Ophthalmologist Dr. Tong Man Kit

Cover image_Cataract_Before surgery_What to know

What to know before cataract surgery

What to know before cataract surgery

What should patients need to prepare before cataract surgery? Here are 5 things to keep in mind:

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1. Get enough sleep and relax the night before surgery.

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2. Wear loose clothing and avoid high necks.

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3. Prophylactic anti-inflammatory drugs can be started 3 days before surgery to reduce the risk of macular edema after surgery.

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4. Diabetes and blood pressure medications must continue to be taken.

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5. If blood coagulants are used, it is recommended to stop the drug for 3 to 7 days after consulting a cardiologist.

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You must also know that
Cataract surgery is a personalized procedure.

Cataract surgery "personalized"

Eyes are like fingerprints, and each eye is different, so when you have a cataract, the condition of each eye will not be exactly the same.

Many doctors try to find a special intraocular lens that works for each clinical situation to treat all cataract patients. However, no one intraocular lens is suitable for all patients, so cataract surgery must be "personalized".

In simple terms,
The doctor will take the patient's needs and optical aberration curve,
Develop appropriate intraocular lenses individually.

Factors to consider include:

  • Age of the patient
  • lifestyle
  • Expectations for vision
  • Status after refractive surgery
  • Corneal topographic map
  • Tomography scan
  • optical aberration
  • Healthy surface of the eyeball
  • Pupil size
  • Macular health

The new technology can accurately assess the above factors, so that doctors can tailor cataract surgery to the patient's eye condition, so that the patient can achieve the best vision after the operation.

In addition to evaluating technical aspects, doctors also recommend determining the appropriate intraocular lens based on visual needs, such as:

  • hobby
  • Whether or not to wear reading glasses
  • Close-range workload
  • Whether night driving is required, etc.

optimal vision after cataract surgery,
Depends on accurate assessment and measurement before surgery,
Surgical techniques and careful selection of implanted intraocular lenses.

Tailor-made procedures to an individual's eye condition can even help patients better correct astigmatism and/or presbyopia.

Astigmatism is when light is focused differently and blurs vision at long and close range; Presbyopia is the loss of near vision with age.

Therefore, cataract patients are no longer limited to simply replacing their cloudy cataract with implanted intraocular lenses, but through personalized cataract surgery to help patients obtain high-definition vision after cataract surgery.

Maybe you are also interested in:

How to choose an intraocular lens? 
—Teach you to choose the most suitable intraocular lens

Good for my cataract surgery
—Cataract surgery program provided by our clinic

What to know before cataract surgery
—手術前該做好什麼準備呢?

The process and new techniques of cataract surgery
—Tell you how FLACS technology can create different surgical procedures

Common cataract myths
—矯正對白內障認知  

What to know before cataract surgery Read More »

IMAGE_FEMTOSECOND LASER CATARACT SURGERY_FLACS_BENEFITS

FLACS FEMTIC SECOND LASER-ASSISTED CATARACT SURGERY

FLACS FEMTOSECOND LASER CATARACT SURGERY

The application of FLACS femtosecond lasers in the field of refractive surgery has brought great changes. Laser vision correction such as LASIK and SMILE are widely used in refractive surgery. However, femtosecond laser-assisted cataract surgery (FLACS) provides doctors with a highly accurate alternative to the less predictable and technically demanding steps of traditional cataract surgery.

Current technology

Generally, cataract surgery is performed under local anesthesia, and the doctor uses a microscope in the operating room to remove the originally cloudy lens and implant a suitable intraocular lens using ultrasound emulsification technology.

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Technology

Connected to an optical imaging system, FLACS guides lasers to perform corneal incision, anterior capsulotomy, and lens fragmentation steps, bringing new options to patients and changing the requirements associated with traditional techniques.

BENEFITS OF FLACS FEMTOSECOND LASERS

FLACS femtosecond lasers are designed to provide safety and ease of operation while improving accuracy and refractive results. Many of the key steps of cataract surgery, such as anterior capsulotomy and lens removal steps, involve corneal incision structure, anterior capsule size, shape, and position of the intraocular lens to the optic axis.

  • Precise corneal incisions provide better wound healing
  • Predicts astigmatism and lower risk of endophthalmitis
  • Reduces ultrasonic emulsification time and energy
  • May reduce damage to corneal endothelial cells and other complications such as corneal and macular edema.
  • Precise anterior capsulotomy effectively predicts lens position
  • Greatly improve and exert the effect of high-end intraocular lenses on vision
PICTURE_FLACS TECHNIQUE_CATARACT
THE PICTURE SHOWS FLACS TECHNOLOGY

In summary, FLACS femtosecond lasers offer comparative advantages over traditional phacoemulsification cataract surgery techniques, especially when implanting high-order intraocular lenses in terms of accuracy, predictability and use in difficult situations such as mature cataracts.

Want to know more about the cataract surgery process?

Maybe you are also interested in:

How to choose an intraocular lens? 
—Teach you to choose the most suitable intraocular lens

Good for my cataract surgery
—Cataract surgery program provided by our clinic

What to know before cataract surgery
—手術前該做好什麼準備呢?

The process and new techniques of cataract surgery
—Tell you how FLACS technology can create different surgical procedures

Common cataract myths
—矯正對白內障認知  

FLACS femtosecond laser-assisted cataract surgery Read More »

Cover image_Cataract_Common myths

Common cataract misunderstandings

Common cataract misunderstandings

Cataract is one of the major eye diseases that causes blindness in the elderly, but there are still many misconceptions surrounding its symptoms and treatments, the most common of which are the following:

number-one (1)

Can only the elderly get cataracts?

Cataracts can affect anyone, from babies to people in their 90s.

Long-term exposure to UV rays may worsen cataracts, but even people who avoid UV rays can still develop cataracts as they get older.

In addition to older factors, cataracts can be caused by congenital, traumatic, diabetes, drugs and radiation. 
number-2

Is cataract surgery no longer necessary at 80?

Cataract is a major eye disease that causes blindness in the elderly. Even if they are not blind, the elderly will be in a state of blurred vision for a long time, which will not only seriously affect the quality of life of the elderly, but also cause danger.

There are currently no effective drugs to treat cataracts, and the ideal way to treat cataracts is surgery, remove the cloudy lens, and replace it with an intraocular lens.

Regardless of age, cataract surgery can be considered if necessary and medically permitted.

number-3

Can cataract surgery only be performed on fully fledged cataracts?

Not. Patients do not need to wait for cataracts to mature.

In the advanced stage of cataracts, the lens will expand or even dissolve, which in turn will cause glaucoma, resulting in irreversible blindness, and advanced cataract surgery is more difficult and vision recovery is slower.

number-four

Can cataract surgery be painful?

Cataract surgery mostly involves ocular anesthesia, which is very painful and acceptable to most elderly people.

It has been reported in the literature that compared with cataract surgery in the first eye, the pain of patients undergoing cataract surgery in the second eye is slightly increased. 
number-5

Is the IOL short life?

At present, the material of intraocular lenses has very stable physical and chemical properties, and patients can use them for life. 

Must poor vision be caused by cataracts?
Will my vision improve immediately after cataract surgery?

Maybe you are also interested in:

How to choose an intraocular lens? 
—Teach you to choose the most suitable intraocular lens

Good for my cataract surgery
—Cataract surgery program provided by our clinic

What to know before cataract surgery
—手術前該做好什麼準備呢?

The process and new techniques of cataract surgery
—Tell you how FLACS technology can create different surgical procedures

Common cataract myths
—矯正對白內障認知  

Common cataract myths Read More »

Visual and visual migraines: What's the difference?

Eye migraines are a rare disease characterized by a temporary loss of vision in one eye or even temporary blindness. Eye migraines are caused by reduced blood flow or vascular spasms in the retina or behind the eye.

In eye migraines, the patient's eye vision usually returns to normal within an hour. Eye migraines can be painless or can occur with migraines (or followed by).

Unfortunately, the term "eye migraine" is commonly used to describe a more common (harmless) disease - called visual migraines or preeclampsia - characterized by temporary visual impairment, which usually disappears within 30 minutes.

Unlike eye migraines, visual migraines usually affect both eyes.

Now, let's take a closer look at eye migraines and visual migraines:

Eye migraines and visual migraine symptoms :

Eye migraine symptoms usually include a small blind spot that affects the central vision of one eye. This blind spot becomes larger, preventing you from driving safely or reading with affected eyes.

In some cases, the entire field of view of one eye may be affected. Typically, the episode lasts less than an hour.

Visual migraine symptoms may vary and may include:

1. Flashing blind spot near the center of the field of view or near the center.

2. A wavy or jagged ring of colored light around the central blind spot.

3. Blind spots that migrate slowly throughout the field of view.

The symptoms of visual migraines usually affect both eyes and last for 30 minutes or less. Visual migraine symptoms may occur shortly after they disappear, or they may not have a headache.

If you experience blind spots or other visual impairments and are not sure if it's an eye migraine or a visual migraine, cover one eye at a time. If visual impairment occurs in only one eye, it is likely to be an eye migraine. If it affects both eyes, it may be a visual migraine.

But don't take any chances. If you suddenly encounter any blind spots in your field of vision, call or consult your ophthalmologist immediately to determine if it is harmless or may be a sign of more severe symptoms, such as retinal disengagement.

What causes eye and visual migraines?

Eye migraines are thought to have the same cause as migraines.

Migraines have a genetic basis, and some studies have shown that up to 70 percent of people with the disease have a family history of migraines.

According to the World Health Organization, migraines appear to be caused by the activation of the deep brain mechanism, which releases inflammatory substances around nerves and blood vessels in the head and brain.

Imaging studies have found that blood flow to the brain changes during eye migraines and migraines. But why this happens and why eye migraines and visual migraines are caused spontaneously remain unknown.

Common migraine "triggers" (including eye migraines and visual migraines) that can cause a person's migraine attack include certain foods, such as aged cheese, caffeinated beverages, red wine, smoked meat and chocolate.

FOOD ADDITIVES, SUCH AS MSG AND ARTIFICIAL SWEETENERS, CAN ALSO CAUSE MIGRAINES IN SOME PEOPLE.

Other potential migraine triggers include cigarette smoke, perfumes and other strong odors, harsh or flickering lights, lack of sleep and emotional stress.

Treatment and prevention.

As already pointed out, visual impairments caused by eye migraines and visual migraines usually disappear within an hour or less without treatment.

If you perform tasks that require clear vision, stop what you are doing and relax until your vision returns to normal when you have eye migraines or visual migraines.

If you are driving, stop at the side of the road and wait for your visual impairment to be completely removed.

If you experience visual impairments accompanied by migraines, consult your family doctor or neurologist to assess your migraine attacks.

Your doctor can advise you on the latest medications for migraines, including those designed to prevent future seizures.

It's a good idea to log your diet and activities before an eye migraine or migraine precursor attack to see if you can identify triggers that may be avoided in the future.

If your eye migraine or migraine precursor (visual migraine) appears to be stress-related, here are some simple ways to reduce the frequency of migraine attacks without medication:

. Eat healthy meals regularly.

. Avoid common migraine triggers.

. Get plenty of sleep.

. Try stress-reducing methods such as yoga and massage.

Visual and visual migraines: what's the difference? Read More »

The eyes suddenly turn red, what can we do?

Red eyes indicate some form of eye inflammation. The condition is usually benign and self-limiting. Recognize that red flags for urgent referrals to ophthalmologists are essential to prevent long-term sequelae. A referral is required when a patient experiences severe eye pain, a large amount of pus secretion, loss of vision, distortion of the pupil, severe light loss, eye trauma and herpes infection. The cause of red eyes can be diagnosed by a detailed medical history and a careful eye examination.

Bleeding or congestion.
There was no pain.
Vision is not affected.
There are no other combined symptoms.

In some cases the treatment options for red eye disease: .

1. Viral conjunctivitis: Treatment is supportive and may include cold applying, and artificial tears. Local antibiotics are rarely used because secondary bacterial infections are not common. SARS-CoV-2 can be transmitted through droplets, but infected patients are less likely to spread the virus through tears, a study suggests. Researchers at Singapore's National Centre for Infectious Infectious Diseases collected tear samples from 17 patients with COVID-19 from the initial symptoms until they recovered, usually on the 20th day. None of the patients had eye symptoms, but one patient developed conjunctiva swelling during hospitalization. The virus was not detected in 64 tear samples collected during the study period, but the viral load was detected in the nasophynascopy and pharynx swabs.

2. Bacterial conjunctivitis: Antibiotics are the subject of treatment, and the choice of antibiotics should be based on cost-effectiveness and local bacterial resistance patterns.

3. Chlamydia conjunctivitis: Treatment sourciting includes local use of erythromycin eye ointment, as well as oral treatment with azithromycin (a single dose of 1 g) or strong lysycin (twice a day, 100 mg each time for 14 consecutive days) to remove genital infections, and the patient's sexual partner needs to be tracked and treated.

4. Allergic conjunctivitis: Avoiding contact with allergens and using artificial tear fluid is an effective way to relieve symptoms in mild cases. Over-the-counter histamines/vascular constrictions are also a viable option, and sometimes topical steroids are required to treat acute seizures.

5. Dry eye disease: Treatment includes frequent drops of the ointment during the day and at night into artificial tears to reduce the evaporation rate. New treatments include the subject environment spore eye drops, which increase the production of tear. Omega-3 fatty acids have also been shown to be helpful.

6. Sculdonitis: Local NSAIDs have not been shown to have significant advantages over placebos in the treatment of suranoculitis, and topical steroids may be useful in severe cases, although it is usually self-limiting.

7. Hemorrhage under conjunctiva: We only need hot and eye lubricant, recurrent bleeding may require a physical examination.

Eyes suddenly turn red, what should I do? Read More »

Wuhan Pneumonia? The route of infection? Latency?

Wuhan pneumonia: Can the eyes spread the virus?

So far, information about the new coronavirus from Wuhan is limited, including how easily it spreads and its severity. In many ways, it appears very similar to SARS (Severe Acute Respiratory Syndrome), with the new coronavirus having an 85% homology with SARS. According to the Center for Disease Control and Prevention, the primary mode of transmission is from animals to humans. However, we know that the virus can also spread from person to person, and it can be transmitted through the following three major routes:

Air (from coughing or sneezing virus particles); 

Close contact (touch or handshake); 

An object or surface with viral particles on it (and then touch the nose or eye before washing your hands);  

The public need to wear eye masks to prevent it? Wuhan Pneumonia: Incubation period What are the symptoms?

Early symptoms are similar to the flu, with an incubation period averaging 7 to 14 days. Many people misunderstand that the virus spreads in the air, but viruses exposed in the air will also die. Only the viruses that live in droplets and are protected by moisture can spread and infect. When droplets touch mucous membranes such as the eyes, the virus will follow the mucous membranes into the body, which is the same for the novel coronavirus. Research shows that after the virus is isolated, it has been proven to have an easy binding capacity to the human angiotensin-converting enzyme 2 (ACE2) receptor, which mainly exists in the lower respiratory tract cells. Therefore, medical staff performing high-risk procedures such as intubation should wear masks that cover their eyes; in this environment, only those who do not wear goggles will be infected. But for us, the general public, the common route of transmission is through droplets, and wearing a mask in public places is sufficient. Since no one will sneeze directly into your eyes, there is generally no need for the public to wear goggles to prevent Wuhan pneumonia.

Wuhan pneumonia s mask wearing the most important! "Pick the nose, rub the eyes" is more likely to become a path of infection!

The virus can spread through droplets or particles. Although masks can block most viruses and prevent the saliva from others from coming out of your mouth and nose, it is still very important to clean your hands, avoid touching your face, and ensure that masks are changed regularly. You should wash your hands after touching public facilities, before eating, after using the restroom, and when you come home from outside. Thoroughly rub both palms, backs of your hands, between your fingers, and especially fingertips, for at least twenty seconds. Moreover, the virus can survive on your phone for twenty-four hours! On January 28 this year, the National Health Commission and the National Administration of Traditional Chinese Medicine announced the 'Pneumonia Diagnosis and Treatment Program for Novel Coronavirus Infections (Trial Version 4)'. The new discovery is that the virus loses its response to ultraviolet light and heat (56°C for 30 minutes); ether, 70% ethanol, chlorinated disinfectants, peracetic acid, and chloroform and other lipid solvents can effectively eliminate the live virus. Therefore, everyone is reminded to regularly use disinfectant wet wipes containing 70% alcohol concentration to wipe the phone. In addition, glasses can be contaminated with the virus, so it is advisable to clean them with hand soap. Avoid using alcohol or other cleaners with chemical properties, as they may damage the glasses.

In summary, access to high-risk locations should be kept at a distance of 1 to 1.5 metres and stayed less than 30 minutes in case of suspicious cases. Hand sanitizer should often be used to clean hands, so as not to touch the mouth, eyes and nose, eye itching, red eyes and other conjunctivitis symptoms do not take lightly, closely observe the changes in the disease, timely medical treatment.

Five tips for preventing viral infections.
1. Regularly wipe your mobile phone with a 70 % alcohol-containing disinfectant wet wipe.
2. Wash your hands frequently with warm water and hand sanitizer, preferably for more than 20 seconds.
3. Try to avoid rubbing your eyes and keying your nose with your hands.
4. Maintain healthy living habits.
5. When the symptoms of conjunctivitis such as itchy eyes, red eyes and so on should not be taken lightly, closely observe the changes in the disease, timely medical treatment.

Dr. Tong Man Kit Ophthalmology, Hong Kong Visual EyeCentre, https://www.hkbrighteye.com/ .

【Wuhan Pneumonia】Symptoms? How is it transmitted? Incubation period Read More »

7 questions to consult your surgeon before laser surgery.

If you have high myopia and vision that affects quality of life or ability to perform your job duties, you may have considered laser eye surgery. This advanced procedure, approved in the United States in 1999, has resulted in significant improvements in vision, work ability, and quality of life for thousands of people, and is very safe.

This article details the 7 most frequently asked questions about laser vision correction surgery to help determine if the procedure will give you the results you need.


What results can I expect?


After the evaluation, your ophthalmologist will know about your myopia. These eye conditions are caused by refractive errors, which are characterized by the shape of the eyes that do not allow light to be focused on the retina, causing the image to appear blurry.


Is laser vision correction surgery potentially risky?


Laser vision correction is a procedure with a high success rate. It is normal for transient blurring, photosensitivity, lacrimation, and mild discomfort to appear after surgery. Postoperative dry eye syndrome is common because tear production is reduced. Eye drops are recommended to help with dry eyes. Infections or complications are rare. Most patients recover quickly within 1-2 days.


Will age be a factor in the success of laser vision correction surgery?


SMILE AND LASIK ARE FDA APPROVED FOR PATIENTS OVER THE AGE OF 18. ALTHOUGH AGE ALONE DOES NOT NECESSARILY AFFECT THE SUCCESS RATE OF SURGERY, SOME DOCTORS BELIEVE THAT THE IDEAL PATIENT AGE IS BETWEEN 35 AND 45 YEARS OLD.


Will my health condition affect the surgery?


CERTAIN DISEASES, SUCH AS DIABETES, AUTOIMMUNE DISEASES, CERTAIN EYE INJURIES, AND EYE DISEASES, MAY EXCLUDE LASIK. AFTER A COMPREHENSIVE LASER VISION CORRECTION SURGERY EVALUATION, YOUR SURGEON WILL BE ABLE TO PROVIDE YOU WITH EXPERT INSIGHTS.


Is the surgery a surname, and I need to perform the enhancement surgery again in the future?


For example, hyperrefractive error or older age may increase the likelihood of having surgery again.


Should I stop taking my medication before surgery?


This is an important question to ask your doctor if you are taking any prescription or over-the-counter medications. Your doctor may recommend that you stop using certain medications, such as tretinoin and antihistamines.


How long will it take for me to resume surgery?


In general, you can see everything clearly within a few days and can perform daily tasks. After the surgeon removes the patch, your vision may be blurred, but it should disappear within a few days and your vision will gradually improve. It can take several weeks to fully recover.

7 questions to ask your surgeon before laser surgery treatment Read More »

What is excessive blinking?

Blink

Blinking is how we protect our eyes from fatigue.

A child blinks an average of 3 – 17 times per minute.

Anything beyond this is considered excessive blinking and may indicate eye discomfort or problems.

Blinking too much can be due to a variety of reasons – anything from facial twitching to extreme dryness of the eyes.

For new parents, it can be difficult to identify the health problems that their child may face.

Unlike symptoms such as fever and cough, it is not easily noticeable.

Causes of excessive blinking

Your child may blink excessively for the following reasons:

  1. Tic - Facial tics can lead to excessive blinking. Tic disorder is a muscular spasm that affects the muscles inside and around the eyes.
  2. Myopia - A common cause of excessive blinking is myopia. It has been observed that these children experience watery eyes, headaches, blurry vision, and excessive blinking. 
  3. Eye allergies - If your child blinks too much, has watery eyes, or has excessive discharge around the eyes, it could be an allergy.
  4. Eye fatigue - It is commonly seen in children who spend prolonged periods watching television and using computers and other electronic devices. Reading in low light, spending excessive time on screens, and inadequate sleep can lead to fatigue.
  5. Obsessive-Compulsive Disorder (OCD) is a mental disorder that can affect many children but often goes undiagnosed. This psychological condition can also lead to excessive blinking or facial tics.
  6. Blepharitis - It is a bacterial infection of the eyelid. This is one of the causes of excessive blinking in children.

How can you help your child? 

Here are a few ways to help children blink : 

There are multiple methods available to treat excessive blinking in children.

Based on the diagnosis, different treatment options may include:  

  1. Moisturizing and anti-inflammatory eye drops 
  2. Glasses 
  3. Psychotherapy 
  4. Antihistamine eye drops

When should you be concerned 
Symptoms occur when your child blinks, such as strabismus and lack of recognition for everyday life and things.

When you encounter such a situation, it is important to consult an ophthalmologist immediately.

In the vast majority of cases, this issue can be resolved with simple over-the-counter (topical) eye drops treatment. However, if the condition does not improve, oral medication can be taken as recommended by the American Academy of Pediatrics.

If you don't let your child develop the habit of excessive blinking, sooner or later they will overcome the habit.

What is excessive blinking? Read More »

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