title: Monsoon and primary acute angle closure in malaysia.
abstract: BACKGROUND
  Acute angle closure (AAC) without prompt treatment may lead to optic neuropathy. Environmental factor such as climate change may precipitate pupillary block, the possible mechanism of AAC.
  
  
  OBJECTIVE
  To determine the association of northeast monsoon and incidence of AAC in Malaysia.
  
  
  METHODS
  A retrospective study was conducted on AAC patients admitted to two main tertiary hospitals in Kelantan, Malaysia between January 2001 and December 2011. The cumulative number of rainy day, amount of rain, mean cloud cover and 24 hours mean humidity at the estimated day of attack were obtained from the Department of Meteorology, Malaysia.
  
  
  RESULTS
  A total 73 cases of AAC were admitted with mean duration of 4.1SD 2.0 days. More than half have previous history of possibility of AAC. There was higher incidence of AAC during the northeast monsoon (October to March). There was also significant correlation of number of rainy day (r=0.718, p<0.001), amount of rain (r=0.587, p<0.001), cloud cover (r=0.637, p<0.001), mean daily global radiation (r=- 0.596, P<0.001), 24 hours mean temperature (r=-0.298, p=0.015) and 24 hours mean humidity (r=0.508, p<0.001) with cumulative number of admission for AAC for 12 calendar months.
  
  
  CONCLUSIONS
  Higher incidence of AAC during northeast monsoon suggested the effect of climate as the potential risk factor. Prompt treatment to arrest pupillary block and reduction of the intraocular pressure is important to prevent potential glaucomatous damage. Public awareness of AAC and accessibility to treatment should be part of preparation to face the effect of northeast monsoon.
authors.affiliation: Universiti Sains Malaysia, Ophthalmology, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan 16150, Malaysia.
authors.forename: T W
authors.initials: TW
authors.lastname: Ch'ng
authors.affiliation: Universiti Sains Malaysia, Ophthalmology, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan 16150, Malaysia.
authors.forename: S A A
authors.initials: SA
authors.lastname: Mosavi
authors.affiliation: Universiti Sains Malaysia, Ophthalmology, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan 16150, Malaysia.
authors.forename: A A
authors.initials: AA
authors.lastname: Noor Azimah
authors.affiliation: Hospital Raja Perempuan Zainab II, Department of Ophthalmology, Jalan Hospital, Kota Bharu, Kelantan 15000, Malaysia.
authors.forename: N Z
authors.initials: NZ
authors.lastname: Azlan
authors.affiliation: Universiti Sains Malaysia, Ophthalmology, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan 16150, Malaysia.
authors.forename: Y
authors.initials: Y
authors.lastname: Azhany
authors.affiliation: Universiti Sains Malaysia, Ophthalmology, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan 16150, Malaysia. liza@usm.my.
authors.forename: A T
authors.initials: AT
authors.lastname: Liza-Sharmini