Cataracts

Cataracts

A DxD Session with Dr Jimmy Lim Wei Kheong


Ended on Wed Nov 14 2018
Ended

Top Answers


Thanks for the D2D. 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.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Hi Hwee Leng, 

Thank you for your D2D. Yes, there are some scientific discussions on the prevention of cataract through the use of anti-oxidants and ultraviolet (UV) protection.

Cataract Singapore

Close up of cataract during eye examination

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.

I often advise my patients to wear sunglasses with UV protection when outdoors to decrease exposure to the harmful UV rays and protective eyewear at work where they are exposed to heat and particles. 

It is most important to consult your ophthalmologist and have your eyes checked if you are experiencing blurring of vision.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Thanks for D2D. Yes, 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.

However, when the cataract becomes “intumescent”, “swollen” or “hypermature”, it may result in inflammation or very high eye pressure. This type of cataract may result in permanent blindness as the nerve of the eye may be damaged from the inflammation or from the high pressure. 

For most of my patients with significant cataract, I recommend them to undergo cataract surgery which is safe and effective,  to enjoy good vision.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Hi Chee Meng, 

D2D. 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.

However, a patient may still need reading glasses if they are best suited for monofocal lenses which corrects his short-sightedness (myopia) or far-sightedness (hyperopia) but not his presbyopia.

A patient with astigmatism, but was not suitable for toric lens will  also require astigmatic glasses to correct his vision after cataract surgery.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

D2D. 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.

My preceptor Professor Douglas Koch from Baylor College of Medicine in Houston, Texas, was the first eye surgeon to discover the changes in the biometric measurements for former LASIK patients, and that additional calculations are required to accurately customize the refractive outcomes for such patients who are about to undergo cataract surgery.

At my clinic, we have the necessary advanced biometric technologies and equipment, as well as the know-how to calculate and customize the refractive outcomes for patients who underwent LASIK and are now going for cataract surgery.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

D2D. 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.

This condition can be managed effectively by undergoing a laser procedure known as YAG capsulotomy. YAG capsulotomy is a quick and effective procedure without the need for fasting and has a very short  down time. Recovery is very quick and vision can improve on the same day the procedure is performed.

It is important that any patient with cloudy vision consult an eye surgeon and have a complete eye examination done to ensure that there are no other problems with the eye apart from having posterior capsular opacities.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Thanks for the D2D. 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.

It is very important to let your eye surgeon know about your symptoms. A thorough eye examination can be performed to ensure that there are no tears, no breaks or retinal detachment, vitreous hemorrhage or inflammatory cells, as these conditions also present as floaters.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

D2D. Yes. 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. 

These measurements enable the precise placement of the lens in the correct axis and thus reduces the astigmatic power of the eye. Many patients have benefited from these technologies, resulting in independence from astigmatic spectacles for distance and near vision.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

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.

Surgery should also be performed in instances where poor vision poses danger, such as an elderly patient with the risk of falling and/or patients who drive frequently and have difficulty seeing street signs and other cars when they are on the road. 

Cataract surgery is not recommended when surgery is performed for correcting one’s refractive errors and there is no cataract seen during the eye examination.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Thanks for theD2D. 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.

At my clinic, we provide our patients with a “care pack” containing the necessary medication, accessories and instructions for post-surgery care. Our patients also come back for a review one day, one week and one month after surgery to ensure their recovery is well on track.

Always consult your eye surgeon early should there be increasing redness, pain, swelling or blurring of vision after the cataract surgery.


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


28 Sep 2018

Hi Elaine

It is important to consider if one’s vision has stabilized after the original LASIK surgery before undergoing LASIK enhancement. There is NO definite duration of time, but in general at least 3 months after LASIK, would be the approximate period.

Nevertheless, the duration after the initial LASIK surgery, is not the most important factor to consider. If there are still changes seen in the spectacles prescription after 3 months, it will not be advisable to undergo LASIK enhancement despite the time duration.

If you are keen for a LASIK enhancement, you will need to consult your doctor and be assessed for necessity and suitability for an enhancement. More importantly, it is to ensure that your spectacles prescription has stabilized despite the duration after the original LASIK surgery.

Do discuss these with your doctor, as your doctor will be the best person to determine the timing for the enhancement


Dr Jimmy Lim Wei Kheong
MBBS, MMed (Ophthalmology), MRCSEd (Ophthalmology), FRCSEd (Ophthalmology), FAMS (Ophthalmology)

JL Eye Specialists

6 Napier Road #07-10
Gleneagles Medical Centre
Singapore 258499 


15 Oct 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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