Cover Image_Comparison_Glaucoma_Macular Degeneration_Cataracts

【Treating Eye Diseases】Glaucoma vs. Macular Degeneration vs. Cataracts: An Ophthalmologist Explains Symptoms and Management Methods

Eye Health / Ophthalmologist Tang Wenjie

Many seniors experience blurred vision and may attribute it to age-related decline, but have they considered that it could stem from an eye disease?

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Eye Disease Symptoms

First, determine whether vision loss is sudden or gradual, and whether it affects central vision, the entire visual field, or peripheral vision. Also note if it's accompanied by eye pain. How can we distinguish between macular degeneration, cataracts, and glaucoma? Take cataracts as an example: vision in older adults typically declines gradually and affects the entire visual field. Macular degeneration, conversely, causes sudden, acute vision loss affecting central vision.Glaucoma also gradually affects vision, typically starting with peripheral vision loss.

These three conditions are easily confused, and seniors can check for them through various methods. One method involves using "checkered paper." This grid-patterned paper allows seniors to observe whether straight lines appear curved. Such distortions can indicate the presence of macular degeneration. For other issues, an ophthalmologist's examination is necessary to determine the specific eye condition.

How to treat it?

Diabetic retinopathy typically presents with two complications, primarily caused by oxygen deprivation leading to vascular proliferation. When blood vessels proliferate, these fragile vessels may leak, resulting in vitreous hemorrhage or macular edema. To prevent this, intravitreal injections are commonly administered to inhibit vascular proliferation and thereby reduce oxygen deprivation.

Cataracts are primarily treated through minimally invasive cataract surgery, which involves removing the clouded lens and implanting an artificial lens. Finally, glaucoma can be managed through early intervention to prevent ongoing damage to the optic nerve. There is no cure for glaucoma; treatment focuses on monitoring eye pressure through regular testing and managing it with eye drops, surgery, or laser procedures to slow nerve damage.

Seniors can prevent eye diseases by making lifestyle changes, such as: reducing sugar and salt intake; consuming foods rich in vitamin A, carotenoids, or omega fatty acids for their antioxidant effects; engaging in at least 30 minutes of aerobic exercise daily; and avoiding smoking. Regular eye examinations are essential for early prevention and treatment. Minimizing exposure of the eyes to ultraviolet light is crucial for preventing various eye conditions.

Source: Topic

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Cover Image_Red and Painful Eyes_Hidden Illness_Rheumatoid Arthritis_Eye Inflammation

【Eye Inflammation】Red, Painful Eyes May Signal Underlying Health Issues Doctor: 80% of Rheumatoid Arthritis Patients Experience Eye Inflammation

Eye Health / Ophthalmologist Tang Wenjie

Many doctors use the eyes as a window to observe bodily ailments, especially in patients with chronic conditions. So, which diseases can affect the eyes?

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Diseases Affecting the Eyes

Eye pain, redness, and inflammation are common experiences among older adults. However, if these symptoms persist, we may become concerned about underlying health issues. One such concern is an autoimmune disorder, which can trigger inflammation throughout the body. The eyes are among the organs affected. If left unaddressed or untreated, this can lead to progressive vision loss and even the risk of blindness.

Symptoms and Treatment of Immune System Disorders

Immune system disorders can affect people of all ages, with the most common being rheumatoid arthritis, Sjögren's syndrome, ankylosing spondylitis, or lupus. Taking rheumatoid arthritis as an example, patients may experience lower back pain, hip joint pain, or inflammation symptoms that cause stiffness and soreness in the back upon waking. Due to inflammation, calcification may occur.Joints may fuse together, making it difficult to bend over or reach down to touch one's toes upon waking. Over time, this can significantly impair joint mobility. First-line treatment involves systemic therapy, typically prescribed by rheumatologists in the form of oral anti-inflammatory medications.

First-line treatment typically involves steroids. However, when high-dose steroids or prolonged therapy is required, second-line medications are generally used to mitigate steroid-related side effects. These second-line agents include biologics and immunosuppressants for long-term disease management.

Research indicates that eight out of ten patients will experience at least one episode of eye inflammation in their lifetime. Iritis is one such inflammatory condition that releases cells causing vision loss. These cells bind to proteins within the eyeball and accumulate in the anterior chamber angle, obstructing the drainage of aqueous humor. This leads to increased intraocular pressure, damaging the optic nerve and potentially resulting in glaucoma.

For treatment, blood tests are typically conducted to measure inflammatory markers, and X-rays are taken—such as chest X-rays or lumbar spine X-rays—to check for lung or spinal issues. If problems are found, medication is usually prescribed to control inflammation (specifically, anti-inflammatory steroid eye drops). Additionally, monitoring for side effects and complications is essential, with glaucoma medication used to manage intraocular pressure. Therefore, both ophthalmologists and rheumatologists collaborate to provide comprehensive care and treatment for the patient.

Medicine

Eye drops come in different types. Some are merely lubricating solutions that offer no therapeutic benefit and may even delay proper treatment. Others constrict blood vessels but do not control inflammation, potentially creating a false impression of ongoing improvement. Finally, if the treatment dosage is insufficient or the duration of use is inadequate, it can delay proper care and lead to irreversible damage to the eyes.

COVID-19

Conjunctivitis often accompanies respiratory infections such as influenza or viral colds, and it is also one of the symptoms of COVID-19. The most common symptom of conjunctivitis is redness and inflammation of the conjunctiva covering the white part of the eye. Research shows that among 30 COVID-19 patients examined during hospitalization, one exhibited conjunctivitis symptoms, indicating a close association.

To prevent COVID-19, first and foremost, we must wash our hands frequently with soap and water for at least 20 seconds. Additionally, we need to maintain a proper social distance of 1.5 meters and ensure adequate ventilation to protect ourselves from the virus.

Source: Topic

【Eye Inflammation】Red, Painful Eyes May Signal Underlying Health Issues Doctors: 80% of Rheumatoid Arthritis Patients Experience Eye Inflammation Read More »

Cover Image_Prevention Methods_Dry Eye Syndrome

How to prevent dry eye syndrome?

Dry Eye Syndrome / Ophthalmologist Tong Man Kit

Many daily habits can contribute to dry eye syndrome, so we should avoid them whenever possible and maintain a comfortable environment for our eyes. What methods can we use to prevent dry eye syndrome?

1. Avoid eye irritation
When using air conditioning or electric fans, position the airflow away from your eyes and avoid directing it directly at them.

2. Take Appropriate Breaks
Whether using electronic devices, working, or studying, remember the 20/20/20 eye care rule. Remind yourself to blink frequently, taking a 20-second break every 20 minutes to focus on an object 20 feet (approximately 6 meters) away. This reduces prolonged close-up and sustained eye strain, helping maintain long-term eye health.

3. Reduce contact lens wear time
Due to reduced tear production in dry eye patients, wearing contact lenses may scratch the cornea and harm eye health. Wear time should be minimized, ideally to less than 8 hours per day.

4. Quit Bad Habits
Avoid staying up late to allow your eyes to rest adequately. Additionally, refrain from smoking or exposure to secondhand smoke, as smoke irritates the eyes and contributes to excessive tear evaporation.

5. Dietary Habits
Moderately supplement foods rich in Omega-3 or Vitamin A, such as choosing salmon, walnuts, and other foods abundant in Omega-3; additionally, carrots, spinach, and similar foods contain ample Vitamin A.

How to Prevent Dry Eye Syndrome? Read More »

Cover Image_Myopia in Children_Prevention and Management_Important Considerations

Tips for Controlling Myopia in Children

Myopia / Ophthalmologist Tang Wenjie

What Should Parents Pay Attention to When Controlling Children's Myopia? Smart Eye Care Tips You Need to Know

Children today frequently use computers for online classes. Even when not attending lessons, they remain glued to their phones and tablets, rarely putting down their devices. Consequently, many children develop myopia at an early age.A survey revealed that over half of myopic children aged 4 to 12 who participated in e-learning during the pandemic experienced worsening myopia. This significantly increases the risk of developing high myopia, potentially leading to more severe eye health issues in the future. Therefore, as parents, it is crucial to teach children early on how to protect their eyes and implement effective myopia control to prevent worsening myopia. Here are nine tips to share with you. When using smartphones, computers, browsing the internet, or reading, remember to pay attention to the following points:

Every 20 minutes, give your eyes a break.

Ensure adequate lighting when reading.

Maintain a minimum viewing distance of 30 centimeters.

Adjust the screen brightness to a comfortable level.

Do not watch while lying in bed or riding in a vehicle.

Increase the amount of time spent on daily outdoor exercise

Go to bed early and rise early every day.

For example, carrots.

Get comprehensive eye exams early and regularly.

More information

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Cover Image_Causes of Childhood Myopia_Symptoms of Myopia

Causes and Symptoms of Childhood Myopia

Myopia / Ophthalmologist Tang Wenjie

Table of Contents

Causes of Myopia in Children

Hong Kong has one of the highest rates of myopia in the world, with nearly 18% of children already experiencing nearsightedness by age 6! What exactly causes myopia in children?

Myopia Myopia occurs when the eyeball is too long. In a relaxed state of distant vision, parallel light rays passing through the eye's refractive system focus in front of the retina. This causes distant objects to appear blurry, while near objects appear clearer.

Myopia can be hereditary, but environmental factors are also major contributors to its development, such as:

Reading at too close a distance for extended periods
Electronic devices emit excessive brightness, and the environment is too dark.
Frequently looking at electronic screens
Lack of exposure to sunlight and outdoor activity time

Symptoms of Myopia in Children

How can you tell if your child has myopia?
Parents should regularly observe whether their child exhibits the following behaviors:

Complaining of a headache
Reporting blurred vision (or double vision)
Frequent blinking and rubbing of the eyes
Eyes are often bloodshot.
When focusing on electronic screens or reading books, you need to squint or tilt your head to see clearly.
When looking at electronic screens or reading books, cover one of your eyes.
When reading, I often overlook certain words.

If parents notice their child frequently exhibiting the above behaviors, there is a high likelihood they have developed myopia. It is recommended that parents promptly take their child for an eye examination and seek professional advice from an ophthalmologist.

Children's Myopia: Don't Ignore It!

Children who frequently view electronic screens have a significantly increased risk of developing myopia. If parents notice their child has myopia, it is recommended to consult a professional ophthalmologist and pursue appropriate vision correction treatment. Currently, there is a " Children's AI Myopia Control Program ." This program can predict changes in a child's myopia over the next three years, enabling the provision of personalized myopia correction treatment plans for children.

Without corrective treatment, myopia is highly likely to worsen. The elongation of the eyeball will cause the retina to thin progressively, simultaneously increasing the risk of developing various eye diseases, such as retinal detachment and macular degeneration , and glaucoma and cataracts , among others. These complications can impair vision, and in severe cases, lead to blindness or loss of sight. Therefore, it is recommended to control myopia in children as early as possible and ensure timely correction!

Early eye examinations for children can effectively prevent or delay the progression of myopia, reducing the likelihood and risks of developing high myopia in the future.

Parents, please remind your children to start protecting their eyes from an early age by improving their daily habits!

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Cover Image_COVID-19 Symptoms_Pink Eye_Dr. Tong Man Kit, Ophthalmologist

Is pink eye also a symptom of COVID-19?

Eye Health / Ophthalmologist Tang Wenjie

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Is pink eye also a symptom of COVID-19?

Amid the COVID-19 pandemic, attention has largely focused on prevention measures, infection symptoms, and recovery treatments, with less emphasis on the link between infection and vision risks. It turns out that conjunctivitis can also be an early sign of COVID-19. Concerns have arisen about whether droplets entering the eyes could cause infection, and whether wearing glasses offers any protective benefit. Below, an ophthalmologist addresses these questions one by one.

Patients with mild COVID-19 commonly experience symptoms such as runny nose, headache, fatigue, sore throat, cough, and even muscle pain, vomiting, or diarrhea. Some claim that red eye syndrome (medically known as conjunctivitis) is also an early sign of COVID-19 infection. What is true and what is false? Ophthalmologist Tang Wenjie explains: "Pink eye or conjunctivitis occurring alongside upper respiratory infections (such as the common cold or flu) could potentially be a sign of COVID-19 infection. Conjunctivitis typically presents with redness and inflammation of the eye's conjunctiva. A study published in the Journal of Medical Virology examined 30 patients hospitalized for COVID-19, one of whom was diagnosed with conjunctivitis."

Pink eye can lead to various eye conditions.

According to the aforementioned research, while the likelihood of patients developing conjunctivitis is relatively low, reports indicate that the novel coronavirus is associated with other ocular issues beyond conjunctivitis. These include episcleritis, uveitis, lacrimal gland inflammation, and inflammation of the retina and optic nerve. Although equally rare, some of these conditions carry the potential to cause vision loss.

Citizens wear masks when going out daily, but their greatest concern is that COVID-19 droplets might enter their eyes and cause infection. Dr. Tang stated that while ocular transmission has not been definitively proven by research, mucous membranes—found throughout many body cavities and organs including the respiratory tract—are typically most susceptible to infection by novel coronaviruses and other viruses."The surface of the eye and the inner eyelid are also covered by mucous membranes known as the conjunctiva. Therefore, if infected droplets enter the eye, it could potentially lead to infection." Published reports indicate that SARS-CoV-2 may be transmitted through aerosols and conjunctival contact.

Safety goggles offer superior protection.

Dr. Tong stated, "Glasses and sunglasses cannot fully block respiratory droplets sprayed directly toward you. Instead, protective eyewear that shields the sides and the area around the eyes offers better protection."In fact, the primary transmission route for the novel coronavirus is still considered to be respiratory droplets between people. However, the virus can also survive on surfaces for several days. Therefore, touching an infected surface and then touching your eyes, nose, or mouth without washing your hands could lead to infection, though this risk is generally considered low.

Can cleaning the eyes with water or over-the-counter eye drops reduce the risk of infection? He explained that the eye surface has its own protective mechanisms, including antimicrobial proteins and natural lubrication. Therefore, daily cleaning or rinsing the eyes with water is unnecessary and may actually wash away some of the natural protective barriers on the eye surface, thereby increasing the risk of infection.If the eyes become inflamed or red, using over-the-counter artificial tears may help relieve symptoms. However, if symptoms persist, it is advisable to seek prompt medical attention from an ophthalmologist.

Remove contact lenses to maintain hygiene

Not only have I heard from myopia sufferers expressing concerns that frequent insertion and removal of contact lenses might increase the risk of COVID-19 infection, but Dr. Tong has reassured us: under proper hygiene conditions, there is no evidence that wearing contact lenses elevates the risk of contracting the virus."However, contact lens wearers tend to touch their eyes more frequently than the general population. The American Academy of Ophthalmology recommends that contact lens wearers temporarily switch to eyeglasses to reduce the risk of COVID-19 infection. Additionally, eyeglasses can somewhat reduce the risk of irritation caused by contact lens wear and act as a barrier, discouraging people from touching their eyes. While not the best protection, glasses can also serve as a partial shield against respiratory droplets."

Despite this, the American Academy of Ophthalmology states that as long as contact lenses are properly cared for during daily wear, maintaining hygiene and washing hands frequently is sufficient. If redness occurs in the eyes, discontinue wearing contact lenses and seek medical attention.

5 Key Methods to Prevent COVID-19 Infection

To reduce the risk of contracting the novel coronavirus, Dr. Tong offers the following recommendations:

- Wash hands with soap and water for at least 20 seconds.
- Avoid touching your eyes, nose, and mouth as much as possible.
Reduce Contact
- Maintain social distancing; use two arm lengths (about 6 feet) as a guideline.
- Avoid poorly ventilated indoor spaces or areas whenever possible.
- If you are sick, stay home unless you need to seek medical care.
Cover coughs and sneezes
- When coughing or sneezing, cover your mouth and nose with a tissue.
- After coughing or sneezing, immediately wash your hands with soap and water for at least 20 seconds.
- Wear a mask in public settings to cover your mouth and nose.
Current evidence indicates that the novel coronavirus can survive on various surfaces for hours or even days. In home and community settings, cleaning visibly soiled surfaces followed by disinfection is the best way to prevent COVID-19 and other viral respiratory illnesses.
Vaccination has been proven to significantly reduce the risk of contracting COVID-19 and lessen the severity of symptoms.

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Personalized Cataract Surgery

Cataract / Ophthalmologist Tong Wenjie

Cataracts Surgery Personalized Benefits

Eyes are like fingerprints—no two eyes are alike. Therefore, when cataracts develop, cataracts , the condition in each eye will not be identical. Many doctors have attempted to find a specific intraocular lens suitable for every clinical scenario to treat all cataract patients. However, no single intraocular lens fits all patients. Cataract surgery must be "personalized."

In simple terms, doctors will tailor appropriate intraocular lenses based on the patient's needs and optical aberration curves.

Factors considered include:
patient age, lifestyle, visual expectations, refractive surgery history, corneal topography, optical coherence tomography (OCT), aberrations, ocular surface health, pupil size, and macular health.

Current advanced technologies can accurately assess these factors, enabling doctors to tailor cataract surgery to your specific eye condition and achieve optimal visual outcomes post-surgery.

Beyond the technical aspects of the assessment, the doctor also recommends determining cataract surgery details based on visual needs: hobbies, whether one chooses to wear reading glasses, the amount of close-up work performed, and whether night driving is required.

The optimal visual outcome following cataract surgery depends on accurate preoperative assessment and measurement, surgical technique, and careful selection of the intraocular lens implant.

The procedure is customized based on individual eye conditions, and can also help better correct astigmatism and/or presbyopia. Astigmatism refers to uneven light focusing, causing blurred vision at both distance and near; presbyopia is the loss of near vision that occurs with age.

Therefore, cataract patients are no longer limited to simply replacing their cloudy cataracts with an intraocular lens. Instead, personalized surgical planning helps patients achieve high-definition vision after cataract surgery.

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白內障年輕化晶狀體功能障礙綜合症

Cataract / Ophthalmologist Tong Wenjie

白內障年輕化晶狀體功能障礙綜合症: 現時科技發達，都市人每天離不開手機、電腦，看屏幕時間長了，不但雙眼疲累，還十分傷眼。與此同時，白內障有年輕化趨勢。

曾有中年患者，他發現近視持續增加，看東西有重影。經過仔細檢查，發現有晶狀體功能障礙綜合症 ( Dysfunctional Lens Syndrome: DLS)。

晶狀體功能障礙綜合症 (Dysfunctional Lens Syndrome: DLS) 是一種普遍存在的疾病，長期以來一直被忽視。這種疾病通常發生在年輕時，雖然白內障還不成熟，由於患者描述的是白內障症狀，因此出現了該綜合症的特徵。

用外行的話來說，DLS 可以被認為是白內障前期，晶狀體開始變硬，失去聚焦能力和近距離視力，對比度和夜視力下降。眼科醫生通過先進的診斷來顯示白內障密度，光線通過晶狀體折射狀況，或裂隙燈照片，幫助我們理解這種先兆性狀態與患者視力下降相關的特徵性。

早期白內障患者徵狀不明顯，常見的包括：雙眼容易疲倦畏光、有眩光問題、看東西有重影、屈光度數經常改變。傳統想法認為白內障要「熟」才可以做手術，但事實是剛好相反，過熟的白內障只會令病情惡化，令患者錯過最佳的治療時機。如果日常生活、工作受到視力影響，便可進行手術了。隨著先進的診斷方法，先進技術，多功能人工晶體的選擇和激光白內障手術的出現，晶狀體功能障礙綜合症更容易被識別和處理。

白內障年輕化晶狀體功能障礙綜合症 Read More »

什麼人最易有白內障？

Cataract / Ophthalmologist Tong Wenjie

什麼人最易有白內障？

白內障，是指眼球的晶體變得混濁，以致影響視力，過往多數出現於60歲或以上人士身上，但近年開始，愈來愈多相對較年輕的人士因白內障求醫，他們一般介乎40-50歲，普遍患有深近視（即600度近視或以上）。

長用類固類或增白內障

白內障有不少風險因素：患有糖尿病，或要長期使用類固醇藥物的人，長遠都有較大機會罹患白內障。曾有一位患濕疹的18歲少年，因視力變得模糊求醫，最後證實患上白內障，要接受人工晶體置換手術。細問病歷，病人全身皮膚受濕疹困擾多年，曾向不同中西醫，甚至坊間神醫求助，更長時間塗用成份不明的藥膏，希望可控制病情，故懷疑當中藥物含有類固醇，導致白內障。故建議病人要在醫生監察下使用類固醇藥膏，如產品來歷或成份不明都要先小心查證。

另外，曾出現虹膜炎、眼睛曾遭受猛烈撞擊、曾接受眼科手術，或患急性青光眼等等都是白內障的誘因。

而深近視對白內障的影響可能更大。一般估計，近視太深會加劇退化問題而形成白內障。較年輕的白內障病人，一般是發現近視突然之間加深了200、300度，要經常換眼鏡，試過一兩次後，覺得不尋常，於是找眼科醫生檢查，才發現自己有白內障。也有病人看影像時有重影、怕光等症狀，接受眼科檢查發現患了白內障。

切除白內障無需等「熟」

白內障不但常見，而且是導致視力喪失的主要原因。現時沒有治療白內障的藥物，病人需通過手術更換人工晶體，才能恢復原有視力。而不少人都以為白內障要「熟啲」才能做手術，這說法其實是誤解，尤其對一些較年輕的病人，若白內障已大大影響日常生活及工作，尤其看文件、用電腦，甚至外出駕駛等，已經適合做切除白內障的手術。

通過一個小的角膜切口，醫生移除混濁的晶狀體，植入人工晶體。如果您患有發展中的白內障，不必等到成熟才將其移除，通常只需要大約15-20分鐘。在大多數情況下，醫生可以使用局部麻醉，從而加快恢復時間。

資料來源: Metro Daily

什麼人最易有白內障？ Read More »