DxD Session held on 26 September 2018.
Dr Jimmy Lim served as a Senior Consultant Ophthalmologist in the National Healthcare Group Eye Institute, Tan Tock Seng Hospital. He is currently the medical director and senior consultant of JL Eye Specialists. His subspecialty focus was in cornea diseases, transplantation, refractive and anterior segment surgery.
Dr Jimmy answered questions from readers on:
- How to prevent cataracts
- Cataract causing damage to eyesight
- How doctors choose the best type of lens
- When to avoid cataract surgery
- How to take care of a patient after catarct surgery
Did you know that as we age, every single one of us will develop cataracts at some point in our lives? It's only a matter of how mild or severe the cataract formation is. Typically, people develop cataracts at around 50 to 70 years of age. However, certain things can cause you to get them at a much younger age.
Hi Yashida, indeed, there are many different types of cataracts. Some cataracts are related to genetics (congenital cataracts) while some are brought about by trauma and injury. Other cataracts may be associated with the use of medication such as steroids. However, the most common cataracts that we see are related to degeneration from aging.
Close up of cataract during eye examination
Hi Hwee Leng, yes there are some scientific discussions on the prevention of cataract through the use of anti-oxidants and ultraviolet (UV) protection. Other preventive measures include wearing protective eye wear when playing racquet games such as squash and badminton to shield your eyes from any accidental injuries.
Hi Dennis, this is true although the likelihood is uncommon in a developed country like Singapore where healthcare is accessible to the population. If cataracts become “hard” or dense, it can block the patient’s vision resulting in poor vision or “blindness”, but this condition can potentially be corrected with cataract surgery.
Intraocular lens implanting inside the lens capsule (3d render)
Hi Amandaina, there are many types of intraocular lens (IOLs) to cater for different refractive needs of the patients. The following are the different lens technologies available:
- Monofocal Lenses (Aspheric/Non Aspheric) which corrects the patient’s short-sightedness (myopia) or far-sightedness (hyperopia).
Eyes before and after cataract removal
Hi Yee Min, with so many types of intraocular lens techonologies, it can be confusing which lens one should choose.
As an experienced cataract and refractive surgeon, one of the most important information I need in order to ascertain the best lens for the patient is to understand his daily activities, occupation, hobbies and visual needs.
Hi Chee Meng, using advanced biometric technologies and the latest equipment at our centre, my objective is for every patient to be independent of spectacles after they undergo cataract surgery.
At my clinic, our team goes through a very stringent and meticulous process of measuring the biometry of each patient’s eye. We use multiple different types of formulae to choose the most appropriate lens for the patient’s needs.
Dear Helen, if your poor night vision is due to a dense or mature cataract, your night vision will certainly be improved after cataract surgery.
However, if you have already been experiencing poor night vision even before the development of cataracts, then your poor night vision may be due to a problem in your retinal as opposed to the cataract.
Dear Estee, yes. Many patients who had LASIK performed when they were younger develop cataracts as they age. They will certainly be able to undergo cataract surgery to improve their vision.
However, as LASIK changes the curvature and power of the cornea, conventional biometric measurements of the eye very often lead to inaccurate refractive outcomes for this group of patients after cataract surgery.
YAG laser surgery of posterior capsule opacification (PCO) after cataract surgery (3d render)
Dear Richie, patients experiencing cloudy vision again after cataract surgery are likely to have posterior capsular opacities or “after cataracts”. This refers to the regeneration of cells along the “bag” or membrane that is left behind to contain the intraocular lens.
This is not a complication from the initial cataract surgery, but it can happen to some patients months or years after a successful cataract surgery.
Dear Imran, floaters are very common symptoms in many people’s eyes. The most common cause of floaters is degeneration of the vitreous gel and posterior vitreous detachment.
As patients with cataracts have poorer vision, it is common that they are unable to detect floaters in their field of view. However, after the patient undergoes cataract surgery, his vision improves and floaters in his eyes become more visible.
Dear Ashley, yes it is possible. Over the years, many different surgical techniques have been employed to correct astigmatism during cataract surgery.
Current intraocular lens technology corrects low to high astigmatism with much precision using Toric (astigmatic) intraocular lenses. In order to place these lenses accurately, we use advanced technologies and the latest equipment at our centre to map out the curvature of the cornea and measure the astigmatism of the eye.
Hi Xie Jing, first and foremost, there must always be an indication for cataract surgery.
Cataract surgery should be performed when the patient’s vision is being affected by cataract, and/or when the cataract is dense and affecting the patient’s daily living activities.
Hi Jonathan, thanks for the D2D. It is very important to follow the post-operation instructions given by the surgeon to ensure a smooth and speedy recovery.
Patients should maintain strict compliance to the post-surgery medications provided and ensure that their eyes and eyelids are always kept clean and water does not enter the eye.
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