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All you need to know about ophthalmologists in Singapore

pronounce ophthalmologist
How to pronounce ophthalmologist?

Increasing need for ophthalmologists in Singapore 

The field of ophthalmology is less well-known than other medical specialities. Many only come to hear of ophthalmology when they require the services of an ophthalmologist or are inspired to pursue the career of one. 

Unbeknownst to many, the need for ophthalmologists' services is progressively increasing in Singapore, with the prevalence of a myriad of eye conditions being a contributing factor: 

  • About 66.67% [1] of Singaporean adults have visually significant cataracts, which were previously undiagnosed. 
  • Glaucoma, the Silent Thief of Sight, affects 10% of Singaporeans and is undiagnosed in 50% of cases [2]. 
  • Symptomatic dry eye disease affects around 12.3% [3] of Singaporeans.
  • Singapore is labelled the Myopia Capital of the World [4], with a staggering increase in myopia in the last two decades.

The rising rate of certain eye diseases is partially attributed to poor eye health literacy. Whilst poor awareness is the fundamental factor, fear of seeking medical attention, and the lack of screening practices (almost half of Singaporeans do not abide by the recommended frequency of eye screening) are arguably the culprits behind these unfavourable statistics. 

Singapore is home to Southeast Asia's most prominent ophthalmologists, many of whom are leading researchers, innovators, and philanthropists who provide eyecare access to remote parts of the world and underprivileged communities. Given that Singapore is indeed a powerhouse for eyecare specialists, it remains a question of whether the proficiency of ophthalmologists will ever reflect upon the population’s health. 

ophthalmologist
Singapore is a powerhouse for eyecare specialists.

Ophthalmologist vs. Optometrist vs. Optician in Singapore 

Ophthalmologists often work closely with optometrists and opticians to provide patients with holistic and optimal care. The roles and qualifications differ between ophthalmologists, optometrists, and opticians. Please refer to the table below to help you understand the differences between the different eye health professionals in Singapore.

ProfessionOphthalmologistOptometristOptician
Qualification 5-Year Ophthalmology Residency Training with Subspecialty and Surgical Experience Diploma in OptometryOpticianry Diploma or Certificate 
Perimeter of medical service -- Diagnosing and treating ophthalmic diseases and conditions
-- Conduct ocular surgery where necessary.
-- Prescribing optical aids and medication.
-- Examine eyes to detect vision problems within remit of qualification
-- Conduct eye screening.
-- Prescribe and fit spectacles, contact lenses, and various optical aids.
-- Refer patients to ophthalmologists for further management, especially if surgery or medications are required. 
-- Perform visual examination.
-- Dispensing and fitting visual aids within remit of qualification.
-- May perform refraction on patients older than 8 years. 
-- Refer patients to ophthalmologists for further management, especially if surgery or medications are required. 

When should I visit an ophthalmologist in Singapore?

  1. Visit an ophthalmologist for regular eye screenings 

One should visit the ophthalmologist to undergo regular eye screening. The frequency will differ by age and risk factors such as family history, prior eye injury, and underlying health conditions that may increase the risk of eye diseases and conditions. 

Below is the prescribed frequency by age:

  • Age 3 and below: screening is done during scheduled paediatric appointments. 
  • Between 3 to 19 years old: annual or bi-annual screenings. In Singapore, it is necessary that screening for myopia is done in these age groups, given they are prone to this condition.  
  • Between 20 to 39 years old: if you have glasses or contact lenses prescribed, get your eye screening done annually for an updated prescription and to keep an eye on the progression of your condition. Additionally, you should undergo a comprehensive eye examination if you have a family history of eye diseases or an eye injury.
  • Between 40 to 64 years old: at the age of 40, it is essential to obtain baseline screening to assess the condition of your eyes. For individuals aged between 40-54 years, you are advised to get a screening every 2 to 4 years, depending on your condition. For those aged 55-64 years, get an eye screening every 1-3 years. 

Additionally, patients with risk factors such as diabetes [5] and high blood pressure [6] require frequent review and assessment by an ophthalmologist. Whilst some health conditions pose risks to one’s vision, an eye screening may also reveal undiagnosed health conditions [7], such as heart conditions, cancer, and lupus. 

eye screening
Regular eye screenings are important and usually increase in frequency as we age.
  1. Visit an ophthalmologist when symptoms of eye conditions are present 

Self-diagnosing is not advised when you suspect your eye health is deteriorating. A few symptoms indicate that you may be suffering from an eye condition and require medical intervention from an ophthalmologist. 

These include:

  • A recent increase in black spots in your vision, known as eye floaters [8]
  • Persistent bumps and lumps in your eyelid 
  • Dry eyes with consistent dependency on eye drops 
  • Recurring itchiness and eye redness that affects your quality of life 
  • Frequent eye discharge (typically yellowish or greenish) 
  • Blurred vision
  • Distortion of vision 

Some eye diseases, such as glaucoma, have no symptoms in the early stages. Hence, we should not undergo eye examinations only when we experience the symptoms above. Often, patients are unaware of their deteriorating eye health. Thus, it is crucial to undergo regular eye check-ups to detect eye diseases early so as to receive treatment early.

  1. Visit an ophthalmologist when you are referred by a doctor or an optometrist 

You are advised to visit an ophthalmologist when suspected of an eye condition that requires further treatment. There are many factors guiding your choice of an ophthalmologist. 

Some would include: 

  • Competence and experience: it is important to research the doctor’s expertise and qualifications before making a choice on your ophthalmologist. If you are seeking treatment for a more specialised eye condition, e.g., glaucoma, pay attention to the fellowship training that the ophthalmologist has received, which provided him/her with the subspecialty training and skills. In Singapore, many ophthalmologists receive subspecialty training abroad at world-renowned institutions. In addition, some Singaporean ophthalmologists are internationally renowned and have been recognised as global leaders in their field.
  • Language: patients often seek doctors who can communicate well in their language of choice. However, translators are easily available in Singapore, so if your chosen ophthalmologist does not speak the same language as you, ensure that a translator is available. 
  • Insurance: patients tend to seek ophthalmologists who are included in their insurance panels. However, insurance companies would still provide a degree of medical coverage for non-panel doctors, with the amount of coverage varying depending on your insurance company and the plan that you have purchased. Hence, do not despair if your chosen ophthalmologist is not on your insurance panel; speak with your insurance agent, and you may be pleasantly surprised that significant reimbursement is still available! 

What eye tests are usually conducted in Singapore? 

Depending on your condition, you may require one or more of the tests listed below:

Test Purpose
Visual acuity tests-- Assesses the sharpness of your vision.
-- Letters or numbers on a chart are projected at a fixed distance away.
-- The smallest line of letters that you can see will give an indication of how good your vision is. 
-- Poor vision can be due to incorrect spectacles prescription, cataractsage-related macular degeneration, and other eye diseases.
Visual field tests-- Assesses your peripheral vision.
-- People with glaucoma lose their peripheral vision first, and they often do not notice this until their central vision is affected.
-- The visual field test will allow us to detect glaucoma as well as other diseases involving the eye nerve and the visual pathway in the brain.
Optical coherence tomography of the macula-- Utilises light waves to obtain a high-resolution and detailed scan of your macula, the central part of the retina, which is responsible for central vision.
-- This will detect diseases such as age-related macular degeneration, macular swelling due to diabetes, and central serous retinopathy. 
Optical coherence tomography of the optic nerve-- Optical Coherence Tomography uses light waves to obtain a high-resolution and detailed scan of your eye nerve.
-- This will allow us to detect diseases involving the eye nerve, such as glaucoma
Anterior segment optical coherence tomography-- The anterior segment optical coherence tomography uses light waves to obtain a high-resolution scan of the drainage angle of the eye.
-- This can detect angle closure, which increases the risk of glaucoma
Refraction-- Lenses are placed in front of your eye to improve your vision.
-- The power of the lens, which is able to achieve the best vision, is recorded.
-- To help you see more clearly, you can make a new pair of spectacles with this lens power.
Tonometry-- The tonometry test measures the pressure in your eye.
-- High eye pressure can be a sign of glaucoma.
Fundus and Optic Nerve Photography-- A photograph of your retina and eye nerve is taken.
-- Abnormalities in the appearance of your retina or eye nerve may indicate glaucoma, age-related macular degenerationdiabetic retinopathy, and other eye diseases.
Colour Vision-- Assesses ability to distinguish colours.
-- Assessed with the Ishihara chart.
-- Abnormalities in colour vision can be hereditary or can indicate disease of your macula and eye nerve.
Amsler Grid-- The Amsler grid is used to check for abnormalities in your central vision (e.g., distortion or dark patches in your vision) which can be caused by diseases of your macula. 

Conclusion 

We hope this article has empowered you to take control of your eye health. As with any health condition, early detection provides the best opportunity to manage and prevent the progression of eye conditions and diseases. A competent ophthalmologist can perform a comprehensive eye examination and provide valuable advice on how to improve your eye health.  If you have not had a recent eye examination, do not put this off any further and make an appointment now

References

  1. Chua, J. et al. (2017) Prevalence, risk factors, and impact of undiagnosed visually significant cataract: The Singapore Epidemiology of Eye Diseases Study, PloS one. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5271362/#:~:text=After%20age%2Dstandardization%20to%20the,CI%2C%204.79%E2%80%936.82%25)%20and (Accessed: 05 June 2023).
  2. Singapore National Eye Centre (2022) Glaucoma: Eye under pressure. Available at: https://www.snec.com.sg/singvision-issue1-2022-glaucoma-eye-under-pressure (Accessed: 05 June 2023).
  3. Tan , L.L., Morgan, P. and Cai , Z.Q. (2014) Prevalence of and risk factors for symptomatic ... - Wiley Online Library, Prevalence of and risk factors for symptomatic dry eye disease in Singapore. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/cxo.12210 (Accessed: 05 June 2023).
  4. Ministry of Health Singapore (2019) Speech By Dr Lam Pin Min, Senior Minister Of State For Health, At The Opening Of The Singapore National Eye Centre’s Myopia Centre, 16 August 2019, Ministry of Health. Available at: https://www.moh.gov.sg/news-highlights/details/speech-by-dr-lam-pin-min-senior-minister-of-state-for-health-at-the-opening-of-the-singapore-national-eye-centre-s-myopia-centre-16-august-2019 (Accessed: 05 June 2023).
  5. Centers for Disease Control and Prevention (2022) Diabetes and Vision Loss. Available at: https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html#:~:text=Eye%20diseases%20that%20can%20affect,way%20toward%20protecting%20your%20eyesight. (Accessed: 05 June 2023).
  6. WebMD Editorial Contributors (2022) High Blood Pressure and Eye Disease, WebMD. Available at:https://www.webmd.com/hypertension-high-blood-pressure/guide/eye-disease-high-blood-pressure (Accessed: 05 June 2023).
  7. Mukamal, R. (2022) 20 surprising health problems an eye exam can catch, Tips and Prevention. Available at: https://www.aao.org/eye-health/tips-prevention/surprising-health-conditions-eye-exam-detects (Accessed: 05 May 2023).
  8. Mayo Clinic Staff (2022) Eye floaters, Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/eye-floaters/symptoms-causes/syc-20372346 (Accessed: 05 June 2023).

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    Dr Chelvin Sng of Chelvin Sng eye center

    Dr Chelvin Sng

    Adjunct Associate Professor
    Senior Consultant Ophthalmologist
    ✓ 4 Gold Medals (Specialist Accreditation Examination)
    ✓ "Top 50 Rising Stars” (2017), “Top 100 Female Ophthalmologists” (2021)
    and "Top 100 Ophthalmologists" (2022)
    ⋆ Global Ophthalmologist Power List (voted by peers worldwide)
    ✓ Cambridge University Graduate with Triple First Class Honours and Distinctions

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