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eye+
february | 2016
AFIQ NOR / Health+
Getting rid of floating nuisance Dr Pall Singh shares enthusiastically about laser vitreolysis treatment and how it enhances patients’ quality of vision
E
ye conditions such as cataract, glaucoma and diabetic retinopathy greatly affect people’s vision and can sometimes result in blindness. People affected by eye conditions should not delay but promptly seek treatment from eye specialists. However, there is another eye condition called muscae volitantes, commonly known as floaters, which has largely been ignored because of its somewhat mild effect compared to other more serious conditions. Floaters are small spots moving in your field of vision, especially when you close your eyes. They occur as part of the natural ageing process and are particularly common among people above 50. The condition is generally harmless and does not affect your vision greatly. Because of this, the general consensus among ophthalmologists is that nothing can be done about it, which means you must learn to live with those troublesome floaters. However, if you are indeed bothered by those floaters, you can actually get rid of them using a modern treatment known as vitreolysis which has been available in countries like the US, UK, Australia and Taiwan for quite some time. According to Tun Hussein Onn National Eye Hospital (THONEH) senior consultant ophthalmologist Dr Pall Singh, in the past whenever patients came to him complaining about floaters, his standard answers were “hopefully they will go away”, “you will learn to live with them”, and “I wish there is something I
could do”. He was somewhat bothered by those standard answers he gave to his patients and that soon fuelled his desire to search for a solution to his patients’ floating problem. And while attending a conference he was told that the YAG laser vitreolysis machine was already available in Malaysia. “I was learning to use the machine at the conference when the product manager told me that an agent in Malaysia actually had one. So I contacted that agent and he told me no one in Malaysia was interested in using it because people lacked the ability to operate it properly,” says Dr Pall. On returning to his clinic, Dr Pall arranged for that person to bring the machine to THONEH for a product demonstration. He knew right then that he must have the machine available because so many of his patients had floaters. “I once had a patient who flew all the way to Taiwan to get treatment for her floaters,” says Dr Pall. And that patient didn’t have to make a return visit to Taiwan for her second treatment as Dr Pall was already trying out the equipment for treatment then. However, it took some time for Dr Pall to convince THONEH to provide vitreolysis treatment using the laser machine, and that eventually became a reality late last year when the hospital brought in the YAG laser vitreolysis machine. And with that, Dr Pall started using the state-of-the-art machine to treat patients living with floaters. As with other medical
Dry eye: More than meets the eye Dry eye occurs when the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly. According to the US National Eye Institute (NEI), inflammation of the surface of the eye may also occur along with
LEADING THE PACK: Dr Pall is currently the only ophthalmologist in the country certified to perform vitreolysis using the YAG laser machine.
I was learning to use the machine at the conference when the product manager told me that an agent in Malaysia actually had one. So I contacted that agent and he told me no one in Malaysia was interested in using it because people lacked the ability to operate it properly,” – Dr Pall
dry eye. If left untreated, this condition can lead to pain, ulcers, or scars on the cornea, and some loss of vision. However, permanent loss of vision from dry eye is uncommon. Dry eye can make it more difficult to perform some activities, such as using a computer or reading for an extended period of time, and it can decrease tolerance for dry environments, such as the air inside an airplane. Dry eye can be associated with: inflammation of the surface of the eye, the lacrimal gland, or the conjunctiva; any disease process that alters the
treatments, vitreolysis does come with some risks. However, Dr Pall points out the risks depend largely on the user of the machine, not so much the treatment itself. “If it is not performed properly, the laser can accidentally hit the lens or retina which can cause bleeding. So it really is up to the doctor to master the technique before performing any treatment,” he says. The treatment has yet to be perfected, and Dr Pall frankly admits the only other “risk” in the treatment is it might not work in just one session. “Patients usually have to go through a few sessions for best results.” With multiple sessions, people with floater problem will obviously be concerned about the high treatment cost. Recognising this nagging concern, THONEH is working out something to keep the cost at a minimum level. “It will definitely be not as expensive as, say, treatment for cataract,” he says.
components of the tears; an increase in the surface of the eye, as in thyroid disease when the eye protrudes forward; cosmetic surgery, if the eyelids are opened too widely. Dry eye symptoms may include any of the following: stinging or burning of the eye; a sandy or gritty feeling as if something is in the eye; episodes of excess tears following very dry eye periods; a stringy discharge from the eye; pain and redness of the eye;
Dr Pall plans to train other doctors to use the machine successfully, and is already busy advocating the treatment at conferences and educating other doctors. “I have several doctors in THONEH who are working to become qualified experts.” THONEH uses conferences to promote the treatment to other medical centres in Malaysia so that they can also improve the quality of their patients’ vision. Dr Pall advises people who have troublesome floaters, but are unaware of this latest procedure, to seek prompt treatment as it is readily available. Ophthalmologists should also educate their patients about vitreolysis treatment. “There are still many doctors giving the same advice which I gave to my patients in the past when they complained about their floaters. We should not be bothered by this nuisance anymore,” he says.
episodes of blurred vision; heavy eyelids; inability to cry when emotionally stressed; uncomfortable contact lenses; decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention; eye fatigue. If symptoms of dry eye persist, consult an eyecare professional to get an accurate diagnosis of the condition and begin treatment to avoid permanent damage.