SUNDAY STAR, 3 MARCH 2019
HEALTHY EYES
IN this digital age, it is important to
know how our digital lifestyles
effect our health, especially when it
comes to eyesight.
Dr Norazah Abdul Rahman,
paediatric ophthalmologist at Ara
Damansara Medical Centre, says
gadgets such as computers and
mobile phones cause multiple
ocular and vision problems for
users.
“Too much screen exposure
could lead to computer vision
syndrome (CVS) or digital eye
strain (DES), characterised by a
range of eye- and vision-related
symptoms, such as dry eye, blurred
vision and risk of early myopia
(short-sightedness). While these
symptoms may be temporary, it
can cause significant and frequent
discomfort,” she says.
Protecting children
CVS or DES affects children more
than adults as their eyes are still
maturing. While Dr Norazah
recognises the different factors for
a child becoming myopic, such as
genetics and lifestyles, she says that
some studies have shown an
association between myopia and
excessive exposure to computers at
work or playing video games. She
urges parents not to expose any
child under 18 months to digital
screens to reduce the risks of
developing myopia.
“Children now have more access
and are encouraged to use
computers either at home or at
schools. Because of this, children
are more likely to stay indoors with
their gadgets,” says Dr Norazah.
“Spending too much time
indoors with a gadget will dissuade
children from doing any outdoor
physical activities. Studies have
found that myopic children have
lower levels of dopamine
compared with children without
any vision problems. Dopamine is
a chemical produced in the brain
that acts as a neurotransmitter,
also famously known as a feel-good
hormone as it creates feelings of
happiness and satisfaction.
“Dopamine helps inhibit the
elongation of the eyeball, which is
the leading cause of myopia. As
dopamine is usually generated
through outdoor activities, it is
helpful for children to play outside,
getting adequate exercise and
proper amounts of sleep to both
stay healthy and reduce the risk of
myopia,” she says.
Prioritising sight at work
Dr Norazah is an advocate of
practising the 20/20/20 rule, an eye
care method where after 20
A hidden threat
Most people cannot escape
digital eye strain (DES). However,
while children experience the
same symptoms as adults, they
are more susceptible because of
unique factors, such as:
l Lack of self-awareness –
When a child performs an
enjoyable task, such as playing
video games, he will forget to
take breaks or blink normally,
causing eye focusing problems
and eye irritation.
l The ability to adapt – While
adaptability is usually an
Maintaining good eye
health in the digital age
minutes of visual display unit use,
the person has to look at objects
over 20 feet away for 20 seconds.
This should be practised by people
of all ages.
She says the 20/20/20 rule will
help minimise the development of
accommodative problems and eye
irritation. Accommodative
problems may occur as a result of
the eyes’ focusing system “locking
in” to a particular target,
sometimes causing what is called
an accommodation spasm.
She also acknowledges that not
everyone, particularly working
adults, has the luxury of taking
frequent breaks from their
computer at work or home, and
suggests some ergonomic practices
that can be done in the workplace
to reduce digital eye strain, as
listed below.
l Maintain normal blinking
during computer usage
l Use artificial tears
l Proper correction of
underlying refractive errors
l Use appropriate lighting
l Carefully position your digital
device
l Adjust image parameters
(resolution, text size, contrast,
luminance) for better eye comfort
l Improve contact lens comfort
l Take breaks
Prevention is care
Knowing the risks and effects of
digital screens on our eyes, what
can we do to manage our risk
exposure?
“Prevention is the main strategy
for management of digital eye
strain,” says Dr Norazah.
“This can be done through
patient education and
implementation of ergonomic
workplace policies, regular visual
examinations and eye care to treat
visual disorders, and special
consideration for people at high
risk of DES.”
She also notes that awareness
for children’s eyesight is still low
in Malaysia.
“Parents seldom notice the signs
of visual problems in children,
such as squinting, rubbing their
eyes and frequent blinking. This
slows the application of therapy by
advantage, it can cause more
harm than good when children
ignore their eyesight problems. A
child may not change the settings
of a computer that is emitting
excessive glare or tell their
parents about their blurred
vision because of a lack of
understanding.
l Ill-designed gadgets –The
most efficient viewing angle of a
computer is a slight downward
angle of 15°. As most computer
workstations are designed for
adult use, and children are
a specialist and it can have
serious health consequences.”
The art of regaining sight
The advice above is helpful to
reduce one’s risk of preventable
vision problems. However, what
happens if a person already has
poor vision related to a refractive
error such as myopia, hyperopia
or astigmatism?
Dr Ainur Rahman Anuar
Masduki, consultant
ophthalmologist and corneal
surgeon at Ara Damansara
Medical Centre, presents the
many choices that modern
medicine has to offer.
“There are surgical and non-
surgical methods to treat
refractive errors. Non-surgical
methods include spectacles and
contact lenses.
“As for surgical methods, there
is refractive surgery and cataract
surgery. Refractive surgery is
where the cornea is reshaped to
correct a person’s refractive error,
as two-thirds of the eye’s focusing
power is in the cornea,” he says.
According to Dr Ainur, laser-
assisted in situ keratomileusis
(LASIK) is one form of refractive
surgery, and is considered well
established, safe and predictable
with good patient satisfaction.
It is also the most frequently
carried out refractive procedure.
However, careful selection of
patients is key to a safe and
successful outcome, as some
smaller in size, they have to look
upwards instead of downwards,
causing eye strain.
l Non-optimal lighting –
Because the lighting level for the
proper use of a computer is about
half as bright as normally found
in a classroom, a child might
increase the brightness of the
computer screen to fit his
surroundings. Increased light
levels can contribute to excessive
glare and cause problems
associated with adjustments of
the eye to different levels of light.
Dr Norazah urges parents not to
expose any child under 18
months to digital screens to
reduce the risks of developing
myopia.
patients are not suited for
refractive surgery or at a higher
risk of poor visual outcome, and
should hence never undergo
surgery.
LASIK can be performed
conventionally (microkeratome)
or with a femtosecond laser. It is
also divided into standard or
customised (wavefront- or
topography-guided).
Cataract surgery, too, has come
a long way. Dr Ainur elaborates,
“Traditionally, cataract surgery is
done by making a big cut in the
cornea to remove the lens in one
piece. However, recovery can
take up to three months, as
stitches are needed to close the
wound and have to be removed
from the eye gradually.
“Small incision cataract
surgery followed, where a
smaller cut is made and a tube is
inserted into the eye to vacuum
out the lens. It is also called
phacoemulsification as
ultrasound is used in addition to
the vacuum to remove the hard
cataract.
“Laser-assisted cataract surgery
was introduced around 10 years
ago. It assists the surgeon in
doing some of the major steps in
cataract surgery, including pre-
softening of the dense cataract
before vacuuming it out. In most
cases, this allows for reduced or
no ultrasound use during surgery,
potentially hastening recovery.”
Dr Ainur says LASIK is one of the
many forms of refractive surgery
and is considered well established,
safe and predictable with good
patient satisfaction.
Good vision for all
While laser-assisted eye surgery
is slowly edging into eye care, Dr
Ainur does not think it will affect
the practice of conventional
cataract surgery in Malaysia.
“In my opinion, conventional
cataract surgery will not be made
obsolete, as laser-assisted surgery
is costly for both the hospital and
patient. Only a handful of
hospitals and eye centres in
Malaysia have the equipment to
carry it out, and the fees for the
surgery can be substantially
higher.
“As not everyone can afford this
treatment and conventional
methods are equally safe,
conventional surgery will not be
made obsolete. Both types of
surgeries have their pros and cons
in terms of cost, recovery time and
risks, but it does not take away the
fact that in both, patients’ eyesight
is restored,” says Dr Ainur.
Medical advancements have
come a long way in helping people
maintain or even improve their
sight. The greater danger lies in
people opting to delay a visit to a
specialist, accepting vision loss or
refusing medical help. It is crucial
for people to know they should
seek early medical intervention
while the problem is still treatable.
n For more information, call
03-5639 1212.
2 Healthy Eyes
Choosing a LASIK
treatment provider
LASER-assisted in situ keratomileusis
(LASIK) is rapidly gaining in
popularity in Malaysia.
As one of the most convenient
methods to permanently reduce or
eliminate dependency on spectacles,
it is a popular option for patients.
However, prospective patients need
to consider these points before
deciding where they will get their
treatment:
l The treatment centre – LASIK
treatments are provided at LASIK
centres, eye clinics or hospitals.
Select one that is known for their
LASIK treatment and has a good track
record of successful LASIK treatments
and public testimonies. Also ensure
that the centre employs well-trained
LASIK surgeons, not just eye doctors,
and that its staff possess a deep
understanding of the procedure and
are able to advise their patients well.
Potential patients are also
encouraged to research whether the
centre has an in-house engineer to
ensure the machinery is kept in good
condition.
l Available treatment types and
methods – There are numerous
LASIK methods and lasers used to
perform these treatments. One
should take note of the treatments
available, including the type of
lasers used, as it can affect the
outcome of the treatment. Also,
ensure that the treatment provided
incorporates the latest technologies.
Prospective patients should also
ask about the duration of the recovery
period.
Some methods require a longer
recovery period and enough time
must be planned and allocated
for the treatment.
l Pricing and other
services – The centre
must include post-
treatment follow-ups and care.
Some areas of concern are whether
the centre offers free or discounted
enhancements in case of a
relapse. If so, how long does
this offer last?
One must note that pricing is
usually proportionate to the quality
of the service. In the case of LASIK
treatments, the prices are always
tied to the three previously
mentioned points.
As prospective patients are spoilt
for choice when it comes to
determining when and where they
want to get LASIK treatment, the
goal is to get the best value for
money, which is not necessarily
achieved by choosing the cheapest
options on the market.
Therefore, do your homework;
speak to friends, go through
testimonials and reviews and read
up on the various treatments
available before making your
decision.
This article was brought to you by
Optimax Eye Specialist.
n For more information, call
1800 881 201 or visit optimax2u.com
Nutrition is a promising way to prevent or delay the progression of
eye diseases.
Nutrients for
ageing eyes
AGEING can lead to vision
changes and increases the risk
of developing some common eye
problems, such as age-related
macular degeneration (ARMD),
cataracts and diabetic
retinopathy. These eye problems
are the leading causes of visual
impairments and blindness
among the elderly.
Blue light, a short-wavelength,
high energy visible light, from
sunlight and digital devices is
one of the leading causes of eye
diseases. The eyes are not able
to block or reflect blue light,
which can pass through the
cornea to the retina. The retina
can be damaged, contributing to
ARMD and subsequently, loss of
vision. Continuous exposure to
blue light is unavoidable in a
tropical country, nor is it feasible
in the digital age.
Diabetes and high blood
pressure have also been found
to be associated with age-related
eye diseases. High sugar levels
in the blood and high blood
pressure can damage blood
vessels in the retina, which can
leak fluid, protein and fat,
forming deposits that can affect
vision.
Nutrition is a promising
way to prevent or delay the
progression of these diseases.
Many studies have shown that
two very important nutrients
that may help reduce the risks of
these eye diseases are lutein and
zeaxanthin.
Lutein and zeaxanthin are
antioxidants that act to filter
harmful high-energy blue light.
Being antioxidants, lutein and
zeaxanthin can also neutralise
free radicals which cause
oxidation of the lens, a major
cause of cataracts.
Unfortunately, the human
body is not able to synthesise
lutein and zeaxanthin naturally.
It is only through diet or
nutritional supplements that the
body is able to get a sufficient
daily amount of these nutrients.
Although there is no
recommended daily intake of
lutein and zeaxanthin, recent
studies have shown the health
benefits of taking 10mg of lutein
SUNDAY STAR, 3 MARCH 2019
and 2mg of zeaxanthin per day.
This dosage is supported by the
Age-Related Eye Disease Study 2,
conducted by the United States’
National Eye Institute, which
studied the nutrients that can
reduce the risk of developing
ARMD.
There are a number of
challenges when it comes to
formulating lutein and
zeaxanthin, which are not
extracted from the same source.
Xanmax is an innovative
formulation of lutein and
zeaxanthin, which are extracted
from the marigold flower. This
formulation follows the
recommended clinical amount
of 10mg lutein and 2mg
zeaxanthin.
Bilberry has long been
recognised for its potential as a
vision enhancer. It contains
anthocynosides, which are
potent antioxidants and protects
the retina from free radicals that
can cause damage to the eye.
Apart from providing
antioxidants, bilberry is believed
to increase the production of
rhodopsin, a compound that
plays a role in improving night
vision and aid vision
adaptations to changes in light.
Bilberry also supports the
integrity of the blood vessels
that supply the eyes with oxygen
and essential nutrients. It keeps
the blood vessels healthy and
flexible, which benefits the
elderly, diabetics, those with
high blood pressure and people
who are at higher risk of
developing glaucoma and
retinopathy. Bilberry may also
prevent the formation of weak,
fragile blood vessels that are
strongly linked to retinopathy.
Apart from nutrition, it is also
important to control your blood
sugar and blood pressure levels.
This will reduce the risk of
developing eye diseases. Take
care of your vision, as it is your
window to the world. Give it the
protection it deserves.
n For more information, call
1300 881 712/03-5638 3600 or
email enquiry@cambert.com.
my
SUNDAY STAR, 3 MARCH 2019 3
4 Healthy Eyes
GLAUCOMA is a leading cause of
blindness, with a global prevalence
for people aged between 40 and 80
years old at 3.5%. It is a condition
that affects the optic nerve and can
go undetected in the early stages.
Therefore, annual eye
examinations are crucial for people
aged 40 and above, or people with
a family history of glaucoma.
Other risk factors include the use
of chronic corticosteroids, eye
trauma, diabetes and high myopia.
Some important preventative
methods are maintaining a healthy
weight through regular exercise,
good blood pressure control,
quitting smoking and limiting
caffeine intake.
A well-balanced diet is also
crucial to maintaining healthy
vision. Some recommended foods
are those rich in vitamins C, A, D
and E, zinc and omega-3 fatty acids.
Although glaucoma is not
curable, there are eye drops, oral
medications, and laser and surgical
treatments currently available to
prevent further progression and
maintain vision.
Recently, microinvasive
glaucoma surgery (MIGS) was
introduced, which provides
additional options to treat
glaucoma. MIGS uses microscopic
equipment and tiny incisions to
treat the disease, offering a safer
alternative to conventional
glaucoma surgery, with the
potential benefit of reducing the
patient’s dependence on topical
glaucoma medication.
Research is also being conducted
on gene therapy to counter the
progressive damage to retinal
ganglion cells.
Some of the common
misconceptions on glaucoma are:
l There is only one type of
glaucoma – There are several
Six key nutrients to protect your eyes
DO you spend hours staring at your
smartphone screen every day? Did
you know that spending too long
looking at screens can do long-term
damage to your vision? Blue light –
the high energy visible light emitted
by digital screens – can have adverse
effects on our eyes and vision.
Seventy-one per cent of
Malaysians own smartphones and
spend an average of 5.1 hours a day
on the Internet. Constant exposure
to potentially damaging blue light
from smartphones and other digital
devices can cause visual stress,
which can lead to retina damage,
accelerate vision deterioration and
increase the risk of developing age-
related eye diseases at a much
earlier age.
While limiting the amount of time
spent exposed to blue light is one of
the precautions to protect your eyes
in this digital world, good nutrition
is also a key factor to promoting
healthy eyes and sharper vision.
Below are six key nutrients for
healthier eyes.
l Marigold – Naturally rich in
lutein and zeaxanthin, which are
important in promoting healthy
vision. Clinical studies in the Age-
Related Eye Disease Study 2 have
shown that an intake of 10mg lutein
and 2mg zeaxanthin is beneficial for
eye health. The combination of
lutein and zeaxanthin can filter
harmful blue light, ultraviolet (UV)
rays and neutralise free radicals.
l Haematococcus Pluvialis – A
type of green freshwater microalgae
that is naturally high in astaxanthin.
Astaxanthin is an antioxidant that
can promote retinal blood flow and
alleviate eye fatigue.
l Wolfberry (goji) – Naturally
high in polysaccharides and
carotenoids, it is traditionally used
The silent
thief of sight
types, with the most common being
primary open angle. Approximately
90% of all cases is diagnosed as
angle closure glaucoma.
l Glaucoma can only affect one
eye – There are many types of
glaucoma, and it can affect both
eyes.
l Glaucoma only affects the
elderly – Glaucoma does mostly
affect adults, but there have been
cases of it affecting people from all
age groups, including children.
l Glaucoma has severe
symptoms – Glaucoma is called the
silent thief of sight for a reason. It
affects the peripheral vision initially
and later progresses to affect central
vision. If left undetected, patients
will begin to gradually lose vision.
By the time more serious symptoms
such as pain, seeing haloes and
blurring of vision appear, it might
already be too late. Therefore,
for improving eyesight, especially
night vision.
l Eyebright – Traditionally used
to relieve eye strain, eye fatigue and
irritated eyes.
l Bilberry – A source of
anthocyanosides, which provides
antioxidant protection and is
essential for visual acuity in dim
light.
l Dunaliella salina – A type of
green microalgae that is naturally
high in mixed carotenoids, including
beta-carotene, alpha-carotene, lutein
and zeaxanthin to support eye
health.
Biogrow OPTIbrite’s new and
improved formulation contains the
clinically approved amount of 10mg
lutein and 2mg trans-zeaxanthin
extracted from marigolds,
astaxanthin from Haematococcus
Pluvialis, anthocyanosides from
Bilberry and other eye health
enhancing nutrients from wolfberry,
eyebright and Dunaliella salina.
SUNDAY STAR, 3 MARCH 2019
regular eye examinations are key
in protecting your vision.
l Glaucoma is curable – At
present, there is no cure for
glaucoma. However, if detected
early, there are many treatment
options, including topical eye drops
and laser treatment, to maintain
vision and prevent progression. If
the intraocular pressure in the eye
is poorly controlled, your doctor
might also suggest surgery.
With early detection, regular
checkups and adherence to
medication, most glaucoma
patients can lead normal lives.
This article is brought to you by
Tun Hussein Onn National Eye
Hospital.
n For more information, call
03-7718 1488.
It is recommended for ageing
adults, students, computer users,
and individuals who are visually
impaired or have poor eyesight,
experience eye strain or tired eyes
from reading, driving and prolonged
use of digital devices, or are
frequently involved in outdoor
activities and exposed to UV rays.
Take one capsule daily after meals
for healthier eyes and sharper
vision.
Biogrow OPTIbrite E Capsule is
certified halal by Jakim and is
suitable for vegetarians. It is
available in all leading pharmacies
nationwide.
This article is brought to you by
Legosan (Malaysia) Sdn Bhd.
n For more information, call 03-7956
2220 or visit www.biogrow.com.my
This is a traditional product
advertisement.
KKLIU No.2262/2017
To combat the
effects of the
digital age on
our sight,
supplementation
with nutrients
beneficial to eye
health can be
effective.
SUNDAY STAR, 3 MARCH 2019 Healthy Eyes 5

Educating the
public on glaucoma
GLAUCOMA is a disease of the optic
nerve, which is the part of the eye
that carries the images we see from
the eye to the brain. The optic nerve
is made up of many nerve fibres.
Glaucoma damages these nerve
fibres, which can lead to blind spots
and vision loss.
There are many causes of this
damage or optic nerve head failure,
MAL13115073NC just like there are many causes of
heart failure. Unique to glaucoma is
that in most cases, there are
humour that flows in and out of the
eye cannot drain properly, pressure
builds up in the eye. The resulting
increase in IOP can damage the
optic nerve.
Other risks factors are age, family
history, extreme refractive errors
such as long- or short-sightedness,
diabetes, migraine, history of
steroid use and eye injury.
The most common form of
glaucoma is primary open-angle
glaucoma, where the fluid that
or optic nerve damage. Symptoms
can include headaches, nausea,
vomiting, seeing halos or colours
around lights and eye pain.
Similar to high blood pressure,
treatment for glaucoma is life-long.
So long as you control your IOP,
then blindness can be preventable,
but if you stop your treatment, then
the disease can still progress and
lead to blindness.
Surgery can be performed if
your IOP cannot be controlled

Antioxidants
absolutely no symptoms in the early
stages. By the time vision is affected,
it is too late to reverse the
condition. Therefore, screening for
normally circulates in the front despite treatment.
portion of the eye is blocked from If your disease is not yet
flowing out of the eye, causing IOP advanced, surgery can prevent
to increase, which can damage the further visual field loss, but

necessary for
this condition is important because
if detected early, blindness is
preventable, but if detected late,
blindness is irreversible.
optic nerve. Most people who what is already lost cannot be
develop primary open-angle recovered. There are several
glaucoma notice no symptoms until operations that can be done to
their vision is impaired. lower IOP.

healthy ageing
FREE radicals are unstable
molecules with an unpaired
electron, which is in search of an
extra electron to achieve a stable
state. This unstable state of free
radicals often results in cell
damage when electrons are
“stolen” from our body’s cells or
molecules needed for cell
metabolism.
While free radicals are
nothing new, their nature of
destroying our cells or disrupting
bodily functions remains
unavoidable as they are
generated by our bodies in
various endogenous systems and
daily activities, including sun
exposure, smoking, exercising
and exposure to radiation from
visual display terminals such as
computers, televisions and other
electronic gadgets.
A balance between free
radicals and antioxidants is
necessary for proper
physiological functions.
However, an excess of free
radicals will overwhelm the
body’s ability to regulate them,
leading to a condition known as
oxidative stress, which will lead
to the destruction of cells and
molecules in the body and a
disruption of homeostatic
balance. Unfortunately, the
effects of free radicals are often
neglected until they cause
physical symptoms.
Astaxanthin is a naturally
occurring carotenoid extracted
from the microalgae
Haematococcus pluvialis that
can withstand and survive harsh
conditions. Astaxanthin has
antioxidant properties, helping it
guard against the effects of
excessive free radicals. AstaREAL
astaxanthin is manufactured by
Fuji Chemical Industry from the
one and only natural source,
Haematococcus pluvialis
microalgae. The microalgae are
cultivated in closed
photobioreactors in pollution-
free environments in
Gustavsberg, Sweden.
The bilberry fruit is high in a
substance called flavonoids,
chemically known as
polyphenols. Bilberry flavonoids
are antioxidants known as
anthocyanosides, which give the
bilberry fruit its blue-red colour.
Vitamin E also acts as an
antioxidant, preventing the
There are many risk factors for In angle-closure glaucoma, the Seek the advice of an eye
glaucoma. A major risk factor has to iris (the coloured part of the eye) specialist for treatment options.
do with the pressure inside the eye, may drop and close off the drainage
or intraocular pressure (IOP). When angle, blocking the flow of aqueous n For more information, email
the clear liquid called the aqueous fluid and leading to increased IOP enquiries@isec.my
Antioxidants like
vitamin E are a major
part of the body’s
immune system. They
provide protection
against diseases
and conditions that
are associated with
ageing by preventing
free radicals from
damaging cells.
damage done by oxidation of
nutrients and other chemicals
in the body.
Antioxidants such as vitamin
E are a major part of the body’s
immune system. They provide
protection against diseases and
conditions that are associated
with ageing by preventing free
radicals from damaging cells. It
is essential in promoting good
health and protects vitamin A
(retinol) from damage by free
radicals.
Certain groups of individuals
are more exposed to the risk of
free radical damage and the
need for antioxidants such as
astaxanthin never ceases.
These individuals include
computer users, individuals
who drive long distances, those
who watch television and read
for long hours, and the elderly,
who generally have a weaker
defence system.
As the saying goes,
“prevention is better than
cure”. Supplementation
becomes important as nutrients
are usually delivered in its
concentrated form, which is
more than what you can obtain
from diet alone.
Vitamode Asta-i-Care is
available in selected
pharmacies nationwide.
n For more information, call
1300 800 228 or email
enquiry@medispec.com.my
This is a supplement product
advertisement.
KKLIU No.0080/2017
6 Healthy Eyes
Maintaining healthy eyesight
AS the Fourth Industrial Revolution bears
down on us, more and more people are
finding themselves glued to their screens.
Forced to do so for work or as a way to kill
time, millenials are spending an increasing
amount of time straining their eyes
unconsciously in the face of unnatural blue
light.
The University of Toledo in the United
States recently published an article titled UT
chemists discover how blue light speeds
blindness last year, suggesting that blue light
emitted from technology can potentially lead
to age-related macular degeneration (ARMD).
ARMD occurs when photoreceptor cells in
the retina die off. According to Dr Ajith
Karunarathne, assistant professor at
University of Toledo’s Department of
Chemistry and Biochemistry, photoreceptor
cells rely on molecules called retinals that
are produced in the eye to enable a person
to see.
However, when these retinal molecules
are exposed to blue light, poisonous
chemical molecules are released instead to
the photoreceptor cells.
“It’s toxic. If you shine blue light on retinal
molecules, the retinal kills photoreceptor
cells as the signalling molecule on the
membrane dissolves,” says Kasun Ratnayake,
a PhD student researcher working under
Dr Ajith.
“Photoreceptor cells do not regenerate in
the eye. When they’re dead, they’re dead for
good.”
Therefore, how do we, as a generation
whose lives are entwined with technology,
Preserving optimal vision
THE eye is a wondrous instrument. It allows
us to see our surroundings by processing
light rays absorbed from the environment.
However, it is also a delicate instrument,
with many parts working together to
translate absorbed light into electrical
impulses which are then carried to the brain
by the optic nerve. In the brain, the visual
cortex interprets these impulses as visual
images, enabling sight.
The quality of your vision can be affected
by various factors, such as obesity, smoking,
exposure to harmful rays from the sun,
ageing, an unhealthy diet and as symptoms
or a consequence of chronic diseases, such
as diabetes and hyperlipidemia.
Cataracts, glaucoma, retinopathy and
macular degeneration are the most common
eye diseases, all of which can cause
deteriorating vision.
However, the following habits can help
prevent eye and vision problems and
maintain good eye health:
l Perform regular eye check-ups
l Regularly exercise to improve blood
circulation to eye tissues and remove any
built-up toxins
l Wear sunglasses that block 99% to 100%
of UVA/UVB rays (harmful rays from the sun)
l Reduce computer-induced eyestrain by
practising the 20/20/20 rule: whenever you
are working on a computer, take a break and
look 20 feet away for 20 seconds, every 20
minutes
l Quit smoking, as smoking damages the
blood vessels that supply blood and nutrients
to your eyes
prolong and maintain our precious
eyesight?
While totally avoiding blue light is almost
impossible, here are some lifestyle changes
or steps that we can take to reduce our
chances of vision deterioration.
Schedule a comprehensive dilated eye
exam – You might think your vision is fine.
But, sometimes, your eyes might be in the
early stages of eye disease that cannot yet
be noticed by you but will be picked up by
a medical professional.
Visit your local eye doctor for a
comprehensive dilated eye exam to ensure
the health of your eyes, and to schedule
early treatment if problems are found.
During the exam, the doctor will place
drops in your eyes to dilate or widen your
eyes to allow the maximum amount of light
to enter your eye. This way, your doctor can
look at the back of your eye for any
abnormalities.
l Know your family’s eye history – To
cover all bases, talk to your immediate
family on their eye health history.
Be aware of any potential eye diseases
that could be hereditary and your risks of
contracting certain eye diseases or
conditions in the future.
l Practise healthy dietary habits – In
all health cases, a healthy diet is always the
main thing suggested by doctors.
Maintaining a healthy weight and diet will
allow your eyes to obtain the nutrients they
need to function well and protect yourself
from conditions such as diabetes and other
systemic disorders that can lead to vision
l Control your blood sugar, blood
pressure and cholesterol levels as these can
lead to chronic diseases, including diabetes
and hypertension, which can cause
retinopathy, glaucoma and cataract
l Get a good night’s sleep to reduce
eyestrain
In addition to the above habits, a balanced
and healthy diet is also essential to
protecting your sight. Eating a diet rich in
fruits and vegetables, especially deep yellow,
orange and green leafy vegetables, such as
carrots, oranges, lemons, kale, spinach and
broccoli, is important for keeping your eyes
healthy.
These vegetables not only contain
vitamins A, C and E and minerals, which are
good for eyes, but also beneficial
phytochemicals, known as carotenoids.
These carotenoids (lutein, zeaxanthin and
beta-carotene) act as antioxidants and can
protect eye tissue from the damaging effects
of light and inflammation.
It may not be possible to get all these eye-
health enhancing benefits from your regular
diet, so supplements containing vitamins,
herbs and phytochemicals may help you
maintain eye health.
This article is brought to you by 21st
Century Products (M) Sdn Bhd.
n For more information, call 03-5636
7363/03-5636 3934, email
support@21stcentury.com.my or visit
www.21stcentury.com.my
loss, such as diabetic retinopathy and
glaucoma.
l Wear protective eyewear – Use
protective eyewear when playing sports or
carrying out riskier activities. Protective
eyewear includes safety glasses, goggles,
safety shields and eye guards specifically
designed to protect your eyes during certain
activities.
Another thing to look out for is ultraviolet
rays. Get in the habit of wearing your
sunglasses at all times when you are
outdoors in the daytime to ensure maximum
protection for your eyesight.
l Ensure eye hygiene – Contact lenses
are a blessing for people who suffer from
vision loss but still need to carry out certain
tasks that will be hindered by spectacles.
However, lens hygiene is extremely
important for the long-term benefit of
your eyesight. Contact lenses that are
poorly cleaned and maintained can
cause infections in the eye, which
Balanced diet is key
to good eye health
AGE-RELATED macular degeneration
(ARMD) is the leading cause of visual
impairment and is associated with
significant reduction in quality of life.
The macula is the central part of the
retina responsible for central, fine and
colour vision. In elderly patients, ARMD
results in poor central vision, which limits
the ability to recognise faces and read small
letters and has a significant impact on
functional independence.
There are two types of ARMD – the dry
type, which is more common and has no
treatment available on the market to stop
its progression, and the wet type, which can
be treated via anti-vascular endothelial
growth factor (anti-VEGF) therapy and laser
treatments.
ARMD is a multifactorial disease.
However, the precise pathogenesis of
ARMD is unknown, although oxidative
stress is highly implicated. Smoking is
related to late ARMD.
Lutein and zeaxanthin are pigments
concentrated in the macula and help
protect the macular region by scavenging
free oxygen radicals and filtering damaging
SUNDAY STAR, 3 MARCH 2019
may aggravate any existing eye conditions.
l Limit screen time – As we come full
circle, the best way to reduce the
deterioration of your photoreceptor cells is
to limit your time on screen.
Practise healthy habits when using your
computer or phone, such as keeping your
computer screen approximately 22 inches
away from your eye, adjusting the lighting of
your screen to reduce glare, and blinking
frequently to prevent dry eyes and extra
strain.
It is also recommended for you to take
regular breaks between your screen usage.
blue light. These pigments are not able to
be synthesised naturally by humans but
can be found in leafy green vegetables.
Leading a healthy lifestyle and having a
balanced diet is the ideal way to get the
nutrition we need. A regular intake of
vitamins and essential fatty acids is
generally adequate to cater for the needs of
healthy individuals.
However, in patients with risk factors for
developing ARMD, randomised clinical
trials have shown the benefits of lutein and
zeaxanthin in reducing the risks of
progression to advanced ARMD. In the
Age-Related Eye Disease Study 2 lutein and
zeaxanthin supplements have been found
to be safe and beneficial. Dietary
supplements can potentially delay the onset
and slow the progression of ARMD.
Another clinical study called LUTEGA has
found that supplementation with 10mg of
lutein, 1mg of zeaxanthin and Omega-3
(100mg of DHA/30mg of EPA) seems to
increase macular pigment optical density in
ARMD patients, conferring some stability to
vision.
With the wealth of information available
on the Internet, nutritional advice to
patients must be balanced. Patients with
ARMD and at risk of developing ARMD are
advised to consume green leafy vegetables
and eat fatty fish twice a week.
If further supplementation is required,
there are commercial preparations, which
are manufactured in accordance with
published clinical trials.
With these measures, we may see a
healthier ageing population and lower
incidence of ARMD. – By Dr Ho Whye Onn
(pic)
n The writer is a vitreo-retina and
cornea surgeon at International Specialist
Eye Centre. For more information, call
03-2284 8989 or email enquiries@isec.my
SUNDAY STAR, 3 MARCH 2019 Healthy Eyes 7

Life with low vision

By NGEH CHEE YEN

BASED on the National Eye Survey 2014, at

least 63,000 or 1.2% of Malaysians are
diagnosed with blindness. In addition,
350,000 or 5.4% of Malaysians suffer from
limited vision.
Among those who suffer from low or
deteriorating vision, cataract makes up 58%
of cases, while diabetic retinopathy and
glaucoma make up 10% and 7%, respectively.
While these numbers do not seem that
significant when compared with the overall
Malaysian population, it is certainly a big
deal to those who face the fate of living with
vision loss.

Navigating in the dark

In Malaysia, services for the visually
impaired are usually provided by the
Government and non-governmental
organisations (NGOs).
However, there is still a lot of catching up
to do to ensure visually impaired Malaysians
are well taken care of. Some daily issues they
face include:
l Job opportunities – According to an
article titled Jobs still out of sight for the blind
published in a local news portal last year,
there are more than 36,000 blind recipients
of welfare aid in Malaysia, even though most
of them hold academic qualifications and
skills equal to their sighted peers.
This is partially caused by the stigma
attached to their visual impairment and the There are more than 36,000 blind recipients of welfare aid in Malaysia, even though most of them hold academic qualifications and skills
perception that supporting their needs is equal to their sighted peers.
inconvenient, which can affect their hiring
chances. Malaysian Association for the Blind (MAB) He says, “I currently use a camera to help vision can still see, albeit with difficulty, we
l Eyecare and treatments – Not who lives with bilateral glaucoma, cites the me read. However, it is difficult because I sometimes experience light glares and can
everyone has the luxury of seeking price of visual aids and gadgets as a barrier have to zoom in and focus on words until be almost blind. These tactile guides are
treatment at private facilities, so most have for the visually impaired, adding that many they are clear enough for me to read. It takes crucial, in addition to traffic lights that beep
to get appropriate care for their eye cannot afford to obtain and use them to ease a lot of time. I need around an hour to read to signal it’s safe for us to cross.”
conditions at public hospitals. Long wait their daily activities. a simple article.”
times, ill-maintained facilities and less
personalised treatment because of limited
He personally hopes to find a sponsor for
a video magnifier to help him read faster.
Azirul also highlights the need for more
disability-friendly facilities in public spaces
Getting the right help
resources can make a doctor’s visit for a According to him, the price for a video for ease of mobility, especially for the Living with vision loss is hard, especially
visually impaired person quite frustrating. magnifier is around RM4,000, which is quite visually impaired. when there is no proper support system to
Muhammad Azirul Asraf, a vocational a large sum and unaffordable for most “In Malaysia, the roads have limited or no
information technology student at the people. tactile paving. Although we people with low > TURN TO PAGE 8
8 Healthy Eyes
Inadequate facilities, social stigma barrier to independence
> FROM PAGE 7
guide you through the experience.
Therefore, when someone is diagnosed with
vision loss, depression and helplessness
usually follow, as the patient feels that he
will no longer be able to lead a normal life.
A 2016 article titled Study links fast vision
loss with depression published in Optometry
Today suggests that the speed of someone’s
vision loss is significantly linked to his
chance of being diagnosed with depression,
mainly caused by the loss of independence.
However, with advances in medical
technology, many vision aids and services
have been created to support the lives of
people with vision impairment. Nik Teh
Aminah Nik Ibrahim, assistant manager for
fundraising at MAB, presents a range of
support provided by both the Government
and NGOs for the visually impaired:
l Medical services – Various treatments
are available, from spectacles, contact lenses
and low vision aids to surgical treatments,
such as corneal transplants and osteo-
odonto-keratoprosthesis, a medical
procedure to correct vision in more severe
cases of corneal and ocular surface
impairment.
l Technological aids – Computer-based
technology, such as voice browsers and
smartphones that use a Braille keyboard,
enable the visually impaired to acquire
knowledge more efficiently.
l Educational facilities and
rehabilitation services for the blind –
Provided by the Education Ministry through
special schools for blind children.
l Vocational training facilities –
Training courses for individuals or families,
financial assistance and assistance for
parents of blind children are made available
through MAB.
The importance of mental health among
the visually impaired isn’t overlooked,
Though many advances in medical technology have made life easier for the visually impared,
more support is needed.
either. Nik Teh Aminah says, “Counselling,
evaluation and consultation for people of
all ages who are blind or visually impaired,
and family members or partners
(caregivers) of the visually impaired are
usually provided.
“Such services help promote healthier
emotional development, social participation
and the ability to talk about and
understand feelings in a safe, confidential
setting.”
Light up their world
Despite the services provided and efforts
carried out for people with visual
impairment, there is still the stigma and
lack of awareness on blindness and low
vision in Malaysia. Nik Teh Aminah
explains efforts to ensure the visually
impaired can lead lives of dignity and
equality.
She says it is up to government agencies
and business and community groups to
ensure the visually impaired are not being
discriminated against, especially in the
areas of:
l Job employment, so they may earn
stable incomes and support their families.
l Increased accessibility, so they may
access any building, public area or public
transport.
l Public awareness, so that ingrained
prejudices towards the visually impaired
may be changed to a more understanding,
accepting perspective.
SUNDAY STAR, 3 MARCH 2019
In Malaysia, the roads
have limited or no tactile
paving. Although we people
with low vision can still
see, albeit with difficulty,
we sometimes experience
light glares and can be
almost blind. These tactile
guides are crucial, in
addition to traffic lights
that beep to signal it’s safe
to cross.
Azirul says that he finds it helpful when
the sighted learn the ways of the visually
impaired to further understand the right
way to help and support them.
He says, “When trying to guide a blind
person, you cannot simply hold our cane to
guide us towards a certain destination. The
cane is our guide. If someone holds the end
of our cane, it makes it difficult for us to
move around.
“Sighted people can also benefit from
orientation and mobility training. It can also
help you prepare in case of vision loss. It
does not just teach you to better assist people
with vision loss, but also acts as knowledge
you can fall back on should you experience
vision problems later in life.
“People must be aware that there are
many types of diseases in the world that can
affect anyone at any time. Therefore, if
sighted people learn the ways that we
visually impaired people use to cope with
our disability, life can be made better for us,”
says Azirul.