SPECIALTIES & SERVICES

Surgeries & Procedures

Eye Surgery
• Cataract surgery (including phacoemulsification)
• Vitreoretinal surgery
• Oculoplastic (eye plastic) surgery
• Cosmetic surgery of the eyelids, eyebrows and mid-face
• Paediatric eye surgery
• Squint surgery
• Glaucoma surgery
• Corneal surgery
• Pterygium surgery

Laser Surgery
• Laser Eye Surgery
• Diabetic retinopathy
• Glaucoma
• Macular degeneration
• Posterior capsule opacification (after-cataract)
• Retinal tears"

Cosmetic Eye Procedure
• Botox injections for wrinkles
• Dermal filler injections for wrinkles
• Chemical peels for ageing skin and facial pigmentation

Topics:

1. Age-Related Macular Degeneration
2. Cataract
3. Common Eyelid Conditions
4. Diabetic Retinopathy
5. Droopy Eyelids

Age-related Macular Degeneration

What is it?

Age-related macular degeneration (AMD) is the leading cause of blindness in individuals over the age of 65 in developed countries. It is due to ageing and deterioration of the central portion of the retina (macula) at the back of the eye. AMD affects central vision necessary for recognizing faces, driving, reading and looking at details.

There are two types of AMD, the dry and the wet type.

Dry AMD is the more common of the two. It usually progresses slowly and vision loss is not severe expect at very advanced stages. It is characterised by yellowish-white deposits (drusen) and loss of retinal cells resulting in changes in central vision.

Wet AMD is less common, but it often results in severe loss of vision. Abnormal blood vessels grow in the eye, which leak fluid and blood.

What are the risk factors?

The risk factors for AMD are as follows: Onset of old age; being female and being a member of a lightly pigmented race. Additionally, some other lifestyle factors also affect the likelihood of developing AMD. These are smoking and a lack of antioxidants in the eye.

What are the symptoms?

The following symptoms indicate the development of AMD: blurring, distortion or dark spots in the central vision. If detected early, treatment for AMD may be effective in correcting or preventing further loss of vision.

What are the treatments for AMD?

You must see an eye specialist as soon as possible if you experience the above symptoms. The specialist will assess your eyes and explain the problem and the necessary treatments.

It is recommended to have regular eye screenings every 2 years if you are above 55 years old.

For Dry AMD, there is no known effective treatment. Progression of the disease may be slowed through the use of antioxidants (e.g. zinc, lutein) and vitamins A, C and E. Quitting smoking is also known to reduce the risk of AMD.

For Wet AMD, vision may be saved with treatment during the early stages. However, at the late stage, visual loss is unlikely to be recovered.

Treatment is aimed at managing the condition with:

• Injections of anti-vascular endothelial growth factor (VEGF) agents into the eye to shrink abnormal blood vessels and reduce leakage.
• Cold laser (Photodynamic Therapy or PDT) treatments to destroy abnormal blood vessels
• Hot laser (Laser Photocoagulation) treatments for abnormal blood vessels located away from the centre of the retina.

For late stage Wet AMD, the treatment focuses on visual rehabilitation with low vision aids such as high-intensity reading lamps, mini-telescopes and magnifying glasses to improve existing vision. Early detection and timely treatment of AMD in the other eye should be aimed for.

Scheduling an Appointment

Should you or a loved one be interested in a consultation with our eye specialists, please contact us at 6555 8828.

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Cataract

What is it?

Cataract refers to cloudiness or opacity in the lens of the eye. They are readily detected during a routine eye examination.

What are the causes?

Cataracts may be caused by many factors. Ageing is the most common cause of cataract in people over the age of 50. Diabetes, trauma to the lens, co-existing eye conditions and medications like steroids can also cause cataracts. Congenital cataract, occurring at birth or within the first year of life, may arise from hereditary conditions or an infection experienced while in the womb.

What are the symptoms?

Blurred vision, seeing glares and/or halos and multiple images are common symptoms of cataract. Another indication of cataract may be frequent change of spectacles.

What are the treatments for cataract?

Cataract surgery is the only effective way to treat the condition. Surgery may be necessary when your vision is affected significantly to impact your lifestyle or daily activities.

• Phacoemulsification is a procedure using ultrasound energy to break up and remove the cataract. A new artificial lens, called the intraocular lens (IOL) is then implanted. The intraocular implants come in various powers suited for your eye.
• Extra Capsular Cataract Extraction (ECCE) is performed when phacoemulsification is not suitable as in hard/advanced cataracts. The surgery involves lens removal via a large wound and then closing it with stitches, hence it has a longer recovery period.

After surgery, eye drops should be regularly applied as prescribed by your specialist. A pair of spectacles may still be necessary after surgery for correction of astigmatism and near work such as reading.

Occasionally, thickening of the lens capsule may cause the vision to worsen many months to years after surgery. This may be easily treated with an outpatient procedure called laser capsulotomy performed with Nd:YAG laser.

Scheduling an Appointment

Should you or a loved one be interested in a consultation with our eye specialists, please contact us at 6555 8828.

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Common Eyelid Conditions

We offer treatment for the following common eyelid conditions:

• Entropion
• Epiblepharon
• Trichiasis
• Peri-ocular Lumps

What is Entropion?

This is the inward rolling of the upper or lower eyelid margin that causes the eyelashes to rub against the eye surface. Entropion is caused by laxity of eyelid tissues due to aging, as well as scarring of the inner surface of the eyelid.

What are its symptoms?

In entropion, patients may experience eye discomfort including: watering, sensation of foreign body or grittiness in the eye, redness, pain and discharge. The condition may also lead to corneal infection and scarring.

What is Epiblepharon?

This is a horizontal skin fold near the eyelid margin that presses the eyelashes against the eye surface. It is a developmental problem commonly seen in younger Chinese children. It may improve spontaneously by seven to eight years of age.

What are its symptoms?

Children with the condition may complain of discomfort to the eye including: Watering, sensation of foreign body or grittiness in the eye, redness, pain and discharge, and frequent eye rubbing. The condition may also lead to corneal infection and scarring.

What is Trichiasis?

Trichiasis is the medical term which describes in-grown eyelashes. It is caused by infection, inflammation, autoimmune disorders or trauma such as burns or eyelid injury.

What are its symptoms?

In-grown eyelashes cause discomfort to the eye including: watering, sensation of foreign body or grittiness in the eye, redness, pain and discharge, and frequent eye rubbing. The condition may also lead to corneal infection and scarring.

What should I do if I have symptoms of Entropion, Epiblepharon or Trichiasis?

The use of lubricating eyedrops and ointments may provide some relief. Minor surgery under local anaesthesia may also be used to tighten or reposition the eyelid or remove the offending eyelashes depending on the underlying cause.

What are Peri-ocular Lumps?

Lumps that appear near the eye are known as peri-ocular lumps. These can be benign (non-cancerous) or malignant (cancerous).

Benign lumps include styes, cysts, moles and warts. They can be cosmetically unsightly or irritating but are generally not harmful. Some of these may rarely be pre-cancerous and may develop into cancers with time.

Malignant lumps are suspected if one or more of the following is present:

• recent or new appearance of the lump
• sudden increase in size of the lump
• change in colour or appearance of a existing lump
• the lump becoming itchy or bleeds upon contact

What should I do if I have Peri-ocular Lumps?

Most benign peri-ocular lumps may be treated with surgical removal. In the elderly, early recognition and treatment of malignant lumps may save vision and life. They should be completely excised (removed) with laboratory (histological) confirmation of its clearance.

Scheduling an Appointment

Should you or a loved one be interested in a consultation with our eye specialists, please contact us at 6555 8828.

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Diabetic Retinopathy

What is it?

Diabetic retinopathy is an eye complication of diabetes mellitus. It results from damage to the retinal blood vessels at the back of the eye. Diabetic retinopathy usually causes no or mild symptoms. However, advanced diabetic retinopathy if untreated, can result in blindness. The condition usually affects both eyes.

What are the risk factors?

All diabetic patients are at risk of diabetic retinopathy, and the risk increases the longer the diabetic condition persists. The risk is highest for persons who: Smoke, have poor control of blood sugar levels; high blood pressure and cholesterol.

What are the symptoms?

Symptoms are unusual in the early stages of diabetic retinopathy. However, the following may indicate the onset of the disease: Spots floating in your vision; blurred vision; dark streaks or a red film that blocks your vision or poor night vision.

What are the treatments for diabetic retinopathy?

You should inform your consulting doctor of any of the above symptoms. The treatment options depend on the stage of the eye disease.

For early diabetic retinopathy, close monitoring will be required.

For advanced diabetic retinopathy, you will need prompt treatment.

• Focal laser treatment can stop leakage of blood and fluid in the eye. This is usually done in one session. Vision will be blurry for about a day after the procedure.
• Scatter laser treatment (panretinal photocoagulation) can shrink abnormal blood vessels. It is usually done in two or more sessions. There may be some loss of peripheral or night vision after the procedure.
• Vitrectomy is surgical removal of gel-like substance (vitreous) and scar tissue within the eye cavity and scar tissue tugging on the retina. A saline based solution is used to help maintain normal eye shape during surgery. A gas bubble may be placed in the eye to help re-attach the retina. You may need to remain face down after surgery for a few weeks until the gas bubble disappears.

Regular eye exams are critical before and after treatment of diabetic retinopathy.

Scheduling an appointment

Should you or a loved one be interested in a consultation with our eye specialists, please contact us at 6555 8828.

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Droopy Eyelids

What is it?

Droopy Eyelids is a term that collectively describes one or more of the following conditions:

• Dermatochalasis
• Ptosis
• Eyebrow ptosis

What are the symptoms?

• Obliteration of upper eyelid crease (“double eyelid” becoming less obvious or not seen)
• Upper eyelid fullness and heaviness
• Headache or eyebrow ache
• Eye fatigue or tiredness
• Blockage of the field of vision e.g. having to force open the eyelids to see

What are the treatments for droopy eyelid conditions?

These conditions can be corrected with minor day surgery procedures under local anesthesia with sedation. The sedation is given to you by the anaesthetist through an injection in your vein to calm you during surgery. The procedure may be performed for functional or cosmetic reasons. Functional surgery is done for severe cases that affect the visual function.

• Dermatochalasis (lax upper eyelid skin) is an ageing change characterised by lax, apparently redundant upper eyelid skin due to loss of skin elasticity. It can be treated by blepharoplasty (“double eyelid” surgery) to remove the lax upper eyelid skin and re-shape the eyelid crease if necessary.
• Ptosis (lowered upper eyelid) may occur in early life (congenital ptosis) due to abnormal levator muscle development. Untreated ptosis may obscure vision to cause ‘lazy eye’ (amblyopia) in children.
  In later life (acquired ptosis), ageing changes, muscle diseases, neurological (nerve) diseases, nerve junction diseases and mechanical problems may cause the condition.
  Ptosis surgery may be done via an external approach (through the upper eyelid crease) or an internal approach (via the inner surface of the upper eyelid).
• Eyebrow Ptosis (lowered eyebrow) describes the eyebrow drooping due to ageing and loss of structural support. The upper eyelids appear full and heavy, especially over the outer aspect (hooding).
  Eyebrow lifting surgery may be performed to treat this condition. A direct eyebrow lift (incision above the eyebrows), browpexy (incision at upper eyelid crease) or endoscopic surgery (via scalp incisions) may be chosen depending on the condition.

Scheduling an Appointment

Should you or a loved one be interested in a consultation with our eye specialists, please contact us at 6555 8828.

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• Research Grants
• Research Awards
• Research Publications

Research Grants

Research Awards

• Outstanding Original Paper
  • Visual Experiences During Vitreous Surgery Under Regional Anesthesia: A Multicenter Stud. Tan CS, Mohmood U, O'Brien PD, Beatty S. Kwok AK, Lee VY, Au Eong KG. American Journal of Ophthalmology. 2005 Dec;140(6):971-75
• Best Case Reports / Small Cases Series
  • Extensive Upper-Extremity Venous Thrombosis After Fluorescein Angiography. Cheng JY, Yap EY, Chao AK, Au Eong KG. American Journal of Ophthalmology. 2005 May;139(5):928:30
• Best Review Papers / Book Chapters / Letters to Editor / Correspondence
  • Visual Experiences During Cataract Surgery: What Anaesthesia Providers Should Know. Tan CS, Au Eong KG, Kumar CM. European Journal of Anaesthesiology. 2005 Jun;22(6):413-19
• The Eye Institute-Novartis Research Prize
  • Winner: Dr Ajeet M Wagle
  • Paper: Health Related Quality of Life and Utility Values Associated with Vitreous Floaters
• The Eye Institute-Novartis Research Merit Prize
  • Winner: Dr Bakthavatsalu Maheshwar
  • Paper: Preferential Hyperacuity Perimetry for Detection of Age-Related Macular Degeneration

• Best Original Paper
  • Macular pigment and ocular biometry- Neelam K, Nolan J, Loane E, Stack J, O'Donovan O, Au Eong KG, Beatty S. Vision Res. 2006 Jun;46(13):2149-56. Epub 2006 Feb 10.
• Outstanding Original Paper
  • An evidence-based analysis of surgical interventions for uncomplicated rhegmatogenous retinal detachment.Saw SM, Gazzard G, Wagle AM, Lim J, Au Eong KG. Acta Ophthalmol Scand. 2006 Oct;84(5):606-12. Review
• Best Review Papers / Book Chapters / Letters to Editor / Correspondence
  • Macular carotenoids and age-related maculopathy. O'Connell E, Neelam K, Nolan J, Au Eong KG, Beatty S. Ann Acad Med Singapore. 2006 Nov;35(11):821-30. Review.

• The Eye Institute-Novartis Research Prize
  • Winner: Dr Ajeet M Wagle
  • Paper: Health-related Quality of Life Associated with Age-related Macular Degeneration Using Utility Values and EQ-5D Health Status Questionnaire
• The Eye Institute-Novartis Research Merit Prize
  • Winner: Dr Sanjay Srinivasan
  • Paper: Awareness of Haemoglobin A1c and its relationship with Diabetic Retinopathy AmongAdult Diabetic Patients Attending a Tertiary Ophthalmic Centre
• The Eye Institute-Hoya Research Prize
  • Winner: Dr Neo Hui Yee
  • Paper: Health-related Quality of Life Associated with Diabetic Retinopathy in Singapore

• AAO's Achievement Award
  • Recipient : Dr Yip Chee Chew

• Meritorius Service Award
  • Recipient : Dr Ajeet Wagle

• TEI-Alcon Research Prize – Best Paper Presentation in Consultants/Specialist category
  • Winner: Dr Ajeet M Wagle
  • Paper: Ophthalmic manifestations in dengue fever patients during epidemics caused predominantly by different dengue serotypes

• Asia-ARVO 2009 Travel Fellowship
  • Recipient : Dr Kumari Neelam

• Oral Paper on Neovascular Age-related Macular Degeneration and Chlamydia pneumoniae antibodies in Asian Patients
• Recipient: Dr Sanjay Srinivasan

Research Publications

• Woo JH, Sanjay S, Au Eong KG. Benefits of early awareness in age-related macular degeneration. Eye 2009 Dec;23(12):2271; author reply 2271-2
• Sanjay S, Chan EW, Gopal L, Hegde SR, Chang BC. Complete unilateral ophthalmoplegia in herpes zoster ophthalmicus. J Neuroophthalmol 2009 Dec 29(4):325-37.
• Sangtam T, Maheshwar B, Au Eong KG. Prevalence of myopia in Danish conscripts : a response. Acta Ophthalmol 2009 Nov;87(8):914; author reply 913-4.
• Sanjay S, Neo HY, Sangtam T, Ku JY, Chau SY, Rostihar AK, Au Eong KG. Survey on the knowledge of age-related macular degeneration and its risk factors among Singapore residents. Clin Experiment Ophthalmol 2009 Nov;37(8):795-800.
• Ng DH, Roxburgh ST, Sanjay S, Au Eong KG. Awareness of smoking risks and attitudes towards graphic health warning labels on cigarette packs: a cross-cultural study of two populations in Singapore and Scotland. Eye 2009 Aug 21 (Epub ahead of print)
• Sachdev N, Tiakumzuk S, Aulakh R, Brar GS. Anomalous bilateral lateral rectus muscles and anterior polar cataract with dysmorphic features. JAAPOS 2009 Jun;13(3):319-21.
• Chew R. Dengue fever-induced optic atrophy. Die Kontaktlinse 2009 Jun;42:21.
• Chew R. Clinical findings and management of racemose haemangioma. Die Kontaktlinse 2009 May;41:5.
• Woo JH, Sanjay S, Au Eong KG. The epidemiology of age-related macular degeneration in the Indian subcontinent. Acta Ophthalmol 2009 May;87(3):262-9.
• Chan EW, Sanjay S. Herpes zoster ophthalmicus complicated by incomplete ophthalmoplegia and a neurotrophic ulcer. Eye 2009 Apr;23(4): 994.
• Woo JH, Au Eong KG, Kumar CM. Conscious sedation during ophthalmic surgery under local anesthesia. Minerva Anestesiol. 2009 Apr;75(4):211-9. Review.
• Sanjay S, Ogle JJ, Wagle AM, Au Eong KG. Awareness and the use of nutritional supplementation for age-related macular degeneration patients. Eye 2009 Feb;23(2):486-7.
• Sanjay S, Ogle JJ, Wagle AM, Eong KG. Awareness and the use of nutritional supplementation for age-related macular degeneration patients. Eye 2009 Feb;23(2):486-7; author reply 488.
• Neelam K, Muldrew A, Hogg R, Stack J, Chakravarthy U , Beatty S. Grading of Age-related Maculopathy: Slit-lamp Biomicroscopy Versus an Accredited Grading Centre. Retina 2009 Feb;29(2):192-8.
• Sanjay S, Wagle AM, Au Eong KG. Dengue optic neuropathy. Ophthalmology 2009 Jan ;116(1):170.
• Ying XH, Wagle AM, Tan L, Sanjay S, Hedge SR, Chew YC, Yap P. A rare case of herpes zoster ophthalmicus with complete ophthalmoplegia.J Am Geriatr Soc. 2008 Nov 56(11):2160-2.
• Neelam K, Hogg RE, Stevenson MR, Johnston E, Anderson R, Beatty S, Chakravarthy U. Carotenoids and co-antioxidants in age-related maculopathy : design and methods. Ophthalmic Epidemiol, 2008 Nov-Dec 15(6): 389-401.
• Woo JH, Au Eong KG. Don't lose sight of age-related macular degeneration: the need for increased awareness in Singapore. Singapore Med J 2008 Nov; 11:850-3.
• Handa S, Chew RY, Au Eong KG. Convoluted vessels in the eye. Am Fam physician 2008 Oct 78(8):981-3.
• Ng DH, Chew RY, Seow-Choen F, Kua CH, Au Eong KG. Opening our eyes to guide dogs for the blind in Singapore. Ann Acad Med Singapore 2008 Sep 37(9):806-8.
• Woo JH, Au Eong KG. Macular hole surgery without prone positioning. Eye 2008 Aug;22(8):1093; author reply 1093-4.
• Dogra MR, Vinekar A, Viswanathan K, Sangtam T, Das P, Gupta A, Dutta S. Laser treament for retinopathy of prematurity through the incubator wall. Opthalmic Surg Lasers Imaging 2008 Jul-Aug; 39(4):350-2.
• Lim JH, Sangtam T, George SM, Au Eong KG. Pseudomonas aeruginosa endophthalmitis following cataract surgery. Indian J Ophthalmol 2008 Jul-Aug;56(4):342.
• Preechawai P, Amrith S, Yip CC, Goh KY.Orbital Metastasis of Renal Cell Carcinoma Masquerading as Cysticercosis. Orbit 2008;27(5):370-3.
• Sanjay S, Wagle AM, Au Eong. Optic neuropathy associated with dengue fever. Eye 2008 May 22(5):722-4.
• Chng E, Yip CC, Lee JC. Oculomotor nerve palsy after functional endoscopic sinus surgery. J Laryngol Otol 2008 Mar;122(3):e9.
• Wagle AM, Sangtam T, Au Eong KG. Double macular hole in vitreomacular traction syndrome. Retina 2008 Feb;28(2):366; author reply 366-7.
• Sanjay S, Yeo TK, Eong KG. Dengue maculopathy: was there also optic nerve involvement? Travel Med Infect Dis, 6(1-2):48. 2008 Jan-Mar; Epub 2007 Dec 11.

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