Dear friends, fellow ophthalmologists, and readers of MSO Express,

It gives me great joy to welcome you to the second edition of the MSO Newsletter 2025. Following the encouraging response to our very first issue, we are excited to continue this journey of sharing stories, ideas, and updates that bring our ophthalmology community closer together.

In this edition, Eye Street News: What’s Happening in Ophthal City? shines a light on the meaningful community service work carried out in Kampung Sugiang Baru, Tenom. These efforts remind us that beyond the walls of hospitals and clinics, our profession holds the power to change lives where care is most needed. The second article in this segment highlights the first-ever Royal College of Ophthalmologists (RCOphth) Part 2 Oral Examination held in Kuala Lumpur. This marks a significant milestone for ophthalmology in our country as we take on a more global role in ophthalmic education.

We are also delighted to feature Behind the Lens: A Conversation with the Expert, where we speak with our newly appointed Head of Ophthalmology Services, Dr. Zalifa Zakiah. Her vision and dedication offer valuable insight into the future of ophthalmic care in Malaysia and provide inspiration for all of us striving to make a difference. This is definitely a read not to be missed.

Looking ahead, Next in Vision: Ophthalmic Updates and Innovation explores an exciting development in presbyopia management which is Presbyond. With innovation at the heart of modern ophthalmology, we hope this segment sparks curiosity about how emerging technologies can shape our clinical practice.

ARTICLES

Eye Street News: What’s Happening in Ophthal City?

KAMPUNG SUGIANG BARU, TENOM EYE SCREENING

On 2 August 2025, we had the privilege of conducting an eye screening programme in Kampung Sugiang Baru, Tenom. This outreach was a joint collaboration between the Malaysian Young Ophthalmologists Special Interest Group (MYOSIG), the Malaysian Society of Ophthalmology (MSO), Hospital Keningau, and Hospital Universiti Malaysia Sabah (HUMS).

Representing MSO was Dr. Barkeh Jumaat from ISEC, who also brought along her two daughters as enthusiastic volunteers. MYOSIG was represented by ophthalmologists Dr. Ng Qi Xiong, Dr. Wai Yong Zheng, Dr. Vithiaa Nilamani, Dr. Karimmah, Dr. Ng Tuck Chun, and myself. From Hospital Keningau, Dr. Fariz Ali led a dedicated team of optometrists, staff nurses, and paramedics, while HUMS staff contributed with the use of a fundus camera. Together, we joined a larger multidisciplinary health screening organised by the Family Medicine Association of Sabah, supported by Klinik Kesihatan staff, dental teams, and physiotherapists.

Our journey began on 1 August, with some members flying in from Peninsular Malaysia and others joining from Kota Kinabalu. After a team briefing and fellowship dinner, we departed early the next morning as a group of eight for the long drive to Tenom.

Eye Street News: What’s Happening in Ophthal City?

THE FIRST ROYAL COLLEGE OF OPHTHALMOLOGISTS (RCOPHTH) PART 2 ORAL EXAMINATION IN KUALA LUMPUR

The Royal College of Ophthalmologists (RCOphth), United Kingdom (UK), is the professional body responsible for the training and regulation of ophthalmologists in the UK. The examinations conducted by RCOphth are held to a high standard and consist of four parts: Part 1, the Refraction Certificate, Part 2 Written, and Part 2 Oral. Successful candidates are awarded the Fellowship of the Royal College of Ophthalmologists (FRCOphth). The examination assesses a wide range of competencies, including clinical knowledge, communication skills, research and audit, ensuring that FRCOphth holders are safe and competent ophthalmologists.

In Malaysia, the Ophthalmology Parallel Pathway has been implemented since 2018, whereby candidates are required to complete all RCOphth examinations while undergoing a 4-years structured training in various Ministry of Health (MOH) hospitals. Previously, Malaysian candidates had to travel overseas to sit for the Part 2 Oral examination, as it was not available locally. This posed several challenges, including long travel times, jetlag due to time zone differences, unfamiliarity with non-Asian eyes, and difficulties understanding different English accents. These factors added extra stress to an already high-stakes professional examination.

From 20th to 22nd June 2025, history was made as the first-ever FRCOphth Part 2 Oral Examination was successfully conducted in Malaysia. The Viva component took place at the Medical Academies of Malaysia, while the OSCE component was held at Hospital Cyberjaya.

This milestone would not have been possible without the tremendous efforts of Dr. Zalifa Zakiah Binti Asnir, who played a pivotal role in organizing and hosting the examination. Dr. Zalifa currently serves as the Head of Ophthalmology Services in the Ministry of Health Malaysia, Head of Training for the Ophthalmology Parallel Pathway since 2018, and Head of the Department of Ophthalmology at Hospital Cyberjaya. Her dedication and leadership have been instrumental in advancing ophthalmology training in Malaysia and in making this long-awaited local examination a reality.

Behind the lens: A Conversation with the Expert

AN INTERVIEW WITH DR ZALIFA ZAKIAH ASNIR

There has been a recent shift in the landscape of ophthalmology services with the appointment of Dr Zalifa Zakiah Asnir as the new Head of Service for the Ophthalmology fraternity in the Ministry of Health, Malaysia. A Consultant Ophthalmologist and Head of Department at Hospital Cyberjaya, Dr Zalifa brings nearly two decades of experience to the role. Beyond her clinical and administrative responsibilities, she has been a driving force in postgraduate training and examinations, leading the Parallel Pathway Programme since its inception.

Today, we take the opportunity to delve deeper into her vision, challenges, and aspirations for ophthalmology in Malaysia.

Congratulations, Dr Zalifa, on your appointment as the Head of Ophthalmology Service for the Ministry of Health. How has the transition into this new role been for you so far?

Thank you very much. It has certainly been a meaningful transition. While the learning curve has been steep, I am grateful for the support of my colleagues and the dedicated teams across the country. This role carries immense responsibility, but I see it as an opportunity to drive positive changes and elevate ophthalmology services in Malaysia.

As the new Head of Service, what are your immediate priorities and what is your long-term vision for ophthalmology services in Malaysia?

In the short term, my focus is on strengthening service delivery across all tiers, ensuring equitable access to eye care particularly in underserved and rural areas.

Next in Vision: Ophthalmic Innovations and Updates

PRESBYOND®

Introduction

There is a paradigm shift where the go-to procedure is no longer clear lens exchange for the management of presbyopia. Clear lens exchange (CLE) carries intraocular risks that, although uncommon, can lead to severe or even complete loss of vision. Reflecting this risk–benefit reality, many countries no longer accept CLE for insurance claims; some have banned or actively discouraged it, and reports of practitioner blacklisting have emerged. In Malaysia, insurers have begun taking steps in the same direction. Against this backdrop, PRESBYOND® has risen as a safer, adjustable, and quality-of-vision–focused alternative.

PRESBYOND® is a laser refractive solution for presbyopia that uses femtosecond-flap LASIK to create a larger depth of field via binocular “micro-monovision” with a controlled tolerance of spherical aberration. The result is a high unaided range, from near through intermediate to functional distance, while preserving stereopsis and contrast better than traditional monovision LASIK. Patients often describe the visual experience as natural, with comfortable depth perception for real-world tasks.

Patient Satisfaction

Compared with multifocal IOLs, PRESBYOND® avoids intraocular dysphotopsias and the contrast loss inherent to diffractive optics, delivering a more natural visual quality. The procedure itself typically takes about 15 minutes for both eyes, with many patients driving the next day and returning to work within a few days. Traditional monovision LASIK, by contrast, has a relatively poor adaptability rate, and patients who struggle often complain of compromised stereopsis and reduced visual comfort. Attempts at “mini-monovision” may maintain some binocularity but typically sacrifice meaningful near vision, leaving patients unsatisfied. PRESBYOND® bridges this gap by providing a more balanced and functional range.