A cataract is the most common eye condition in Singapore, and the only way to treat it is through surgery. Singapore cataract surgery is performed by a cataract surgeon in Singapore as a day surgery procedure, which means you will not be required to stay in the hospital after that. Typically, it takes 30 minutes to complete.

Yes, in Singapore, cataract surgery is covered by Medishield and other insurance policies. Many patients have been able to recover the entire cost of their bill through Medishield and other personal or corporate insurance policies. While cataract surgery is a day surgery procedure, it is Medisave claimable up to the approved surgical limit. Furthermore, if you have an Integrated Shield Plan, you can claim a portion or all of your cataract surgery costs for both private and public hospitals. It depends on your insurance coverage.

What is the maximum amount of Medisave that you can use for cataract surgery?

Singapore’s national health savings plan, Medisave, is available to all Singaporeans and Permanent Residents. While working, a portion of your monthly earnings will be transferred to your Medisave account for future healthcare needs.

When it comes to cataract surgery, every Singaporean and Permanent Resident can claim up to $2450 from their Medisave account or the Medisave account of an immediate family member. The procedure for using your Medisave is straightforward, with the administrative work completed before your surgery.

What steps must you take to use your Medisave for cataract surgery?

To begin, the clinic arranging your surgery will require you to complete a medical claims authorization form. Once completed, you only need to pay the remaining balance (after deducting the Medisave claimable amount) in cash or by credit card. The clinic will handle the rest of the administrative work after your surgery, including submitting an e-file to claim the amount from your Medisave.

Can your Integrated Shield Plan (IP) be used for cataract surgery?

Integrated Shield Plans are private insurance plans that can be added to your basic MediShield Life plan, available to all Singaporeans and PRs. Depending on your IP selection, you will have additional coverage for B1 and A-class wards in public hospitals, as well as private hospitals.

If you purchased a rider for your Integrated Shield Plan, the claim limit would be higher depending on your rider plan. Individuals who purchased full riders before April 1, 2019, will not have to pay anything out of pocket for the surgery*.

*If you purchase your full rider after March 8, 2018, but before April 1, 2019, you will have full coverage on coinsurance and deductible portions of your bill until April 1, 2021. After this date, a 5% co-payment will be required. All full riders sold after April 1, 2019, will have a minimum co-payment of 5%.

How do you use your Integrated Shield Plan for cataract surgery?

The procedure for using your Integrated Shield Plan is straightforward and can be completed concurrently with using your Medisave for the surgery. Again, you must first complete the medical claims authorization form. Following that, you must pay a deposit (the amount of which depends on the type of IP you have) in cash or by credit card.

Again, the clinic will handle the rest of the administrative work after your surgery. It includes submitting an e-file to claim the amount from your IP and Medisave. If your insurance provides full coverage, the deposit you paid will be refunded to you within a few months.

Can I use Medisave and the Integrated Shield Plan for my surgery at the same time?

You can use MediSave to pay for the deductible and coinsurance portions of your medical bills that are not covered by your insurance policy, up to the applicable limits. The deductible is the initial fixed amount of the medical bill that you must pay before you can file a claim with your insurance company (the deductible is reset each policy year). Depending on the plan and ward class, the deductible ranges from $1,500 to $3,500.

After you pay your deductible, you may still be required to pay co-insurance. The amount you must split with your insurer after deducting the deductible from your medical bill is referred to as co-insurance. It is most commonly expressed as a percentage. For example, if you have a 10% co-insurance, you will pay 10% of the medical bill after the deductible, while your insurer will pay the remaining 90%.

Individuals who have purchased the full Integrated Shield Plan Rider will have their coinsurance and deductibles covered.

As an example:

The cost of treatment	$10,000
Deductible (for private hospital)	$3,500
Co-insurance (10% of the balance amount from deducting the deductibles from treatment cost)	$650
Total out-of-pocket expenses (Deductible + Co-insurance)	$4,150

Medisave claimable limit for cataract surgery: Up to $2,450

Net out-of-pocket expense: $1,700 (Cash or credit card accepted)

Your Integrated Shield Plan will cover the remaining costs of the surgery (IP). As previously stated, individuals who purchase the full Integrated Shield Plan Rider are fully covered for coinsurance and deductibles.

Are private hospital services covered by all Integrated Shield Plans?

Yes, private hospital services are covered by all integrated shield plans. The amount of coverage, however, is determined by the plan you choose. In terms of coverage, each insurer will have a slightly different percentage.

For example, if your integrated shield plan states that it covers “Restructured hospital for ward class B1 and below,” it will only cover up to 50%* of private hospital treatment fees after coinsurance and deductibles. After coinsurance and deductible portions, integrated shield plans that state “Restructured hospital for ward class A and below” only cover up to 65%* of private hospital treatment fees. If your integrated shield plan covers “Standard room in private hospital or private medical institution,” it will pay up to 100% of private hospital treatment fees after coinsurance and deductibles.

*The coverage percentage is taken from the NTUC IncomeShield website. Please consult with your insurer to fully understand your coverage.

If you recently got cataract surgery in Singapore, you can use Medishield for it.

Diabetic macular edema (DME) is a complication of diabetic retinopathy, a diabetic eye disease. According to the National Eye Institute, DME affects an estimated 750,000 people in the United States, and it is the leading cause of blindness in diabetic retinopathy patients. DME has no cure, but treatment can halt or slow its progression. Continue reading to learn more about DME, treatment options and goals, and how you can protect your vision.

What exactly is diabetic macular edema?

DME is a diabetic retinopathy complication that can result in vision loss and blindness.

Diabetic retinopathy is a common eye disease caused by diabetes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it affects roughly one in every three diabetics over 40 years old.

Diabetic retinopathy develops when your blood sugar levels are consistently high, causing damage to the small blood vessels throughout your body, including your eyes.

When blood vessels are damaged, they can begin to leak blood and other fluids. The retina, a part of your eye, can absorb some of the excess liquid. When there is too much fluid, the macula, an area in the center of the retina that helps you see clearly and precisely, can swell and thicken.

At first, you may not notice any signs of DME. However, DME can cause symptoms such as:

• Blind spots and floaters
• Double vision
• Loss of vision, partial or total
• Faded and less vibrant colours
• A sight that is blurry or wavy near the center of your field of vision

The longer you have diabetes, the more likely you will develop diabetic retinopathy, also known as DME.

Is diabetic macular edema curable?

There is no cure for DME, but scientists are investigating potential ways to reverse or prevent the condition’s vision damage.

According to the National Eye Institute, researchers are investigating whether micro-RNAs or molecules that regulate specific genes can aid in the shutting down of genes associated with the development of macular edema. More research is required.

Meanwhile, macular degeneration treatments and diabetes management strategies can help to halt or slow the disease’s progression.

The macular edema treatment’s goal is to prevent further vision loss or blindness. In some cases, treatment can improve vision in people with DME but rarely fully restores sight.

Options for treatment

If DME hasn’t made a noticeable difference in your vision, you may not require immediate treatment.

However, your eye doctor will want to notice signs that the condition is worsening, so you may need to get regular vision checks.

Doctors usually initiate treatment once your vision deteriorates to avoid permanent damage.

The severity of your vision loss determines your DME treatment options. An ophthalmologist may recommend a combination of therapies at times.

Here are some DME treatment options:

Anti-VEGF treatment

These injections inhibit the activity of vascular endothelial growth factor (VEGF), which promotes blood vessel growth. It can slow the progression of DME by reducing leakage from damaged blood vessels.

Anti-VEGF medications include:

• bevacizumab (Avastin)
• ranibizumab (Lucentis)
• aflibercept (Eylea)

Anti-VEGF therapy is typically a quick procedure performed in the doctor’s office. You will not be able to feel the needle if you use numbing drops. To keep your vision, you may need a series of anti-VEGF injections over time.

Anti-VEGF injections, unfortunately, do not work for everyone. According to the National Eye Institute, roughly half of those who try this treatment do not see any improvement.

Laser therapy

Laser therapy seals off leaky blood vessels by using tiny laser pulses. It can also prevent the formation of new abnormal blood vessels.

You can do laser therapy in a doctor’s office. It is a painless procedure, thanks to anesthetic eye drops. A doctor will use special instruments to keep your eye open and your head from moving while focusing the light beam on the damaged areas.

If you have macular edema in both eyes, your doctor will most likely treat it separately. Depending on the extent of the macula damage, you may require several laser therapy appointments.

Laser therapy can reduce the risk of vision loss caused by DME.

It’s worth noting that, while laser therapy was once the standard treatment for DME, most doctors now rely on anti-VEGF injections instead.

Anti-inflammatory medications

Corticosteroids can also aid in the treatment of DME by decreasing inflammation and swelling. They are administered as drops, tablets, or injections into or around the eye.

In addition, doctors have approved three sustained-release corticosteroid implants for the treatment of DME:

• fluocinolone (Retisert)
• fluocinolone acetonide (Iluvien)
• dexamethasone (Ozurdex)

When corticosteroids fail to work or are not well tolerated, your doctor may advise you to try nonsteroidal anti-inflammatory drug eye drops (NSAIDs).

Surgery

Surgery may be an option in advanced cases of DME. It entails a vitrectomy to remove vitreous, a gel-like substance that fills the inside of the eye and can pull on the macula.

After removing the vitreous, the surgeon will replace it with another substance, such as a saline solution.

Remember that vitrectomy may increase your risk of cataracts, and you may develop DME again after surgery.

Other methods for slowing or reversing the progression of diabetic macular edema

Understanding the risk factors for DME can help you take preventative measures. These are some examples:

• high-fat levels in the blood (hyperlipidemia)
• blood pressure is too high
• high blood sugar levels for an extended period

Keeping an eye on these conditions and managing your diabetes can help you improve your symptoms and your eye health. Other diabetes-management strategies include:

• participate in regular physical activity
• consume a nutritious, well-balanced diet
• give up smoking
• inform your doctor about any new or worsening symptoms
• every year, get a thorough eye examination
• take medications as directed
• consult your endocrinologist as directed
• avoid or reduce your alcohol consumption
• maintain a healthy weight for your body type and size, as advised by your doctor or healthcare provider

Diabetic Macular Edema is a diabetic retinopathy complication caused by long-term damage to blood vessels in the retina. Although there is no cure, you can manage DME. There are several treatments available to help slow the progression of the disease and prevent partial or total vision loss.

Scientists are investigating the possibility of using micro-RNAs to treat or prevent DME, but more research is needed. If you notice symptoms of DME, such as blurry or wavy vision or colours that appear less vibrant than usual, consult an eye care professional immediately.

iDesign iLasik is the most advanced iLasik technology utilised in Singapore which was pioneered by Dr Natasha Lim. It boasts a 5 times higher resolution than its predecessors and has been used by NASA for their Astronauts and the US Military for their Aviators. Dr Natasha Lim specialises in customising treatments for each patient using Wavefront-Guided iDesign which benefits all her patients by providing them with better night vision after LASIK surgery.

iDesign iLasik surgery is split into 3 main steps:

1. iDesign Advanced Wavescan
2. Intralase Bladeless Flap creation
3. VISX Star S4 IR Excimer Laser

iDesign Advanced Wavescan

iDesign is the world’s most advanced Wavefront-Guided Aberrometer which uses its wavescan system to scan each eye over the pupil using 1257 data points to measure the wavefront of the eye to create a unique map for treatment. iDesign provides the greatest precision in measuring irregularities in the eye and not only does it help patients achieve independence from the need for spectacles, it also helps improve visual quality and contrast sensitivity significantly in low-light areas.

Intralase Bladeless Flap creation

Modern LASIK surgery features a bladeless technique to create a LASIK flap called the femtosecond (iFS) laser system which is also known as “All-Laser LASIK”. Dr Natasha Lim uses the most advanced iFS to create a bladeless flap in 12 seconds using minimal energy to create the thinnest flap possible for speedy recovery.

This ensures that there will not be any damage to the cornea for long term safety and stability and Dr Lim’s LASIK surgeries are truly bladeless using this method.

VISX Star S4 IR Excimer Laser

The next step is Iris Registration which is necessary for compensating for cyclotorsion that occurs when the patient goes from the upright position to lying down. Cyclotorsion occurs when the visual axis of an eye is rotated. This can be caused by misaligned laser ablation which can cause irregular astigmatism and diminished visual clarity. Even 2 degrees of torsional error can induce higher-order aberrations in the eye.

VISX Star S4 Iris Recognition (IR)’s Wavefront-Guided treatment gives superior outcomes because the treatment uses Iris Recognition technology that ensures delivery of a well-centered treatment and variable spot-scanning that helps with tissue saving. Each individual eye is given tailor-made vision provided by this system and the excimer laser treatment is applied under the corneal flap. The ViSX Star Excimer laser is proven to completely eliminate myopia, presbyopia and astigmatism.

Many patients who undergo cataract surgery for the first time are apprehensive. They are concerned about how long it will take for their vision to clear up after cataract surgery, among other things.

Yes, someone’s vision will appear to be very clear after surgery. It is much better after getting rid of the clouded natural lens and replacing it with a clear synthetic lens. However, the best vision is unlikely to appear for some time.

This article will discuss what cataract surgery accomplishes for patients and how long it takes to restore complete vision.

What exactly are cataracts?

A cataract is a clouding of the natural lens of the eye. It’s similar to looking through a pair of clear eyeglasses that have fogged up or have a lot of dirt and oil on the surface. In other words, cataracts obstruct your vision.

Cataract symptoms include:

• Having trouble seeing at night or requiring more light to read
• Vision hazard
• Increased light sensitivity
• Seeing something in twos
• Colours appear dull or have a yellow tint

The classification of cataracts is posterior subcapsular, nuclear sclerotic, and cortical. Each has a unique set of causes and affects different parts of the lens of the eye.

Each type also affects vision and vision loss, with some being more gradual than others. When the time comes to replace the lens, however, the entire lens is removed.

What exactly happens during cataract surgery?

Patients spend about 2-4 hours in pre-op and surgery, followed by another 2 hours or so of rest—mostly sleeping off the light medication that kept them calm during the procedure. Many patients are driven home by friends or family members immediately after the surgery to recover.

Preparing for cataract surgery is similar to preparing for most other day surgeries. In the hours leading up to the procedure, there are some minor dietary restrictions. Administration of the calming medication is through an IV, which will require setting up.

There will be numbness of the eye before the surgery begins. The cataract surgeon will then make an incision in the cornea to remove the cloudy cataract lens and replace it with the new synthetic lens. She then sews the incision and bandages the eye.

How long does it take for cataract surgery vision to clear? In the short run.

It is why so many people are amazed by the results of successful cataract surgery and talk about it for weeks, describing how much clearer their vision became afterward.

Immediately after surgery

The post-surgery joy stems from the contrast between how clouded your vision was before surgery and the implantation of a crystal clear new lens.

So, enjoy the excellent vision, but don’t let it distract you from the attention you need to give your still-healing eye for as long as the doctor thinks necessary.

Because surrounded by the new lens is the tissue that has been cut, stretched, and sutured, healing could take several months. Make sure to rest your eye frequently, take your prescribed medications, and protect it as directed by your doctor.

Instructions for after surgery

Expect a follow-up appointment with your doctor the day after the surgery and possibly another one a week later.

Meanwhile, taking a few simple precautions can help ensure that your cataract surgery goes smoothly and without complications.

• For one week, refrain from swimming.
• For at least three weeks, avoid strenuous physical activity.
• Do not stoop to pick up heavy objects or bend at the waist.
• When going outside, wear dark, UV-protective sunglasses.
• Try not to rub your eyes.
• Avoid getting water in your eyes, especially when showering.

You may also experience some common side effects in the days following the procedure. These are common and include:

• Blurriness or double vision
• Wet eyes
• A grittier or more sensitive sensation in the eyes
• Redness

Rare complications can also occur, which may indicate something more serious, so notify your ophthalmologist if you experience any of the following symptoms:

• Ongoing discomfort
• Flashes of light or floating spots in the eyes
• Coughing or sneezing that persists
• Vomiting or nausea
• Loss or deterioration of vision

Keep an eye out for any unusual symptoms, either in the days following the surgery or later on. It is especially true if you are older or have other health issues, such as diabetes.

How long does it take for the eye to heal fully following cataract surgery? In the long run.

The consensus appears to be that it takes 1-3 months. As a result, you should expect your eyes to be stabilised 2-4 months after surgery. Around that time, you’ll most likely have another ophthalmologist appointment.

That’s when you should be ready to have your eyes tested and, if necessary, get a new glasses prescription.

What will my eyes be like in the future?

If this was your first cataract surgery and another cataract form in the other eye, you have to wait at least a few weeks before having that surgery again.

Can a cataract reappear in a synthetic lens?

Cataracts do not grow back in artificial lenses, but a condition known as a “secondary cataract” can develop 4-6 months after surgery.

It isn’t a cataract but rather an issue with the capsule. It is a cellophane-like outer lining that holds both the natural and replacement lenses.

The removal of the natural lens in the eye will be during cataract surgery, but there is great care to keep the capsule in place to hold the replacement lens.

Months after surgery, the subsequent capsule can become cloudy, just as the natural lens did to form the cataract.

It causes some vision loss. Your ophthalmologist will need to perform a posterior capsulotomy. She will use a particular laser tool to get rid of the obstruction. It is a simple office procedure that usually results in significant vision improvement.

You will have the best vision you had in a long time.

A year after cataract surgery, you’re probably wondering, “How long does it take for vision to clear up after cataract surgery?” You now have the answer. If you are scared of getting cataract surgery due to its consequences, fear not because now you know what will happen during recovery. Get your cataract surgery in Singapore today, and receive the best vision ever.

Cost of Cataract surgery in Singapore

The cost of cataract surgery varies in Singapore. The expenses vary depending on the doctor’s skill, the severity of the cataract, and the numerous methods of eye surgery. The patient’s medical history is also important. The following is an estimate of the cost in Singapore:

Service	Estimated Cost
Cataract Eye Examination (Pre-operative)	$80 to $200 per visit
Cataract Surgery	$3,000 to $12,000 per eye
Post Surgery Medication	$100 to $300
Post Surgery Review	$50 to $200

Types of Cataract

Cataracts come in many different types. Among them are:

Nuclear Cataract:

This type of cataract forms in the centre of the lens, causing blurring and glare. This form of cataract is frequently linked to advancing age. Our eyes’ lenses are comprised of a translucent protein known as ‘crystallin.’ Crystallin proteins clump together when people get older and are exposed to more UV rays. These proteins do not degrade and remain clumped together. The lens of our eyes hardens and yellows over time. While this is normal, it grows heavily yellow and causes vision obstruction.

Cortical Cataracts:

As the name implies, it develops and appears first at the eye’s cortex (edges) and then forms streaks at the nucleus’s outer region. It gradually moves to the centre of the eyes, interfering with the passage of light through the lens.

Posterior Capsular Cataracts:

This type of cataract develops significantly more quickly than the previous two varieties. It develops toward the back of the lens and can coexist with other types of cataracts. Furthermore, when we stare at light, it can cause us to see ‘halos.’

Congenital Cataracts:

Although most cataracts are associated with age, this does not mean that they do not occur in children. Though uncommon, congenital cataracts is a birth defect in the eye that can affect one or both eyes due to genetics. Additionally, there is a risk of developing cataracts during childhood.

Traumatic Cataracts:

Blurred vision can also be caused by a blunt, penetrating trauma. This trauma is the result of eye injuries. The cataract may take years to form and may not appear immediately after the injury.

Radiation Cataracts:

Due to the long duration of chemotherapy and radiotherapy, cancer patients can be exposed to long hours of UV light. Hence, they have a high possibility of developing Cataracts.

Suitability and risks of the patient:

When their eyesight is not significantly affected, most Singaporeans will avoid surgery due to the inconvenience. However, in such cases, the patient is strongly advised to undergo cataract surgery in Singapore:

• Patients suffering from blurred vision
• Patients who have difficulty reading Patients whose driving abilities are impaired due to glare from vehicle lights
• Patients who work in a field where vision is critical

Cataracts will only worsen as time passes. As a result, prevention is always preferable to cure before vision deteriorates. Rest assured that a typical cataract surgery is relatively low risk and can be completed in a single day. The patient does not need to be admitted to the hospital after the surgery and can go home. However, there may be uncommon complications from the surgery. Inflammation, swelling, bleeding, drooping eyelids, loss of vision, increased eye redness, and retinal detachment are all risks following surgery. These are uncommon and easily corrected.

Risk factors of developing Cataract:

The risks of cataract includes:

• Age
• Diabetes
• High Blood Pressure
• Too much sun exposure
• Eye injury
• Family genetics
• Smoking
• Consumption of excessive alcohol

Prevention of developing Cataract:

Though the only permanent solution is undergoing surgery, there are ways that one can take to delay the worsening of eyesight by taking precaution with:

• Wearing sunglasses to prevent excessive sunlight
• Reduce consumption of alcohol
• Stop smoking
• Living a healthy lifestyle
• Visit the eye doctor for regular examinations
• Family genetics
• Smoking
• Having the right pair of spectacles prescription

Summary of Cataract Surgery:

Before the surgery	Ultrasound of eye to determine the type of lens implant Fasting 12 hours before the surgery
During the procedure	Local anaesthetics of the eye Old lens are replaced with new clear artificial lens
After the surgery	Swelling and Itchiness in the eye is expected Colours may seem brighter Use of eyedrops to prevent infection Wearing of sunglasses to minimise sun exposure of eyes

The expected recovery time after the surgery is expected to be four to six weeks. However, depending on the severity, healing may take longer. It is critical to take good care of the eyes after surgery. If this is not done properly, the patient may develop posterior capsule opacification (PCO). This occurs when the cells inside the eyes grow over the lens capsule (the part that holds the new lens) causing the patient’s vision to become cloudy again.

Once again, early detection of cataract is critical. Do not put off seeing an eye doctor until the last minute when complete loss of vision occurs. Make sure to visit the eye doctor on a regular basis and heed their advice. If you or your loved ones are having problems with vision, see a cataract surgeon in Singapore as soon as possible before it is too late.