Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice.

To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

The purpose of this study was to investigate the reproducibility of choroidal thickness measurements in normal subjects on 3 spectral domain optical coherence tomography instruments, namely: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA), Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany), and Optovue RTVue (Optovue Inc., Fremont, CA). This cross-sectional non-interventional study was performed in a single institution. Images were obtained in 47 eyes of 47 healthy volunteers which age ranged between 23 and 72 without ocular pathology. All subjects were imaged on the fovea using Cirrus HD 1-line raster, Spectralis enhanced depth imaging, and RTVue retina-cross. The choroid was measured subfoveally and at intervals of 500 µm from the fovea nasally and temporally up to 2500 µm. Paired t test, modified Bland-Altman plot, and Pearson's correlation were used to compare the results. There is no significant difference between the systems for any measurement within 2500 µm either side of the fovea for most points. Inter-observer correlation was strong for RTVue, and moderate in both Cirrus and Spectralis.

Sir, Determination of seasonal allergic conjunctivitis variation using internet search engine data A common and potentially debilitating disease, seasonal allergic rhinoconjunctivitis (SAR) can greatly affect the quality of life and is associated with lost productivity.

Wilson's disease (WD) is characterized by excessive accumulation of copper in the central nervous system, liver, kidneys, cornea, and other organs, leading to damage of the liver and brain. 1 A KaysereFleischer (KF) ring, a brownish coloration of the outer margin of the cornea in the Descemet's membrane, is characteristic of WD. 2 Another rare ophthalmic manifestation of WD is sunflower cataract. 3 Both KF rings and sunflower cataracts are best observed with an ophthalmic microscope. An 8-year-old girl with WD presented with lethargy, abdominal distension, and bilateral edema that had been present for 6 months. On examination, we noted jaundice, abnormal liver enzymes, and prolonged coagulation time. The total and conjugated serum bilirubin levels were 125 mmol/L and 98 mmol/L, respectively. Alanine trans-* Corresponding author.