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Glaucoma - Tonometry

Eye Health – Glaucoma (Part 5)

Dr S S Gill, Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S S Gill, Consultant Ophthalmologist

In conjunction with World Glaucoma Awareness Week, Ipoh Echo talks to Consultant Eye Surgeon Dr S.S. Gill about this “silent thief of sight” – PART 5

Glaucoma as you know has been nicknamed the “silent thief of sight”. This disease results in permanent irreversible blindness in the affected eye(s) that often goes without symptoms until the loss of vision is significant or the patient is blind.

Early diagnosis means early treatment and therefore prevention of major loss of vision. Diagnosing glaucoma may require elaborate testing to be done by the eye doctor.

The following are basically the tests that are done before making a diagnosis of glaucoma:

Examination of:                                                            Name of Eye Test:

1. Eye Pressure                                                                     >Tonometry

2. Angle of the eye where the aqueous (eye fluid) drains      >Gonioscopy

3. Optic Nerve check                                                              >Ophthalmoscopy (dilated eye exam)

4. Field of Vision                                                                     >Perimetry

5. Thickness of the Optic Nerve Fibre Layer                         >Ocular Coherence Tomography Scan

1. Tonometry

Glaucoma - TonometryThis is the measurement of the eye pressure (intraocular pressure or IOP). This is often the first test that is done. If a person has higher than normal eye pressure, it would mean that the person would have a higher

risk for glaucoma. It is important to understand that having eye pressure higher than normal does not mean a definite diagnosis of glaucoma.

The test is done by first instilling some eyedrops to numb the eye. Following that, the eye pressure (IOP) will be measured using a Goldmann tonometer. Sometimes an air-puff tonometer is used but this is less accurate than the Goldmann tonometer which is the gold standard in measurement.

Glaucoma - Gonioscopy2. Gonioscopy or examination of the eye drainage area

This test is done if you are suspected to have glaucoma. A special device called a gonioscope is used to examine the angle where the aqueous (eye fluid) drains in the eye. The viewing of this drainage area allows the eye

doctor to diagnose the kind of glaucoma a person may be suffering from in order for the correct treatment to be given to the patient.

3. Optic Nerve check

Glaucoma - Normal optic disc
Normal optic disc

An instrument called an ophthalmoscope or Fundus Imaging Camera is used to examine the optic nerve. The appearance indicates whether or not damage from glaucoma is present. It is important to examine the optic nerve from time to time, in order to look for progression of nerve damage due to glaucoma. The picture on the left shows a normal optic nerve (optic disc).

Glaucoma - Optic nerve damage
Optic nerve damage in glaucoma

Normal Optic Nerve

The picture on the right shows the damage that occurs to the optic nerve or optic disc due to glaucoma (indicated by the arrows).





Dr Gill will elaborate more on the eye tests that are done for glaucoma in the next issue of the Ipoh Echo.

For more information, contact Gill Eye Specialist Centre at 05-5455582, email: gilleyecentre@dr.com or visit www.fatimah.com.my.

Basketball – Sultan Azlan Shah Cup


ipoh echo issue 141, Sultan Azlan Shah Cup International Basketball Championship 2012China Xiamen emerged champion of the inaugural Sultan Azlan Shah Cup International Basketball Championship 2012 held at Stadium Indera Mulia, Ipoh. The Chinese team defeated Philippines Far Eastern University 90-64 after a hard fought match which saw tempers flaring. The narrow defeat of the Chinese to the Filipinos in the preliminary round could be the reason for the highly charged match. China Xiamen’s top scorer, Liu Yi-Sheng netted 22 points.

This is the second time the Chinese team had won an international invitation title in Malaysia. They won the Johor International Invitation in October last year.

Perak Selection defeated Royal Thai Navy 102 – 58 to end the tournament as the 5th best team. Australia’s Gold Coast Authentic All-Stars edged Taiwan’s Normal University 103 – 87 for the 3rd spot. A total of eight teams participated.

The tournament was organised by the Malaysian Basketball Association and held in Ipoh in conjunction with Visit Perak Year 2012. The opening ceremony on Tuesday, March 27 was officiated by DYMM Sultan Azlan Shah while the final on Monday, April 2 was graced by DYTM Raja Muda, Raja Nazrin Shah.  Chief Minister, Dato’ Seri DiRaja Zambry Abd Kadir was in attendance.


Henry Cats & Friends Ipoh - ipoh echo issue 141

Personalised Gifts for Sale


Henry Cats & Friends Ipoh - ipoh echo issue 141Henry Cats & Friends Ipoh - ipoh echo issue 141If you think it is hard to find a good gift for animal lovers, look no further. The newly-opened Henry Cats & Friends outlet at Tesco Ipoh is the place to go. Located on the first floor next to Time Galerie, the novelty shop features items for the home and kitchen, as well as fashion. All with cute animals printed on them.

On entering the chic-looking outlet, customers are greeted with a remarkable display of hand-painted stones of furry animals. Designed by Henry Lee from Taiwan, each stone takes about two months to paint. Each item is designed to be a unique personalised gift for friends and family.

Make a date with Henry Cats & Friends outlet at Tesco Ipoh and get your personalised gifts. No customer has ever regretted stepping into the outlets throughout the world. Online purchases can be made at www.henryfriends.com with prices ranging from RM5 to RM300.


Italia Mia - musings on food - see foon chan-koppen

SeeFoon goes Italian


See Foon Chan-KoppenBy See Foon Chan-Koppen

Chef Kenny Lim doesn’t believe in shortcuts. Coming from a family of hoteliers, Kenny has been drilled in formal kitchen and culinary skills from the age of 17 when he went to Les Roches International School of Hotel Management in Switzerland. Armed with a diploma in Hotel Management from Les Roches (rated one of the top four hotel schools in the world), Kenny decided that hotel management was not for him and went straight into doing what he loved best: cooking.

Italia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenItalia Mia - musings on food - see foon chan-koppenSince then he has worked in some of the finest kitchens in both East and West Malaysia including stints with Shangri-la and Regent Hotels in Kuala Lumpur, the Hard Rock Cafes in Singapore and KL, the Cyberview Lodge in Cyberjaya and many others.

It was serendipity that found him in Ipoh where he and his wife were staying with his brother -in-law before moving on to Penang, where he was considering re-joining his ex-boss at the Hard Rock Hotel there. Finding that his wife and their three girls aged 16, 15 and 9 loved Ipoh, and as luck would have it, he met up with an American investor who was keen to take over the existing Italia Mia restaurant which was then up for sale. And so a partnership was formed, with Kenny presiding in the kitchen and Soli, the American partner’s wife helming the service and front of the house.

I noticed the difference the first time I went there after the new management took over. I have always been a regular at the ‘old’ Italia Mia and I needed to find out what was happening in the ‘new’.

The decor has remained but the menu was different – more trattoria style and less formal. But it was the prices that caught my eye. Visibly lower than the previous management, the only option was to use the old adage ‘proof of the pudding is in the eating’, which a group of us did with gusto.

We decided to blow diets to the wind and ordered a selection of their appetizers that included fried mozzarella sticks and deep fried calamari (squid) both served with their home-made marinara sauce, a tangy fresh tasting tomato based sauce that lent a piquancy to the fried titbits.

We then had a slice of pizza each, the one we ordered being the Pepperoni (beef) from a choice of five. The crust was thin and crisp, with a generous topping of cheese and pepperoni. The roast duck pizza is apparently a must try and will be on the new menu which is due out shortly.

The Parrot fish Piccata, pan fried with capers and served with a lemon butter sauce was very flavourful, tinged with the tartness of the capers which complemented the firm fresh fish.  It wasn’t on the menu and was one of their featured ‘Fish of the Day’ specials. However, this will be on the new menu – RM42.

We followed this up with the country roast lamb rack, marinated and braised in own juices served with ratatouille (mixed vegetables stew) and mashed potatoes. Hints of rosemary, garlic, and citrus flavours wafted from the table as we tucked into this very succulent lamb – RM56.

Next was the Seafood Spaghetti A’lio O’lio one of their signature dishes, a cornucopia of seafood – prawns, mussels, squid – pan fried with garlic and tossed with white wine and al dente spaghetti, topped with parsley – RM28. Definitely a must-have for those into seafood.

The entire menu is small but with a selection to please all palates from the vegetarian to the ‘fishtarian’ to the carnivore with a choice of chicken, lamb and rib eye steaks.

Their wine list is modest ranging from RM85 to RM110, great for an evening of wining and dining in air-conditioned comfort in a European ambience, with white table cloths, where the service provided by Soli is extremely friendly and superlative and for me most importantly of all, where the toilets are clean and fresh smelling!

Italia Mia Ristorante Italiano
10 Persiaran SC12/1, Sunway City, Ipoh
Tel: 05-5474007
Closed Wednesdays
Pork Free

PUO Students Graduate


Some 2,818 students from Politeknik Ungku Omar (PUO), Ipoh received their diplomas during a convocation ceremony held at the college hall recently. Due to the number, the ceremony was held over a three-day period. DYTM Raja Muda Perak, Raja Nazrin Shah gave away the parchments on the first day followed by the Chief Secretary of the Ministry of Higher Education, the Managing Director of PERODUA and finally the Chairman of Gas Malaysia. It was PUO’s 41st convocation ceremony since its inception.

ipoh echo issue 141 - politeknik Ungku Omar (PUOA number of excellence awards were also given to students who had excelled in their fields of work. Among them were the polytechnic’s overall top student, the top-semester students and the most innovative project winners.

Politeknik Ungku Omar is the first of the many polytechnics established in the country. Founded in 1969 with assistance from UNESCO, it has developed by leaps and bounds to be a top-notch technical institution in the country. Graduates of PUO are well sought after by industrial players. Its transformation into a full- fledged university by 2015 is well underway.

Chief Minister of Perak, Dato’ Seri DiRaja Zambry Abd Kadir was in attendance on the first day of the convocation ceremony.


Cleanliness Is a Matter of Attitude


By Mariam Mokhtar

RubbishWe will never be rid of the twin terrors of trash and toilets if our attitude to filth remains. Just read the mainstream papers. Littered streets, blocked drains, fly-tipping and dirty amenities, are regularly reported, but very little improvement is made.

Despite claims by the Ipoh Mayor, Roshidi Hashim, that he will not tolerate piles of garbage and indiscriminate dumping, the problem persists. At one time, Ipoh was dubbed the Garden City and envied by other Malaysian cities. Today, the deterioration is evident. How can Ipoh return to its former glory? Can we ever regain the pride we once had in Ipoh?

Last Chinese New Year, Mrs Choo’s celebration was marred by the stench from an illegal rubbish dump nearby. No-one should have to put up with the foul smell, the mess and the health hazards caused by rats and stray dogs foraging for food. “Last year during house-cleaning, someone threw over 30 bags full of waste over there. A few days ago, someone threw a sofa, wooden planks and eight bags.”

Began 10 Years Ago

Mrs Choo, a resident of Taman Ipoh for the past two decades, claims that the impromptu dump-site began 10 years ago. “It’s even worse during Chinese New Year, as people clean their houses and generate more rubbish. Some even have the nerve to throw junk directly into my drain.”

In another part of town, visitors to Jalan Spooner in Buntong are confronted with what looks like a landfill site. There are piles of putrefying organic matter, discarded furniture, construction rubble, food-waste and assorted plastic items.

Residents here claim that the dump appeared in the past decade. When a complaint was made via someone with influence, city council workers equipped with a bulldozer pushed the rubbish from the road into the nearby bushes. The newly created space just attracted more fly-tippers.

In Fair Park, Mrs Kua has lost count of the number of times she has contacted the Ipoh City Council (MBI) to clear the rubbish dump behind her house. Her problem is worse during wet weather because the rubbish clogs the drains. She is not alone in witnessing other residents throwing rubbish onto the dump.

Ipoh’s growing mountain of rubbish is a problem that is also experienced in more affluent parts of the city. Residents close to the Ipoh Turf Club and the Perak Golf Club are angry with uncollected garbage and blocked drains.

One resident, Cik Poniah said: “There are weeds and small trees, around four feet high, growing in the drains. Council workers have avoided the area and have not been seen for months.

“The vegetation clogs up the drains, and when it rains, the roads flood. Monitor lizards and snakes thrive in these drains. Plant roots damage the drains. Don’t the authorities realise that it will cost more to mend the broken drains?”

Her neighbour, Puan Rose, agreed: “The decline in the services happened about 10 years ago when MBI appointed contractors with a lackadaisical attitude to work. If they felt like it, they would turn up to collect the rubbish. Previous to that, the council had a supervisor to check on their work. Nowadays, we’d be lucky if the dumpster appears.”

The litter situation has declined further and Ipohites believe that MBI will accept complaints about rubbish but will do nothing, because they know that the people will eventually tire of complaining and then stop contacting MBI.

Residents have requested that more enforcement officers patrol the streets to fine errant offenders. One resident was furious when told that MBI “had no idea when their officers would turn up”.

Taking Matters into Own Hands

One irate resident who was frustrated with MBI’s failure to look after the interests of Ipoh’s ratepayers, decided to take matters into his own hands. In early March, three lorry loads of coconut husks were dumped beside the highway, near Ampang, in Ipoh, whilst another lorry-load was dumped close to mayor Roshidi’s home.

Roshidi responded by demanding that his enforcement officers locate the culprit and punish him. “I don’t care who is responsible for throwing the coconut husks. There will be no compromise when it comes to illegal rubbish dumping. They are traitors to our cause to keep the city clean.”

He warned that his officers would monitor illegal dumpsites and announced that unsightly garbage piles would deter tourists, especially during VPY 2012.

Public Mind-sets Change

Various people and organisations have been trying to get to grips with the filth, but unless our mind-set changes and until we educate the public and the workers, by going back to basics, hygiene and rubbish issues will remain unresolved.

Tourists have already begun complaining. In late March two Swedes reported to the regional papers about having to pay to use filthy toilets at the bus terminal in Medan Gopeng, but their horrifying experience is worthy of another article.

Priorities must be made. It was reported that the mayor and the Tourism Perak CEO Ahmad Fathil Abd Ghani will spend RM1 million to “beautify” Ipoh, by illuminating the limestone hills around the city.

Roshidi said, “When lit up at night, they will be really beautiful and I believe this will be an added tourist attraction for Ipoh.

This money would be better spent on a more efficient rubbish collection service, more regular rubbish collection and more enforcement officers. Rather than illuminate the limestone hills which do not require more “beautifying”, the money could be spent on street lighting to reduce crime and drug addicts. In times of austerity, money should be spent wisely.

Polo: Iskandar Merdeka League Tournament


The recently held Iskandar Merdeka League Tournament had an exciting final when the score after the 4th chukka was a 6 all draw which had the teams going into sudden-death overtime.

Polo Champs Team Izira. 2nd from left is co-Patrons Tengku Uzir followed by 'Ijan'

Team Izira ultimately won the tournament when teammate Yudie Fazly Jamili put in the final goal to beat Royal Pahang 7-6 in a keenly fought match which saw relative newcomer Team Izira putting up a hard fight for their first ever league tournament win.

Ijan, Izira's Patron, can't stop smiling over the teams first big win.

Izira Patron Azlizan Zabidin, more popularly known as ‘Ijan’, was ecstatic explaining that this was her team’s first win since being formed a year ago adding that she and co-Patron Tengku Uzir would shuttle between KL and Ipoh during the tournament, to plan ahead before their upcoming matches.

Organising Committee members of IPC. Extreme right, IPC President Dato' Radzi Manan with wife Datuk Kamilia Ibrahim.

The President of Iskandar Polo Club (IPC), Dato’ Radzi Manan, the organiser of the tournament said he was satisfied with the overall tournament considering that this was the first league tournament it had organised after a long hiatus. A total of eight teams participated in this low goal polo tournament of which three teams were from Pahang. IPC’s team is called the Tambun Tigers.

(l-r) Team Royal Pahang (runners-up) and IPC's Team Tambun Tigers


SHE Expo 2012


ipoh echo issue 141, SHE (Slimming - Healthy - Enrich) Expo 2012SHE (Slimming, Healthy, Enrich) Expo 2012 will be back in Ipoh. The exposition, to be held at Stadium Indera Mulia from April 20 to 23, is open to the public. Operating hours are between 10.00 a.m. to 10.00 p.m. daily and admission is free. The expo targets female consumers with a few thousand enticing beauty products up for grabs.

Last year nearly 50 exhibitors participated in the show. This year 62 exhibitors have so far registered and will operate from over 100 booths. Among them are Vigico, Diapex, Coway, PAMA and many more.

A lucky draw will be held each day with attractive prizes such as LED TVs, I-pads, travel vouchers, spa vouchers and beauty products to be won. Hospital Fatimah will be giving a health talk. Make-up shows by Aery Jo Academy and a catwalk presentation by models from the Amber Chia Academy are on the cards to keep the crowd enthralled.

Visitors in excess of 50,000 are expected over the three-day period. The exposition is set to break new grounds.


ipoh echo issue 141, Gua Tempurung

Gua Tempurung


 ipoh echo issue 141, Gua Tempurungipoh echo issue 141, Gua TempurungI visited Gua Tempurung on March 31 and was shocked at the amount of rubbish in the show cave. Considering it was a Saturday morning and only just the start of the weekend, I dread to think how much more rubbish would accumulate over the weekend. Maybe the rubbish bins have not been emptied for a while. But why are visitors allowed to dump their rubbish, mainly plastic bottles – in the cave. Also there are many broken shoes, and soles from shoes littering the cave. The other problem is visitors are given stickers denoting which tour they are on, but these stickers fall off and there are so many lying on the walkways. Not a good advert for Visit Perak Year 2012, or for Malaysian show caves.

Liz Price

Is The Future In Our Hands?


By Fathol Zaman Bukhari

Tengku Razaleigh Hamzah - ipoh echo issue 141
Tengku Razaleigh Hamzah

Former Finance Minister and Umno stalwart, Tengku Razaleigh Hamzah has a strong affinity for Ipoh and this could be the reason why he makes frequent trips here. And each time he stops by there is no telling what he will say about the goings-on in the country. Tengku Razaleigh, or more fondly Ku Li to his legion of fans, would take a pot shot at the BN-led administration especially its most dominant partner, Umno. It is not that he has a dislike for the party but more like advice from a senior member whose heart is with the rakyat.

Ku Li was on another of his whistle stops when he was invited to launch a book by Koon Yew Yin on Sunday, April 1 at Syuen Hotel, Ipoh. Despite it being an April Fools’ Day the significance of the occasion was never lost. As expected, his presence did much to excite the 100-odd invitees who waited patiently for the Kelantan prince to make his appearance. It did not matter that he was late by over an hour, the audience, which consisted of the who’s who of Ipoh’s society, was prepared to forgive. They were there to hear what the Umno maverick had to say.

There have been many comments and views expressed about his short speech. The most succinct had been those on the online news portals. The mainstream media, however, were less enthusiastic, treating it like some insignificant event not worth reporting. That is only expected of them.

The speech titled, “Malaysia: The Future is in Our Hands” was delivered in true Ku Li’s fashion – direct and to the point. Dispensing advice must be made in such a manner in order to make it more effective. And since much has been said about his speech, I wish to only dwell on three aspects which are relevant at this moment in time.

On our future Ku Li proclaimed: “…the future of innocent children yet unborn for generations to come is in your hands. It is not the King who will decide the future for us. It is not what the Prime Minister wants that will be of any consequence. It is you, the ordinary citizens, meaning the farmer, teacher…and even the unemployed vagrant who is going to decide the destiny of our children.”

Unemployed vagrant? That is a tall order considering that the unemployed, the mat rempits, the snatch thieves and a horde of other unsavoury characters are a bane to society, as they need to be cared for using our depleting resources. But what Ku Li said is true. The future is ours to decide. We cannot leave it to the politicians to do the thinking. We cannot allow those with bloated egos to think for us. Neither can we allow kleptocratic leaders to do the honours. We have to decide what is good or bad for us. And in making this decision we have to cast aside religion, colour and race and think as one.

On voting he warned, “There are many Malaysians who complain about the government but are not registered voters. They do not commit themselves wholeheartedly to seek change and to exercise their voting rights to choose a better government.”

Ku Li was right. If we failed to treasure these rights then we have ourselves to blame.  So if you have not yet registered as a voter, please do so before it is too late. Stop whining about a bias Election Commission. Leave that to Ambiga and her Bersih gang.

Our less-than-perfect education system, said Ku Li is one of the reasons for our debilitating captive mind which has inhibited our power to reason and see things beyond race and creed.

“Our educational curricula do not encourage the moral and intellectual reform of the mind…the education system has failed to impart the fundamentals of scientific thinking and reasoning in relation to our own society.”

The flaw in our education system needs no elaboration, as is evidenced from the quality of people joining the job market each passing year. If and unless a total overhaul is done, our society will forever be mired in mediocrity.

And having discussed the foregoing, do we honestly feel that the future is in our hands? The answer is both yes and no. Yes, if we have the commitment to make a change and no if we are contented with what is around us.  I rest my case.