Eye disease in Singapore: Steady but Often Undiagnosed

Photo by Carl Cheng on Unsplash

The Importance of Primary Eye Care

Common Misconception

“I am able to see perfectly fine, so there is no reason why I should go for a comprehensive eye check”

Do you know that EVEN IF you have perfect vision with or without glasses, you are still susceptible to eye conditions like glaucoma, cataract, diabetic retinopathy, or retinal detachment? One of the common misconceptions of eye checks revolve only around the need to correct the uncorrected vision. However, the eye checks offered at retail optical shops are just vision checks to test the prescription for spectacles and contact lenses. They are unable to detect and diagnose eye and chronic diseases.

In fact, a comprehensive eye examination involves analysis of the front and back structures of your eye, as well as vision and other eye-related functional tests like depth perception, colour-blindness. These checks can only be conducted using sophisticated equipment by an Optometrist or Ophthalmologist. Through these thorough procedures, eye diseases can be detected. If surgery and medication are required for an eye condition, a referral to the Ophthalmologist will be made.

..the eye checks offered at retail optical shops are just vision checks to test the prescription for spectacles and contact lenses, they are unable to detect and diagnose eye and chronic diseases..

One of the deadliest misconception about eye checks, especially with e-commerce sales, cross-border purchase and opening of many fashion-forward, appliance-driven shops in Singapore
– Ken Tong, President of Singapore Optometric Association

Due to this common misconception, treatment for irreversible blindness usually comes too late as patients usually feel no symptoms at its early stages. Symptoms would only appear in its late stages, and that would already be too late for vision to be regained.

Glaucoma Prevalence in Singapore

Dr. Aung Tin and colleagues at the Singapore National Eye Center looked at prevalence and risk factors among Singaporean Chinese and compared the results with those of the earlier study. The authors selected 3,353 Chinese adults (with an average age of 59.7 years old and 50.4 percent women) from the southwestern part of Singapore, who were examined at a single tertiary care research institute.

The authors reported that of the 3,353 participants, 134 (4%) had glaucoma, including primary open-angle glaucoma (POAG) in 57 (1.7%), primary angle-closure glaucoma (PACG) in 49 (1.5%) and secondary glaucoma in 28 (0.8%). Of the 134 patients with glaucoma, 114 (85.1%!) were unaware of their diagnosis.

This crippling phenomenon explains a lot about the gap between the community and optometrists, which means that there is a lot more that we can do as a community to curb this condition in a more inclusive manner. 

Glaucoma, which affects around 3 per cent of people over 40 in Singapore alone (approximately 53,580 people of the population), can be difficult to diagnose early because patients typically do not suffer noticeable vision loss until the condition becomes severe.

It is sometimes caused by a build-up of pressure in the eye – usually from fluid – that damages the optic nerve.

However, blindness can largely be prevented if the disease is detected and treated earlier.

Contributing Factor Pertaining the Gap

The cost of a comprehensive eye examination starts from $128 at a government hospital and at least $200 at a private clinic. With this price tag and the expected waiting time at the hospital or clinic, it is not surprising that people are not inclined to get their eyes examined regularly as part of their health screening.

What the Public Should Know

Here are the proper components to a primary eye care:

  • Eye health education
  • Symptom identification
  • Visual acuity measurement
  • Basic eye examination
  • Diagnosis
  • Timely referral

Primary eye care services include the following:

  • Educating patients about maintaining and promoting healthy vision.
  • Performing a comprehensive examination of the visual system.
  • Screening for eye diseases and conditions affecting vision that may be asymptomatic.
  • Recognizing ocular manifestations of systemic diseases and systemic effects of ocular medications.
  • Making a differential diagnosis and definitive diagnosis for any abnormalities that are detected.
  • Performing refractions.
  • Fitting and prescribing optical aids such as glasses and contact lenses.
  • Deciding on a treatment plan and treating patients’ eye care needs with appropriate therapies.
  • Counselling and educating patients about their eye disease conditions.
  • Recognizing and managing local and systemic effects of drug therapy.
  • Determining when to triage patients for more specialized care and referring to specialists as needed and appropriate.
  • Coordinating care with other physicians involved in the patient’s overall medical management.
  • Following up with patients to monitor their compliance to advice – referral, surgery, medication or review visits.
Comprehensive Eye Exams should be done once every two years for kids above 8 years old

Primary‌ ‌eye‌ ‌care‌ (PEC) ‌on‌ ‌its‌ ‌own‌ ‌is‌ ‌a‌ ‌broad‌ ‌concept,‌ ‌encompassing‌ ‌the‌ ‌prevention‌ ‌of‌ ‌blinding‌ eye‌ ‌diseases‌ ‌through‌ ‌primary‌ ‌health‌ ‌care‌. PEC‌ ‌includes‌ ‌the‌ ‌identification,‌ ‌with‌ ‌treatment‌ ‌or‌ ‌referral‌ ‌of‌ ‌individuals‌ ‌with‌ ‌treatable‌ ‌causes‌ ‌of‌ ‌blindness‌ ‌and‌ ‌diagnosis‌ ‌and‌ ‌treatment‌ ‌of‌ ‌common‌ ‌eye‌ ‌disease‌ ‌eg.‌ ‌acute‌ ‌red‌ ‌eyes‌. The‌ ‌correct‌ ‌identification‌ ‌and‌ ‌timely‌ ‌referral‌ ‌is‌ ‌very‌ ‌crucial‌ ‌in‌ ‌the‌ ‌success‌ ‌of‌ ‌primary‌ ‌eye‌ ‌care.‌ ‌ ‌

The‌ ‌public‌ ‌need‌ ‌to‌ ‌recognise‌ ‌that‌ ‌primary‌ ‌eye‌ ‌care‌ ‌plays‌ ‌a‌ ‌crucial‌ ‌part‌ ‌to‌ ‌ensure‌ ‌an‌ ‌effective and cost-saving healthcare ecosystem.

Taking Action

Eyesight.sg is a huge advocate for primary eye care and we only seek to optimize your vision through proper comprehensive eye check for everyone regardless of your age, race and socioeconomic background. We give genuine advice based on your needs, because we believe that everyone deserves the knowledge for their own health.

Over at our practice, our comprehensive eye exams are set at $49. Kindly call 9824 1607 to book an appointment. We hope to see you soon.

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