Query from Connie Kum

In my left eye, I have long-sightedness of 600 degrees, myopia of 175 degrees and astigmatism of over 600 degrees. In my right eye, I have myopia of 175 degrees.

I consulted two eye doctors some years back and both advised that only a cornea transplant can correct my condition. While Lasik and Wavefront procedures will be able to correct one of the conditions, it will worsen the other.

Given the advancements in Lasik technology, are there ways to improve my condition besides undergoing a cornea transplant?



Dr Lee Hung Ming

Medical Director and Senior Consultant, Parkway Eye Centre, Gleneagles Hospital

It is not common to have such high astigmatism in only one eye. The most likely diagnosis is keratoconus, a degenerative corneal disease characterised by progressive thinning of the cornea with cone-like corneal protrusion. This results in irregular corneal surface, short-sightedness, irregular astigmatism and blurring of vision.

Keratoconus typically worsens when the patient is 20 to 40 years of age. Constant rubbing of the eye can also worsen the condition.

Lasik is not recommended in this instance as it will thin the cornea further. Besides corneal transplant, there are currently two new options to treat keratoconus - Intra-stromal Rings (Intacs) and Collagen Cross-Linking.

Intacs surgery involves the insertion of two arc-like plastic segments into the middle of the cornea to flatten the cornea. This procedure takes about 20 minutes and is good for patients who are contact lens intolerant and who want to avoid a corneal transplant.

Collagen cross-linking, too, has been shown to stop the progression of keratoconus. Vitamin drops are soaked into the cornea and a specialised lamp that emits UV light at a predetermined wavelength is put over the patient's eye for approximately 30 minutes. The cross links that link the fibers of the cornea are increased during this process, thereby strengthening the whole cornea.

These two methods are now available in Singapore and I would advise you to seek consultation with an ophthalmologist who specialises in corneal diseases.



The information provided above is for your general knowledge only. You should seek medical advice or treatment for your condition. Email questions to health@newstoday.com.sg.