Diabetes causes blindness

Diabetes is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. Diabetes can happen when your body either doesn’t make enough insulin or can’t effectively use the insulin it makes. Untreated high blood sugar from diabetes can damage your eyes. People with diabetes can have an eye disease called diabetic retinopathy. This happens when high blood sugar levels damage blood vessels in the retina. These blood vessels will be blocked and leaky. Sometimes abnormal new blood vessels will grow on the retina. All of these changes can make your vision become worse.

Types of diabetic retinopathy

  1. Non-proliferative diabetic retinopathy is the early stage of the disease. The blood vessels in the retina are weakened and there may be fluid leaking into the retina which may lead to swelling of the retina.
  2. Proliferative diabetic retinopathy is the advanced stage of the disease. The blood vessels might rupture and the blood may leak into the vitreous cavity, this causes patients to have acute blurry vision.

Artificial intelligence (AI) fastest way in detecting diabetic retinopathy

Previously, diabetic retinopathy was analysed and graded manually, therefore it usually takes around an hour to identify the findings. Next, these patients diagnosed as diabetic retinopathy will go through a second round of grading to ensure that the diagnosis is accurate. Artificial intelligence(AI) programme is a new technology which can deliver diagnosis within just a couple of minutes and the accuracy for AI systems is about 90% because it eliminates human inconsistencies when analysing data.

How does artificial intelligence (AI) work?

It uses selena+ software which looks out for symptoms such as bleeding,swelling and microaneurysms, which would appear as tiny red lesions in retina photography. After uploading the retinal image, the software will compare it against the dataset it has been trained on, which comprises nearly 500,000 retinal images of patients with the diseases.

OasisEye Specialists is the first Eye Centre to initiate the use of Artificial Intelligence (AI) for diabetic eye screening in Malaysia. OasisEye is ahead in providing premier eye care to its patients and collecting data to further strengthen the current AI algorithms or develop new ones.

How to prevent blindness

Diabetic retinopathy is asymptomatic at an early stage. Therefore, patients with diabetic are advised to have an annual eye screening. Early detection and treatment can prevent vision loss.

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UV Light & its effects to the eye

The human eye is constantly being exposed to sunlight and artificial light. Natural sunlight or artificial UV rays that produce UV radiation can seriously harm the eyes, affect vision and compromise overall eye health. There are several eye diseases that are caused by long term exposure to UV radiation.

a) Cataracts
A cataract is the clouding of the eye’s natural lens. Cataract is usually caused by aging; however, it can progress rapidly with increased exposure to UV light. This condition causes decrease in vision and glare. A cataract surgery is performed to replace the eye’s natural lens with an artificial lens.

b) Photokeratitis
This condition is swelling or inflammation of the cornea due to excessive UV exposure. This is usually caused by high intensity light from welding equipment. Temporary symptoms include pain, tearing, twitching of eyelids and discomfort when exposed to bright lights. This condition requires treatment with antibiotics and artificial tears to help relieve its symptoms.

c) Pterygium
A wing-shaped growth on the cornea that can show up due to prolong exposure to UV light. Those who are at risk of developing this eye condition are surfers, skiers, fisherman and farmers who spend long hours under the midday sun near the rivers, oceans and mountains. If a pterygium grows progressively, it can cause symptoms such as itchiness and discomfort. A surgery will be advised to remove it to save vision.

d) Skin Cancer
Skin cancer around the eyelids have also been linked to prolong UV exposure. Melanoma, the most common type of cancer involving the eyes sometimes require surgical removal of the eyeball. It is important to note that we do need some amount of sunlight to promote our physical and mental health in many ways. Healthy exposure to sunlight can have positive effects to a person. A little natural sunlight everyday can help you sleep well. The light-sensitive cells in the eye plays a natural role in our body’s natural wake-sleep cycles. Spending time outdoors in the natural sunlight has also been shown to prevent development of myopia or short-sightedness in kids. It is important to protect your eyes from long hours of UV exposure by using proper eyewear. Regular eye examinations with an Ophthalmologist is also important so that eye disease related to UV exposure can be detected early.

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Types of Red Eye

Red eye can be a sign of a minor irritation or a serious medical condition such as an infection. Conjunctivitis or pink eye is a common red eye in Malaysia. This eye condition is very contagious, most of the time a patient gets the red eye from either a family member or a friend who has it. It can affect one eye or both eyes can be involved as well. Common symptoms of conjunctivitis are tearing, redness, discomfort and sandy sensation in your eye. This eye disease can be resolved with medication. To avoid it spreading, patients should wash their hands frequently and avoid rubbing their eyes.

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Another type of red eye is allergic eye disease which is common among children. It is associated with a history of allergic rhinitis, allergy to seafood or medication, asthma and eczema. Unlike conjunctivitis, patients will develop very severe itching associated with redness and tearing. The severe itching will lead to constant eye rubbing which eventually causes thinning of cornea (keratoconus).

Next, dry eyes are also very common in Malaysia. Those who are affected are those who are frequent contact lens wearers. Long hours of contact lens wear can cause dry eyes. Normally mild dry eyes are quite tolerable but severe dry eyes can lead to redness, frequent discomfort such as sandy feeling. In some severe cases, patient vision can be affected as well.

Red eyes can also be caused by a foreign body attaching to the eye which leads to irritation. Foreign body can be attached to the eyelid or cornea causing pain when blinking, tearing and blurry vision. Labourers are at most risk of getting this type of red eye.

The most serious cause of red eyes is corneal ulcer. It is an infection of cornea that causes thinning and perforation of the cornea as the disease progresses. It is a painful red eye. Common causes can be poor handling of contact lenses. If a corneal ulcer is not treated immediately, it can lead to severe vision loss.

An ophthalmologist will be able to assess your eye and diagnose the type of red eye you have. Some red eyes are benign while some others are serious and may need serious medical attention. Red eyes accompanied with severe pain and impaired vision should be treated immediately.

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Food for Your Eyes

A balanced nutritional intake is important for eyes to remain healthy. Adding certain nutrients to our diet can help preserve vision and reduce risk of certain eye diseases.

  1. Vitamin C
    Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. Excessive sun exposure, cigarette smoking and alcohol consumption will create free-radicals molecules that can damage and kill body cells. Thus, we need vitamin C to repair and grow new cells. Good sources of vitamin C include citrus fruits (orange and lemons), kiwis, blueberries, strawberries, chili peppers and broccoli. According to the Age-Related Eye Diseases Study (AREDS), antioxidants when taken in combination with other nutrients, it can slow the progression of age-related macular degeneration (AMD).
  2. Vitamin E
    Another powerful oxidant is Vitamin E which also helps to repair cells. It is commonly found in nuts (almonds and peanuts), vegetable oil (wheat germ oil and sunflower oils) and sunflower seeds. Similar to Vitamin C, it helps to reduce risk of progression from intermediate to advanced AMD by about 25% when combined with certain nutrients.
  3. Lutein and Zeaxanthin
    Lutein and zeaxanthin are important nutrients found in green leafy vegetables and other brightly colored foods. They are key nutrients to protect the macula, which is the area of the eye that gives us our central vision. Spinach and peas have plenty of these nutrients. Other foods with useful amounts of lutein and zeaxanthin include romaine lettuce, brussels sprouts, pumpkin, broccoli and carrots. And while not all are leafy and green, eggs and wolfberries also are a good source of these nutrients.
  4. Zinc
    Zinc is an essential mineral or “helper molecule”. It is needed for the production of vitamin A from the liver to retina to produce melanin (a protective pigment in the eyes). Foods rich in zinc include red meat, shellfish, legumes and whole grains. Deficiency of zinc can cause night blindness.

Generally, it is best to obtain most nutrients through our daily food intake, including two to three servings of fish per week and plenty of colourful fruits and vegetables. Taking multivitamins or eye vitamins can fill the nutritional gap in a less optimal diet. If you plan to begin a regimen of eye vitamins, be sure to discuss with your ophthalmologist as taking too many supplements can cause problems especially if you are taking prescription medications.

If you are looking for some new and home cooked recipe, you can find several great recipes from “Food for your eyes” which are designed to boost your eye health.

“Food for your eyes” is a unique recipe-cum-self-help book aimed to educate the public about the prevention of AMD through diet. The author Ms Goo Chui Hoong, dietitian and Ophthalmologist Dr Kenneth Fong has translated the recent scientific research of dietary methods to prevent AMD into simple recipes for the Asian diet. This book also contains a lot of detailed information on common eye conditions and various supplements for the eye. The book is now available for purchase in OasisEye Specialists.

Book_cover_of_'Food_for_Your_Eyes'_featuring_a_bowl_of_soup,_promoting_eye_health_through_diet.

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Keratoconus Causes & Symptoms

Keratoconus is a very serious disease affecting the cornea. The cornea is the clear, outer layer of the eye which functions to focus light rays onto the retina. Keratoconus causes progressive thinning of the cornea. The usual round shape of the cornea thins and begins to bulge into an irregular cone shape. This abnormal shape prevents light entering the eye from being focused correctly onto the retina causing blurred and distorted vision. The irregular cone may also cause glare and light sensitivity. Visual loss primarily occurs from irregular astigmatism and myopia and secondarily from corneal scarring. Corneal scarring occurs in the advance stage of Keratoconus when the cornea becomes significantly thin causing a tear in the descemets membrane leading to flow of fluid or aqueous into the stroma causing the cornea to swell and thus leaving a scar. This disease typically begins at puberty and progresses till the age of 30. This condition may progress slowly for 10 years or longer. Keratoconus typically affects both eyes, with one being severely affected than the other. The risk factors are usually those with a family history of Keratoconus and eye rubbing. Eye rubbing is associated with patients who have allergic conjunctivitis or allergic eye diseases. They are quite prone to constantly rub their eyes. This rubbing actually causes thinning of the cornea. Early diagnosis is crucial for patients with Keratoconus. Signs and symptoms of Keratoconus may change as the disease progresses. At an early stage, patients may complain of blurred or distorted vision and an increased sensitivity to bright light and glare. These patients also usually have a large change in refraction over the course of a year. This is usually a 0.50D of myopic change or 1.00D of cylinder change over the year. If you noticed you need frequent change in your glasses prescription, then you should get your eye checked by an Ophthalmologist.
A cornea specialist would be able to assess your eye and rule out Keratoconus. Keratoconus treatment depends on the severity of the condition and how quickly the disease progresses. Once a patient has been diagnosed with Keratoconus, the next important thing is to prevent its progression. Patients will be advised to stop eye rubbing and any eye allergies should be treated. Surgical intervention such as corneal cross linking will also be advised to stop progression of the disease.

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What is Myopia?

Myopia is also known as short sightedness or near sightedness. Myopia occurs when the eyeball is too long or when the cornea is too curved. This causes the eye to focus the image in front of the retina and not on the retina. People with this condition can see objects clearly at near, but distant objects appear blurred. The World Health Organization (WHO) has predicted that by 2050, 50% of the world’s population will be myopic.

Myopia in Children

Generally, myopia occurs in children. These children do not usually complain of blurring of vision. However, there are certain signs that parents can look for in their children such as squeezing their eyes to see clearly, go up close to see an object, rub their eyes and some may also tilt their head to see. Myopia in children is usually genetic in nature. If their parents have myopia, then there is a high chance for their child to develop myopia. Early onset myopia which usually starts before the age of 6 are hereditary. There are certain activities that have been shown to increase myopia in children. These are excessive near work such as reading and increase of screen time with a computer, laptop or handphone and lesser outdoor activities.

Research on Myopia

Strong evidence has shown that exposure to ultraviolet light (sunlight) outdoors at a young age influences the growth of the eyeball. When the eyeball gets exposed to ultraviolet light, there is a release of a neurotransmitter called dopamine which prevents elongation of the eyeball. A study in 2008 done among school children has shown that outdoor activity is a major protective factor against myopia in childhood. Another study done in Taiwan among school children showed that by increasing 18 minutes a day of outdoor activity during recess time showed a reduction of 20% of myopia within a year. This shows that natural sunlight has a positive effect on reducing risk of myopia progression. Excessive near work and increased screen time with gadgets such as laptop, computer and smartphones have also been associated with increase in progression of myopia. The ciliary muscle in the eye tends to work harder when doing excessive near work in unnatural lighting thus causing reduction of dopamine levels in the brain leading to myopia. The American Academy of Pediatrics recommends that children below age of 2 should not be exposed to any of the tablet devices.

In summary, myopia in children is naturally progressive in nature. Children’s eyes tend to grow during childhood and myopia progresses till about the age of 20. Treatment for myopia is a proper prescription of glasses. Myopia in children who are still progressing in their early childhood and not responding to the conservative method will require myopia control treatment. The best age to get your child’s eye to be tested is between ages of 4-6. Your child’s eyes are best checked by a Pediatric Ophthalmologist.

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Know Your Ocular Sport Injuries

Everyone enjoys sports! Sports can help to achieve fitness goals and maintain healthy weight. Furthermore, it also helps to promote good mental health. Football, badminton, golf, tennis, squash and martial arts are some popular sports among Malaysians. However, these sports are potential for eye injury which can lead to permanent damage to the eyes.

Sports are further classified to low, high and very high risk categories based on the potential eye injuries. Low risk indicates no use of a ball, bat or racquet, and no body contact. Examples include track/field, swimming, gymnastics, and cycling. High risk sports involve the use of a ball, bat or racquet, and/or body contact. Examples of high risk sports include baseball, hockey, football, basketball, racquet sports, tennis, fencing, and golf. Very high risk sports, such as boxing, wrestling, and contact martial arts, are those in which eye protectors typically are not worn.

The most common mechanisms of eye trauma involve blunt, penetrating, and radiation injuries. Most sports related eye injuries are blunt trauma. The extent of ocular damage depends on the hardness, size and velocity of the object. Usually a blunt object smaller than the eye’s orbital opening induces more damage than a large object. It is due to rapid and great force transmitting to the internal ocular structures while larger objects exert force on the eye socket, resulting fractures of thin bones.

Penetrating injuries are relatively uncommon but such injuries may range from mild abrasions to serious lacerations. Broken glasses, fishing hooks and contact with other player’s equipment can cause penetrating injury. Contra to blunt and penetrating injuries, radiation injuries occur as a result of extensive exposure to ultraviolet light in snow skiing, water skiing, and other water sport.

Eye injuries can cause vision loss or blindness if not treated immediately. It is important to see an Ophthalmologist to examine the eye as soon as an injury occurs. Even if the injury seems minor, do not try to treat the injury by yourself.

Eye protection has reduced the number and severity of eye injuries and it is strongly recommended that protective eyewear be worn by all participants in sports in which there is risk of eye injury. Protective eyewear made of polycarbonate, a highly impact resistant plastic is stronger than regular eye glasses. Polycarbonate lenses are available in prescription and non-prescription lenses and can be fit into wrap-style frames which cover more eye area and protect eyes from flying objects. If you need prescription sport glasses, you must purchase these from an optical store with a valid eyeglass prescription.

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