Benefits of TransPRK

Transepithelial Photorefractive Keratectomy (TransPRK) is a touch-free laser eye correction for refractive errors such as short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism.

To date, the touch-free, single step TransPRK can only be performed with SCHWIND Amaris laser. With other lasers, two laser steps are required to perform TransPRK, one to remove the corneal epithelium and then to perform the refractive correction. Unlike the other refractive surgeries, TransPRK is the new one-step incision free procedure. The SCHWIND Amaris laser removes the epithelium and treats the refractive error without suction, flap or blade. This touch-free procedure is non-invasive, safe and gentle to the eye. The result of this technique is higher quality vision and faster healing.

Laser is applied to on the surface cornea epithelium. Laser is continuously applied to correct the refractive error.

The resultant cornea is flatter, thinner, and refractive error is treated.

TransPRK is the newer version of Epi-LASIK. In Epi-LASIK procedure, a fine blade is used to remove the corneal epithelium cells. Due to the advancements in technology, TransPRK surgery can now offer patients a one step, no touch procedure with the use of the SCHWIND Amaris laser. Using the TransPRK, the surface epithelial cells will first be removed with the excimer laser, and then proceed immediately with the same laser to reshape the cornea for the refractive correction. TransPRK is safer, more accurate and gives consistent predictable results.

After surgery, eye drops will be prescribed to aid in the healing and to prevent infection. A special contact lens is worn to promote healing and protect the cornea as well as to minimize the discomfort. The epithelium will heal in usually 3 to 5 days and once the epithelium is healed, the contact lens is removed to prevent mucus and bacteria from sticking onto the contact lens. TransPRK is able to provide long term vision correction for a wide range of refractive errors. Patients no longer have to rely on their glasses or contact lenses for clear vision. This procedure is suitable for those who are above the age of 18 and with a stable eye refraction (‘power’).Benefits of TransPRK

1. Corrects vision without the need to cut a flap on cornea and without a blade

Treatment for TransPRK is done directly on the upper surface of the cornea. Hence, there are no cut or flap-related complications as compared to LASIK. TransPRK has been introduced as a form of laser surface ablation and it is non-invasive. It is a no blade surface based procedure so it is a safer procedure that is suitable for almost everyone.

2. TransPRK can be the second chance for patients with thin cornea or patients who have had complications from other refractive surgeries.

If you have thin cornea, you may already have been rejected for the LASIK procedure. TransPRK can be your second chance to regain clarity to your unaided vision. Scars from LASIK and Epi-LASIK complications can be treated with TransPRK. TransPRK is ideal and recommended for many cases of enhancement even in previous LASIK and Epi-LASIK.

3. Fast

TransPRK is done in just one step procedure. The epithelium is removed and the refractive correction is performed in a single laser step. The shorter the treatment time, the risk of corneal dehydration is minimized, resulting in a lower risk of post-operative dry eyes. Due to the small wound area, the healing process is faster than the older methods.

4. Versatile

Due to its tissue saving laser profile, TransPRK is suitable for almost all laser refractive candidates wishing to see clearly. It is ideal for active and athletic people and for professions where sharp vision is needed.

What is Presbyopia?

Presbyopia is a common type of vision disorder that causes a gradual loss of ability to focus on near objects. It’s a natural aging process of the eyes. Presbyopia usually becomes noticeable in the early to mid-40s and continues to worsen until around age 65. Individuals begin to have trouble focusing up close and may hold books or newspapers at arm’s length to be able to read them including text messages on their phone.

Symptoms

Presbyopia develops gradually. These signs and symptoms may first be noticed after the age of 40:

  • Trouble seeing things-up close/ blurred vision at normal reading distance
  • Holding the reading material farther away to make the letters clearer
  • Difficulty reading in less bright conditions
  • Eyestrain or headaches after reading or doing close-up work

What causes presbyopia?

When an individual is younger, the lens of the eye is soft and flexible, allowing the tiny muscles inside the eye to easily reshape the lens to focus on close and distant objects. Presbyopia occurs when the age-related changes within the proteins in the lens causes gradual thickening and loss of flexibility of the natural lens inside the eye. As well, age-related changes also take place in the muscle fibers surrounding the lens. With less elasticity, it becomes difficult for the eyes to focus on close objects.

Treatment for presbyopia

In early stages of presbyopia, some simple habit changes can be made to help on reading, like:

  • Holding the reading materials farther away
  • Choosing large-print books or increasing font size on the electronic devices
  • Using brighter reading lights

As your presbyopia worsens, glasses or contact lenses are needed to help with reading. Some people use over-the-counter reading glasses, or an eye care professional can prescribe spectacles to help you see as clearly as possible.

Reading glasses

Eyeglasses are a simple, safe way to correct vision problems caused by presbyopia.  Reading glasses helps to correct close-up vision problems by bending light before it enters the eye. They can be bought without a prescription, but the accurate power of reading glasses that are needed should be determined from an eye examination. Most non-prescription reading glasses range in power from +1.00 diopter (D) to +3.00 D.

If prescription corrective lenses are required for other vision problems such as short-sightedness, long-sightedness or astigmatism, then bifocals, trifocals, or progressive lenses might be needed to obtain a clear vision for distance and near.

  • Bifocals can correct close-up and far vision. These lenses have a visible horizontal line that separates the prescription. The top portion refracts light to allow you to see distant objects and the bottom of the lens refracts light for close up vision.
  • Trifocals have three portions to correct for close-up, middle distance and distance vision. Trifocals come with two visible horizontal lines in the lenses.

     

  • Progressive multifocal lenses correct vision like bifocals and trifocals, but instead of a line that divides each refractive area, different areas of the lens have different focusing strengths. The upper portions usually corrects distance vision, middle portion corrects intermediate vision (computer distance), while lower portions corrects near vision.

     

Contact Lenses

There are two types of contact lenses that help presbyopia:

  • Monovision contact lenses. Monovision can be achieved by wearing a contact lens for distance vision in one eye (usually the dominant eye) and a contact lens for close-up vision in the other eye. Monovision requires some adaptation time and train the brain to receive images from different eyes to fuse into a single clear image.
  • Multifocal contact lenses. These lenses have several rings or zones set at different powers. With this design, both near and far vision are obtained at the same time. However, the brain learns to automatically select the right focus for what we want to see. This could make the vision with a multifocal lens less sharp than using a monofocal lens.

Surgery

Refractive surgery. Some people decide to have surgery to achieve monovision. For presbyopia, this treatment can be used to improve close-up vision in the non-dominant eye. Using a laser, the cornea is reshaped for clear far vision in one eye and close-up vision in the other. This is like wearing monovision contact lenses but refractive surgery is an irreversible procedure. Refractive surgical procedures include: Conductive keratoplasty, Laser-assisted in situ keratomileusis (LASIK), Laser-assisted subepithelial keratectomy (LASEK) and Trans-epithelial Photorefractive Keratectomy (TransPRK). Implantable Collamer Lens (ICL) is a refractive procedure which is reversible.

Corneal inlays. Tiny devices known as corneal inlays, can help correct presbyopia. It involves inserting a small plastic ring with a central opening, into the cornea of one eye. The opening acts like a pinhole camera and allows in focused light so that you can see close objects. Corneal inlay is a reversible procedure, eye surgeons can remove the rings if the result is not satisfied.

Macular Hole

Macular hole occurs when there is a tear or hole that develops in the central part of your vision known as the macula. Macula is the small area of the retina where light is sharply focused which allows you to see colour and detailed vision. The common symptoms of a macular hole are distortion of vision (straight lines appear wavy), blurred vision or a dark spot in your central vision. You may not notice these symptoms with both eyes open. You should close one eye (better eye) and then you will notice straight lines appearing wavy and also a dark spot in the center of your vision. It is important to schedule an appointment with an Ophthalmologist as soon as possible if any of these symptoms occur. A special imaging test known as optical coherence tomography (OCT) which gives a cross sectional view of the retina will be performed by your eye doctor to diagnose the macular hole.

Age is the most common cause for macular hole. As you get older, the vitreous starts to shrink and pull away from the retina. Usually the vitreous pulls away without causing any problems. Sometimes, the vitreous can stick to the retina and this causes the macula to stretch and a hole to form.

Treatment for macular hole

The treatment for a macula hole is by a surgery known as vitrectomy. Vitrectomy surgery is done by making three incisions into the sclera. The first incision is to make a hole for the infusion cannula where fluid is injected into the eye to keep the eyeball in shape. The second incision is for the light pipe to allow surgeons to see inside the eye. The last incision is for the vitrectomy cutter where it functions to remove and suck out the vitreous jelly from the eye. Vitrectomy is done by removing the vitreous jelly inside the eye that is pulling on your macula and filling the eye with a gas bubble. The bubble helps to flatten the macula hole and hold it in place until the eye heals. You should not fly or go uphill with a gas bubble in the eye until the gas dissipates on its own and is replaced by natural eye fluids. You will need to maintain a face-down position for several days to keep the gas bubble in place and help close the hole.

The complications of vitrectomy surgery are rare. Some complications include infections, bleeding, retinal detachment or recurrence of a macula hole. These complications can be easily treated. This operation is successful about 90-95% to close the hole. However, as the retina is a nerve tissue, it can take quite a few months to heal completely. People who have had a macular hole in one eye have about 10-15 percent chance of developing a macular hole in another eye over a lifetime. If you have symptoms such as blurred or distorted vision, do consult your eye care professional immediately. A relatively early treatment may give a better outcome in terms of improvement in your vision.

Differences: Pinguecula vs Pterygium

Pterygium and pinguecula are conjunctival growths that form on the surface of the eye. Both are not dangerous and will not cause blindness. In the early stage, there is no effect on vision and the main concern is cosmetic appearance, So what’s the difference between them?

Pterygium is the fleshy triangular mass that extends to the cornea while pinguecula is the yellowish elevated bump or lump that does not grow across the cornea. Pterygium can be a lot more obvious as it grows onto the clear surface of the cornea. It is also known to change the shape of the cornea causing changes in vision which is an increase in astigmatism. Pterygium may grow over a period of months to years until it covers the cornea, only then it will interfere with vision. Pinguecula usually develops on the side of the eye and doesn’t typically grow to a bigger size. Pinguecula does not typically harm your vision.

What causes these growths?

Both are caused by extended exposure to ultraviolet (UV) light (sunlight), wind and dust. They occur in people who spend more time outdoors, especially in hot, dry and sunny climates. The risk is also increased by not wearing sunglasses or a hat. People whose jobs expose them to UV light such as fishermen, farmers and contractors are also prone to develop this eye condition. Sailors, surfers and skiers are also more prone to develop pterygium as they encounter high levels of reflected UV light.

What do you feel?

Most people don’t feel anything. However, some people will experience foreign body sensation, grittiness and irritation in their eyes due to interference with the tear film. These symptoms are most difficult for contact lens wearers as the contact lens may not fit very well on the eye due to the uneven eye surface. Pinguecula and pterygium may occasionally get inflamed, and this will cause more discomfort, redness and grittiness. Furthermore, if the pterygium extends to the cornea, the curvature of the cornea will change and will cause some visual disturbance such as glare and blurred vision.

How are pterygium and pinguecula treated?

Once either one has formed on the eye, they will not go away by itself. An Ophthalmologist will do a full eye examination and determine the appropriate management for the pterygium and pinguecula. Lubricant eye drops can be prescribed to reduce irritation and discomfort and provide relief. Pterygium can remain small or will grow until extending towards the pupil.

It is important to have regular eye exams to monitor the progression of the pterygium. If eye drops do not help relieve symptoms and when a pterygium is large enough to interfere with vision, a pterygium removal surgery may be necessary to help restore vision. Unlike pterygium, pinguecula will not grow across your cornea, therefore surgery is not usually necessary. However, in some cases pinguecula can develop into a pterygium and affect vision.

How to prevent it?

Polarized sunglasses or hats with wide brim when outdoors can help to prevent and slow the progression of these types of tissue growth. People that work under exposure to sunlight can use appropriate protective eye equipment in work environments. Try to avoid exposure to environmental irritants such as smoke, dust, wind, and chemical pollutants. Protect your eyes from dust by wearing spectacles or goggles. It is also recommended to use artificial tears if you are exposed to dry conditions.

Floaters and Flashes

What are floaters?

Have you ever noticed little tiny black dots in your vision? These are usually called floaters in layman’s terms. Floaters are usually more noticeable in a bright environment or a bright blue sky on a sunny day. Floaters can come in different shapes such as little dots, circles, lines, clouds or cobwebs. It may be of a sudden onset and it is usually due to the vitreous which is the jelly inside your eye shrinking due to age. This process occurs especially when you’re growing older or if you’re very short sighted (myopia) then you would get it earlier. However, it can come about in other conditions as well such as in diabetes and when you have an infection or inflammation in your eye. In most people this is an innocuous or relatively minor problem that happens as you get older.

Floaters are normal and a common part of aging. However, at least 1 percent of the time, the shrinking of the vitreous or the jelly may happen. It starts from peeling off your retina. The retina is a thin layer inside your eye that is full of nerve tissues which is like the film in a camera and is what you use to see things. Now if this jelly shrinks and pulls on your retina too hard, it can sometimes cause a tear. If there is a tear, you will need treatment for it. The incidence of this is about 1 percent so most of the time nothing needs to be done. However, we also need to rule out other problems such as infection or inflammation or perhaps bleeding in the eye. While floaters are typically harmless, if it appears suddenly and accompanied with flashes of light or impaired vision, it can signal a potential serious eye problem.

What are flashes of light?

Flashes look like flashing lights or lightning streaks in your field of vision. Flashes happen when the vitreous pulls on the retina. In younger people, the gel inside the eye (vitreous) is firmly attached to the retina. As you get older, the vitreous gel becomes more liquid and slowly collapses away from the retina. Flashes can be a symptom of a retinal tear or retinal detachment. A retinal tear is a break in the retina while a retinal detachment is when the vitreous pulls away, creating a break and fluid from the vitreous gets behind the retina causing blurred vision. These are serious conditions that can damage your sight. Flashes are usually seen in people as they age or those with migraines. Flashes can appear on and off for several weeks or months. Flashes that are caused by migraine usually happen among the younger people. When you have a migraine it causes flashes that look like jagged lines or heat waves. This can occur in one or both eyes and can last up to 20 minutes.

Treatment

Treatment of floaters and flashes depends on the underlying condition. A thorough eye examination by an Ophthalmologist will determine if there are any damages to the retina. While some floaters will remain in your vision, many of them will fade over time and cause less problems. However, for large floaters that obstruct daily tasks, a vitrectomy surgery can be performed to remove the vitreous gel inside the eye and will be replaced with a bubble of air or gas. The gas will disappear over time and will be replaced with a clear fluid produced by the eye.

What can you do about floaters and flashes in your eye?

It is important to take care of your eyes as you age. If you notice occasional eye floaters or flashes in your vision is not something you should worry about. This is normal and often happens when you age. An increased number of floaters in your vision or flashes should be a call for an emergency. When this occurs, it is wise to see an Ophthalmologist immediately to avoid any vision loss. Make an appointment to see an Ophthalmologist if you experience any of the warning signs below:

  • A new onset or increase in floaters or flashes of light
  • A sudden increase in size and number of floaters
  • A sudden change or decline in vision

Mata berkedip sebelah – Normal atau Tidak?

Pernahkah anda mengalami mata berkedip dengan sendiri? Ianya berkedip berulang kali dan tidak dapat dikawal. Biasanya ia terjadi pada kelopak mata atas, namun ada juga yang mengalami pada kelopak mata bawah. Mata berkedip (eye twitching) atau dalam bahasa saintifiknya myokymia adalah kekejangan otot pada kelopak mata. Kebiasaannya berlaku beberapa saat dan akan hilang dengan sendirinya. Ianya tidak menyakitkan malah tidak juga mendatangkan bahaya tetapi situasi ini mengganggu dan menyebabkan ketidakselesaan kepada individu yang mengalaminya. Walaubagaimanapun masalah ini mungkin menjadi tanda awal bagi penyakit kronik sekiranya kekejangan kelopak mata tersebut melibatkan waktu yang lama atau pergerakan yang tidak terkawal pada bahagian muka yang lain.

Antara punca terjadinya mata berkedip (eye twitching)

  • Tekanan mental dan keletihan
  • Pengambilan kafein/alkohol
  • Mata kering
  • Menghadap skrin komputer/telefon/buku terlalu lama

Kadangkala keadaan mata berkedip tanpa henti boleh menjadi tanda masalah yang lebih serius seperti:

  • Radang pada kelopak mata (Blepharitis)
  • Kekejangan pada otot mata (Blepharospasm)
  • Kekejangan otot muka (Facial spasm)

Walaubagaimanapun, ada sesetengah individu mengalami kesan sampingan daripada masalah ini. Antaranya ialah:

  • Kelopak mata jatuh (Ptosis)
  • Penglihatan berganda (Diplopia)
  • Kabur penglihatan
  • Mata berair yang berlebihan

Oleh itu, sekiranya anda mengalami kesan sampingan seperti ini, dapatkan rawatan daripada doktor pakar mata secepat mungkin.

Cara atasi mata berkedip (eye twitching)

Mata berkedip biasanya hilang sendiri tanpa rawatan. Anda boleh mengelaknya daripada kerap berlaku dengan mengatasi punca-punca masalah ini seperti:

  1. Mendapatkan rehat dan tidur yang mencukupi
  2. Kurangkan pengambilan kafein/alkohol
  3. Minum air secukupnya, tingkatkan kekerapan kedipan mata dan menggunakan titisan air mata tiruan jika perlu untuk masalah mata kering
  4. Hadkan masa semasa menggunakan komputer, telefon atau membaca

Sekiranya blepharospasm terjadi, rawatan suntikan botulinum toxin (botox) boleh digunakan bagi meredakan kekejangan. Manakala untuk kes blepharospasm yang teruk pembedahan akan dilakukan.

Dry Eyes

Are your eyes red and tired at the end of the day? Does your vision become blurry after long hours of screen time? These are common complaints of a patient with dry eyes. The recent COVID-19 pandemic in the past year has kept people indoors for work purposes and many are seeking treatment for dry eyes. Dry eyes is a condition when a person doesn’t have enough quality of tears to lubricate and nourish the surface of the eye.

The tear film

Tears are important in maintaining the health of the front surface of the eye and providing clear vision. The tear film consist of three layers which are:

  1. The outer layer of the tear film is the oil or lipid layer which serves to maintain tears on the surface and avoid evaporation. The oil is produced by the meibomian glands at the eyelid margins.
  2. The middle layer is the aqueous layer which makes up most of the tear layer. It consists of water and proteins that are produced by the lacrimal gland. It functions to lubricate the eye and wash away foreign particles.
  3. The innermost layer is the mucin layer that allows the even distribution of the tears on the surface. Without the mucus layer, tears would not stick to the eye surface.

Types of dry eye

  1. Evaporative dry eye is due to tears being dried up quickly. This is caused by inflammation or blocked meibomian glands. These blocked glands cause reduced secretion of oil that leads to quick evaporation of tears.
  2. Aqueous deficient dry eye may be due to aging. The tears are produced by the lacrimal gland in the eyelids. As you grow older, certain medical conditions and side effects of medications can cause less amount of tears to be produced by the gland.

Symptoms of dry eyes

  • Below are the common symptoms experienced by those who have dry eyes.
  • Redness and eye pain
  • Stinging or burning sensation
  • Sandy or gritty sensation
  • Light sensitivity
  • Watery eyes
  • Heavy eyelids
  • Stringy mucus near the eye
  • Blurred vision

There are also some circumstances that can worsen dry eyes.

  1. Environmental changes such as windy, dusty or dry conditions can make dry eye symptoms worse. Any place with low humidity or high wind such as air-conditioners can cause the eye to dry faster.
  2. Activities such as computer or handphone use for extended periods of time can cause less blinking and lead to greater tear evaporation and dryness.
  3. Certain medications can cause dry eyes as a side effect which include antihistamines, antidepressants, certain blood pressure medications such as beta-blockers and birth control pills.
  4. LASIK and other corneal refractive surgery can sometimes cause dry eye and is usually temporary and resolves within a few weeks after the procedure.
  5. Mask-induced dry eye is also common nowadays especially worn for protection during the Covid-19 pandemic. A mask with poor fitting can cause the air we breathe to flow up across the surface of the eye and lead to evaporation and dryness.
  6. Contact lens associated dry eyes are also common among contact lens wearers as the contact lens can partially block oxygen from entering the eye. Although many contact lenses are able to allow larger amounts of oxygen to permeate the eye, the wearers can still experience dry eyes towards the end of the day.

Treatment for dry eyes

Dry eyes can be managed successfully and result in greater comfort, fewer dry eye symptoms and sometimes even sharper vision. Treatment usually depends on the root cause of your symptoms. Eye drops known as artificial tears can be used to moisturize the eyes and provide a relief for dry eyes. People with dry eyes that do not respond well to artificial tears will need to take additional steps to address their dry eye condition. One revolutionary non-invasive dry eye treatment available is Tixel, which uses thermal energy around the eyes to improve the quality of tears, hence reducing dry eye symptoms.

Degenerasi Makula Berkaitan Usia (ARMD)

Degenerasi makula adalah penyakit yang berkait rapat dengan usia. Penyakit ini disebabkan oleh kerosakan pada bahagian makula.

Makula adalah satu kawasan kecil di bahagian tengah retina yang memiliki banyak sel penglihatan. Punca utama degenerasi makula kering masih tidak dapat dikenalpasti. Tetapi penyelidikan menunjukkan ianya mungkin dipengaruhi oleh faktor genetik dan factor persekitaran, termasuk merokok, obesiti dan diet. Apabila umur semakin meningkat, bermula pada usia 55 tahun dan keatas sesetengah berlakunya perubahan negatif pada makula. Kekurangan zat juga menyebabkan sel-sel di makula rosak dan tidak dapat berfungsi dengan baik. Perubahan ini menyebabkan penglihatan menjadi kabur sehingga menjadi buta.

Jenis-jenis Degenerasi Makula

  1. Degenerasi Makula Kering
    Lapisan makula menipis dan terbentuk mendapan lemak berwarna kuning yang dikenali sebagai “Drusen’. Kebiasaannya pada peringkat ini penglihatan akan terjejas apabila bilangan “drusen” semakin banyak dan saiz semakin besar.
  2. Degenerasi Makula Basah
    Salur darah tidak normal akan terbentuk di makula. Ini akan menyebabkan pendarahan berlaku dan penglihatan menjadi kabur. Meskipun jenis ini boleh mengakibatkan hilang penglihatan yang teruk, namun ianya jarang menyebabkan buta sepenuhnya.

Bagaimana pesakit degenerasi makula melihat?

Tanda-tanda awal yang mungkin anda perhatikan adalah kualiti penglihatan berkurang secara beransur-ansur atau garis lurus kelihatan bengkok dan senget. Apabila degenerasi makula berkembang, penglihatan pusat akan menjadi kabur. Oleh itu mereka mengalami kesukaran untuk membaca, mengenali wajah dan memandu. Mereka juga sensitif pada cahaya yang terang. Namun begitu mereka yang mengalami penyakit ini tidak akan mengalami kebutaan keseluruhan kerana penglihatan sisi (periferi) masih kekal.

Bolehkah degenerasi makula disembuhkan?

Walaupun tidak ada penawar untuk AMD, terdapat pilihan rawatan yang dapat mencegah atau melambatkan perkembangan penyakit ini. Rawatannya merangkumi ubat-ubatan, suntikan dan terapi laser. Rawatan terbaik untuk makula degenerasi basah adalah terapi anti-VEGF- iaitu suntikan bahan kimia yang disebut “anti-VEGF” secara intravitreal (ke dalam mata). Dalam kehidupan normal tubuh manusia, VEGF adalah molekul sihat yang menyokong pertumbuhan darah baru. Rawatan ini dapat membantu menghentikan kebocoran salur darah yang disebabkan oleh makula degenerasi basah.

Bagaimana anda mencegah degenerasi makula menjadi lebih teruk?

  • Mengekalkan berat badan yang sihat
  • Makan makanan berkhasiat yang merangkumi sayur-sayuran berdaun hijau, buah kuning dan oren, ikan dan bijirin
  • Tidak merokok
  • Mengekalkan tekanan darah normal dan mengawal penyakit yang lain
  • Bersenam secara berkala

Walaupun degenerasi makula tidak dapat dicegah tetapi dengan rawatan awal dapat melambatkan perkembangannya agar tidak dapat komplikasi yang teruk. Oleh itu, penting untuk menjalani pemeriksaan mata setiap tahun apabila usia mencecah 40 tahun dan ke atas.

What is digital eye strain (DES)?

Digital eye strain also known as computer vision syndrome, is a condition where a person experiences a temporary eye discomfort after prolonged use of electronic devices such as computer, tablet, mobile devices. The level of discomfort increases with the amount of digital screen use. DES can occur differently in each individual based on their visual device lifestyle, but their symptoms are usually the same.

Symptoms of DES

The most common symptoms associated with digital eye strain are

Causes of DES

  1. Reduction of blinking when staring at electronic devices is one of the reasons people experience DES. A person normally will blink about 15 times per minute. However, the blinking rate can be less than half when a person continuously stares at the screen.
  2. Glare can occur on devices with glass screens which contribute to DES due to the reflection and brightness of the screen.
  3. Improper viewing distance by staring at the computer at a too close or too far distance for a long time can cause DES.
  4. Poor seating position while staring on screen at a different height level can lead to many problems such as headache and neck and shoulder pain. This is because the position of the eye viewing is not parallel to the screen.
  5. Uncorrected vision problems such as short-sightedness, astigmatism, presbyopia and underlying eye problems can easily cause a person to be more symptomatic towards DES.
  6. Contact lens wear can increase the chance of having dry eyes and irritation.

Treatment & Prevention of DES

  1. Taking a break frequently while looking at a screen for long hours is very important. By practicing the “20-20-20” rule, for every 20 minutes look away from the screen and look at an object 20 feet away for at least 20 seconds. This allows the eyes to rest and refocus themselves.
  2. Reduce glare by adjusting the brightness on the screen or dimming the light near the screen can help to reduce the DES. An additional matte screen filter on top of the screen can also help.
  3. Ergonomics are crucial in the working environment.
    a) Adjusting the seating position while looking at the screen for long hours is important to prevent neck strain and shoulder pain while working. The chairs must be comfortably padded and conform to the body and the chair height should be adjusted so the feet rest flat on the floor. Arms have to be adjusted to provide support while typing and wrists shouldn’t rest on the keyboard when typing.b) Location of the computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches from the eyes. Most people find it more comfortable by viewing the computer with their eyes looking downward.c) The arrangement of reference materials has to be below the monitor and above the keyboard. Otherwise, a document holder can be placed beside the monitor. The reason for positioning the documents is to reduce head effort to reposition from the document to the screen.
  4. Correct refractive errors and underlying eye problem by visiting an optometrist or ophthalmologist for proper management and eye prescription in order to have a better vision performing daily tasks.
  5. Contact lenses wearers can consider having a pair of glasses while staring at the devices for long periods especially during working hours. Using artificial tears to lubricate the eyes with or without contact lenses can reduce symptoms.

Digital eye strain can be diagnosed through a comprehensive eye examination. During the exam, it is important to tell your Ophthalmologist how often you use a computer or digital device at home or work. Generally an eye strain can be treated with simple methods, however prolonged eye strain and discomfort may be a sign of something serious that should be treated by an Ophthalmologist.
Those living in areas such as Shah Alam, Cheras, Puchong, Shah Alam, Petaling Jaya, and Kepong can come visit our ophthalmologists to have their eyes examined.

The Red Eye Emergency

Most red eyes are usually not sight threatening and can recover without leaving any permanent damage to the eye.

However, one of the red eyes that may require immediate attention is Acute Angle Closure Glaucoma. Acute angle closure glaucoma is vision or sight threatening and needs urgent and timely treatment to prevent irreversible damage to the optic nerve. Optic nerve is the “cable” that connects the eye to the brain and once it is damaged it cannot regenerate.

Some symptoms of acute angle closure glaucoma besides a red eye are usually headaches (in very severe cases nausea and vomiting), pain in the eye associated with blurring of vision and sometimes seeing haloes (due to swelling of the cornea due to increased intraocular pressure).

Acute angle closure glaucoma, is a true ocular emergency and needs to be treated urgently to prevent irreversible damage to the optic nerve.

The first thing to do is to reduce the intraocular pressure (IOP) with topical/oral anti-glaucoma medications. In certain cases, patients may require intravenous (IV) medications too. The doctor will also treat the inflammation with steroid eye drops.

Laser peripheral iridotomy (LPI) needs to be done as soon as possible to the affected eye and also for the other eye to prevent a similar problem in the future. Iridotomy is a procedure where we create a hole in the iris (with laser). If it not possible, then it has to be created surgically, to relieve the pupillary block due to angle closure glaucoma.

Once the IOP is controlled with laser treatment and anti-glaucoma medications and the affected eye has stabilized, there is a need to plan for cataract surgery in the future. All these are done to reduce and prevent irreversible damage to the optic nerve and thus maintain quality of life.