24/04/2026
๐๐ก๐ ๐๐ข๐ฅ๐๐ง๐ญ ๐๐ข๐๐ญ: ๐ ๐
๐ข๐ฏ๐-๐๐๐๐ซ ๐๐จ๐ฎ๐ซ๐ง๐๐ฒ ๐จ๐ ๐๐ข๐ฌ๐ข๐จ๐ง
Five years ago, I stood in my clinic looking at a piece of equipment that cost RM 40,000โthe Welch Allyn Spot Vision Screener. To many, it was just a high-tech handheld device. To me, it was a promise.
The seed for this investment was sown years earlier in Hong Kong. While attending a medical conference, I read a local newspaper feature about a local celebrity pleading with parents to adhere to the national vision screening program following the detection of her daughter severe visual impairment.
As a father myself, the story haunted me. I kept imagining the crushing guilt of a parent realizingโtoo lateโthat their childโs vision was permanently impaired simply because of a missed check-up.
โ๐ผ๐๐๐๐๐๐๐๐ ๐๐ ๐ ๐๐ข๐ฅ๐ข๐๐ฆ ๐๐ข๐ ๐โ๐๐๐๐๐๐ ๐๐๐๐๐๐ก ๐๐๐๐๐๐.โ
I decided then: no child under my care would ever lose their sight to my ignorance.
๐๐ก๐ ๐๐ซ๐ข๐๐ ๐จ๐ ๐๐ซ๐๐ฏ๐๐ง๐ญ๐ข๐จ๐ง
When I first brought the machine to my clinic, I faced the harsh reality of private practice. I charged a small fee to break even, but I was met with skepticism. "Is this necessary?" or worse, the stinging comment: "Doctors just want more money."
It was disheartening. As a physician, we dedicate our life to healing, yet we are sometimes viewed through a lens of greed.
It was a crossroads. I could let the machine gather dust, or I could honor the "heart of service" my mentor taught me. I chose the latter. I made the screening free โ a silent gift included in the trust parents gave me. We never advertise it; we just quietly did it. We absorbed the cost of the machine and the strain on our manpower because the trust parents placed in us was worth more than the equipmentโs price tag.
๐๐ก๐ ๐
๐ฎ๐ฅ๐ฅ ๐๐ข๐ซ๐๐ฅ๐
Over the years, we detected cases in children as young as one year oldโanisometropia, squints, and severe astigmatism. Each detection was a victory, but one case recently brought my entire career into focus.
A senior nurse, someone who had mentored me when I was a struggling house officer, brought her four-year-old daughter to see me for a febrile illness. I noticed a subtle, intermittent squint.
"I only see it when she's tired or unwell," the mother told me, unfazed.
I insisted on a screening. Because she trusted me, she agreed. The result was a shock, The screen flashed a devastating number: -5.00 myopia in both eyes. The room went quiet. At -5.00, the world for this four-year-old was a smear of colors. She wasn't "unruly" or "distracted"โshe was effectively blind to the beauty of the world around her. She couldn't tell us because she didn't know the world was supposed to be sharp.
As I watched my nurseโs face realize the gravity of what weโd found, I realized the RM 40,000 had finally been "paid back" in full. It didn't come back in Ringgit; it came back in the sight of a child whose future was just restored.
We don't do this for the "likes" or the fees. We do it because, as doctors, we are the gatekeepers of a childโs potential. Sometimes, the best things we do for our patients are the ones they never even knew we did.
๐๐๐๐ฅ๐๐๐ญ๐ข๐จ๐ง๐ฌ
Today, many parents leave my clinic not even realizing their child was screened for free. Thatโs okay. Being a paediatrician isn't about the accolades or the ROI on a piece of technology. Itโs about the quiet satisfaction of knowing that somewhere out there, a child is seeing the world clearly because five years ago, I decided that vision shouldn't have a price tag.
๐๐ก๐ ๐๐ก๐๐๐จ๐ฐ ๐จ๐ ๐ญ๐ก๐ "๐๐๐ณ๐ฒ ๐๐ฒ๐" (๐๐ฆ๐๐ฅ๐ฒ๐จ๐ฉ๐ข๐)
The reason I am so insistent on early screening is to prevent Amblyopia, commonly known as Lazy Eye.
When a child has a condition like -5.00 myopia in one or both eyes, the brain receives a perpetually blurry image. To protect itself from confusion, the brain simply "switches off" the connection to that eye. If this isn't corrected during the "Critical Period" (usually before age 7 or ๐, the brain permanently loses the ability to see clearly through that eyeโeven with the best glasses in the world.
By the time a child is 10 or 12, the window has closed. The "Lazy Eye" becomes a permanent disability.
๐๐ฎ๐ซ๐ซ๐๐ง๐ญ ๐๐ซ๐๐๐ญ๐ข๐๐ ๐ข๐ง ๐๐๐ฅ๐๐ฒ๐ฌ๐ข๐: ๐๐ก๐ ๐๐๐ฉ ๐๐ ๐๐ซ๐ข๐๐ ๐
In the Malaysian public health system, vision screening is typically part of the KKIA (Klinik Kesihatan Ibu dan Anak) protocol. However, there are two major hurdles:
1. ๐ป๐๐ ๐จ๐๐ ๐ฎ๐๐ : Formal screening often happens when a child is older (pre-school or primary school age), as it relies on the Snellen Chart (the chart with letters/symbols).
2. ๐ป๐๐ "๐ฎ๐๐๐๐๐๐๐" ๐ฎ๐๐๐ : Using a Snellen chart requires a child to be cooperative, recognize symbols, and communicate effectively. Many toddlers simply "guess" or get distracted, leading to "false passes" where vision problems are missed because the child is just nodding along.
While the KKIA does a heroic job with limited resources, many refractive errors like the ones I found in my nurseโs daughter are "silent" and exist long before a child can accurately read a chart.
๐๐ฌ ๐๐จ๐ฎ๐ซ ๐๐ก๐ข๐ฅ๐ ๐๐ญ๐ซ๐ฎ๐ ๐ ๐ฅ๐ข๐ง๐ ๐ญ๐จ ๐๐๐? (๐๐ก๐๐ญ ๐๐ซ๐ ๐ญ๐ก๐ ๐๐จ๐ฆ๐ฆ๐จ๐ง ๐๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐ฌ)
Many parents are still guessing because children don't complainโthey don't know what "clear" is supposed to look like. Here are the red flags to watch for:
๐๐ก๐ฒ๐ฌ๐ข๐๐๐ฅ ๐๐ข๐ ๐ง๐ฌ
โข ๐บ๐๐๐๐๐๐๐๐ : Narrowing the eyes to see things far away (like the TV).
โข ๐ฏ๐๐๐
๐ป๐๐๐๐๐๐: Turning the head to one side to use only the "good" eye.
โข ๐ญ๐๐๐๐๐๐๐ ๐ฌ๐๐ ๐น๐๐๐๐๐๐ : A sign of eye strain or fatigue.
โข The "๐พ๐๐๐๐ ๐น๐๐๐๐๐": An unusual white glow in the pupil when taking a flash photo (this requires immediate medical attention).
๐๐๐ก๐๐ฏ๐ข๐จ๐ซ๐๐ฅ ๐๐ข๐ ๐ง๐ฌ
โข ๐บ๐๐๐๐๐๐ ๐๐๐ ๐๐๐๐๐ : Crawling right up to the television or holding books inches from their face.
โข ๐ช๐๐๐๐๐๐๐๐๐ : Frequently bumping into furniture or tripping (poor depth perception).
โข ๐บ๐๐๐๐ ๐จ๐๐๐๐๐๐๐๐ ๐บ๐๐๐ : Quickly losing interest in coloring, puzzles, or detailed play because it's physically exhausting for them to focus.
โข ๐ฐ๐๐๐๐๐๐๐๐๐๐๐ ๐บ๐๐๐๐๐ : An eye that seems to "drift" only when they are tired or unwell (exactly like my mentor's daughter).
๐ ๐
๐ข๐ง๐๐ฅ ๐๐ก๐จ๐ฎ๐ ๐ก๐ญ ๐๐จ๐ซ ๐๐๐ซ๐๐ง๐ญ๐ฌ
Don't wait for your child to tell you they can't see. By the time they realize it, it might be too late to fix. Whether itโs at my clinic or elsewhere, ensure your child gets an objective screening (using technology like the Spot Vision Screener) as early as age one.
๐ ๐๐๐ฅ๐ฅ ๐ญ๐จ ๐๐๐ญ๐ข๐จ๐ง: ๐๐๐ฒ๐จ๐ง๐ ๐ญ๐ก๐ ๐๐ข๐ซ๐๐ฅ ๐๐จ๐ฆ๐๐ง๐ญ
While the recent video by Sylvia George from Sabah have moved our hearts, they must also move our hands. Seeing the challenges faced by children with vision loss should not just make us sad; it should make us determined.
In Kota Kinabalu, we have the tools to ensure that a child's future is not determined by a preventable "lazy eye." Here is why we need to change our approach:
๐. ๐๐ก๐ ๐
๐ฅ๐๐ฐ ๐ข๐ง "๐๐๐ข๐ญ ๐๐ง๐ ๐๐๐"
Current practice in Malaysia often relies on the Snellen chart (reading letters) at an older age. But for a toddler, a Snellen chart is a guessing game. By the time a child is old enough to tell us they can't see, the window for correcting Amblyopia (Lazy Eye) may already be closing.
We need objective screening, not subjective guessing.
๐. ๐ ๐๐๐ฌ๐ฌ๐๐ ๐ ๐ญ๐จ ๐๐ฎ๐ซ ๐๐จ๐ฅ๐ข๐๐ฒ ๐๐๐ค๐๐ซ๐ฌ
We have been quietly providing free screenings for five years because we believe health is a right, not a luxury. But a single clinic cannot reach every child in Sabah.
โข ๐ป๐๐ ๐ท๐๐๐ : We need a standardized, nationwide screening protocol for preschoolers (ages 1 to 4) using modern, handheld technology.
โข ๐ป๐๐ ๐ท๐๐๐๐ : In my own practice, we found a child with -5.00 myopia who had no outward symptoms. Small screenings make a massive, life-long difference in a childโs educational and economic future.
๐. ๐๐จ ๐๐ฒ ๐
๐๐ฅ๐ฅ๐จ๐ฐ ๐๐๐๐๐ก๐๐ง๐ฌ
Our children are our future. If we can detect a vision defect at age one, we can fix it. If we wait until age seven, we might only be able to "manage" it
โข Don't wait for symptoms.
* Don't wait for your child to complain.
* Seek early, objective screening.
๐ต๐ ๐๐๐๐๐
๐๐๐๐๐๐
๐๐ ๐๐๐๐๐
๐๐๐๐ ๐ ๐๐๐๐ ๐๐ ๐ 30-๐๐๐๐๐๐
๐๐๐๐๐๐๐๐๐.
๐ฌ๐๐๐๐ ๐
๐๐๐๐๐๐๐๐ ๐๐๐'๐ ๐๐๐๐ ๐๐๐๐๐ ๐๐๐๐๐๐๐; ๐๐โ๐ ๐๐๐๐๐ ๐๐๐๐๐๐ ๐๐๐๐๐ ๐๐๐๐๐๐ ๐๐๐๐๐๐๐๐๐.
.
