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Medical Diary Official Publication for the Federation of Medical Societies of Hong Kong VOL.12 NO.9 SEPTEMBER 2007 ॷġ෫ġᚂġଉ THE HONG KONG MEDICAL DIARY OFFICIAL PUBLICATION FOR THE FEDERATION OF MEDICAL SOCIETIES OF HONG KONG www.fmshk.org Editorial Editorial Dr. Timothy YY Lai Medical Bulletin Management of Tearing in Adults Dr. Alan CK Ng Dr. Dylan DN Chan Ocular Allergy in Children Dr. Koon-man Lam Neuro-ophthalmology for General Practitioners: A Revision Dr.CarmenKMChan Normal Tension Glaucoma - a Sick Eye in a Sick Body Dr. Dexter YL Leung Retinal Complications of High Myopia Dr. Timothy YY Lai Amblyopia: An overview Dr. Wilson WK Yip Prof. Dorothy SP Fan Surgical Correction for Near Sightedness Dr. Arthur CK Cheng Traditional Chinese Medicine and Ophthalmology Dr. Jane CC Yeung Special Feature Rosiglitazone and Risk of Myocardial Infarction: Clear Danger or Dr. Norman Chan Media Hype? Clinical Quiz Clinical Quiz Dr. Helen KS Tung Society News Medical Diary of September Calendar of Events ISSN 1812 - 1691 ᚂᖒԙষΙড়ᒑȅᩧҕ୊ஶቆᜰЖ VOL.12 NO.9 SEPTEMBER 2007 Contents The Federation of Medical Societies of Hong Kong 4/F Duke of Windsor Social Service Building, Contents 15 Hennessy Road, Wanchai, Hong Kong Tel: 2527 8898 Fax: 2865 0345 Editorial President Dr. FONG To-sang, Dawson 方道生醫生 1st Vice- President Editorial 2 Dr. CHAN Chi-kuen 陳志權醫生 2nd Vice- President Dr. Timothy YY Lai Dr. LO Sze-ching, Susanna 盧時楨醫生 Hon. Secretary Dr. LO See-kit, Raymond 勞思傑醫生 Medical Bulletin Deputy Hon. Secretary Dr. CHAN Sai-kwing 陳世炯醫生 Management of Tearing in Adults 4 Hon. Treasurer Mr. LAM Lop-chi, Nelson 林立志先生 Dr.AlanCKNg Deputy Hon. Treasurer Dr. Dylan DN Chan Mr. LEE Cheung-mei, Benjamin 李祥美先生 Executive Committee Members Dr. CHAN Chi-fung, Godfrey 陳志峰醫生 Ocular Allergy in Children 8 Dr. CHIM Chor-sang, James 詹楚生醫生 Dr. Koon-man Lam Dr. HO Chung-ping 何仲平醫生 Dr. HUNG Kwan-ngai 洪君毅醫生 Dr. KING Wing-keung, Walter 金永強醫生 Neuro-ophthalmology for General 11 Dr. LEE Man-piu, Albert 李文彪醫生 Practitioners: A Revision Dr. LI Fuk-him, Dominic 李福謙醫生 Ms. MAN Bo-lin, Manbo 文保蓮女士 Dr. Carmen K M Chan Dr. MAN Chi-wai 文志衛醫生 Dr. MOK Chun-on 莫鎮安醫生 Mr. TO Yuen-yuk, Peter 杜元郁先生 MCHK CME Programme Self-assessment Questions 13 Executive Manager Ms. CHENG Shu-yue, Sue 鄭淑儀小姐 Normal Tension Glaucoma - a Sick Eye in 16 a Sick Body Dr. Dexter YL Leung ġ ġ ġ ġ President Retinal Complications of High Myopia 18 Dr. CHOI Kin 蔡 堅醫生 Vice- Presidents Dr. Timothy YY Lai Dr. CHU Kin-wah 朱建華醫生 Dr. SHIH Tai-cho 史泰袓醫生 Amblyopia: An overview Hon. Secretary 22 Dr. LEUNG Chi-chiu 梁子超醫生 Dr. Wilson WK Yip Hon. Treasurer Dr. CHOW Pak-Chin 周伯展醫生 Prof. Dorothy SP Fan Council Rep. Dr. CHAN Yee-shing 陳以誠醫生 Dr. HO Chung-ping 何仲平醫生 Surgical Correction for Near Sightedness 25 Chief Executive Dr. Arthur CK Cheng Mrs. Yvonne LEUNG 梁周月美女士 Tel: 2527 8285 (General Office) 2527 8324 / 2536 9388 (Club House in Wanchai / Central) Traditional Chinese Medicine and Ophthalmology 27 Fax: 2865 0943 (Wanchai), 2536 9398 (Central) Email: [email protected] Dr. Jane CC Yeung Website: http://www.hkma.org ġ ġ ġ ġ ġ ġ ġ Special Feature President Dr. Jason BROCKWELL Rosiglitazone and Risk of Myocardial 30 Vice-President Prof. David ANDERSON Infarction: Clear Danger or Media Hype? Hon. Secretary Dr. Norman Chan Dr. LO See-kit, Raymond 勞思傑醫生 Hon. Treasurer Dr. Alex YIP Council Rep. Clinical Quiz Dr. Jason BROCKWELL Dr. CHEUNG Tse-ming 張子明醫生 Clinical Quiz Tel: 2527 8898 Fax: 2865 0345 32 Dr. Helen KS Tung ġ ġ ġ ġ ġ ġ ġ ġ ġ Board of Directors Society News 33 President Dr. FONG To-sang, Dawson 方道生醫生 1st Vice- President News from Member Societies 33 Dr. CHAN Chi-kuen 陳志權醫生 2nd Vice- President Dr. LO Sze-ching, Susanna 盧時楨醫生 Medical Diary of September 34 Hon. Secretary Dr. LO See-kit, Raymond 勞思傑醫生 Hon. Treasurer Mr. LAM Lop-chi, Nelson 林立志先生 Calendar of Events Directors Dr. CHIM Chor-sang, James 詹楚生醫生 Dr. KING Wing-keung, Walter 金永強醫生 Meetings 36 Dr. LI Fuk-him, Dominic 李福謙醫生 Courses 36 Mr. CHAN Yan-chi, Samuel 陳恩賜先生 Ms. MAN Bo-lin, Manbo 文保蓮女士 VOL.12 NO.9 SEPTEMBER 2007 Editorial Published by The Federation of Medical Societies of Hong Kong Editorial EDITOR-IN-CHIEF Dr. KING Wing-keung, Walter 金永強醫生 Dr. Timothy YY Lai EDITORS MBBS, MMedSc, MRCSEd, FCOphthHK, Dr. CHAN Chi-fung, Godfrey FHKAM(Ophthalmology) 陳志峰 醫生 (Paediatrics) Dr. CHAN Chun-hon, Edmond Associate Professor, Department of Ophthalmology & Visual Sciences, 陳振漢醫生 (General Practice) The Chinese University of Hong Kong Dr. MOK Chun-on Editor 莫鎮安醫生 (Plastic Surgery) EDITORIAL BOARD Dr.Dr. P Timothy YY Lai Dr. AU-YEUNG Cheuk-lun, Henry 區陽卓倫 醫生 (Paediatrics) Patients with various eye conditions are frequently encountered in Dr. CHAN Chi-wai, Angus the primary care setting and it is important for general practitioners 陳志偉 醫生 (General Surgery) to be equipped with ophthalmic knowledge in order to offer proper Dr. Norman CHAN 陳諾 醫生 (Diabetes, Endocrinology & Metabolism) management and arrange referral. In this issue of Medical Diary, Dr. CHIANG Chung-seung members of the Hong Kong Ophthalmological Society will share 蔣忠想 醫生 (Cardiology) their experience in the management of some common and important Dr. CHONG Lai-yin 莊禮賢 醫生 (Dermatology & Venereolgy) ophthalmic diseases. Dr. CHUH An-tung, Antonio 許晏冬 醫生 (Family Medicine) Tearing and children with allergic conjunctivitis are two common Dr. FAN Yiu-wah conditions in clinical practice. In two separate articles, Dr. Dylan 范耀華 醫生 (Neurosurgery) Dr. FONG Ka-yeung D.N. Chan, Dr. Alan C.K. Ng, and Dr. Woon-Man Lam will be 方嘉揚 醫生 (Neurology) discussing the diagnosis of these two conditions and how treatment Dr. FUNG Ho-chuen, Alec can help to alleviate the symptoms suffered by these patients. 馮浩泉 醫生 (Dermatology & Venereolgy) Dr. FUNG Yee-pong, Adrian 馮貽邦 醫生 (Dermatology & Venereolgy) Since the visual system is an extension of the central nervous system, Dr. HO Pak-leung ophthalmic disorders can be one of the earliest presentations of a 何 良 醫生 (Clinical Microbiology and Infections) variety of neurological disorders. In a review article, Dr. Carmen Dr. KWOK Kwan-ho, Alvin 郭坤豪 醫生 (Ophthalmology) K.M. Chan will provide an overview on some important Dr. KWOK Po-yin, Samuel neuroophthalmic conditions which might be encountered by general 郭寶賢 醫生 (General Surgery) practitioners. Besides the central nervous system, other systemic Dr. LAI Cheuk Seen, Edward disorders may also have a close interaction with eye diseases and Dr. 黎卓先 醫生 (General Surgery) Dr. LAI Kei-wai, Christopher Dexter Y.L. Leung will highlight the association between 賴奇偉 醫生 (Respiratory Medicine) cardiovascular diseases and a specific entity of glaucoma known as Dr. LAI Sik-to, Thomas normal tension glaucoma. 黎錫滔 醫生 (Gastroenterology & Hepatology) Dr. LAM Tat-chung, Paul 林達聰 醫生 (Psychiatry) Myopia is the commonest ophthalmic condition in Hong Kong and Dr. LAM Wai-man, Wendy patients with myopia of greater than 6 diopters are classified as high 林慧文 醫生 (Radiology) myopia. Retinal complications can be associated with high myopia, Dr. LAO Tzu-his, Terence 勞子僖 醫生 (Obstetrics & Gynaecology) resulting in significant visual impairment and some of these sight- Dr. LEE Man-piu, Albert threatening retinal complications will be reviewed in my article. An 李文彪 醫生 (Dentistry) important aspect of the visual system is the critical developmental Dr. LEUNG Wai-tong, Thomas period during childhood and any sensory deprivation during this 梁惠棠 醫生 (Clinical Oncology) Dr. LO See-kit, Raymond period can result in amblyopia. The practical tips and importance of 勞思傑 醫生 (Geriatrics) making prompt diagnosis and treatment of amblyopia will be Dr. MAN Chi-wai presented by Dr. Wilson W.K. Yip and Prof. Dorothy S.P. Fan. 文志衛 醫生 (Urology) Dr. MOK Mo-yin 莫慕賢 醫生 (Rheumatology) With the rapid advancements in ophthalmic surgical techniques and Dr. MONG Hoi-Keung increasing patients' expectations, clinicians will need to be aware of 蒙海強 醫生 (Forensic Pathology) the new treatment options for presbyopia, as well as alterative Dr. TEO Man-lung, Peter 張文龍 醫生 (Clinical Oncology) therapies for eye diseases including Traditional Chinese Medicine Dr. TSANG Wai-kay (TCM). Previously, the only treatment option for individuals with 曾偉基 醫生 (Nephrology) presbyopia is to wear glasses for near correction. Advancements in Dr. TSE Tak-fu surgical techniques and instrumentations in the past decade have 謝德富 醫生 (Cardiology) Prof. William I WEI allowed for the development of safe and effective treatment of 韋霖 教授 (Otorhinolaryngology) presbyopia and Dr. Arthur C.K. Cheng will present some of these Dr. WONG Bun-lap, Bernard treatment modalities. With increasing popularity of TCM among the 黃品立 醫生 (Cardiology) general public, it is important for us who are practising Western Dr. WU Wing-cheung, Stephen 胡永祥 醫生 (Orthopaedics & Traumatology) Medicine to be aware of the use of TCM. Dr. Jane C.C. Yeung will be sharing with us her experience of TCM in Ophthalmology as an ophthalmologist and as an undergraduate student in TCM. EXECUTIVE MANAGER Ms. CHENG Shu-yue, Sue 鄭淑儀 小姐 2 VOL.12 NO.9 SEPTEMBER 2007 Medical Bulletin Management of Tearing in Adults Dr. Alan CK Ng MBBS (HK), MRCS (Edin), MMed (Ophth)(Singapore) Dr. Dylan DN Chan FHKAM (Ophthalmology) Dr. Alan Ng Dr. Dylan Chan INTRODUCTION decide whether the patient is having an overproduction of tears or suffering from an obstructive cause of tearing. Tearing, also known as epiphora means overflow of In cases of suspected drainage obstruction, further tears. The clinical spectrum ranges widely from examinations may be needed to define its level and occasional overflow to constant bothersome tearing.1 nature. These tests include: Tearing is due to a disruption in the balance between tear production and drainage. This complex system is Syringing and probing -- Syringing involves the use dependent on the interaction of anatomy and of a syringe filled with saline, which is injected physiology.
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