MyMedR

Fulltext Intralenticular metallic foreign body: a case report

Reddy SC

Int J Ophthalmol, 2011;4(3):326-8.

PMID: 22553673 DOI: 10.3980/j.issn.2222-3959.2011.03.25

A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.

Reddy SC, Tajunisah I

Ann Ophthalmol (Skokie), 2008;40(1):39-44.

PMID: 18556981

Fifty-six contact lens-related corneal ulcers (central in 32; hypopyon in 24 and stromal abscess in 6) were studied. Culture was positive in 78.9%. Corneal ulcers healed with intense antibiotic therapy in nearly all patients. Increased awareness of lens care/disinfection and frequent replacement of storage cases and solution, and early detection of pathogens and intensive appropriate antibiotic therapy are key points in management.

Fulltext Dropped nucleus following phacoemulsification cataract surgery

Tajunisah I, Reddy SC

Med J Malaysia, 2007 Dec;62(5):364-7.

PMID: 18705466 MyJurnal

Twenty two cases of dropped nucleus following 1,196 phacoemulsification procedures in cataract surgery were examined retrospectively to determine the incidence, predisposing factors and visual outcomes of this dreaded complication. All the cases underwent pars plana vitrectomy and the lens fragments were removed with phacofragmotome, vitrectomy cutter or delivered through limbus. The incidence of dropped nucleus was 1.84%. The predisposing factors were hard cataracts (13.6%), polar cataracts (9.1%), previously vitrectomized eyes (4.5%) and high myopia (4.5%). The final visual outcome was > or = 6/12 in 10 eyes (45.5%); complications were seen in 5 eyes (22.7%). The interval between initial surgery and vitrectomy, the method of fragment removal and the type of lens implanted, did not influence the final visual outcome.

Acute retinal necrosis complicating chickenpox in a healthy adult--a case report and review of literature

Tajunisah I, Reddy SC

Compr Ther, 2007;33(1):25-31.

PMID: 17984490

Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.

Fulltext Topical chloramphenicol/gentamicin in the empirical treatment of acute conjunctivitis--is it rational?

Subramania A, Reddy SC

Med J Malaysia, 1996 Dec;51(4):491.

PMID: 10968042

Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters

Reddy SC, Jackson N

Acta Ophthalmol Scand, 2004 Feb;82(1):81-5.

PMID: 14738490

PURPOSE: To determine the prevalence of retinal changes in newly diagnosed acute leukaemia patients, and to establish the relationship between retinal lesions and haematological parameters in these patients.

METHODS: A total of 127 patients with acute leukaemia (myeloid and lymphoid), of both genders, aged between 13 and 77 years, were examined by an ophthalmologist for retinal changes using direct/indirect ophthalmoscopy within 2 days of diagnosis before starting chemotherapy.

RESULTS: Retinal lesions were seen in 62 cases (49%), with intraretinal haemorrhages being the most common lesion (42%). A high white blood cell count was significantly associated with intraretinal haemorrhages (p = 0.04) and white-centred haemorrhages (p = 0.001), while a low platelet count was significantly associated with intraretinal haemorrhages (p = 0.03) in acute myeloid leukaemia patients.

CONCLUSIONS: A high white blood cell count may be considered as important as a low platelet count in the pathogenesis of leukaemic retinopathy.

Adverse reactions to local anaesthetics

Reddy SVG

Family Physician, 1989;1:42-42.

Fulltext Brain laryngeal mask--study in 50 spontaneously breathing patients

Reddy SV, Win N

Singapore Med J, 1990 Aug;31(4):338-40.

PMID: 2255930

Brain laryngeal mask (BLM) was used to assess its suitability in 50 spontaneously breathing patients by one lecturer and 4 Medical Officers. Insertion of the laryngeal mask was successful at the first attempt in 42 patients, second attempt in 7 and third attempt in one. The incidence of airway obstruction secondary to downfolding of the epiglottis, which was corrected by reinsertion, was 16%. Post-operative complications included clenching of teeth in 5 patients, vomiting in 2 and excessive salivation in 3. The incidence of sore throat was 10%.

Fulltext Potassium and massive blood transfusion

Reddy SV, Sein K

Singapore Med J, 1991 Feb;32(1):29-30.

PMID: 2017701

Sixty patients who received massive blood transfusion intraoperatively and/or in the immediate post-operative period were analysed. Six patients had hypokalemia and two had hyperkalemia. The multifactorial changes leading to electrolyte disturbances especially involving potassium are discussed in relation to hypotension, hypothermia, acidosis, pH, and release of catecholamine. Potassium changes in relation to anaesthesia are discussed. The danger of routine administration of calcium during massive blood transfusion is stressed.

Fulltext Clinical presentation of retinoblastoma in Malaysia: a review of 64 patients

Reddy SC, Anusya S

Int J Ophthalmol, 2010;3(1):64-8.

PMID: 22553520 DOI: 10.3980/j.issn.2222-3959.2010.01.15

To analyze the demography, presenting clinical features, spread of the disease of retinoblastoma in patients who were treated in two tertiary hospitals in Malaysia.

Ocular malignant melanoma - a report of two cases

Reddy SC, Darnal HK

Nepal J Ophthalmol, 2014 Jan;6(11):113-8.

PMID: 25341837 DOI: 10.3126/nepjoph.v6i1.10783

INTRODUCTION: Melanoma is a rare malignant tumour in the eye.

OBJECTIVE: To report two cases of malignant melanoma in the eye, one in the conjunctiva and the other in the choroid.

CASES: The first case was in a 49-year-old lady who presented with a swelling on the inner side of left upper eyelid. The vision was 6/6. On everting the eyelid, multiple, pigmented, nodular swellings were noted on the tarsal conjunctiva. Excision biopsy confirmed the diagnosis of malignant melanoma of the conjunctiva. A pigmented nodular swelling occurred on the lower bulbar conjunctiva in the same eye one-and-a-half years after the first presentation. There were no secondary nodules in the body. Excision biopsy confirmed malignant melanoma of the conjunctiva. The second case was in a 72-year-old lady who presented with pain and bleeding in the right eye. There was no perception of light. The cornea was hazy and the details behind it could not be seen. There was micro perforation of the cornea with oozing of blood and secondary glaucoma. B-scan ultrasonography of the right eye revealed an intraocular tumour. The histopathology of the enucleated eyeball confirmed the diagnosis of malignant melanoma of the choroid.

CONCLUSION: In the case of conjunctival melanoma, the occurrence of tumour at multiple sites and absence of recurrence at the original site suggests the possibility of de novo origin of the tumour. Secondary glaucoma and bleeding may be the presenting features of melanoma in the choroid.

Fulltext Visual outcome in open globe injuries

Thevi T, Mimiwati Z, Reddy SC

Nepal J Ophthalmol, 2012;4(2):263-70.

PMID: 22864032 DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6542

To determine the factors affecting the visual outcome in patients with open globe injuries of eye.

Fulltext Understanding and preventing computer vision syndrome

Loh KY, Reddy SC

Malays Fam Physician, 2008;3(3):128-30.

PMID: 25606136 MyJurnal

The invention of computer and advancement in information technology has revolutionized and benefited the society but at the same time has caused symptoms related to its usage such as ocular sprain, irritation, redness, dryness, blurred vision and double vision. This cluster of symptoms is known as computer vision syndrome which is characterized by the visual symptoms which result from interaction with computer display or its environment. Three major mechanisms that lead to computer vision syndrome are extraocular mechanism, accommodative mechanism and ocular surface mechanism. The visual effects of the computer such as brightness, resolution, glare and quality all are known factors that contribute to computer vision syndrome. Prevention is the most important strategy in managing computer vision syndrome. Modification in the ergonomics of the working environment, patient education and proper eye care are crucial in managing computer vision syndrome.

Fulltext Prevalence and risk factors for diabetic retinopathy--a study of 217 patients from University of Malaya Medical Centre

Tajunisah I, Nabilah H, Reddy SC

Med J Malaysia, 2006 Oct;61(4):451-6.

PMID: 17243523

Two hundred and seventeen diabetic patients attending the eye clinic were examined to determine the prevalence of retinal changes, and the association between diabetic retinopathy and risk factors. A detailed fundus examination was done, after dilating the pupils, using 90 D lens and slitlamp biomicroscope. Diabetic retinopathy was detected in 112 patients (51.6%). Background retinopathy was seen in 40 out of 217 (18.4%), pre-proliferative retinopathy in 11 (5.1%), proliferative retinopathy in 61 (28.1%) and maculopathy in 58 (26.7%) patients. Factors significantly associated with occurrence of retinopathy were duration of diabetes, presence of hypertension and presence of systemic complications (diabetic foot ulcer, lower limb amputation, nephropathy, and peripheral neuropathy).
Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Ocular lesions in the inmates of leprosy rehabilitation centre

Reddy SC, Raju BD

Int J Biomed Sci, 2006 Sep;2(3):289-94.

PMID: 23674993

A detailed eye examination of 145 inmates of a leprosy rehabilitation centre was done to determine the prevalence of ocular involvement. Age, gender of patients, type and duration of leprosy, systemic disabilities were noted. The mean age of patients was 45.8 years (range 19-70 years); 72.4% were males; 55.2% were suffering from paucibacillary leprosy. The mean duration of leprosy was 18.2 years in multibacillary type and 13.1 years in paucibacillary type. Ocular lesions related to leprosy were seen in 85.5% of patients; more often in multibacillary leprosy (92.3%). Corneal changes (80.7%) were the most frequently observed lesions followed by eye lid lesions (48.2%). Potentially sight threatening lesions such as lagophthalmos (23.4%), cornealanaesthesia (43.4%), and iridocyclitis (8.9%) were seen in both types of leprosy. Nine out of 26 (34.6%) patients with history of erythema nodosum leprosum reaction showed eye changes related to this reaction. Blindness in one eye due to lesions related to leprosy was seen in 2.7% of eyes. Age related cataract was the most common cause of blindness in patients of leprosy. The prevalence of ocular lesions was found to be high in the inmates of leprosy rehabilitation centre, and they were seen more frequently in patients with longer duration of the disease. Potentially sight threatening lesions were more often associated with systemic disabilities in these patients.

Fulltext Prevalence and causes of visual impairment and blindness in a rural population in Sepang district, Selangor

Reddy SC, Rampal L, Nurulaini O

Med J Malaysia, 2004 Jun;59(2):212-7.

PMID: 15559172 MyJurnal

A community based cross-sectional study was carried out to determine the prevalence and causes of visual impairment and blindness in residents aged forty years and above in kampung Jenderam Hilir of Sepang district, Selangor state. A total of 311 out of 341 (91.3%) respondents participated in this study. The prevalence of visual impairment and blindness observed was 18.9% and 2.9% respectively. The prevalence of visual impairment and blindness increased significantly with age. Amongst the 159 respondents who agreed for eye checkup, refractive errors (56%), cataract (20.1%), glaucoma (4.4%) and diabetic retinopathy (1.3%) were found to be causing visual impairment and blindness.

Causes of childhood blindness in Malaysia: results from a national study of blind school students

Reddy SC, Tan BC

Int Ophthalmol, 2001;24(1):53-9.

PMID: 11998890

A national study was conducted in children attending six schools for the blind in Malaysia to identify the anatomical site and underlying causes of blindness (BL) and severe visual impairment (SVI), with a view to determine the potentially preventable and treatable causes so that appropriate control measures can be implemented in the future. The standardized clinical examination of eyes was performed and the findings were recorded on the WHO Prevention of Blindness Programme eye examination record form for children with blindness and low vision. A total of 358 children aged between 7 and 17 years were examined, of whom 332 (92.7%) were blind or severely visually impaired. The results relate to these 332 children. Lens was the major anatomical site (22.3%) of visual loss followed by retina (20.8%), whole globe (17.2%), cornea (15.1%), optic nerve (8.7%) and uvea (5.1%). Glaucoma was responsible for BL/SVI in 7.2% and others in 3.6% of cases. Hereditary diseases were responsible for visual loss in 29.5%, intrauterine factors in 4.5%, perinatal factors in 9% and childhood factors in 7.8% of cases. However, the aetiology was unknown in 49.1% of cases which included congenital anomalies of the globe. Childhood cataract and corneal scarring are major treatable causes of BL/SVI that can benefit from future intervention strategies. Perinatal screening for intrauterine factors and hereditary eye diseases, and appropriate interventional therapy will help in reducing the prevalence of childhood blindness.

Tumours and tumour-like lesions of the eye: a clinicopathological study from Hospital University Sains Malaysia

Reddy SC, Das PK

Malays J Pathol, 1996 Dec;18(2):113-20.

PMID: 10879232

A total of 89 histopathologically proven ocular tumours and tumour-like lesions treated in Hospital University Sains Malaysia, Kubang Kerian, Kelantan over a period of nine years were reviewed for their age distribution, site of lesion and histological type. The tumours were observed in all age groups with a maximum prevalence in the first decade. Twenty lesions were malignant and 69 were benign. The eyelid was the most frequent location (51%), followed by the conjunctiva (32%). Retinoblastoma was the most common malignant tumour (10 cases) and dermoid cyst was the most common tumour-like lesion (16 cases).

A prospective study of ocular manifestations in childhood acute leukaemia

Reddy SC, Menon BS

Acta Ophthalmol Scand, 1998 Dec;76(6):700-3.

PMID: 9881556

PURPOSE: To determine the prevalence of ocular manifestations in childhood acute leukaemia at the time of presentation.

METHODS: Eighty-two children with acute leukaemia were examined for ocular lesions within two days of diagnosis before starting chemotherapy. The detailed ocular examination of both eyes was carried out by the ophthalmologist irrespective of the presence or absence of eye symptoms in all cases.

RESULTS: Only 3 out of 82 children presented with eye symptoms (3.6%). However, ocular changes were found in 14 children (17%); ten with lymphoblastic and four with myeloid leukaemia. The ocular lesions observed were proptosis, intraretinal haemorrhages, white centered haemorrhages, cotton wool spots, macular haemorrhage, subhyaloid haemorrhage, vitreous haemorrhage, papilloedema, cortical blindness, sixth nerve palsy, and exudative retinal detachment with choroidal infiltration.

CONCLUSION: In view of the high prevalence of asymptomatic ocular lesions in childhood acute leukaemia, routine ophthalmic examination should be included as a part of evaluation at the time of diagnosis.

Fulltext Upper eyelid and eyebrow dimensions in Malays

Dharap AS, Reddy SC

Med J Malaysia, 1995 Dec;50(4):377-81.

PMID: 8668060

The upper eyelid crease height pretarsal skin and eyebrow height were studied in 305 Malay subjects (146 males and 159 females) varying in age from 2-80 years, who were randomly selected from the residents of Kota Bharu, Kelantan. In females, from the age of 11 years the mean pretarsal skin height increased progressively with age. In males, however, it decreased with age up to 60 years. In both sexes, subjects more than 60 years old showed highest values for pretarsal skin height. The mean eyelid crease height increased progressively with age from 11 years onwards in males but not in females. The mean eyebrow height increased with age in females but not in males. Eyebrow and eyelid measurements seem to show a definite racial variation. Besides establishing normal values for eyelid and eyebrow measurements in Malays, our findings indicate that age and sex should be taken into consideration to achieve satisfactory results in cosmetic eyelid surgery in Malays.

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