Dear MSO Members,
 
Much has happened since the last AGM with the election of a new MSO committee and it gives me great pleasure to introduce some new members and welcome back many from the previous committee, namely, Dr Kenneth Fong Choong-Sian (President), Dr Miswan Muiz Mahyudin (Vice President), Dr Manoharan Shunmugam (Secretary), Assoc Prof Amir Samsudin (Assistant Secretary), Dr Lee Ming Yueh (Treasurer), Dr Fang Seng Kheong, Prof Dr Liza Sharmini Ahmad Tajudin, Dr Shelina Oli Mohamed & Prof Dr Mae-Lynn Catherine Bastion (Committee Members).

The MSJOC held in March at Kuantan, Pahang proved popular and provided a nice change of scenery for most of us city-dwellers. The scenic and culturally-rich city proved to be a great host with much praise for its organisation led by Assoc Prof Dr Amir Samsudin, Assoc Prof Dr Khairidzan Mohd Kamal & Assoc Prof Dr Ahmad Nurfahmi Akhtar Ali. There was a great line-up of experts both locally and abroad with Keynote lectures delivered by Assoc Prof Dr Shuan Dai, Assoc Prof Dr Khairidzan Mohd Kamal, Assoc Prof Dr Carmen Chan & Prof Dr Liza Sharmini.

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Another exciting development is MSO’s move into our brand new office which we own. Located at PJ Midtown (Unit #UG33) on Jalan Kemajuan, the space is also available to members should you be interested to hold a meeting or discussion. Bookings are on a first-come first-served basis and only during office hours for the moment.

ARTICLES

WHAT IS BLUE LIGHT?

Visible light consists of red, orange, yellow, green and blue light rays and the shades of colour between them. Light rays that have relatively long wavelengths contain less energy, and those with short wavelengths have more energy. The red end of the visible light spectrum has a longer wavelength and therefore, less energy. Rays on the blue end of the spectrum have shorter wavelengths and more energy are sometimes called blue-violet or violet light.

Ultraviolet radiation, in moderation, also has beneficial effects, such as helping the body manufacture adequate amounts of vitamin D.

What does blue light do to your body?

Sleep and blue light

Light exposure at night is linked to several illnesses. The theory is that exposure to light suppresses the secretion of melatonin. The production of melatonin follows a very distinct pattern, which is very closely linked to the individual's circadian rhythm. Following light exposure during the day, almost no melatonin is produced, whereas during the night, when it is dark, almost all melatonin is produced. If a person is intermittently exposed to light at night, a profound melatonin reduction was observed in humans after 2 weeks. Melatonin is a pineal hormone that is involved in circadian regulation, facilitation of sleep, inhibition of cancer development and growth, and enhancement of immune function. It is recommended to refrain yourself from using blue-enriched light from screens about 4 hours before bedtime. In fact, increase more natural sunlight or bright light during the day to help keep the circadian rhythm healthy.

INTERVIEW WITH ASSOCIATE PROFESSOR DR NORSHAMSIAH BINTI MD DIN

Associate Professor Dr Norshamsiah binti Md Din
Senior Consultant Ophthalmologist (Glaucoma)
Head of Department, Department of Ophthalmology
University Kebangsaan Malaysia Medical Centre (UKMMC)
Chairperson of Malaysian Universities Conjoint Committee of Ophthalmology (MUCCO)
Academy of Medicine

1. Tell us about your hometown and family

I was born in Universiti Malaya Medical Centre (University Hospital at that time) and grew up in Kampung Tunku, Petaling Jaya. But both my parents are from Malacca before they moved to Petaling Jaya in the 1960s. I am the fourth among nine siblings. Besides me, I have two younger brothers who are medical doctors as well. One of them is an anaesthesiologist in HKL and the other one is a urology MO in Hospital Selayang. I am married with five children, age ranging from eleven to nineteen. Three of them were born during my master study in Ophthalmology.

2. Tell us about your educational background

I graduated from Universiti Kebangsaan Malaysia in 1997. I did my housemanship in Universiti Malaya Medical Centre. I was then sent to Sarawak for 2 years after completion of my housemanship. I then came back to Peninsula Malaysia and served at Hospital Tengku Ampuan Rahimah, Klang. Subsequently, I started my Masters in Ophthalmology at Universiti Kebangsaan Malaysia and graduated in 2007.

3. Where did you do your subspecialty?

I did my PhD study in University College of London. My field of study was uveitic glaucoma. I was lucky because I could also do a clinical fellowship in uveitis and glaucoma in the three years that I was at Moorfields Eye Hospital. I was honoured to be attached to Professor Susan Lightman for uveitis and Dr Keith Barton for glaucoma in Moorfields Eye Hospital. They were great teachers.

UVEITIC GLAUCOMA

Uveitic Glaucoma is a dreaded complication of uveitis which can cause irreversible blindness even when the uveitis has been successfully treated. While uveitis accounts for 10-35% of blindness in individuals under 65 years of age, intraocular pressure (IOP) elevation occurs in approximately 8.6-41.8% of cases. ^{1, 2}

Aetiology and Mechanism

In general, glaucoma may arise as a complication in all types of uveitis. However, certain uveitic syndromes are more commonly associated with elevated IOP even at the onset of the uveitis. These include Possner Schlossman Syndrome and Fuch’s Heterochromic cyclitis which are usually unilateral; and herpetic uveitis and Juvenile idiopathic arthritis which commonly affect both eyes.³

Many factors may cause elevated IOP in uveitic glaucoma. The most notable of them would be reduced aqueous outflow, pupillary block due to synechial closure and side effect of corticosteroid treatment.

Among the reasons for reduced aqueous outflow are clogged trabecular meshwork from inflammatory debri, changes in the cytoskelton of the trabecular meshwork, trabeculitis, angle closure from synechiae or angle neovascularization; or less commonly angle closure associated with anterior rotation of the ciliary body caused by ciliary body effusion from excessive inflammation.