Tag Archives: Ophthalmologist

What is glaucoma?

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Dr S S Gill, Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S S Gill, Consultant Ophthalmologist

In conjunction with World Glaucoma Week 2012, Ipoh Echo talks to Consultant Eye Surgeon Dr S.S. Gill about this “silent thief of sight”.

What is glaucoma?

Glaucoma is a group of eye diseases that result in progressive damage of the optic nerve (the “main cable” that carries visual information from the eye to the brain). If glaucoma is not treated, it permanently damages vision in the affected eye(s) and results in blindness.  It is often, but not always, associated with increased pressure of the fluid in the eye (aqueous humour).

Glaucoma has been nicknamed the “silent thief of sight” because the vision loss normally occurs gradually over a long period of time without significant symptoms until you eventually lose significant vision. In other words, it means that one will only notice poor vision when the disease is serious and the damage to the optic nerve is advanced.

Worldwide, glaucoma is the second leading cause of blindness after cataracts. Glaucoma affects one in 200 people aged fifty and younger, and one in 10 over the age of eighty. As many as 6 million people are blind in both eyes from glaucoma today. Most of these people were once unaware they had this disease until they lost significant vision in one or both eyes.

One reason why a person may not realise that he or she is losing vision is because the vision loss involves the peripheral part of a person’s vision.  This peripheral vision loss is the reason why it goes unnoticed by the patient until the very late stage when the central vision starts being affected. Rarely, in some patients there may be symptoms of slight eye discomfort, mild headache and haloes around lights.

Any person who is 40 years and above should go for glaucoma screening. More so, if you have a family history of glaucoma and have never been screened for glaucoma yourself, you should go for an eye check as soon as you can.

More on Glaucoma in the next issue.

For more information, contact Gill Eye Specialist Centre at 05-5455582, email: gilleyecentre@dr.com or visit www.fatimah.com.my.

Eye Health – Cataracts

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Dr S S Gill, Consultant Ophthalmologist

Ipoh Echo’s eye health series continues with consultant eye surgeon Dr S.S. Gill talking to us about multifocal intraocular lens implants during cataract surgery. The Multifocal Intraocular Lens (Multifocal IOL)

An intraocular lens (IOL) is an artificial lens that is implanted in the eye during cataract surgery as highlighted in the previous issue of the Ipoh Echo.  IOLs may be grouped simply as follows:

  • Monofocal IOLs – discussed in issue 131 of the Ipoh Echo
  • Astigmatism-correcting monofocal IOLs (Toric IOLs) – discussed in issue 132 of the Ipoh Echo
  • Multifocal IOLs (Presbyopia correcting) – discussed here
  • Presbyopia & Astigmatism correcting IOLs

In order to understand what a multifocal IOL is, you will need to understand a condition called Presbyopia. The word presbyopia comes from the Greek word presbys meaning “old man” and the Neolatin suffix opia meaning “sightedness”.

Presbyopia

It is the loss of the eye’s ability to change focus to see near objects usually starting around 40 years of age. This loss of power of accommodation to see near objects worsens with age. No one is really spared from this.

The first sign is often the need to hold reading material farther away in order to read a book. You can liken it to a ‘menopause’ of the eye!

Previously, after a person underwent cataract surgery, he or she would have to wear spectacles to read a book unless he is deliberately made short-sighted in which case the distant vision becomes compromised.

Now, with the advancement in IOL technology, we have presbyopia-correcting IOLs or multifocal IOLs. This would generally help a person see both far and near without glasses, therefore providing the comfort of “spectacle-freedom” most of the time or at least close to spectacle freedom for the daily chores.

Multifocal IOL

Multifocal IOLs are high-tech marvels. Most individuals have a good level of satisfaction when implanted with these IOLs. However, even though there is a high level of satisfaction, it is important to note that these IOLs may not produce ABSOLUTELY crisp vision at multiple distances at ALL times and in ALL patients! Even though the majority of people may not need any spectacle correction and enjoy spectacle-freedom, a small number may still require some spectacle help to read fine print. If you cannot accept this fact, then you are not a candidate for a multifocal IOL choice.

Another phenomenon with multifocal IOLs that you may have to be prepared for is the possibility of at least some glare and haloes around light sources at night. This may occur especially immediately after surgery. Nevertheless, these haloes and glare rarely prohibit night driving. They gradually reduce with time and most individuals do not see any haloes or glare by the end of 6 months if not all by the end of 1 year.

Generally, if you do not have any other eye diseases, you will most likely be satisfied with your vision by the end of 6 to 8 months.

As with anything of premium quality, Multifocal IOLs are about 2-3 times more expensive than a standard Monofocal IOL. Still, if you are a suitable candidate, the long-term savings you gain on the regular changes of reading glasses and multifocal spectacles would be well worth your investment.

Dr Gill will discuss more on cataracts & IOLs in the next issue of the Ipoh Echo.

For more information, contact Gill Eye Specialist Centre at 05-5455582, email: gilleyecentre@dr.com or visit www.fatimah.com.my.

Eye Health – Cataracts

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Dr. S.S. Gill, Consultant Ophthalmologist

Ipoh Echo’s Eye Health series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about artificial lens implants during cataract surgery.

The Intraocular Lens (IOL)

Dr Harold Ridley stumbled upon the idea of implanting an artificial lens (intraocular lens or IOL) after an intern asked him why he was not replacing the cloudy natural lens (cataract) that he had removed during cataract surgery.

Ridley noticed that RAF pilots of World War II who had pieces of shattered canopy fragments accidentally pierce their eyes in battle had no inflammation. This made him realise that the material was inert and could be used to make the artificial lens (IOL). He then embarked on implanting the first IOL in 1949 using similar material to that of the airplane canopy. The rest is history with implantations of IOLs being routinely performed restoring vision to millions throughout the world especially so since 1977.

Once implanted into the eye, the lens implants (IOL) requires no after-care at all and generally last a lifetime. To the question a patient might ask “What kind of IOL should I choose?” the many varieties of intraocular lenses in the market today can be broadly classified as follows:

  1. Monofocal IOLs,
  2. Astigmatism-correcting monofocal IOLs (Toric IOLs),
  3. Presbyopia correcting IOLs,
  4. Presbyopia & Astigmatism correcting IOLs
Acrysof IQ Lens (pic courtesy of Alcon)

Monofocal Intraocular Lens

These are the most commonly used type of IOL implants worldwide. The monofocal IOL is basically a single focus lens. Unlike the natural lens of the eye, a monofocal intraocular lens cannot alter its shape to bring objects at different distances into focus. Hence, it improves vision for only one distance – either near, intermediate or far vision. This vision is still heaps better than seeing through a cataract!

Most of the time, the eye surgeon generally selects a lens (IOL) that will provide good distance vision, and the person then resorts to wearing reading glasses for the near vision. If you do not mind wearing reading glasses for near, then these IOLs will do fine. A patient who has monofocal IOLs implanted in their eyes may have to wear spectacles at least part of the time, either for near vision or distant vision. Most patients usually just go back to wearing similar multifocal spectacles that they used to wear before the operation. A small number who may be happy with their distant vision may just make spectacles for reading near only (presbyopic glasses).

Monovision Correction

The other thing that may be planned for a patient who is going to undergo cataract surgery is something called monovision correction where the monofocal IOL implanted in one eye corrects for clear distant vision while the IOL implanted for the other eye is corrected for near vision. This is called monovision and the patient slowly gets adjusted to seeing clearly for distance with one eye and reading near clearly with the other eye. This kind of correction requires a little patience on the patient’s part as he or she gets adjusted to the monovision correction. Monovision correction is good when you do not want to wear spectacles and at the same time do not want to spend so much money on IOLs. The cost of these IOLs is relatively affordable for most.

Dr Gill will discuss more on IOL’s in the next issue of the Ipoh Echo.

For more information, contact Gill Eye Specialist Centre at
05-5455582, email: gilleyecentre@dr.com or visit www.fatimah.com.my.