Ask an Ophthalmologist: Dr Au Eong Kah Guan from Mount Elizabeth Hospital (Orchard) Singapore

Ask a Doctor ForumCategory: OphthalmologyAsk an Ophthalmologist: Dr Au Eong Kah Guan from Mount Elizabeth Hospital (Orchard) Singapore
dr. Au Eong Kah Guan asked 3 years ago
I am Dr Au Eong Kah Guan, an eye specialist (ophthalmologist) based in Mount Elizabeth Hospital (Orchard) Singapore and Farrer Park Hospital in Singapore. I am currently Medical Director & Senior Consultant in International Eye Cataract Retina Centre at Mount Elizabeth Medical Centre and Farrer Park Medical Centre. I am also a Visiting Senior Consultant to the Department of Ophthalmology & Visual Sciences at Khoo Teck Puat Hospital. I was previously Head & Senior Consultant in the Department of Ophthalmology & Visual Sciences at Alexandra Hospital; Head & Senior Consultant of the Eye Clinic at Jurong Medical Centre; Adjunct Associate Professor in the Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; Deputy Director & Head of Research in The Eye Institute, National Healthcare Group; and Deputy Director of the Clinical Research Unit at Tan Tock Seng Hospital. I graduated from the National University of Singapore with a Bachelor of Medicine and a Bachelor of Surgery in 1989 and a Master of Medicine (Ophthalmology) in 1995. I obtained my Fellowships of the Royal College of Surgeons of Edinburgh and the Royal College of Physicians & Surgeons of Glasgow in 1995, and from the Academy of Medicine in Singapore in 1998. I obtained my Diploma in ophthalmology from the Royal College of Ophthalmologists in London in 1999 and my Membership of the Royal College of Ophthalmologists in London in 2010. After completing 6 years of Basic and Advanced Surgical Training in Singapore, I received two additional hands-on fellowship training in diseases and surgery of the vitreous and retina in Europe and North America. I completed my first one-year clinical fellowship at the University of Manchester and Manchester Royal Eye Hospital in Manchester, United Kingdom, from 1998 to 1999 and my second 14-month clinical and research fellowship at the Wilmer Eye Institute, Johns Hopkins University School of Medicine and Johns Hopkins Hospital in Baltimore, Maryland, from 1999 to 2000. I am a clinician-scientist active in teaching, research and innovation in many areas of ophthalmology. I have published more than 29 books and book chapters, and more than 214 scientific articles and letters in peer-review local and international journals. My current areas of practice include retinal and macular diseases, cataract and comprehensive ophthalmology. Learn more about Mount Elizabeth Orchard Hospital here: and Farrer Park Hospital here: Learn more about me here: I am excited to be here to discuss Eye Conditions and Eye Health. Ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
18 Answers
Robin M answered 3 years ago
My father has cataracts. I want to know if the surgery for cataracts is only done once or does he need multiple surgeries? My father has diabetes. Is it safe for him to undergo cataract surgery?
dr. Au Eong Kah Guan replied 3 years ago

A cataract is a clouding of the normally clear lens of the eye. Cataract surgery typically is performed only once in each eye. Once a cataract has been removed, it does not recur. During surgical removal of the cloudy lens, the back portion of the lens capsule (called posterior capsule) is retained. This remnant lens capsule is used to support an artificial lens implant which replaces the original natural lens.

This remnant lens capsule in the eye can sometimes becomes cloudy after several years. This condition is called an “after-cataract” or “posterior capsule opacification”. It can cause blurring of vision once again, like the original cataract. However, this is not a true cataract. “After-cataract” can be easily treated with a procedure called "YAG laser posterior capsulotomy”. A small opening is made in the capsule to clear the visual axis during the laser procedure and this enables the eye to see clearly again.

It is generally safe for a diabetic to undergo cataract surgery. However, before any cataract surgery, it is important to check the health of the retina, especially in a diabetic patient. Diabetic retinopathy is a common diabetes complication that affects the retina, the light-sensitive back portion of the eye. If a cataract patient also has diabetic retinopathy, the diabetic retinopathy may have to be treated first if it is severe. Otherwise, the diabetic retinopathy may sometimes rapidly worsen after cataract surgery, leading to worsening of the vision.

Renatha Arini answered 3 years ago
Good afternoon doctor. My eyes are reddened and I cannot open them and wax comes out of them. It has been two weeks. How do I treat it?
dr. Au Eong Kah Guan replied 3 years ago

Eye redness and discharge may be caused by a number of conditions.

If the redness is acute and severe, it could be due to an infection of the conjunctiva or conjunctivitis. The conjunctiva is the transparent membrane that covers the white of the eye. Conjunctivitis caused by bacterial infection can cause eye redness with pus or mucus-like discharge. Viruses can also cause conjunctivitis, producing eye redness and watery discharge. Viral conjunctivitis may also be associated with sore throat and running nose.

If the eye redness and discharge are associated with blurry vision, pain or light sensitivity, it could be due to a serious infection or inflammation in the eye such as anterior uveitis.

Eye redness and discharge can also be due to blepharitis or meibomian gland dysfunction. Blepharitis is a chronic disorder of the eyelids and cause cause foamy or frothy eye discharge and eyelid crusting. Dry eye can also cause eye redness and discharge.

The treatment of eye redness and discharge depends on its cause. An examination by an eye care professional can show up signs in the eyes which can help narrow down on the cause of the condition.

Hanissa answered 3 years ago
Hello doc, I've been using contact lens since I was 15 years old. I feel pain when I blink my eyes, I can see a white dot on my eyeballs and it’s reddish around it. Is it dangerous?
dr. Au Eong Kah Guan replied 2 years ago

It is not normal for you to feel pain when you blink your eyes, even when you are wearing contact lenses. Pain is a sign of inflammation and is nature’s way of warning you that something is not right with your eyes. Likewise, redness in the eye is also a warning sign of inflammation.

The key warning signs of inflammation in the eye can be summarised by the following mnemonic: “R.V.S.P.”. “R”stands for redness, “S”for swelling, “V” for vision decrease and “P” for pain. If you have one or more of these four symptoms in your eye, you are likely to have inflammation in your eye and this can be dangerous.

A white dot on your cornea, the normally transparent covering on the front of your eye, could be infiltration of white blood cells in your cornea or a corneal ulcer, especially when it is associated with eye redness. A corneal ulcer is a potentially blinding condition. In contact lens wearers, it is commonly caused by Pseudomonas aeruginosa, an aggressive bacteria that can cause the cornea to perforate in days.

You should cease contact lens wear and consult an eye specialist immediately for your symptoms.

Ziazia answered 3 years ago
Hello doctor, my friend has a mole that grows in the caruncle area -it is getting bigger and bigger. I have consulted several times with an ophthalmologist and they said that his eyes will be fine. If he does surgery, the doctor is concerned it will harm the eyes, but there is still a sense of worry. Because he has felt pain around the mole, should he do surgery or follow the doctor’s recommendation to leave it that way? Thank you
dr. Au Eong Kah Guan replied 2 years ago

The caruncle is the small pink nodule at the inner corner of one’s eye. It is made of skin covering some glands.

A mole is a coloured-spot on one’s body, and can occur on the caruncle.

Most people have moles on their body and they are usually nothing to worry about unless they change size, shape or colour.

If your friend’s mole is indeed getting bigger and bigger, it may be wise to have it surgically removed and sent for examination. The examination can determine if the mole is benign or cancerous. It is unusual to feel pain around a mole and other causes of eye pain should be excluded. If no other cause for the pain is found, it is another reason to consider having the mole removed.

If the mole is small, the surgery should be straightforward and relatively safe. However, as in all surgeries, there are risks involved with the surgery and these include bleeding, scarring and possible injury to other tissues near the mole. The doctor can discuss the potential risks and benefits of surgery with your friend so that he or she can make an informed decision on whether to proceed with the surgery or to continue observing the mole for further changes.

Zoe L answered 2 years ago

Whenever I wear contact lens, I feel a throbbing pain in my head and pressure on my forehead. Is this because the contacts (I wear monthlies) are not suitable for me? Hygiene wise, I change them on time every month. I don't experience the same symptoms when I'm in glasses.

Adeline H answered 2 years ago

My father is 65 years old. He is blind in his right eye due to glaucoma. He has been complaining recently about pain in the left eye and severe headaches. Is it possible for the glaucoma to spread to his left eye too? What can we do to prevent it?

Elisah answered 2 years ago

My son is 9 years old. My husband and I have noticed he constantly squints and blinks. His teacher also pointed it out. We have gotten glasses for him so the squinting is better but he still blinks excessively. Is it out of habit or is there something wrong with his eyes?

dr. Au Eong Kah Guan replied 2 years ago

A child with uncorrected refractive errors such as short-sightedness, long-sightedness or astigmatism may squint to see better. Wearing corrective glasses help to reduce the squinting, as you have observed in your son.

Excessive blinking in a child is often due to an eye allergy called allergic conjunctivitis. It can also be caused by problems with the eyelids, front surface of the eye or habitual tics.

You should bring your son to see an eye specialist to determine the exact cause of his symptom so that the most appropriate treatment can be given.

Foo Jook answered 2 years ago

Doctor, I am 59 years old. When i am in a dark room, i keep seeing circular light spots. This has been happening for almost 5 years. Is this normal and will my eyes get worse in the future?

Simon Lee answered 2 years ago

I am considering lasik. I understand lasik is considered quite mainstream and safe now, but are there still risks involved with the surgery? What can go wrong?

Andy answered 2 years ago

Since undergoing cataract surgery 3 months ago, my mom has been complaining that her eyes get irritated and itch easily. Is this normal considering the surgery was quite recent?

dr. Au Eong Kah Guan replied 2 years ago

In the first few weeks after cataract surgery, eye irritation and itch are common and may be caused the surgical incisions or medicated eyedrops. These often improve after several weeks. Less commonly, an actual allergic reaction to the eyedrops may be the cause.

If your mother still has eye irritation and itch 3 months after surgery, they are likely due to dry eye or unstable tear film. Dry eye and cataract are both age-related conditions, and often co-existing together. Many cataract patients, especially if they are older, already have a dry eye tendency and may first become more aware of it after their cataract surgery.

During cataract surgery, incisions made in the corneal cut some corneal nerves. These corneal nerves are important in the self-regulation of tears since they provide the sensation in the feedback loop that signals tear production. When we damage or decrease the function of these nerves, we can significantly limit the eye’s ability to create a proper tear film which can lead to irritation and itch.

Your mother can use artificial tears or lubricating eyedrops frequently for relief. If lubricating eyedrops or gels do not help, or if the irritation and itch are severe, your mother should consult her ophthalmologist.

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