Category Archives: Eye Health

Column by Dr S.S. Gill

Thyroid eye disease - S.S. Gill

Thyroid Eye Disease

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about Thyroid Eye Disease.

The Thyroid gland is an organ that is found in the front of the neck. Thyroid hormones are released by the thyroid gland into the bloodstream as “chemical messengers” which are essential for managing the metabolism in our bodies. As with most organs in the body, when the thyroid gland functions well, it goes unnoticed but when it starts producing too much or too little hormones, it causes a lot of problems to the body. The eyes get affected when the gland becomes hyperactive. When this happens, it is termed as either Thyroid Eye Disease or Thyroid Orbitopathy, Graves’ Ophthalmopathy, Ophthalmic Graves’ Disease or Thyroid Ophthalmopathy.

Who Gets Thyroid Eye Disease?

Thankfully this is not a very common condition. In every 100,000 people, approximately 15 women and 3 men are affected by Thyroid Eye Disease. Most of the time it affects the middle age group. There is a genetic link, making those in some families to be more predisposed to suffering from Thyroid Eye Disease.

What Happens To The Eyes In Thyroid Disease?

Thyroid eye disease - S.S. GillIn Thyroid Eye Disease, the eye muscles and fat that surrounds the eyeball gets inflamed (swollen). The two eyeballs may or may not be affected equally, giving rise to the following symptoms in the eyes:

  • Eyes protrude or bulge out of its sockets – an appearance that the person is staring! Thyroid Eye disease is the most common cause of protruding eyes (proptosis).
  • More of the cornea (transparent part of the eye) and the conjunctiva (white of the eye) get exposed because the eyelids may not fully close over the eyes well enough (eyelid retraction).
  • The eyes may ache, with intermittent sharp pain when the cornea dries out especially   when the person is concentrating on something for long as in reading.
  • Some people get diplopia (double vision) because the eye muscles are unable to move properly due to the swelling of the eye muscles.
  • Blurring vision in some patients.

This may happen along with other features such as irritability or nervousness (mood disturbances), preference for cold environments, increased sweating, insomnia (sleeping difficulty), palpitations (a rapid heartbeat), tremor of the hands, weight loss, frequent bowel movements, unexplained fatigue or weakness of muscle, difficulty in conception and irregular menstruation.

How Is It Diagnosed?

If a doctor suspects that you may be having Thyroid Eye Disease, the following tests are usually done:

  • Thyroid Function Test (blood test): This will measure hormone levels in your body which includes TSH (Thyroid Stimulating Hormone), T4 which is the principal thyroid hormone and another thyroid hormone T3, plus Thyroid Stimulating Immunoglobulin Test (TSI). The other blood test that may be done is the RAIU test             (Radioactive Iodine Uptake) – which helps to evaluate the Thyroid gland and to find out the cause of increased production of thyroid hormones (hyperthyroidism).
  • Thyroid Scan – to determine the shape and size of the thyroid gland and to pick up any thyroid nodules that may be benign or cancerous.
  • MRI Scan of the Orbits – to determine the amount of proptosis (bulging forward of eyes) and the amount of inflammation of the eye muscles within the eyeball sockets.

More on Thyroid Eye Disease prognosis and treatment in the next issue.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

Colour blindness

Colour Blindness

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about Colour Blindness or Colour Deficiency.

So many of us take the ability of seeing colours for granted. Every year, 17 year olds undergo colour vision assessment as part of their drivers’ licence test. A fraction of these teenagers are shocked when they find out that they have colour blindness (better called Colour Deficiency). What does colour deficiency mean?


The eye is a very sophisticated camera! Inside the eyeball, right at the back of the eye is the layer of the retina where all the nerve cells are. These nerve cells comprise of special cells called Rods and Cones. The Rods have no colour vision function except that they are very sensitive to light and help in our night vision.

On the other hand, the cells responsible for picking up the colour that we see are the Cone Cells. Among these Cone Cells, there are varying degrees of pigment present. Depending on the pigment present in the Cone Cells, they help react to different colours. Some of them respond and pick-up the longer wavelength light like the red colours and some of them respond to the shorter wavelength light like that of blue colours.


Although there are many conditions that can result in Colour Blindness, for most people who suffer from this, it is mainly of genetic cause. This just means that they are born with Colour Blindness. When we say it is genetic, it means that the Colour Blindness has been passed down in the genes from the parents.

In our genes, there are the X and Y chromosomes. The gene which is responsible for Colour Blindness is carried on the X chromosome and so more men suffer from Colour Blindness than women. Women are usually only the carriers but do not normally have Colour Blindness. Worldwide it is estimated that there are some 250 million people who are colour blind to a lesser or greater extent.


Colour Deficiency may be mild, moderate or severe. Also, depending on the amount of pigment deficient, it may be divided into:

Red-Green Colour Deficiency – Is the most common type where the reds and greens appear similar (adjacent picture is a simulation of how it would appear)

Blue-Yellow Colour Deficiency – These are less common. Most of the time they also have some concomitant red-green deficiency too.


There has been on-going research in the area of gene therapy for the treatment of Colour Deficiency. Animal studies for this have shown promise where the introduction of a gene (opsin gene) has given the animals colour vision that they did not have before treatment.

In the USA, special kind of spectacles have been developed which are purplish in colour that are able to help those with the most common form of Colour Blindness. These glasses filter out certain wavelengths of light that disturb the perception of colour vision. They are not without trouble though because some things disappear from vision when these glasses are worn in some instances. If you are unsure of whether you have colour deficiency or not, do not hesitate to get your eyes checked.


For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

Inflamed Eyelids

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about BLEPHARITIS, or inflammation of the eyelids.

Blepharitis, or “inflammation of the eyelids”, comes from the Greek word “blepharos”, which means “eyelid” and “itis” which means inflammation.


The eyelids usually appear crusted, red and swollen. The crust is yellowish-white and powdery, like the scalp of a person who suffers from dandruff. There may be varied symptoms. In most cases, the eyes become itchy, irritated and sometimes feel dry due to the disruption of the layer of tear film that is normally present in the eye. Contact lens wearers may complain of discomfort and a gritty sensation. This is often mistaken by the layman as “dry eyes”.

When blepharitis becomes chronic, there may not be much signs of inflammation such as redness but just a visible crusting on the eyelid and eyelashes. This may appear a little unsightly especially when the crusting on the eyelashes is visible. You may liken it to a skin condition except that in the case of blepharitis, it affects the eyelid margins where the eyelashes arise. Blepharitis can affect any age, both young and old.

Inflamed eyelids - dr gillWHAT CAUSES BLEPHARITIS?

When the oil glands at the eyelid margins malfunction and produces too much oil (sebaceous secretions), blepharitis can occur. At times, it may be associated with an underlying skin condition called Acne rosacea where there is already a generalised illness of the oil glands of the skin. Allergies to certain cosmetics like mascara, eyelid lotions, contact lens solutions, allergens in the air and some chemicals may also trigger blepharitis.


Blepharitis usually does not cause any serious eye conditions. However, it may cause the following:

1. Stye:

    This occurs when the oil glands of the eye gets infected. A lump appears on the eyelid margin in a localised area. There may be some pus seen on the tip of the stye (appearing like a pimple about to rupture), with surrounding redness of the eyelid.

2. Chronic Conjunctivitis:

    Blepharitis may cause recurrent bouts of conjunctivitis or pink eye. If this happens, eliminating this underlying problem is essential.

3. Chalazion:

    Occurs when the oil glands of the eyelid get blocked. This is painless but appears unsightly with a lump appearing on the eyelid.

4. Cornea Ulcers:

    Due to chronic irritation by the inflamed eyelids and/or a misdirected eyelash growth, an ulcer may form on the cornea. Corneal ulcers are serious conditions.


Good eyelid hygiene is essential to prevent blepharitis. Frequent face washing, warm compresses over the eyelids and removal of eye makeup is important. Remove any crusting present on the eyelid margins. Cleaning the eyelids with a cotton bud soaked in a very dilute (5 parts water to) baby shampoo is helpful to control any excessive oiliness and crust. Basically, every effort must be made to keep the eyelid clean. The other alternative is to use a special over-the-counter Lid Care cleaner. Keep the eyes closed when cleaning. Be especially careful to avoid rubbing or scratching your eyes.

If you are in doubt about any eyelid problems, do seek professional help.

Contact lens

Do’s and Don’ts with Contact Lenses

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

 Ipoh Echo’s Eye Health Series Continues with Consultant Eye Surgeon Dr S.S. Gill Talking About Contact Lens Care.

Many young people these days prefer not to wear glasses to correct short-sightedness and other refractive errors, preferring to wear contact lenses either for cosmetic or sports reasons. Regardless of the reasons, it is important to know how to look after them to avoid contact lens related problems.

There are basically two general categories of contact lenses – soft contact lenses and rigid gas permeable (RGP) contact lenses requiring different care requirements. There should be no short cuts in the care of these lenses.

Contact lensSome pointers to take note of are as follows:

1. CLEAN YOUR HANDS: This is the most basic and crucial step before you handle any contact lenses. Failure to do so can result in serious eye infections. It is mandatory to wash hands with soap and clean water, dry them with a clean dry towel, before handling contact lenses. Make sure that the soap is free from moisturizers as it may then end up in the eye, only to cause problems such as eye irritation, eye pain, redness or blurred vision.

2. USE PROPER DISINFECTING SOLUTIONS: It is important to use the proper disinfecting contact lens solutions and enzymatic protein removing cleaners if you are not wearing daily disposable lenses. Never ever use tap water or any other solutions to wash or clean your lenses. Microorganisms easily contaminate the contact lenses and may lead to eye infections. Clean each contact lens carefully by gently rubbing the surface between your palm and fingers. Remember to clean your contact lens case daily too. The contact lens case will also need to be replaced every three months. Never leave the contact lens storage case in the bathroom where moisture and bacteria can settle on it.

3. MAKE-UP: All make-up should be applied after putting on the contact lenses and not before doing so. Likewise, take out your contact lenses before removing eye make-up.

4. LEARN HOW TO WEAR THEM CORRECTLY: Learning the correct method of putting on and taking off contact lenses is essential to prevent the accidental scratching of your corneas or tearing the soft contact lenses. Learn how to recognise whether the contact lenses are the correct way up by placing them on the tip of the finger before putting them on. Make sure that they are the right side up. If not, do remove them and reinsert them into the eyes.

5. DO NOT SWIM WITH CONTACT LENSES: Never ever swim with your contact lenses on. This is because there is a risk of getting an eye infection from a kind of bacteria commonly found in swimming pool water, tubs, oceans and lakes. The organism is called Acanthamoeba. Should this organism get into the eye through contaminated contact lenses, it could lead to an eye infection that is difficult to treat.

Additional pointers:

a-      Remove your contact lenses if you experience any symptoms of eye irritation, redness or eye discharge, excessive tearing, burning, blurred vision or eye pain.

b-      Remove your contact lenses if they feel uncomfortable as they may be torn.

c-      Should you have eye problems associated with contact lens wear, don’t throw them away as you may be required to bring along the lenses when you see your eye doctor as he  may wish to send them to a laboratory to identify the organisms that may be causing your eye problems.

Contact lenses when used correctly, have been a safe alternative to correct refractive errors like myopia. However, if you do not follow proper procedures, you may be unnecessarily exposing your eyes to problems. If you are in doubt about any contact lens related eye problems, do seek professional help.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

World Sight Day 2013

World Sight Day 2013

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

World Sight Day 2013

In conjunction with WORLD SIGHT DAY on the October 10, Ipoh Echo talks to Consultant Ophthalmologist Dr S.S. GILL on ways to prevent visual impairment.

Visual impairment is a term used to describe any kind of vision loss to the extent that even with conventional forms of correction or treatment, the person’s vision remains poor.

The World Health Organization lists the following facts:

  • About 285 million people are visually impaired worldwide:
    • 39 million are blind and
    • 246 million have low vision (severe or moderate visual impairment)
  • preventable causes are as high as 80% of the total global visual impairment burden
  • About 90% of the world’s visually impaired people live in developing countries
  • Globally, uncorrected refractive errors are the main cause of visual impairment
  • Cataracts are the leading cause of blindness
  • 65% of visually impaired, and 82% of blind people are over 50 years of age, although this age group comprises only 20% of the world population

What Causes Visual Impairment?

Many factors can cause visual impairment. Cataracts, or the clouding of the eye’s lens preventing light from passing through to the retina, are common causes for loss of vision. Because cataracts form slowly, causing gradual vision loss, it may not be noticeable to the patient. Cataracts usually affect people in their 60s and 70s, but may sometimes appear earlier in people who are excessively exposed to sunlight.

Many patients who present early are golfers and sports people who are not in the habit of wearing sunglasses. The general rule is that you should always wear good sunglasses whenever you go out during daylight hours. Symptoms of cataract include double vision, cloudy or blurry vision, difficulty seeing in poorly lit spaces, and when colours seem faded. Replacement of the eye’s cloudy lens with an intraocular lens (IOL) implant through cataract surgery usually restores vision in these cases.

If you have diabetes, you need to be screened regularly for Diabetic Retinopathy, which is a condition where the tiny blood vessels in the retina (back of the eye) are damaged due to diabetes. People with retinopathy may not have any problems seeing at first. But if the condition gets worse, they can become blind. To help prevent retinopathy, people with diabetes should avoid smoking, keep their blood pressure under control, and keep their blood sugar at an even level.

Another common cause is Glaucoma, a condition where an increase in pressure inside the eye impairs vision by damaging the optic nerve. Any damage to the optic nerve is irreversible so it is important to find out if there is any history of glaucoma in your family as the condition is hereditary. Early detection and treatment is crucial or the vision will gradually deteriorate over time to a small tunnel vision, and then blindness can occur.

Most people may also find it surprising to note that injury is one of the commonest cause for vision loss. Examples like getting hit with a hockey ball or a shuttlecock, or children playing with sharp objects, and injuries from car accidents are common factors. These incidences are potentially devastating and a drastic accident can cause blindness.

Macular degeneration is a gradual deterioration of the macula (centre point at the back of the eye), which is the most sensitive region of the retina. The condition leads to progressive loss of central vision (the ability to see fine details directly in front). Excessive exposure to sunlight and smoking can increase the risk for age-related macular degeneration. Symptoms may include increased difficulty reading or watching TV, as vision becomes distorted and straight lines appear wavy or objects look larger or smaller than normal.

In children, amblyopia or “lazy eye” in early childhood can drastically reduce vision in an eye if the weak eye is not corrected. It is important to detect and treat the lazy eye before the age of 7 or 8 years, before the “vision center” in the brain completes development.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

Conjunctival Naevus

Conjunctival Naevus

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr. S. S. GILL talking to us about CONJUNCTIVAL NAEVUS.

Every now and then, there are patients who come in complaining of some patches of brown or grey on the white (conjunctiva) of their eyes. Well, most often than not, it will probably be a conjunctival naevus. Conjunctival naevus is a pigmented growth or lesion similar to a mole on your skin. It may be referred to as a “freckle in the eye.”

The word “naevus” has its origins from Latin. The Oxford dictionary defines it as a birthmark or a mole. Medically, a naevus may be found in the eye usually in the clear front white of your eye (conjunctiva), around the colored part of the eye (iris), or underneath the retina (nerve at the back of the eye). If the naevus is at the back portion of the eye (retina), it is called a choroidal naevus.


Conjunctival naevus appears as a dark brown to black patch in the white of the eye (conjunctiva). The size of the patch may range from a small, barely noticeable patch, to a large patch that may cover a noticeable portion of the white of the eye (see adjacent picture).


A conjunctival naevus (pigmented growth) is produced by pigment cells called melanocytes. These are the same pigment cells which contribute to the colour of our skin, hair and eyes. These melanocyte cells are usually distributed evenly in the eyes, but when they form a cluster, it results in the formation of a conjunctival naevus.


Conjunctival naevus, although benign, should be periodically assessed with photographs taken at every check-up. This is to ensure that if it should ever start growing in size, it should be removed surgically. Sometimes there may be changes in colour and when this happens it should also be removed. This is because there is a small risk of the growth turning malignant and becoming a melanoma (cancerous). Thankfully, the risk of this happening is very low.


There are no eye drops or medication available to treat conjunctival naevus. The only option for treatment is surgical removal.

Surgical excision is always done mainly for two reasons:

Cosmetic reasons – this is the commonest reason especially in cases where the growth is very dark or large, and appears unsightly to the patient.

Malignant (cancerous) transformation – this is the other reason that a conjunctival naevus growth is removed, that is, if it undergoes malignant transformation. In such instances, surgical removal is mandatory.

If you are in doubt about any pigmented lesions around the eye, do seek professional help.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah

(05-545 5582) or email


Consultant Eye Surgeon Dr S.S. Gill

Subconjunctival Heamorrhage

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s Eye Health series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about Subconjunctival Haemorrhage.

Subconjunctival Haemorrhage or subconjunctival bleeding is a condition where there is bleeding under the conjunctiva. The conjunctiva is the clear transparent layer that covers the white part of the eye (sclera). When the white of the eye has a bleed, this is called subconjunctival haemorrhage. Every other week, someone or the other walks into the consultation of an Ophthalmologist seeking treatment for this.

The appearance of such a bleed is often alarming to a person. Thankfully, it is generally a harmless condition when it occurs by itself and it is confirmed that the person has no other underlying serious conditions associated with it.

Consultant Eye Surgeon Dr S.S. GillWhat does it look like in the eye?

Subconjuntival haemorrhage or a subconjunctival bleed appears blood red and is located over the white of the eye (see adjacent picture).

It may appear in any area of the white part of the eye. It does not cause any pain but may cause some discomfort or heaviness if there is a large amount of blood collection.

Who gets subconjunctival bleeding?

Subconjunctival bleeding may occur in any age group – in adults, children or even infants. It is basically a bleed that arises from the tiny blood vessels of the conjunctiva. These tiny blood vessels are fragile and easily bleeds into the white of the eye.

What are the causes of subconjunctival bleeding?

The commonest cause is trauma of some form to the eye. This may range from too vigorous rubbing of the eyes, swimming goggles that are too tight, any direct trauma of any nature to the eye, head injuries, severe cough or sneezing, severe straining when lifting heavy objects or straining when passing stools especially when one is constipated. It may be also seen in those who do bungee jumping and in children who have been  physically abused.

Underlying systemic conditions that may cause this is uncontrolled hypertension, bleeding disorders, those who may be on anti-platelet (blood-thinning medication) therapy, and also sometimes it maybe seen immediately after eye surgery, particularly Lasik.

Should you be concerned?

Subconjunctival bleeding does not cause any problems with vision and is generally a harmless condition. However, it is important to be sure that it is not associated with some underlying systemic illness of the body.

How is it treated?

If it has been confirmed that the subconjunctival bleeding is not part of a systemic illness like uncontrolled hypertension, a blood disorder, etc., then it will not require any form of treatment because it is harmless. The reason it does not require any treatment is because the body’s natural mechanisms of healing will absorb the blood collection. It usually takes a few days to a few weeks for the blood collection to clear. The smaller the bleed, the faster it  gets absorbed. Those with a large collection of blood may take longer.

Subconjunctival bleeding while harmless in most instances, should be checked out especially if it occurs spontaneously and it has occurred with no direct trauma to the eye. If you are in doubt as to the underlying cause of the bleed, do consult your local practitioner or eye doctor.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah

(05-545 5582) or email

Eye Health – Arcus Senilis

Arcus Senilis

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about ARCUS SENILIS.

Arcus Senilis, (pronounced “ar-kus see-nil-is”) is a visible whitish-grey arc seen above and below the outer part of the cornea (clear dome shaped part of the eye). It is easily visible in some people and often mistakenly referred to as a cataract by layman. Arcus Senilis is also sometimes referred to as Corneal Arcus or Arcus Cornealis.

Eye Health – Arcus SenilisHOW DOES IT LOOK LIKE IN THE EYE?

Arcus Senilis affects the cornea of the eye. The cornea is the clear transparent dome shaped part of the eye, like the car windscreen. Arcus Senilis appears greyish or whitish over the peripheral part of the cornea. In the initial stages, it appears over the upper and lower part of the cornea. Later, this whitish-grey area on the corneal periphery eventually may become a complete ring around the cornea, making it appear as a white ring around the edge of the clear part of the eye.


Arcus senilis is often seen in the eyes of senior people. It’s caused by fat (lipid) deposits deep in the periphery of the normally clear cornea. Arcus senilis doesn’t affect vision but it does give the doctor a sign. Remember again, as highlighted (in previous issues of the Ipoh Echo) that our eyes are not isolated from things that are happening in our bodies including the effects of aging. It increases with age in both male and female. It however occurs more frequently in men.


Arcus Senilis is mainly an aged-related change, a sign of aging. However, it may be also seen in younger individuals. When it is seen in younger individuals, that is, those below the age of 50 years, it is important to look for dyslipidaemia (abnormal amount of lipids or fat in the blood) which is one of the risk factors for coronary heart disease. The formation of Arcus Senilis is more often seen in those having high serum LDL-cholesterol.

In other words, it is seen in aging individuals. The other link is when it occurs in younger people, that is, the association of high serum LDL-cholesterol in such individuals.


Arcus Senilis does not cause any problems with vision, so there is no need for any concern. You do not need to be running to see an eye doctor for this. It is a harmless condition for the eye.

The only thing that you will need to be concerned about is if you are younger than 50 years old and the Arcus Senilis is visible in your eye. In such instances, it would be wise to get a blood examination done to look for dyslipidaemia, remembering that dyslipidaemia has an association with heart disease.


Arcus Senilis requires no treatment because it does not cause vision problems. What would need to be looked into and treated is the dyslipidaemia if this is found to be abnormal in order to avoid cardiovascular risk. Arcus Senilis is only a sign – common in aging, to be concerned of only when seen in younger individuals. There is no treatment for arcus senilis by itself. If you are in doubt whether you have such a condition, do consult your local practitioner or eye doctor.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

See fingers

Signs of Eye Problems – Part 2

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about THE WARNING SIGNS OF EYE PROBLEMS – PART 2.

Our eyes are not isolated from medical problems like diabetes and hypertension, and also other factors like the effects of aging, the harmful rays of the sun, smoke and dust around us.

Warning Signs

There are some symptoms and signs that may indicate prompt treatment  be required. In most cases, you should see your eye doctor immediately if you experience some of the following:


See fingersDouble vision or ‘ghost’ images

Double vision is also called diplopia. This symptom may be caused from eye conditions ranging from minor to serious. In most cases, any sudden onset of double vision cannot be taken lightly. This is because it may be a signal of an underlying condition such as a stroke.

The other conditions that may cause double vision are brain tumours, nerve paralysis, brain swelling and abnormal brain vessels impinging on some part of the brain. Sometimes a person may need to be referred to neurologist or neurosurgeon depending on the kind of stroke that occurs.

Remember that if you have a sudden onset of double vision, see your eye doctor or general practitioner immediately. Quick treatment is invaluable in these cases.

Irritated eyes with redness and a scratchy feeling

Often this is as a result of dry eyes. It is not really an eye emergency but if left untreated may affect the eyesight of the individual affected. The symptoms of dry eyes may at times be very  severe, Dry Eye Syndrome is also known as keratoconjunctivitis sicca (quite a mouthful). It is a condition due to the changes in the quantity or quality of the tears. Dry eye normally occurs as irritated eyes.

Dry eyes may affect vision because it disturbs the tear film layer on the cornea that is  essential for good vision. Our tears help bend the light on its way to the back of your eye (the retina) so that you can see nice and sharp images. Consult your eye general practitioner for advice about remedies, which may include over-the-counter or prescription eye drops.

Blurred Vision with Eye Pain, Nausea and/or Vomiting:

These vision changes may be due to an acute glaucoma. Since there may be associated symptoms like vomiting and nausea, the glaucoma may sometimes be missed and passed on as gastroenteritis. The patient may end up seeing their Physician only to be picked up as a glaucoma suspect to be sent to the ophthalmologist. Keep a lookout for this if you have a family history of glaucoma.

Sudden Brief Loss of Vision

You may be experiencing a condition called Amaurosis Fugax. The name  is derived from the Greek word amaurosis meaning ‘dark’, and the Latin word fugax meaning ‘fleeting’ – referring to a transient loss of vision in one or both eyes. It may be a symptom of Central and Branch Retinal Artery occlusion and must not be taken lightly.

These are only some of the warning signs. Never hesitate to seek professional help if you experience any unusual eye symptoms that you are unsure of.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email

Eye Health - Warning signs of eye problems

The Warning Signs of Eye Problems

Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh

Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about THE WARNING SIGNS OF EYE PROBLEMS.

Many people ask me why is it that their eyes are just not same like they were before. Well, the answer is simple. It’s because our eyes are not isolated from medical problems (diabetes, hypertension & other conditions), from the effects of aging or even from the environment that we live in with all the sun exposure, smoke and dust around us. Eye problems may occur at any age but they are often more common in old age. It is important to be wary of the warning signals that something is going wrong with your eyes and to take proper action should that occur. In many cases, such as diabetic eye disease, eye strokes or acute angle closure glaucoma, quick intervention is important to avoid permanent vision loss.

Some Warning Signs

There are some symptoms and signs that may indicate a medical emergency. In most cases, you should see your eye doctor immediately if you experience:

Eye Health - Warning signs of eye problemsRed Painful Eye with Blurring Vision

This is often a sign of an acute glaucoma (angle-closure variety) attack. There may be nausea and vomiting with a throbbing headache as well. Left untreated, this condition may result in permanent irreversible blindness. Seek treatment early should this happen. This condition may sometimes be mistaken for acute gastroenteritis (food poisoning) because of the symptom of nausea and vomiting. Seek quick treatment for this.

Blur Wavy Vision in the Centre Part of Vision

This may be an early sign of macular degeneration (AMD). It is a disease that destroys your sharp, central vision. The macular is the central part of the retina where all the fine vision takes place. When the macular is affected, the vision appears distorted, lines appearing crooked or wavy and in the late stages, the vision may be lost centrally. In recent years, there has been medication available for treatment of this condition. The sooner treatment is instituted the better.

Vision Blurring in part of your Field of Vision

If the vision loss appears like a curtain falling or like water rising from the floor, then this may be a signal of a detaching retina. The retina is a layer of nerve tissue in the back of your eye. This layer receives the images that you see and transmits it to the brain. When this retina (nerve layer) gets detached in some portion, then the vision gets lost in the corresponding part of the field of vision. The detachment is sometimes preceded by a sudden shower of floaters.

Blurred Vision with Halos around Lights

These vision changes may be due to glaucoma when there is a higher than normal eye pressure. Watch out for these subtle symptoms that may occur with a mild headache or mild eye discomfort. Be especially on the lookout for this symptom if you are already a diagnosed glaucoma patient or have a family history of glaucoma.

Sudden Blurring and/or Floaters in Diabetic Patients

In diabetics, this may be a sign of bleeding in the eye because of diabetic eye disease. It is best for diabetics to get their eyes checked regularly and not have to wait for eye symptoms such as this before seeking eye treatment. By looking into a diabetic’s eye, the eye doctor is able to obtain valuable information about the general diabetic condition which is helpful for the physician who is managing your diabetes. Regular eye exams are important if you are diabetic, regardless of whether you have blurring vision or not.

These are only some of the warning signs. Never hesitate to seek professional help if you experience any unusual eye symptoms that you are unsure of.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email