The branch of medicine specialising in the anatomy, function and diseases of the eye is called ophthalmology. As eye diseases increase, in part due to lifestyle factors and longer lifespans, ophthalmologists are expected to play a bigger role in society, conducting not just regular eye checkups for the general population, but more importantly dealing with the growing number of eye conditions that plague society today.


Ranked among the top centres in Asia, specialising in cataract, glaucoma, retinal diseases, corneal grafting, paediatric ophthalmology, oculoplastic and aesthetic surgery, Singapore boasts of high standards in ophthalmology, its eyecare researchers and professionals receiving worldwide acclaim and recognition for their accomplishments.

Singapore’s Eye Doctors Score top Success Rates in Lasik

Ophthalmologists here are among the best in the world when it comes to LASIK (Laser- Assisted In Situ Keratomileusis) surgery. A paper released by Singapore’s Ministry of Health said that their success and safety records beat those of several centres, including some in the United States. “The results are excellent by any world international standard,” says Dr Lee Hung Ming, the head of Tan Tock Seng Hospital’s Lasik Centre. Dr Lee also mentioned that the drop in prices in laser treatments here means it is now not necessary to go abroad for treatment and follow-up checks. Our Talents and Advancements In July 2006, the Singapore National Eye Centre (SNEC) team of eye specialists, led by deputy director Donald Tan, won accolades from the government for being the first in the world to draw a link between rising numbers of fungal corneal infections and Bausch & Lomb’s ReNu Moistureloc contact lens solution; and in August 2006, scientists here discovered the gene that causes blindness in children. The study, led by clinician-scientist Associate Professor Aung Tin from SNEC and geneticist Dr Eranga Vithana from the Singapore Eye Research Institute (SERI), has made it possible to identify and treat the condition early.

“Having worked in other parts of the world, I can safely say that Singapore offers the most recent advances in eye surgery,” says Dr Vish Padmanabhan from SuperSight Lasik Centre, a private clinic which offers the latest small incision cataract surgical techniques as well as the latest techniques of LASIK and wavefront refractive surgery. Dr Vish, who has run educational courses concentrating on the areas of advanced and state-of-the-art cataract surgery, surgical safety and the prevention of post-operative infection every year for the past eight years at the American Society of Cataract and Refractive Surgeons (ASCRS), has himself been involved in two major advancements in eye surgery over the past few years: firstly in the area of endophthalmitis prevention, and secondly in the treatment of angle-closure glaucoma.

In preventing endophthalmitis, which is a severe and sight-threatening eye infection that can occur after cataract and other intraocular surgical procedures, Dr Vish’s eight-year support of the use intracameral antibiotic at the end of surgery was advocated in 2006, after a large-scale multicentre study from Europe found that instilling antibiotic directly into the eye at the end of surgery reduces the rate of postsurgical infection considerably. Where angle-closure glaucoma is concerned, a video presentation Dr Vish created on the technique of lens removal and replacement as treatment for this common variety of glaucoma in Asia was awarded first prize at the 2001 ASCRS conference in San Diego.

Some Common Eye Problems

Cataracts A cataract is an eye condition where the crystalline lens of the eye becomes cloudy, possibly due to physical changes such as an increase in the compression of lens cells, causing them to lose their transparency. Cataracts may be caused by aging, injury or trauma to the eye, congenital defects, or physical conditions like diabetes for instance. Symptoms of cataracts include blurry vision, poor vision at night or in bright light, double vision, seeing a black spot in the centre of the eye or haloes around lights, and severe pain, redness and loss of vision. Glaucoma Glaucoma occurs when the optic nerve is damaged, resulting in vision loss. This damage is related to increased pressure within the eye, causing it to press on the optic nerve. Glaucoma is a leading cause of blindness worldwide, but can be treated if diagnosed early. Certain types of glaucoma such as open-angle glaucoma offer no symptoms, as the loss of sight is gradual. In angle-closure glaucoma however, patients may suffer from severe eye pain, redness and blurred vision, in combination with headaches, vomiting and seeing haloes around lights.

Diabetic Retinopathy
When the arteries in the retina become damaged due the diabetic condition, resulting in decreased vision and other damage to the eye, this is called diabetic retinopathy. Diabetic retinopathy occurs in stages and can lead to blindness. Among those at risk are Type 1 or Type 2 diabetes sufferers, the obese, those with high blood pressure and cholesterol, and kidney disease patients. Symptoms include seeing floaters and experiencing flashes, as well as the sudden loss of vision.

Retinal Detachment Retinal detachment involves the retina separating from the outer layers of the eye, causing vision impairment and even blindness. It is usually the result of one or more tears in the sensory layer of the retina, which may be brought about by aging, injury, short-sightedness, and hereditary conditions. Retinal detachment is characterised by a sudden or gradual increase in floaters in one’s vision, light flashes in the eye, and/or the appearance of a curtain over one’s field of vision. Retinal tears should be treated so as to prevent them from ultimately causing retinal detachment.

Other Conditions
Some other conditions that may afflict the eye include myopia, age-related macular degeneration (ARMD), thyroid eye disease (TED), uveitis, and damage to the eye related to the nervous system. All these conditions warrant attention and consultation with an ophthalmologist should be made.

New and Emerging Technologies
The high demand for refractive surgery from patients around the region has spurred the development of state-of-the-art facilities and modern equipment in many of Singapore’s eye clinics.

The SNEC’s Refractive Surgery Centre offers high quality LASIK and PRK (PhotoRefractive Keratectomy) services that utilise the Zyoptix Z100 laser system with iris recognition technology, operated by a team of refractive surgeons who undergo strict accreditation and re-accreditation annually to maintain their currency and expertise.

The Zyoptix software combines data from two different types of diagnostic equipment, then programmes the laser with the patient’s unique treatment based on this data, while the Z100, as the first laser in North America with 3D iris recognition capabilities, allows for the exact alignment of astigmatism treatment with pre-operative wavefront measurements, ensuring an exact match between the pre-op measurement and the laser treatment for every eye. Because the precise rotational position of the eye during surgery is measured by matching the iris patterns to the pre-op photos, the laser can correct for “cyclotorsion” – the slight rotation of the eye that can occur when the patient changes from an upright to horizontal position.

Another formidable laser system used in LASIK treatment is the Carl Zeiss Meditec MEL 80 Excimer, endorsed by the US Food and Drug Administration’s (FDA) lead trial investigator, Dr Roger Steinert. Shown to deliver the most accurate surgical results during the FDA trials, Dr Steinert says, “This laser has impressed everyone involved in this study. Even at week one more than 80% of patients came up with an uncorrected visual acuity of 20/20 or better and at six months, well over 90% of patients see uncorrected 20/20 or better. The investigators found this very impressive and the patients are very aware of that.” SuperSight Lasik Centre is one such clinic that utilises this powerful system.

More About LASIK As a safe, effective, fast, painless and accurate way of correcting vision impairments, the hype about LASIK is welldeserved. Technology advancements have made it such that the surgery itself only takes 15 minutes at most, and requires only anaesthetic eyedrops to be administered as part of the post-operative procedure. Patients usually see a dramatic improvement in their vision soon after surgery, and are able to resume their normal activities the very next day. LASIK works by using a laser to change the shape of the cornea. For short-sighted (myopic) patients, the cornea is flattened to reduce its refractive power. For longsighted (hyperopia) patients, the cornea is steepened. LASIK can also be used to correct astigmatism through the correction of corneal irregularities. A large part of LASIK’s appeal is that almost anyone can opt for it. Ideally though, the patient should be over 21 years old, not pregnant, and free of any eye disease or other diseases that might result in complications. Things to observe before and after a Lasik procedure Pre-op Tips Unless previously instructed otherwise, do not wear soft contact lenses one week prior to your surgery. Do not wear hard or gas permeable contact lenses two weeks prior to your surgery. Avoid alcohol and any medication that may produce drowsiness. Do not wear eye make-up. Plan for a recovery time of at least one hour following the procedure. Post-op Tips Arrange for alternative transportation instead of driving home on your own. You may wish to take a nap to allow your eye to begin healing while you remain comfortable. Avoid touching your eye. Keep your eye clean and avoid eye makeup and swimming for two weeks. Always use protective eye-wear for racquet sports and similar activities. Contact your doctor immediately if you experience unusual pain after 24 hours.