Colour vision is important in our daily life in order to let us perceive better images about our living environment. Colour vision is the ability to discriminate between different colours. Our colour vision perception is also known as photopic vision, which is appreciated by cones cells. The cones cell is mainly located at the centre part of the retina, which is the fovea area. There are 3 primary colours sensed by the cones cell in fovea which are blue, red and green. Sensation of other colours such as white, yellow, orange, purple can be produced by mixing the 3 primary colours in different combinations.

3 Primary colours

Various tests that can be used to diagnose colour vision deficiency in our clinical field. The Ishihara chart is the most common and simple test that we always use to diagnose colour vision deficiency, especially red-green colour vision deficiency. Moreover, the Farnsworth D-15 hue test can also be used to diagnose colour vision deficiency. The Farnsworth Munsell 100 hue test was a more advanced test that we can know in more detail what exactly colour vision deficiency that the patient had. These are the common tools that we used to diagnose colour vision deficiency in the clinic.

Ishihara plate

Farnsworth D-15 hue test

Farnsworth 100 hue test

 

Basically, colour vision deficiency can be divided into 3 categories which are deutan, protan and tritan. Deutan patients mainly will have weakness in perceiving green colour or completely cannot perceive green colour, whereas protan is the patient having difficulty in perceiving red colour or completely cannot perceive red colour. Moreover, tritan mainly will cause patient difficulty in perceiving blue colour. Colour vision deficiency can be categorised as inherited or acquired. Acquired colour vision deficiency is usually caused by drug use or some ocular disease.

For your info, red-green colour vision deficiency is more common as compared to blue-yellow vision colour deficiency. However, male had higher risk compared to females to have colour vision deficiency as it is an X-linked disease. As male only have 1 X chromosome so if their mother passed the gene which is lack of colour vision, the son is likely to have colour vision deficiency. Females who have a father with colour vision deficiency has a 50% chance to transmit the disorder to their sons. The prevalence of colour vision deficiency worldwide is reported to be 8% in male and 0.5% in females. With early detection proper counselling can be done to the patient in order to adapt and have an idea on what is the suitable future pathway or profession that can be pursued. Hence, it is important for us to screen for colour vision deficiency especially in young male children as they have higher prevalence in getting inherited colour vision deficiency.

There are no available treatments for colour deficiency at the moment. However, there are special tinted lenses or contact lenses that can help the patient to have better perception of the colour. Early detection of colour vision deficiency since young children is vital in order to overcome the limitations such as future career pathways. We don’t treat colour vision deficiency people as disabled as they only have difficulty in differentiating colour, but the vision was usually normal. We can always provide guidance and advice for colour vision deficiency patients in choosing the right pathway or profession in the future. For acquired colour vision deficiency, we can treat the underlying problem in order to resolve the colour vision deficiency problem. Therefore, it encourages parents to bring their children to visit an eye specialist/ophthalmologist for a proper consultation which includes colour vision screening, especially for male children.

Corneal ulcer is an inflammation of the cornea secondary to infection. It will cause red eyes, pain, excessive tearing, blurred vision and light sensitivity. Corneal ulcer can be caused by bacteria, viruses, fungi and parasites. If left untreated or if infection is severe, corneal ulcer can lead to permanent damage of vision.

Bacterial keratitis

Bacterial infections are the most common cause of corneal ulcer. Most of the time Pseudomonas Aeruginosa, Staphylococcus species and Streptococcus species are responsible for this type of infection. Bacterial keratitis can develop quickly. There is a high risk of getting infection from long hours of wearing contact lenses or not taking care of them correctly. Thus, proper care of contact lenses will reduce the risk of developing a corneal infection.

Fungal keratitis

Improper use of contact lenses or steroid eye drops can lead to fungal infection. A corneal injury that results in plant material like being hit by a tree branch also will cause fungal keratitis which is mostly due to Fusarium or Aspergillus species. Candida species will typically cause keratitis in the eye with preexisting ocular surface disease or eyes that have recently been treated with topical steroid. Fungal keratitis is devastating, hard to treat and remains a common cause of blindness in tropical countries.

Herpes simplex keratitis

Herpes keratitis is a viral infection caused by herpes simplex virus. It may cause recurring attacks and be very contagious when contact with someone who has the virus. After primary infection, the virus lies in a dormant state, living in the nerve cell of the eye. It can be triggered by stress, trauma, fever or certain medications.
Acanthamoeba keratitis

Lastly, parasitic infection caused by Acanthamoeba is a rare, vision threatening corneal ulcer. Acanthamoeba is a microscopic, single-cell living organism and can be found in freshwater and soil. People who wear contact lenses develop higher risk of getting Acanthamoeba keratitis when they clean lenses with tap water, swimming while wearing contacts or contact with contaminated water. Early diagnosis and treatment of Acanthamoeba keratitis is essential to prevent loss of vision.

An ophthalmologist will be able to assess your eye and diagnose the type of corneal ulcer/infectious keratitis you have. All these conditions may cause severe pain and impaired vision. Therefore, corneal ulcer/infectious keratitis may need serious medical attention and should be treated immediately to prevent the conditions from worsening.

Astigmatism (散光 in Mandarin / ‘silau’ in Malay) is a common type of refractive error that can cause blurred or distorted vision. Other types of refractive errors are myopia (short-sightedness), hyperopia (long-sightedness) and presbyopia. Astigmatism is usually caused by an imperfection in the curvature of the cornea, causing a person to see images that are blur or not in focus at all distances.

If your cornea is almost perfectly round in shape, it is able to focus light onto a single point. However if both your cornea and lens is more oval than round, instead of focusing onto a single point, it focuses on multiple points on the retina (back of the eye). When the cornea or lens shape is highly irregular, a person may experience significant blur vision at all distances.

Who is at risk for astigmatism?

Astigmatism can affect both children and adults. It may be congenital, or present at birth due to the natural shape of the eye. In babies, astigmatism usually resolves by the first year of life. However, there are some children who do not outgrow astigmatism and this can negatively impact their learning and development. Thus, it is necessary to schedule for periodic eye examinations for children to detect astigmatism or other refractive errors. Parents who have been diagnosed with high astigmatism should get their child’s eye tested for severe astigmatism as it is believed to be hereditary. Some people can also develop astigmatism after an eye injury or surgery. Those with a family history of keratoconus (degeneration of cornea) should also get their eye tested for high astigmatism at an early age.

What are the symptoms of astigmatism?

The most common symptom of astigmatism is blurred and distorted vision at all distances. Many people with low astigmatism may not have any symptoms. Those with astigmatism of 0.75D and above will start to have noticeable symptoms. These signs and symptoms include headache, eye strain and squinting to see clearly. Astigmatism can also cause shadowing of images which makes letters appear double. Night vision can also be poor due to debilitating glare and halos around lights.

What are the treatment options for astigmatism?

If the astigmatism is mild, your eye care practitioner may suggest no treatment at all. If you have moderate to high astigmatism, corrective lenses either glasses or contact lenses are the most suitable treatment options. Eye glasses contain special cylindrical lens prescription to correct astigmatism. Both soft toric contact lenses and rigid contact lenses can correct astigmatism. For high astigmatism (above 3.00D), rigid gas permeable lenses may be a better option. Surgical treatments of astigmatism include refractive surgery by reshaping the cornea via TransPRK or implantation of ICL. If you have cataract in your eyes, a toric IOL can be implanted in your eye to simultaneously remove the cataract and correct astigmatism.

How is astigmatism diagnosed?

A comprehensive eye examination by an optometrist or ophthalmologist will help to diagnose astigmatism. Children who have astigmatism rarely report it to their parents. Therefore, parents should look out for signs and symptoms in their children such as eye rubbing, squinting to see things, moving closer to see things and closing of one eye. Regular eye examinations are important to maintain a high quality of life and productivity.

Hyperopia is also known as far-sightedness. It is a common type of refractive error that occurs when the light is focused behind the retina of the eye. Hyperopia affects near vision more, which means that distant objects can be seen more clearly than near objects.

There is a possibility that a combination of refractive errors can occur concurrently. For an example, hyperopia and astigmatism can occur in the same eye, or one eye can be short-sighted while the other is far-sighted. Hyperopia (rabun dekat in Malay) should not be confused with presbyopia (rabun tua in Malay) as they are not the same. Presbyopia is age-related and occurs when changes in the eye is less able to accommodate, and losing its ability to focus on close-up prints or objects. Hyperopia can occur at any age while presbyopia usually occurs over the age of 40.

Symptoms of Hyperopia/Far-sightedness

• Common symptoms of far-sightedness:
• Difficulty in seeing close-up objects
• Eye strain or eye tiredness
• Headaches, especially when doing close-up tasks
• Blurred vision
• Squinting
• Fatigue

These symptoms tend to be more obvious after doing some near work such as reading, computer use, mobile phone activity and so on. The symptoms can vary, depending on the prescription. For individuals with mild farsightedness, the symptoms may not be so noticeable. Regular eye examinations are important to ensure that your vision is optimal. Individuals with moderate or severe hyperopia, may notice their vision is blurred for near and distant objects.

Causes of Hyperopia

Hyperopia occurs when images are focused behind the retina. From an anatomical standpoint, it is seen in eyes that are shorter. The cornea also plays a major role. If the cornea is too flat or less curved than normal, it might also cause images to fall behind the retina.

There is a genetic component involved with hyperopia, so most hyperopic individuals are born with a preponderance for it. Studies show the refractive errors are primarily influenced by multiple genes, so if a direct family member such as a parent or sibling is hyperopic, there is an increased likelihood of developing hyperopia. External factors such as lifestyle and diet may also influence changes.

Treatment

In young individuals, treatment may not be necessary because the natural lenses in the eyes are flexible enough to accommodate and compensate for mild to moderate degrees of hyperopia. The common management for hyperopic individuals is with glasses or contact lenses

• Glasses -This is the most direct, simple and safe way to improve vision caused by hyperopia. There are different types of lenses such as those for single vision, bifocal lenses and progressive multifocal lenses.
• Contact lenses. Soft clear lenses are worn on the eyes. They are available in a variety of materials and designs such as soft and Rigid Gas Permeable (RGP) lenses. They are available in monofocal or multifocal designs. There are contact lenses that correct hyperopia and astigmatism as well.

For individuals who prefer to be glasses-free and not rely on any glasses or contact lenses:

Orthokeratology lens (Ortho-K):

Ortho-K is the fitting of a customized rigid gas permeable (RGP) lens that is worn overnight. While the individual sleeps with the RGP lenses on, the lenses will gently reshape the front surface of the eye known as cornea. Clear vision can be achieved the following day upon removal of the lenses. Ortho-K can lenses only correct low degrees of hyperopia.

Refractive Lens Exchange (Cataract surgery):

This procedure involves removing the natural lens in the eye and implanting an artificial lens that corrects the hyperopia. This procedure usually applies to individuals who are above 40 years old, around the time when cataracts may start to develop and presbyopia sets in. Following a refractive lens exchange, individuals will not require cataract surgery in the future.

Laser Refractive Surgery

Laser surgery is done by reshaping the curvature of the cornea using a low energy laser machine. It is a good option for patients with hyperopia including PRK, TransPRK, and LASIK. TransPRK is a no touch ‘LASIK’ and bladeless treatment which is able to treat up to +6.00D of hyperopia.

Did you ever know what you consume or eat does not just affect your body shape, weight and health? In fact, an individual’s diet can also impact their eye health and cause some irreversible damages.

Does too much salt affect your eyes?

Salt is important and essential in almost every recipe to make it tasty, but did you know the high level of sodium can increase the risk of having high blood pressure. Salt will not only bloat our body and affect our body tissues, it will also lead to the restriction of blood flow to our eyes when the blood pressure is high.

Hypertension due to raised systemic blood pressure (BP) both diastolic and/or systolic is associated with stroke, cardiovascular, renal or ocular disease. Researchers have shown high blood pressure as a significant risk factor for glaucoma progression. Glaucoma is a common blinding disease which is due to damage to the optic nerve and raised intraocular pressure. Therefore, too much salt can increase overall blood pressure and lead to an increase of intraocular pressure.

Is it too sweet for the eyes?

Diabetes is a disease that occurs when the blood glucose levels are too high and people living with diabetes are at greater risk of developing eye problems. When the body does not produce enough insulin or does not produce any insulin, it will remain in the blood and not reach any cells causing an increase of glucose in the blood. Diabetes damages the blood vessels all over the body.

Diabetic retinopathy is the most common diabetic eye condition. It damages or changes your eyes by blocking the tiny blood vessels that go to the retina and lead to swelling or bleeding. In some serious conditions, the new blood vessels may grow on the surface of the retina. Diabetes retinopathy can appear in patients with either Type 1 or Type 2 and if the condition is left untreated, there is a chance to cause blindness.

The long term result of having diabetes can result in developing a cloudy substance in the lens which is known as cataract. Cataract develops for multiple reasons and most commonly is age-related whereas diabetes also increases the risk of getting cataract. The risk of developing cataract in diabetes patients is caused by the changes of tissues in the eyes that make up the eye’s natural lens.

In conclusion, poor diet control will be a risk for the health of your eyes. However, you can prevent and lower the risk of developing eye problems by just making a few changes to your diet. Having a healthy and well-balanced diet that includes lots of fruits, vegetables and lean proteins is important for most people to get the right nutrients for eye health. Those with vision problems and those with very restrictive diets should talk to an eye professional about the right foods to eat for their eye condition. An eye health professional can help you create a diet that suits you and reduce the chances of developing age-related eye diseases.

Kelopak mata adalah lipatan kulit yang berada di atas dan bawah mata. Pada kelopak mata pula terdapat bulu mata yang mana keduanya-duanya berfungsi untuk melindungi mata daripada kecederaan dan benda asing, cahaya berlebihan serta membantu dalam penyebaran air mata yang dihasilkan oleh kelenjar air mata.

Pemakaian maskara dan penggaris mata (‘eyeliner’) adalah untuk serlahkan kecantikan mata anda. Namun begitu, mungkin tidak terlintas difikiran anda bahawa penggunaan solekan mata boleh menyebabkan jangkitan kuman berlaku pada kelopak mata seterusnya menyebabkan keradangan dan gangguan penglihatan. Menurut FDA, alat solekan adalah selamat daripada pencemaran ketika anda membelinya, namun setelah beberapa kali penggunaanya kemungkinan kuman yang berada pada kulit anda boleh merebak dan membiak pada alat solekan. Oleh itu, anda digalakkan untuk kerap menukar alat solekan dan ianya sangat penting bagi mengelakkan jangkitan kuman berlaku.

Simptom-Simptom Radang Mata

• Mata merah dan berair
• Mata rasa sakit dan bengkak
• Sensitif terhadap cahaya
• Kabur penglihatan

Jenis-Jenis Infeksi/Radang Mata

• Radang luaran mata – Ketumbit adalah bisul kecil hasil daripada jangkitan kuman ke atas akar (folikal) bulu mata
• Radang luaran mata – ‘Conjunctivitis’ adalah radang konjunktiva yang disebabkan oleh jangkitan kuman seperti bakteria dan virus
• Radang kelopak mata – ‘Blepharitis’ adalah keradangan kelopak mata disebabkan kelenjar minyak kecil berhampiran pangkal bulu mata tersumbat
• Radang dalam mata – ‘Endophthalmitis’ adalah radang serius pada bahagian dalam mata disebabkan oleh kuman

Memang tidak dapat dinafikan lagi bahawa solekan dan wanita tidak dapat dipisahkan. Ianya merupakan rutin harian bagi kebanyakan wanita di seluruh dunia. Oleh itu, berikut adalah langkah-langkah mudah dan penting bagi anda untuk mengelakkan masalah mata yang tidak diingini.

Petua Menggunakan Solekan Mata Dengan Selamat

1. Elakkan penggunaan alat solekan yang sudah tamat tempoh kerana ianya meningkatkan risiko jangkitan disebabkan pembentukan kulat dan bakteria. Walaupun kebanyakan alat solek mengandungi bahan pengawet, bakteria masih boleh terbentuk. Sekiranya anda tidak pasti jangka hayat sesuatu produk, anda dinasihati supaya buang selepas 3 bulan penggunaannya.
2. Bersihkan solekan mata sebelum tidur. Ini adalah penting untuk mengelakkan pengumpulan solekan pada kawasan kelopak mata yang boleh menyebabkan radang mata.
3. Elakkan memakai solekan pada tepi kelopak mata. Tepi kelopak mata anda (margin kelopak mata, berhampiran tempat bulu mata anda tumbuh) mengandungi kelenjar minyak (kelenjar meibomian). Kelenjar ini menghasilkan komponen berminyak yang berfungsi mengekalkan kelembapan mata. Penggunaan solekan pada tepi kelopak mata boleh menyebabkan kelenjar pada kawasan tersebut tersumbat, lalu menyebabkan masalah mata kering dan tidak selesa.
4. Elakkan berkongsi alat solek. Berkongsi alat solekan adalah berbahaya kerana ianya boleh meningkatkan risiko penularan jangkitan yang boleh menyebabkan konjunktivitis.
5. Baca label dan elakkan bahan berbahaya. Sebelum anda membeli sesuatu produk solekan, pastikan anda membaca dan mengenalpasti kandungan yang digunakan. Terdapat sesetengah bahan yang digunakan berbahaya untuk kulit dan boleh meningkatkan risiko kanser.

Kesimpulannya, pemakaian dan pengamalan teknik membersihkan solekan yang salah berisiko membahayakan mata anda. Sekiranya mata anda mengalami kemerahan, kesakitan, tidak selesa, atau kabur penglihatan, hentikan penggunaan solekan mata dan dapatkan rawatan dengan pakar mata secepat mungkin.

Ketumbit adalah benjolan kecil pada kelopak mata. Terdapat dua jenis ketumbit iaitu ‘stye’ (hordeolum luaran) dan chalazion (hordeolum dalaman). Jadi, apakah perbezaan antara mereka? Stye adalah benjolan kecil berpunca daripada jangkitan kuman ‘staphylococcus aureus’ yang menyebabkan kelopak mata menjadi bengkak, kemerahan dan sakit. Chalazion pula berpunca daripada kelenjar bulu mata tersumbat dan menyebabkan bengkak, tetapi tidak sakit. Namun begitu chalazion jarang menyebabkan bengkak pada keseluruhan kelopak mata.

Anda lebih berisiko untuk mendapat ketumbit sekiranya anda:

1. Kerap menggosok mata tanpa membersihkan tangan terlebih dahulu
2. Tidak membersihkan kelopak dan bulu mata terutamanya selepas menggunakan kosmetik
3. Blepharitis, sejenis radang sekeliling tepi kelopak mata
4. Mempunyai masalah kesihatan, terutamanya pesakit kencing manis

Bagaimanakah cara untuk anda menyembuhkan ketumbit?

Biasanya, ketumbit akan hilang dengan sendiri tanpa memerlukan rawatan. Ianya juga boleh dirawat di rumah dengan melakukan tuaman suam pada ketumbit beberapa kali sehari. Sekiranya tidak sembuh, antibiotik akan diberikan terlebih dahulu. Namun begitu, dalam kes yang lebih teruk, pembedahan kecil mungkin diperlukan untuk merawat ketumbit. Harus diingatkan juga, ketumbit boleh terjadi berulang kali. Oleh itu, kebersihan kawasan mata seperti kelopak dan bulu mata adalah sangat penting bagi mencegah ketumbit.

Cara-cara tuaman suam (warm compression) adalah:

1. Menggunakan sehelai sapu tangan atau kain yang bersih
2. Rendam dalam air separuh panas dan perah sehingga air tidak menitis
3. Letakkan di atas kelopak mata dengan mata tertutup selama 10 minit
4. Ulang 2-3 kali sehari mengikut nasihat doktor anda

Cara-cara untuk membersihkan bulu mata

1. Campurkan sedikit air bersih dan beberapa titis syampu bayi dalam bekas kecil
2. Celup putik kapas ke dalam campuran tadi dan kesat bahagian kelopak mata yang secara lembut dengan putik kapas tersebut. Elakkan daripada terkena bahagian kornea
3. Lakukannya 2-3 kali sehari
4. Sekiranya kelopak mata terlalu kotor dan berkeruping, lakukan tuaman suam dulu agar keruping menjadi lembut dan senang untuk dibersihkan

Walaupun ketumbit tidak berbahaya kepada penglihatan, tetapi ia boleh menyebabkan ketidakselesaan dan menjejaskan penampilan diri seterusnya akan mengganggu aktiviti seharian anda. Oleh itu, sekiranya keadaan masih tidak bertambah baik selepas beberapa hari atau seminggu, sila berjumpa dengan doktor untuk mendapatkan rawatan selanjutnya.

Transepithelial PhotoRefractive Keratectomy (TransPRK) is the latest technique of laser refractive surgery. TransPRK may be known to some as No Touch LASIK, No Touch Laser Epi-LASIK, SmartSurface PRK or Transepithelial Surface Ablation (TESA). Like any medical procedure, you will have to undergo a series of tests and scans to determine if you are suitable for TransPRK laser refractive surgery.

Here are a few things you may expect during your initial consultation at OasisEye Specialists.

1. You will need to stop wearing contact lenses for a short period prior to the eye examination

It is important to remove contact lenses for a certain period before your initial consultation. Contact lenses will mould our cornea and change the corneal curvature, which might lead to a change in your eye power and cornea measurements. In order to calculate your actual refractive error (eye power) for the TransPRK treatment, you will have to stop wearing contact lenses for a specific period. This step is crucial for the cornea to return to its natural shape and curvature to avoid inaccurate measurements.Before the eye examination or the procedure, it is recommended to stop wearing soft contact lenses for at least 5 days, and at least 10 days for rigid gas permeable (RGP) or Orthokeratology (Ortho-K) lenses.

2. TransPRK suitability eye examination

The first eye examination will take about 2 hours to complete as you will go through a comprehensive eye examination and counselling with an optometrist and eye surgeon. The eye examination results will help surgeons to determine if you are a suitable candidate for refractive surgery. The pre-operative assessment consists of diagnostic analysis of your cornea, measurement of your refractive error (eye power), dry eyes evaluation and ocular health evaluation.First, an optometrist will take your corneal measurements with a corneal topographer. Then the optometrist will check your vision and perform eye power measurements (refraction). The optometrist will test your eyes with different lenses and determine the power needed to correct your vision. The optometrist will discuss your refractive surgery options available based on the measurements taken.Lastly, a surgeon will examine your cornea, retina and optic nerve to ensure your eyes are healthy. The surgeon will discuss the surgery procedure, risks and benefits of the surgery with you if you are suitable for TransPRK. Do not hesitate to ask any questions before deciding to go through the surgery. You will given the opportunity to raise any concerns during the discussion.

3. Dilation of pupils may be performed

Dilation of pupils may be performed during the initial consultation. The dilation drops relaxes your focusing eye muscles for the optometrist to measure your final eye prescription and aids the surgeon to evaluate your retina. After the dilation, your eyes may be sensitive to light and your vision will be blurry, particularly at near distance for a few hours. Thus, do bring a pair of sunglasses for your comfort. It is also advisable not to drive on that day.

4. Bring a pair of sunglasses on your procedure day

After your surgery, your eyes may be tearing and sensitive to light. Wearing a pair of sunglasses will help with the glare and protect your eyes from dust and foreign particles. You are encouraged to cultivate a habit of wearing sunglasses when outdoors for the next few months after your treatment. Get a pair of good sunglasses with UV400 protection to protect your eyes from harmful UV rays. Polarized sunglasses help reduce glare and reflection off surfaces. Larger and wraparound sunglasses help protect our eyes from foreign particles.