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Caring for the community’s eyes

In the Segamet region of Malaysia, on-ground teams of data collectors are part of an ambitious project to discover the factors that affect health and wellbeing in the local community.

Bringing together researchers and the community, the Monash South-East Asia Community Observatory (SEACO) research platform sends staff and volunteers door-to-door to collect high-quality data on demographics, health and nutrition, the use of health services, education and more.

Funded by Monash Uni, Malaysia and Australia, Monash SEACO is hosted by the Jeffrey Cheah School of Medicine and Health Sciences and supported through the Monash Technology Research Platforms.

One of Monash SEACO’s latest projects aims to improve eye health in children.

Although kids in Segamat are routinely screened for eyesight problems as infants, and again as they start primary school, it doesn’t often happen in 2 to 6-year-olds. Problems such as near and far-sightedness, lazy eye and squinting caught at this age can often be corrected – but if untreated, they can rapidly develop into serious issues later in life.

One of the barriers to catching this kind of problem early is a lack of community awareness, combined with a low level of acceptance for contemporary scientific evaluation. Put simply, many eye problems are not picked up, either because parents don’t accept eyesight screening results, or because children are scared of the testing process. Enter SEGPEADS: the Segamat Pediatric Eye Disease Study.

As a feasibility pilot to see how the community would respond to a bigger study, SEGPEADS sent an eye specialist to screen more than 1,000 children in Segamat’s kindergartens. Forty-six kids with potential problems were then tested further at the Hospital Kuala Lumpur eye department, led by Dr Kumar Thavaratnam from the hospital’s Paediatric Ophthalmology team.

The project was coordinated by Pn Ruhaida Bachok, the SEACO field operations manager and her team. The Head of Paediatrics at the Segamat District Hospital, Dr Intan, and her team provided support for the children who were referred for specialist treatment.

The second round of testing revealed that almost half of the children screened had symptoms suggestive of some type of eye problem, with more than one in five requiring intervention. Yet only 12 per cent of parents were aware that their child had a problem.

Lead researcher on the SEGPEADS study, Dr Joseph Alagaratnam, says that being able to make use of hospital staff from both Hospital Kuala Lumpur and Hospital Segamat was of great use in resolving parents’ and children’s concerns with eye screening.

“The innovative, caring and understanding methods [used] demonstrated… the benefits of the program and the value that the results provided to all those who participated,” he says.

Dr Alagaratnam adds that the long-term benefit to the community is that the value of this type of assessment is now understood. As a result, he hopes that future families will be more proactive in assessing their child’s eye health.

“We should now be able to catch eye disease at the onset, and plan the management of these diseases early,” he says.

The next phase of the project, a study commissioned by the National Institutes of Health, and involving a larger population of children, is expected to inform national policy on pediatric eye screening in Malaysia.

In memory of Dr Joseph Alagaratnam, who passed away in October 2016.