Turf War 2

There isn't really a part I to this post, but the title refers to this article in Today which caught angry doc's, well, eye.


Eyeing Lasik surgery?
Risk of some vision loss more than wearing contacts: Experts
Jinny Koh

IN A country with one of the world's highest rates of myopia, would Singaporeans opt for laser eye surgery if they knew that the risk of some vision loss is about 100 times more than that when wearing contact lenses?

This risk was highlighted by Professor Fiona Stapleton, head of the School of Optometry and Vision Science at the University of New South Wales, Australia, at a press briefing for the fifth Asia Cornea and Contact Lens Conference yesterday.

According to her study, six out of 100,000 contact lens wearers suffer some form of vision loss each year, compared to 700 cases per 100,000 refractive surgeries such as Lasik (laser-assisted in situ keratomileusis). However, she noted that 50 out of 100,000 contact lens wearers suffer from contact lens-related corneal infections every year.

Lasik will also leave the patient with a thinner cornea and compromise the quality of vision after surgery, said Dr Koh Liang Hwee, vice-president for the Singapore Optometric Association (SOA), which is the organiser for the conference.

Other possible side effects of Lasik include loss of contrast, poor night vision, as well as seeing haloes or starbursts. Dr Koh said Singaporeans should know the risks involved before undergoing the procedure.

However, consultant eye surgeon Dr Lynn Yeo said that having a thinner cornea after surgery has no ill effects on the patient, unless the cornea becomes too thin, which is unlikely because of the pre-operation screening guidelines Lasik surgeons have to adhere to.

"If the patient's cornea is naturally too thin, we will recommend implantable contact lenses for them if they are found to be suitable," she said.

Dr Yeo added that few Lasik patients have complained of night vision problems after surgery.

"With the customised wavefront-guideline Lasik treatment, the chances of getting these side effects have been minimised," she said.

Alternative help for myopia

An alternative in treating myopia is the use of rigid gas-permeable contact lenses worn at night to reshape the cornea.

Known as orthokeratology (Ortho-K), it has been available in Singapore for 15 years, but only became popular about five years ago, said Mr David Chong, president for the Singapore Optometric Association. About 20,000 Singaporeans have been treated using Ortho-K.

Another way to improve eyesight is through NeuroVision, which uses a series of computerised visual tasks to train the brain to process visual information.

When asked how Ortho-K compares to NeuroVision, Mr Chong said that the latter has not been subjected to a worldwide trial. It is also not a treatment for myopia but a means to enhance one's visual capability, he added.
However, Professor Donald Tan, medical director of the Singapore National Eye Centre, noted that a pilot study at Evergreen Primary School last year showed that children who participated in the NeuroVision programme improved their vision by more than 70 per cent and reduced the progression of myopia by almost 50 per cent.


angry doc doesn't think that there is in fact a turf war between ophthalmologists and optometrists, or amongst ophthalmologists themselves. However, it does look to angry doc like the reporter is trying to paint the picture that there is one, perhaps in the hope of imitating the 'success' a reporter in another newspaper had recently in covering a "turf war" between doctors?

O the competition!