Cataract leads the list of reasons people in Singapore go blind, yet the condition can be easily treated with surgery. It is the delayed treatment of various eye conditions that often leads to loss of sight.
As the hair on your head starts to grey, your eyes begin to dim too. The passing of the years not only leads to the wear and tear of the windows to the soul, but also raises one’s chances of getting diseases that can close the shutters of those windows – for good. With the average lifespan of a person here rising from 63 years in 1960 to 80 years now, and the population greying rapidly, more people here will face the risk of losing their sight, said doctors.
Four of the top five causes of blindness here, including reversible blindness, are linked to ageing. They are cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy. A consultant eye surgeon in Singapore said: “For diseases which are age-related, the longer you live, the higher the likelihood of getting them.” The only other major cause of blindness here that does not plague just the elderly is severely undercorrected refractive error, which comprises mainly short-sightedness. The growth in the number of people suffering from refractive errors and diabetic retinopathy is a result of changes in lifestyle here, doctors said.
Another eye surgeon noted that in the past, vision loss would probably have been caused more by
malnutrition, such as vitamin A deficiency, and by infectious diseases, such as trachoma, which are still
major problems in developing countries. “In developed countries now, we have mostly age-related and lifestyle
associated vision problems,” he said. For example, more people are short-sighted now compared to 30 years ago, as children spend more time reading and less time outdoors, said Professor Saw Seang Mei of the National University Health System (NUHS), Department of Epidemiology and Public Health. She found these risk factors for myopia in her ongoing study, which was started in 1999, on 2,000 children, then aged seven to nine.
Singapore Malay Eye Study
The incidence of such diseases will continue to rise as the population is ageing rapidly. Since it takes time for people to modify their lifestyles to promote good eye health, it may be decades before any change can be seen.
It is not known exactly what proportion of the population here is blind or has low vision, which is defined as the inability to see well enough to drive.
A study on 3,280 Malays aged 40 to 79, completed in 2006, gives an idea of the extent of vision loss and
sight-threatening eye diseases here. The Singapore Malay Eye Study found that 0.3 per cent of the Malay
population here are blind in both eyes, and 4.4 per cent have low vision in both eyes. Of the Malays who were blind in both eyes, 65 per cent suffered from cataracts, while almost 20 per cent had undercorrected refractive errors. Those with AMD accounted for less than 5 per cent of those who were blind in both eyes. The glaucoma and diabetic retinopathy groups each made up a similar proportion.
The study’s researchers, from NUHS, the Singapore Eye Research Institute and the Singapore National Eye Centre (SNEC) are analysing data from a similar study on 3,400 Indians completed last year. They are conducting a study on the Chinese, which will be completed next year. The good news is that the top two causes of blindness here – cataract and undercorrected refractive errors – can be treated effectively and hardly anyone with these conditions has to be blind permanently.
Regular eye screening
Treatment methods for glaucoma, diabetic retinopathy and AMD have also improved over the years and can
help slow, or even halt vision loss, especially for those who are diagnosed and treated early. However, many patients do not seek help early enough because they do not know about the disease and the fact that it can be treated. Some may fear consulting doctors or are afraid that the treatment will be costly, said Prof Saw, who is part of the research team. This results in unnecessary loss of quality of life. She said: “You won’t have optimal quality of life if you don’t have at least driving vision. You’ll also be at a greater risk of falls.” As many eye diseases do not have obvious symptoms, the key to detection and prevention is regular screening, said Dr Mohamad Rosman Othman, another member of the research team and consultant at SNEC’s refractive surgery service.
Diabetic patients should go for screening every year, while those aged above 40 should have an eye check every two years, he said. Such eye checks can be done by optometrists or doctors. “If the disease is caught early, there is a chance it can be prevented from getting worse. If it is found late, we may not be able to reverse the damage done,” Dr Rosman said.