structures without extension beyond the sclera, usually secondary to...

Nutrition therapy in the older critically ill patients: A scoping review

The increasing levels of life expectancy and decreasing fertility are shifting the age structure of the world population towards older ages.1 From year 2020...

A Descriptive Study of the Demography, Symptomology, Management and Outcome of the First 300 Patients Admitted to an Independent Hospice in Singapore

Modern society views death as an aberration which has to be postponed and, if possible, prevented at all cost. Death is just unacceptable and...

Glaucoma Pattern Amongst the Elderly Chinese in Singapore

Glaucoma is a major cause of world blindness in developing and developed nations. The WHO Global data on blindness show that over half of...

Frontal Sinus Mucoceles Causing Proptosis—Two Case Reports

Frontal mucoceles are collections of inspissated mucus which occur when there is obstruction to the outflow of the frontal sinuses. The obstruction may be...

A Case Series of Ocular Disease as the Primary Manifestation in Sarcoidosis

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...

Trends in the Pattern of Blindness and Major Ocular Diseases in Singapore and Asia

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...

Day Hospital Rehabilitation for the Elderly: A Retrospective Study

Alexandra Hospital is the first hospital in Singapore with a Day Hospital for the elderly. One of the main functions of the Day Hospital...

Self-Perception of Health among Elderly Community Dwellers in Singapore

The single most important determinant of the quality of an elderly person’s life is health. In the elderly, health matters affect all other areas...

A Case of Accelerated Development of Proliferative Diabetic Retinopathy in a Woman with Type 2 Diabetes Mellitus after Pregnancy

Diabetic retinopathy is the leading cause of blindness in persons between the age of 24 and 64 years both in the US and the...

Trilateral Retinoblastoma—A Case Report

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...

Chryseobacterium meningosepticum (Flavobacterium meningosepticum)—A Report of Five Cases in a Local Hospital

Chryseobacterium meningosepticum has been known to be a causative agent of meningitis particularly in the premature and newborn infants. The first case of human...

Excimer Laser Phototherapeutic Keratectomy for Recurrent Corneal Erosions

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...

Use of EMLA Cream or Alfentanil for Analgesia during Ophthalmic Nerve Blocks

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...

Bilateral Caudate Infarct—A Case Report

The head of caudate nucleus forms a prominent bulge in the lateral wall of the anterior horn of the lateral ventricle. Its blood supply...

Perceived Need for Community Geriatric Services: A Survey at a Regional Hospital in Singapore in an Inpatient Setting

Singapore has one of the most rapidly ageing populations in the wor1d. The number of the very aged (>75 years old) has already increased...

Swallowing Impairment and Feeding Dependency in the Hospitalised Elderly

Loss of ability to feed independently and swallowing impairment are common problems in the elderly and will be an increasing cause of disability as...

Retinopathy of Prematurity in Very Low Birth Weight Infants

Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship...

Diabetic Retinopathy

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...

Cross-Sectional Study of Near-work and Myopia in Kindergarten Children in Singapore

Myopia is the commonest eye disease worldwide, and is especially prevalent in certain Asian countries such as Taiwan, Japan and Hong Kong. Physiologic myopia...

The Reliability and Validity of the Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the Elderly Chinese in Hong Kong

The Alzheimer’s Disease Assessment Scale (ADAS) is a 21-item scale designed to assess the severity of cognitive and non-cognitive impairment in patients with Alzheimer’s...

The Correction of Oriental Lower Lid Involutional Entropion Using the Combined Procedure

Involutional entropion is a frequent cause of ocular irritation in the local elderly patients. The inturning of the lid margin and the eyelashes result...

Myopia: Gene-environment Interaction

Myopia affects up to 70% of adults in Singapore, Taiwan, Hong Kong and Japan. The prevalence rates in these Asian countries are higher than...

Screening for Hearing Impairment in Hospitalised Elderly

The prevalence of hearing impairment in the local elderly population is not known. Hearing loss prevalence estimates that 25% to 40% of individuals over...

End-of-life Issues—Preferences and Choices of a Group of Elderly Chinese Subjects Attending a Day Care Centre in Singapore

Doctors caring for elderly, dying and terminally ill patients are often faced with the dilemma of having to make difficult decisions especially regarding treatment...

Preparing for the silver boom: A falls prevention tool for older adults in the emergency department

Each year, 28–35% of community dwelling adults over 65 years fall.1 This figure increases to about 50% for those above 80 years old.2 Falls...

Critical Role of Functional Decline in Delayed Discharge from an Acute Geriatric Unit

In the last decade, many countries have experienced alarming transformation in their demographic patterns, with the elderly population emerging as the fastest growing segment...

Urinary Retention in Hospitalised Older Women

Voiding dysfunction is a relatively common problem in hospitalised older patients. Up to one-third of hospitalised elderly were reported to have post-void residual urine...

Causes and Management of Descemet’s Membrane Detachment Associated with Cataract Surgery—Not Always a Benign Problem

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...

Body Mass Index and Its Related Factors in the Elderly

Cardiovascular disease is one of the leading causes of mortality and morbidity in developed countries, especially among the elderly. In Taiwan, cardiovascular disease is...

The Practice of Foregoing Life Support in the Critically Ill “Old Old”: A Singapore Perspective

Studies on the foregoing of life support (FLS) in North America, Europe and Australia have shown diversity in terms of the incidence, decision-making process...

The Impact of Swallowing Disorders in the Elderly

In 1898, Bastian first reported on the case of a man who had been admitted to hospital with hemiplegia and aphasia, but who had...

Early Unplanned Readmission of Elderly in Singapore: A Retrospective Study

The number of elderly people in Singapore is expected to increase over the next 2 decades. The proportion of those 60 years and above...

6th Yahya Cohen Lecture: Visual Experience During Cataract Surgery

What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress...

Age-related Macular Degeneration: What’s New

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...

Visual Rehabilitation with New-Age Rigid Gas-Permeable Scleral Contact Lenses—A Case Series

Advanced primary corneal ectasia presents a difficult problem in terms of visual rehabilitation. Soft contact lenses do not address the astigmatic aberrations in these...

Epidemiology of Beta-haemolytic Group G Streptococcal Bacteraemia in Singapore (1996 to 1998)

Human isolates of group G streptococci (GGS) that form large colonies are similar to group A streptococci (GAS) in terms of virulence and cause...

Correlates of Habitual Walking and Sports/Leisure-time Physical Activity in Older Persons in Singapore: Interaction Effects Between Educational Attainment and Gender

Physical inactivity has been identified as a major cause of morbidity and mortality secondary to cardiovascular disease, diabetes mellitus and hypertension. It contributes to...

Nursing Home Falls: A Local Perspective

Falls in the elderly has been a well-studied subject and now occupies an important place in geriatric medicine. While many studies have been done...

Bedside Clinical Methods Useful as Screening Test for Aspiration in Elderly Patients with Recent and Previous Strokes

Cerebrovascular disease is the fifth commonest cause of hospitalisation in Singapore, and accounts for 2.7% of all hospital discharges. Neurogenic dysphagia is a common...

End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy

A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch...

Considerations in the Assessment and Management of Older People with Chronic Pain

Persistent pain has been estimated to occur in 50% of community dwelling older people of age 65 years and above. It has been associated...

Late-life Depression: Current Issues and New Challenges

Depression in late life (>60 years old) is one of the most common and treatable psychiatric disorders in the elderly. It not only causes...

Neurofibrillary and Ethico-legal Tangles: In Search of Surrogates for Dementia Patients Lacking Decision-making Capacity and Relatives

Dementia is an age-prevalent chronic degenerative disease that causes gradual and progressive deterioration of a patient’s cognitive abilities. With Singapore’s rapidly ageing population, the...

Assessing Decision-making Capacity in Dementia Patients: A Semi-structured Approach

Given the rapid ageing of Singapore, all practising clinicians can expect to see an exponential rise in the medical and surgical problems of the...

An Evidence-based Clinical Approach to the Diagnosis of Dementia

The prevalence of dementia or cognitive impairment in local studies has been shown to range from 2% to 13%. These differences in prevalence rates...

Urinary Incontinence in Older Persons: A Simple Approach to a Complex Problem

Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and is a social or hygienic problem. Trivial as it may sound,...

The Development of Geriatric Psychiatry Services in Singapore

The population of Singapore is ageing. In 2002, it was estimated that there were 252,700 persons aged >65 years, forming 7.5% of the population....

Aged Care Issues and Services in Australia

In Australia, the number of elderly people is increasing rapidly. In 2001, the population of Australia was approximately 19 million people and about 12.6%...

Aged Care Services in Singapore – An Overview

The last century has witnessed the establishment of geriatric medicine as a well-recognised medical specialty supported by a respectable body of evidence, which shows...

Challenges in Geriatric Medicine: Geriatric Services and Education

Ignatz Nascher first proposed disease and medical care of the aged as a separate specialty and invented the term “geriatrics” in 1909. However, the...

Primary Meningococcal Arthritis and Endogenous Endophthalmitis: A Case Report

Primary meningococcal arthritis (PMA) and endogenous meningococcal endophthalmitis are both uncommon presentations of meningococcal infection that should be considered in the differential diagnosis of...

Emergency Department Usage by Community Step-Down Facilities – Patterns and Recommendations

It is projected that elderly persons will make up 18.4% of Singapore’s population by the year 2030. Currently, there are 5189 residents staying in...

Critically Ill Elderly Who Require Mechanical Ventilation: The Effects of Age on Survival Outcomes and Resource Utilisation in the Medical Intensive Care Unit of a General Hospital

Increasing life expectancy and ageing of the “post-war baby boomer” generation have led to the rapidly ageing demographic of many Asian countries. Singapore’s elderly...

Gyrate Atrophy of the Choroid: Two Cases

Gyrate atrophy of the choroid (GA) is a rare choroidal dystrophy. It is an autosomal recessive disorder that results in progressive deterioration in peripheral...

Thyroid Dysfunction in Elderly Patients

Symptoms and signs of thyroid dysfunction in the elderly tend to be atypical and may be mistakenly attributed to the ageing process. Currently, thyroid...

Initial Experience of Macular Translocation in Singapore – One-year Results

Choroidal neovascularisation (CNV) is a devastating complication of macular degeneration and a major cause of irreversible vision loss in many developed countries. The most...

Improving the Diagnosis Related Grouping Model’s Ability to Explain Length of Stay of Elderly Medical Inpatients by Incorporating Function-linked Variables

Casemix refers to the numbers and types of patients within a healthcare setting and Diagnosis Related Groupings (DRGs) represent one mode of classifying casemix....

Ocular Surface Stem Cells and Disease: Current Concepts and Clinical Applications

The ocular surface is a complex biological continuum responsible for the maintenance of corneal clarity, elaboration of a stable tear film for clear vision,...

Re: Evidence for an “epidemic” of myopia

In the Annals January 2004 theme issue on Myopia, Park and Congdon have disputed the reality of the increases in prevalence of myopia in...

Contact Lens Microbial Keratitis and Prior Topical Steroid Use: A Disaster in the Making?

Topical steroid use in cornea ulcers is still a very contentious issue in ophthalmology. A recent review by Wilhelmus found that the use of...

Integrated Hydroxyapatite Implant and Non-integrated Implants in Enucleated Asian Patients

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,...

Impact of a Pharmacist Consult Clinic on a Hospital-based Geriatric Outpatient Clinic in Singapore

A general philosophy in the care of elderly patients is to use the least drugs possible to achieve the desired clinical outcome. In the...

Polypharmacy and Inappropriate Medication Use in Singapore Nursing Homes

The elderly usually have multiple medical problems, requiring prescription drugs to treat diseases and to prevent complications arising from them. Currently, in the United...

The Correction of Myopia Evaluation Trial: Lessons from the Study Design

“A properly planned and executed clinical trial is a powerful technique for assessing the effectiveness of an intervention”. While each new clinical trial involves...

Myopia Progression Among Preschool Chinese Children in Hong Kong

Myopia occurs when the image of distant objects, focused by the cornea and lens, falls in front of the retina. It is the commonest...

The Epidemiology of Myopia in Hong Kong

Myopia is a refractive condition in which the image of a distant object is formed anterior to the retina of the unaccommodated (relaxed) eye....

Prevalence of Myopia in Taiwanese Schoolchildren: 1983 to 2000

Today in Taiwan, with increasing level of educational and living standard, the prevalence and severity of myopia appear to be on an upward trend....

Evidence for an “Epidemic” of Myopia

A number of authors have recently proposed that myopia is increasing at an “epidemic” rate, particularly in East Asia, and especially among populations of...

Using Natural STOP Growth Signals to Prevent Excessive Axial Elongation and the Development of Myopia

Myopia in humans results from an imbalance between the refractive power of the cornea and lens and the axial length of the eye, such...

Ocular Shape and Myopia

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...

Is it Possible to Slow the Progression of Myopia?

The rates of myopia, including high myopia , have been reported to be rising to epidemic proportions in Asia and solutions to this huge...

Issues and Challenges for Myopia Research

Myopia is an ocular disorder of major public health and socioeconomic significance in many East Asian urban cities. In Singapore, the prevalence of myopia...

Accommodative Stimulus Response Curve of Emmetropes and Myopes

There is a strong association between myopia and near work, and it has been reported that the rapid rise in the prevalence of myopia...

Electrophysiological Findings in Persons With Nyctalopia

Nyctalopia is a subjective sensation of poor vision under dark conditions. It may be clinically associated with retinal diseases affecting the rod photoreceptors or...

Neisseria meningitidis Keratitis in Adults: A Case Series

Neisseria meningitidis has been reported as a causative organism for conjunctivitis and endogenous endophthalmitis, more commonly in neonates and young children. A search of...

Visual Recovery Following Emergent Orbital Decompression in Traumatic Retrobulbar Haemorrhage

Acute retrobulbar haemorrhage is a potentially sight threatening condition that can occur spontaneously or following retrobulbar injections and trauma to the orbit. Visual loss...

Macular Carotenoids and Age-related Maculopathy

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...

Book Review

Ophthalmologists today depend heavily on various investigative modalities such as fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) for an...

Recombinant Tissue Plasminogen Activator (r-TPA) in Fibrin Dissolution due to Postoperative Endophthalmitis

Cataract surgery is one of the most successful surgical procedures performed. However, postoperative endophthalmitis, defined as severe inflammation involving both the anterior and posterior...

Orbital Metastatic Tumour as Initial Manifestation of Asymptomatic Gastric Adenocarcinoma

Metastatic orbital tumour from gastric cancer is rare. In a Japanese survey of metastatic orbital tumours seen over 95 years, gastric metastases accounted for...

Eye Injuries in Singapore – Don’t Risk It. Do More. A Prospective Study

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...

Retrospective Review of Eyes with Neovascular Age-related Macular Degeneration Treated with Photodynamic Therapy with Verteporfin and Intravitreal Triamcinolone

Among the variety of paradigms implicated in the pathogenesis of choroidal neovascularisation (CNV), an inflammatory component has been a recent focus of interest. The...

Rates of Posterior Capsule Rupture During Cataract Surgery Among Different Races in Singapore

Posterior capsule rupture (PCR) is a potentially serious intraoperative complication of cataract surgery. The anecdotal experience of some surgeons suggests that differences in the...

Surgically-induced Corneal Changes Following Macular Translocation with Punctate Retinotomies and Chorioscleral Infolding (Limited Macular Translocation)

Changes in corneal curvatures and astigmatism after retinal surgery are well documented. Although some of these changes are mild and transient, some have reported...

Updates on the Surgical Management of Paediatric Cataract with Primary Intraocular Lens Implantation

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...

Efficacy of Measuring Visual Performance of LASIK Patients under Photopic and Mesopic Conditions

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...

Role of Ultrasound Biomicroscopy (UBM) in the Detection and Localisation of Anterior Segment Foreign Bodies

The presence of an intraocular foreign body (IOFB) is a common complication of ocular trauma. For surgical planning, the localisation of IOFBs has to...

Diabetic Retinopathy in Type II Diabetics Detected by Targeted Screening Versus Newly Diagnosed in General Practice

The epidemic of type II diabetes mellitus is now recognised worldwide. In India, it has been estimated that the population with type II diabetes...

Ethical Issues in Ophthalmology and Vision Research

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...

Can Long-term Corticosteroids Lead to Blindness? A Case Series of Central Serous Chorioretinopathy Induced by Corticosteroids

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterised by serous detachment of the macula, retinal pigment epithelial (RPE) detachment and areas of RPE...

A Novel Locus for X-linked Retinitis Pigmentosa

Retinitis pigmentosa (RP) is characterised by initial night blindness followed by progressive loss of visual fields and eventually, loss of central vision. RP is...

Utility and Validity of the Self-administered SF-36: Findings From an Older Population

The shift towards broader health perspectives and the emphasis on patient preferences have led to the development of many health questionnaires and their inclusion...

The Role of Optical Coherence Tomography (OCT) in the Diagnosis and Management of Retinal Angiomatous Proliferation (RAP) in Patients with Age-related Macular Degeneration

Retinal angiomatous proliferation (RAP), initially described as deep retinal vascular anomalous complex in 1992 by Hartnett et al, has been recently defined as a...

Axial Length: A Risk Factor for Cataractogenesis

There are several known risk factors for cataract formation, including older age, lower educational status, smoking, ultraviolet light exposure, trauma, dehydration, diabetes, uveitis and...

Clinical Features of Autosomal Dominant Retinitis Pigmentosa Associated with a Rhodopsin Mutation

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...

A Novel Mutation of the VMD2 Gene in a Chinese Family with Best Vitelliform Macular Dystrophy

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...

Characterisation of Human Tear Proteins Using High-resolution Mass Spectrometry

Over the last few years, with advances in mass spectrometry, there has been increasing interest in exploring the proteome of body fluids such as...

Scanning Laser Polarimetry in Pulmonary Tuberculosis Patients on Chemotherapy

Pulmonary tuberculosis is a worldwide disease. In Hong Kong, there are about 7000 new cases of pulmonary tuberculosis each year and the prevalence remains...

Evaluation of Dementia: The Case for Neuroimaging All Mild to Moderate Cases

Dementia has been reported to affect 4% to 13% of individuals above the age of 65, with the difference in prevalence rates being dependent...

Time to Raise Awareness of Blindness as Another Smoking-related Condition

Singapore currently has a comprehensive range of tobacco control policies and programmes. It started implementing legislative measures against cigarette smoking in the early 1970s,...

“Galaxy in My Eye”: An Artist’s View of Cataract Surgery from Behind the Crystalline Lens

Cataract surgery is the most commonly performed elective surgery in many countries. As a result of advances in surgical and anaesthetic techniques, most cataract...

Methodologies for Interventional Myopia Studies

Past studies on intervention in myopia progression have given conflicting results. For example, in the past, studies on (PMMA) hard contact lenses took researchers...

Ethambutol-associated Optic Neuropathy

Tuberculosis (TB) has been present since ancient times. Around 460 BC, Hippocrates identified phthisis, which is the Greek term for consumption (TB seemed to...

Concurrent Intermediate Uveitis and an Enhancing Intracranial Lesion as the Initial Manifestation of Sarcoidosis

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...

Retrobulbar Alcohol Injection for Orbital Pain Relief Under Difficult Circumstances: A Case Report

The management of pain in the orbital region, whether ocular or orbital in origin, is complex and lies at the margins of several subspecialty...

Are Sensory and Cognitive Declines Associated in Older Persons Seeking Aged Care Services? Findings From a Pilot Study

Many cross-sectional and longitudinal studies have reported an association between sensory and cognitive functions in the normal ageing population. Few studies have assessed the...

Book Review

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...

Vision 2020 and Prevention of Blindness: Is it Relevant or Achievable in the Modern Era?

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...

Enhancement of the Mechanical and Biological Properties of a Biomembrane for Tissue Engineering the Ocular Surface

The most recent treatment for severe ocular surface disease is the transplantation of cultivated corneal and conjunctival epithelial stem cells, which makes use of...

Mycobacterium-related Ocular Inflammatory Disease: Diagnosis and Management

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...

Photodynamic Therapy for Choroidal Neovascularisation Secondary to Inflammatory Chorioretinal Disease

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...

Variables Determining Perceived Global Health Ranks: Findings from a Population-based Study

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...

Multivariate Analysis of Childhood Microbial Keratitis in South India

Corneal infection is the most common cause of profound ocular morbidity leading to blindness worldwide. Corneal infection in children is difficult to diagnose and...

Can the Sequential Use of Conventional Silicone Oil and Heavy Oil be a Strategy for the Management of Proliferative Vitreoretinopathy?

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...

Surgical Outcomes of 25-Gauge Transconjunctival Vitrectomy Combined With Cataract Surgery for Vitreoretinal Diseases

The recent development of 25-gauge instrumentation for vitreous surgery has promoted a great interest in the transconjuctival sutureless vitrectomy system. Similar to the trend...

New Concepts in the Management of Optic Nerve Sheath Meningiomas

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...

Ophthalmic Regional Block

Patient comfort, safety and low complication rates are the essentials of local anaesthesia. The anaesthetic requirements for ophthalmic surgery are dictated by the nature...

Hyperbaric Oxygen Therapy for Radiation-induced Optic Neuropathy

Radiation optic neuropathy (RON) is an infrequent but usually devastating consequence of radiation to the optic pathways. It is almost exclusively an iatrogenic phenomenon,...

The Natural History of Occult Choroidal Neovascularisation Associated With Age-related Macular Degeneration. A Systematic Review

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...

Retinal Prostheses for the Blind

Each year, thousands of people are afflicted with photoreceptor degenerative diseases that reduce vision to bare light perception or complete blindness. Retinitis pigmentosa (RP)...

Age-related Macular Degeneration: An Emerging Challenge for Eye Care and Public Health Professionals in the Asia Pacific Region

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...

Intravitreal Triamcinolone Acetonide for the Treatment of Diffuse Diabetic Macular Oedema – A Case Report

Focal and grid laser photocoagulation are the primary surgical treatments for diabetic macular oedema. However, laser treatment of eyes with diffuse macular oedema has...

Bruch’s Membrane Abnormalities in Dome-shaped and Mushroom-shaped Choroidal Melanomas

Uveal melanoma is the most common primary intraocular malignancy and is diagnosed chiefly in the fifth to seventh decades of life. The choroid is...

Human Limbal Progenitor Cell Characteristics are Maintained in Tissue Culture

The surface of the eye is covered by 3 distinct forms of non-keratinising stratified squamous epithelium – transparent corneal epithelium overlying the corneal surface,...

Angiographic Characteristics of Acute Central Serous Chorioretinopathy in an Asian Population

Acute central serous chorioretinopathy (CSCR) is a condition of unknown origin characterised by a serous detachment of the macula. It afflicts young healthy adults,...

A Nationwide Survey on the Knowledge and Attitudes of Malaysian Optometry Students on Patients’ Visual Experiences During Cataract Surgery

Cataract is one of the most common causes of visual impairment in the elderly and its surgery is the most common major ophthalmic surgery,...

Factors Causing Delay in Discharge of Elderly Patients in an Acute Care Hospital

With the introduction of block budget for acute care hospitals, cost containment is an important issue for all secondary and tertiary hospitals. Though health...

Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit

Hospitalisation is a stressful event for the older person. The physiological changes associated with ageing, such as decreased muscle strength and aerobic activity, reduced...

Towards 2020 Vision in Singapore

With the increasing demands of contemporary life, higher levels of visual performance are expected. In modern societies such as Singapore, many more adults will...

Fungal Pan-sinusitis with Severe Visual Loss in Uncontrolled Diabetes

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...

Attitudes of First-year Medical Students in Singapore Towards Older People and Willingness to Consider a Career in Geriatric Medicine

With the exponential increase in the elderly population in Singapore, the training of young physicians of tomorrow in the care of elderly patients will...

Prevalence of Refractive Error in Malay Primary School Children in Suburban Area of Kota Bharu, Kelantan, Malaysia

Refractive error remains one of the primary causes of visual impairment in children worldwide. Prevalence of visual impairment in children, is defined as uncorrected...

Opening Our Eyes to Guide Dogs for the Blind in Singapore

The concept of the modern guide dog first began in Germany after World War I in an effort to support veterans blinded in combat....

Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme

Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM)...

Progressive Hemi-facial Atrophy and Keratoconus

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...

Effects on the Contralateral Eye After Intravitreal Bevacizumab and Ranibizumab Injections: A Case Report

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...

Alzheimer’s Disease – Towards More Patient-centred and Meaningful Clinical Outcomes

More than 100 years ago Alois Alzheimer first presented the clinical and pathological features of an unusual brain disease at his seminal lecture in...

Current Understanding of the Treatment and Outcome of Acute Primary Angle Closure Glaucoma: An Asian Perspective

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...

Acute Concomitant Esotropia during Heroin Detoxification

Although acute concomitant esotropia following heroin detoxification or withdrawal has been described in a few case reports in Europe and Australia, it has not...

Intraocular Avastin (Bevacizumab) for Neovascularisation of the Iris and Neovascular Glaucoma

Neovascularisation of the iris is associated with many ischaemia retinal disorders and elevated levels of the vascular endothelial growth factor is found in patients...

Lack of Awareness amongst Community Patients with Diabetes and Diabetic Retinopathy: The Singapore Malay Eye Study

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...

Cysticercosis of the Levator Palpebrae Superioris

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...

Resource Consumption in Hospitalised, Frail Older Patients

The number of older adults in Singapore has been steadily increasing over the years and will continue to do so. In 2007, older adults...

Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden

Dementia is a growing public health issue in the Asia-Pacific region. The number of people with dementia in the Asia-Pacific region will increase from...

Intraretinal Segmentation on Fourier Domain Optical Coherence Tomography

Optical coherence tomography (OCT) has become an indispensable tool in the management of retinal and optic nerve diseases as well as in clinical trials....

Intravitreal Bevacizumab for the Treatment of Myopic Choroidal Neovascularisation in an Asian Population

Myopic choroidal neovascularisation (mCNV) is one of the most common causes of permanent central visual loss in patients with high myopia, and its natural...

Validity and Reliability of the Expectations Regarding Aging (ERA-12) Instrument among Middle-Aged Singaporeans

With increasing life expectancy and low fertility rates, the proportion of the elderly is rapidly increasing in developed nations, Singapore being no exception. The...

Inadvertent Use of Bevacizumab to Treat Choroidal Neovascularisation During Pregnancy: A Case Report

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...

Atypical Presentation of Central Retinal Artery Occlusion

Central retinal artery occlusion (CRAO) typically presents with a retinal “cherry red spot”. In CRAO, infarction of the retinal nerve fibre layer renders the...

Bilateral Polychromatic Crystalline Keratopathy as the Initial Manifestation of IgG-Lambda Multiple Myeloma

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...

Successful Ageing in Singapore—A Viable Goal?

Ageing is a complex process. Achieving it successfully has implications and significance not only for individuals on a personal level but for society at...

Re: An Alternative Diagnosis: Bartonella Neuroretinitis

I would like to thank the authors for the reply to our case report. The differential diagnosis of Bartonella neuroretinitis in this patient was...

An Alternative Diagnosis: Bartonella Neuroretinitis

We refer to the letter ‘Lyme Neuroretinitis in Singapore: A Diagnostic Dilemma’ published in the April 2012 Vol. 41 No. 4 issue of the...

Unipolar versus Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly: Is There a Difference?

Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. The advantages of hemiarthroplasty over internal fixation include earlier mobility, less reoperations and better...

27-Gauge Vitrectomy for Primary Rhegmatogenous Retinal Detachment: Is it Feasible?

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...

Diagnosing Bacteraemia Early in Older Adults

Sepsis is a prevalent and important cause of morbidity and mortality in the general population. Approximately 750,000 patients in the United States alone develop...

Anti-BP180 NC16A IgG Titres as an Indicator of Disease Activity and Outcome in Asian Patients with Bullous Pemphigoid

Bullous pemphigoid (BP) is a subepidermal blistering dermatosis characterised by circulating autoantibodies targeting BP180 and BP230 hemidesmosomal proteins. Anti-BP180 NC16A IgG antibodies have been...

Evidence-balanced Medicine: “Real” Evidence-based Medicine in the Elderly

Case 1: An 85-year-old male with past history of hypertension is otherwise healthy and enjoys his daily walks and good food. During a health...

Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry

Ophthalmic cancers are commonly encountered in clinical practice and are an important cause of morbidity and mortality. Globally, the incidence of ophthalmic cancers have...

Seeing through the eyes of patients with age-related macular degeneration

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....

Neuro-Behçet’s disease presenting as isolated intracranial hypertension

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...

Teleophthalmology and its evolving role in a COVID-19 pandemic: A scoping review

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,...