If you are in your 70s or older, and have not developed cataracts, you’re a very lucky one-in-10 member of your age group. This is as almost 90% of those above 70 years of age would have developed cataracts, according to corneal specialist Dr Chuah Kay Leong.
He notes that ageing is the most common cause of this eye condition, which is a clouding (or opacity) within the lens of the eyes. Failing vision is the most common symptom of this condition.
Benedict Yee, who is in his 60s, has blurry vision and suspects that he might have cataracts. The retired businessman attended the talk where Dr Chuah presented on Cataract – Restore Your Vision With Lens Implantation as he wanted to find out more about cataracts.
“I was happy with answers and plan to get my eyes thoroughly checked,” he says.
Dr Chuah also notes that, “In some people with short-sightedness who have developed cataracts, the short-sightedness goes up and they may need to change their glasses very often. The optometrist may eventual-ly advise you not to waste your money and go see an eye doctor!”
Cataracts, which often develop slowly, can affect one or both eyes. Besides age, those on long-term steroid medication are also at risk of developing this eye condition.
“People who use steroids topically – such as cream around the eyes for skin allergy – or who take steroid pills for asthma, can also get cataracts. Those with dry scaly skin or allergies, or suffer from chronic itchy skin, are also in for bad news,” says the ophthalmologist.
He had recently performed cataract surgery on a 20-year-old student with bad eczema. He explains: “Not only can the skin condition give him cataracts, but the steroids he used for his skin condition also precipitated the cataract.”
Hence, it is important that those who have to use steroids have their eyes checked regularly. “Steroids can also pump up eye pressure,” he says. Increased eye pressure is a risk factor for glaucoma.
Lecturer Lee Yee Lien, 40, has psoriasis and uses steroid cream to control her condition. “Having confirmed that steroid cream does pose a high risk of getting cataract and glaucoma, I plan to get my eye pressure checked regularly,” she says.
Other causes of cataracts include rubella, Down’s Syndrome, Marfan syndrome, retinitis pigmentosa and nasal cancer radiotherapy.
Dr Chuah notes that a common question asked by cataract patients is the percentage of cataract they have. However, he says that this question is irrelevant.
“It doesn’t matter because it depends on the location of the cataract and its density,” he says, adding that cataracts can be aggravated by smoking and ultraviolet (UV) exposure.
Nurse Chong Pooh Yen, 67, had cataract surgery last August and wanted to find out what remedial action could be taken if her cataract struck again. “I realise that I can go for laser surgery if that happens,” she says.
Protect our retina
While eyes may or may not be the window to our soul, they are definitely a window to our health, according to retinal specialist Dr Jason Ngo Chek Tung. Speaking on Retina – 10 Ways To Protect Your Retina, he notes that to protect our retina is also to protect our general health.
The retina is the layer of tissue lining the inner surface of the back of the eyeball, which converts light images to nerve signals to send to our brain for interpretation. Diabetes, he says, can affect our eye because it affects the blood vessels that provide oxygen to the eye.
“When diabetes is not control-led, bleeding at the centre of the eye (diabetic retinopathy) may occur and can cause blurred vision. Hence, those with diabetes need to go for a yearly eye check,” he says.
Meanwhile, a stroke in the eye (retinal vein occlusion) is a condition where blood flow in the retina is blocked due to the formation of blood clots and narrowing of the retinal blood vessels due to artherosclerosis.
Says Dr Ngo: “It gives a warning sign that if you don’t take care, you may have a stroke of the brain.” A balanced diet, control of blood sugar and blood pressure, and exercise, are some of the ways to protect your retina.
To prevent age-related macular degeneration, his advice is to stop smoking, as this habit is bad for the retina.
Certain supplements such as astaxanthin (from natural sources) can help protect the retina, especially when one eye has already developed age-related macular degeneration.
He also emphasises the importance of an annual eye check and shares that the public can use the Amsier chart (available online) to check their eyesight.
Some people are concerned that the blue light from digital devices can cause harm, but Dr Ngo says there is no direct evidence of that yet. However, he advises: “Try not to read in the dark.” And wear sunglasses to protect your eyes from UV damage.
Housewife M. Nirmala, 64, was concerned about whether LED and fluorescent lights could be harmful to the eyes. The answer she received was to avoid bright lights and be generally careful of her eye health.
Those in the habit of vigorously rubbing their eyes are also advised not to do so. It may feel good, but it can lead to serious damage to the eyes. Says Dr Ngo: “It is not good for the retina and may cause retinal detachment.”
Improved laser treatment
General ophthalmologist and refraction surgeon Dr Stephen Chung Soon Hee spoke on ReLEx SMILE – Laser Vision Correction Beyond Lasik. The treatment involves the use of a laser to reshape the front of the eye to treat short-sightedness and astigmatism.
“The earliest treatment, photo-refractive keratectomy (PRK), takes several weeks to heal, and weeks or months before vision recovers. It was not that popular,” he says.
Meanwhile, Lasik treatment is done after cutting a cornea flap, lasering the deeper cornea tissue, then closing the flap back, he explains.
However, the latest treatment, ReLEx SMILE, “involves using a femto laser to make a lenticule in the cornea and this is removed without making a flap,” which is less invasive, describes Dr Chung.
The three ophthalmologists were speaking at a talk titled Keep An Eye On Your Vision in Petaling Jaya, Selangor, on Aug 18, 2019. Some 180 people attended the eye safety event.