Ophthalmology (Eye)

Femtosecond and Excimer lasers can be used to reshape the cornea to correct refractive errors such as Myopia, Hyperopia, Astigmatism, and even Presbyopia.

Introducing the latest, revolutionary FEMTO LDV ™ Z8 Laser by Ziemer. Its remarkably advanced technology brings a new level of accuracy, flexibility, speed, and mobility to laser eye treatments with its low energy, the lowest amongst all femtosecond lasers.

Our clinic is the first practice in Singapore to pair the FEMTO LDV Z8 with J&J’s Star S4 Excimer Laser, one of the most established and trusted excimer lasers. The latter has been the gold standard for LASIK, approved by the United States’ FDA even for aviation and aeronautical professionals for decades. This pairing provides a bladeless and truly customized vision correction experience for our patients.

• Bladeless Z-LASIK (Laser-Assisted In-Situ Keratomileusis)

With the FEMTO LDV™ Z8, a corneal flap is created within just 30 seconds by using extremely fast, short bursts of low range pulsed light! This allows access to the underlying cornea tissue. Our Surgeon will then use the Excimer laser to treat the eye according to the patient’s visual requirements. Lastly, the flap will be repositioned. No stitching is required, visual recovery is quick and there is minimal discomfort.

• Advanced Surface Ablation

This flapless procedure is performed directly on the cornea surface. Our Surgeon will gently remove a thin superficial layer of the cornea known as the Epithelium with a special solution, followed by shaping the underlying tissue with the Excimer laser according to the patient’s eye power. Once done, a soft bandage contact lens will be placed over the treated area temporarily to protect it while new epithelial cells grow to resurface and heal the cornea. Recovery will take approximately 5 days.

• CLEAR (Cornea Lenticule Extraction for Advanced Refractive Correction)

This newly developed proprietary application is bladeless, flapless, fast and gentle. Performed with the FEMTO LDV™ Z8, it uses overlapping laser spots with the lowest energy per pulse, thereby allowing smoother incisions with higher precision.

Using this Femtosecond laser alone, a disc of tissue is created underneath the cornea surface. This is known as a “Lenticule” and its thickness is calculated according to the individual’s required correction. Subsequently, our Surgeon separates and extracts this lenticule through a small 2mm opening on the cornea surface. The removal of the lenticule changes the shape of the cornea, thus correcting one’s vision in a minimally invasive manner.

This procedure ensures reduced downtime, quicker recovery with less post-operative dryness and discomfort.

• Cataract Treatment

Surgical removal is currently the only treatment for cataracts. This highly successful surgery in the hands of an experienced surgeon has a short downtime, and vision improvement can be achieved as early as the very next day.

Our clinic offers two kinds of Intraocular Lens implants (IOLs)

1. Monofocal implant:

• Only able to correct vision for a fixed target distance, and astigmatism (if any)
• Still requires a pair of glasses after surgery

2. Multifocal implant:

• Provides correction for both distance and near viewing, and astigmatism (if any)
• No glasses required after surgery
• Patients feels free and convenient

Each procedure lasts approximately for half an hour. During this time, an incision as small as 1.8mm is created. A small incision allows quicker and more comfortable recovery. With the help of ultrasound energy, the cataract is softened and extracted. An IOL implant is then implanted to replace your natural lens. No stitching is required at the end of the surgery.

For additional precision and safety, our clinic offers Femtosecond Laser-Assisted Cataract Surgery (FLACS) as well.

An image-guided Femtosecond laser provides complete imaging of the eye and makes fine, precise corneal and lens cuts. Plus, it allows better lens implant positioning in the eye. The amount of ultrasound energy used during the surgery is also reduced, lowering the risk of complications.

Our surgeon employs reliable surgical techniques, updated calculation formulae and is able to customize the treatment for each of our patients.

There are different treatment options available for both open and closed-angle glaucoma.

 

• Open-angle glaucoma

1. Medicated eyedrops
   • Reduces eye pressure
   • Facilitate better fluid outflow

2. Micro invasive Stents
   • A recent innovation for treating glaucoma
   • A stent made of titanium
   • Creates a permanent and smoother pathway for the eye fluid
   • Can be implanted separately or along with cataract surgery

• Closed angle glaucoma

1. Laser peripheral iridotomy
   • Relatively painless
   • Create tiny hole in iris to ensure smoother fluid drainage

2. Lens extraction surgery
   • Creating more space within the eye
   • Allows refractive correction at the same time

It is possible to control the progression of glaucoma if you diagnose and treat it early. With regular comprehensive eye exams and suggested treatment plans, the better the chances of preserving the remaining sight that you have!

1. Myopia

2. Hyperopia

3. Presbyopia

4. Astigmatism

Ways to correct refractive errors:

1. Glasses
2. Contact lenses (including Orthokeratology)
3. Refractive surgeries

• Laser Vision Correction (LASIK, Advanced surface ablation, SMILE or CLEAR)
• Implantable Contact Lens
• Refractive Lens Exchange and Cataract Extraction surgeries.

The above treatments are longstanding and have very high safety, accuracy and patient satisfaction, and are FDA, CE and HSA-approved.

Also known as “The Silent Thief of Vision”, Glaucoma is a degenerative eye disease that gradually damages the optic nerve.

• Can occur at any age although more commonly in the elderly.
• Often hereditary and associated with high intraocular pressure (IOP).
• Damage to the optic nerve can still occur even with normal IOP.
• No noticeable symptoms especially in the early stage of the disease.
• Field of view shrinks over time and eventually results in blindness.

Dry eyes can happen in anyone especially those who have undergone eye surgeries, are contact lens wearers and women undergoing menopause etc.

Your eyes may not produce sufficient tears or have tears that evaporate too quickly, causing a variety of possible symptoms like:

• Red eyes
• Tired eyes
• Grittiness
• Itchiness
• Constant tearing
• Blurry vision

There are various kinds of treatment available for dry eyes, depending on the cause.

1. Eye lubricants (Most common type of treatment)
   • Drops

• Convenient as it comes in individual preservative-free vials
• Can be used as and when necessary
  • Gel
• Texture is thicker
• Moisturize for a longer period of time, used right before bed

2. Oral Food / Supplements (Improves dry eyes)

• Good intake of Omega 3 fatty acids
• Good quality olive oil

3. Medicated eye drops

• Often prescribed by our Ophthalmologist
• Contains mild dosage of cyclosporine, effective in relieving dry eye symptoms
• Proven to treat dry eyes, anti-inflammatory properties
• Helps with allergic conjunctivitis as well

4. Lid Hygiene

• A regime to cleanse oil glands that surround our eyelid margins
• Unclogged glands contribute to healthy tear film and relieves dry eye symptoms

5. Punctal Plugs

• 4mm bio-compatible collagen plugs, dissolves on its own after several months
• Carefully inserted at the tear ducts to prevent tears from draining away quickly
• Allows eye surface to be moist and comfortable

6. Tixel Dry Eyes Treatment

• Rejuvenates periorbital skin
• Treatment takes less than 5 minutes for both eyes
• Non-invasive and no downtime

Allergic Conjunctivitis can be prevented if the allergen is avoided. Our Ophthalmologist treats the condition with medicated eyedrops, lubricating eyedrops and antihistamine medication. Although it resolves quickly with treatment, Eye Allergies can recur with repeated exposure to allergens therefore limiting exposure to allergens is also important for best results.

Myopia cannot be naturally reversed. But we can definitely help to slow down its progression. It is important for parents to note that healthy lifestyle habits, outdoor play, and controlled screen time are essential in keeping the child’s myopia under control.

Diabetes is a condition in which the body is either unable to produce sufficient insulin or responds poorly to insulin leading to high levels of sugar in the blood.

Diabetes can lead to various health complications and cause eye diseases such as:

1. Diabetic Retinopathy (DR)
2. Cataracts
3. Glaucoma

Various treatment plans are available for advanced stages of DR

1. Laser treatment

• Focal / scattered laser creates laser burn in retina
• Reduces oxygen deprivation
• Prevents blood vessels from leaking/breaking
• Reduces the rate of worsening vision

2. Intra-vitreal injection

• Contains Anti-VEGF (vascular endothelial growth factor)
• Slows down the growth of new vessel
• Reduces the chances of bleeding
• Safe and demonstrates good results

3. Vitrectomy (Retinal Surgery)

• Performed only when visual recovery is slow or progression happening despite having laser treatment or injection done
• Decreases the chances of vision worsening
• Removal of accumulated blood
• Removal of scar tissue (if any) to prevent tractional retina detachment

The Macula is the small central part in our retina that allows us to see things sharp and clear. Age-related macular degeneration (ARMD) involves the deterioration of the macular due to aging. Vision impairment from damage to the macular is almost always irreversible.

Risk factors that can possibly cause ARMD:

• Positive family history
• Age above 60
• Obesity
• Smoking

ARMD patients have difficulty in doing simple daily tasks such as recognizing faces, reading, and even driving. Their central vision is lost, leaving only their peripheral vision to function. ARMD progresses slowly, showing almost no symptoms in the early stage. As it advances, some of the symptoms might present as blurring of central vision, distorted vision, loss of contrast sensitivity, and loss of certain areas of vision.

Floaters are caused by tiny debris floating in the eye, seen as either black or transparent dots or lines, most obvious against white or bright background.

The most common cause of floaters is aging. Changes in the vitreous (a jelly-like substance in the eye) over time, causes it to shrink and detach from the retina. This is termed “Posterior Vitreous Detachment (PVD)”. Floaters are commonly seen in a PVD and although it is not serious, it needs close monitoring to rule out associated retinal problems.

Patients who are more myopic and who have had eye surgery before have an increase chance of experiencing floaters and flashes. Flashes are experienced in the form of flashing lights or lightning streaks. These are usually more ominous and are may indicate a retinal tear/detachment.

A prompt consultation and a dilated eye examination with an Ophthalmologist is highly recommended, to check for a retina tear/detachment.

In cases where there is a sudden onset of many floaters and/or observing flashes of light more frequently than usual, contact your Ophthalmologist immediately. This could be a sign of a retina tear, bleed or detachment which are medical emergencies. It may require a laser or surgical repair as soon as possible to prevent permanent blindness.