Eye Conditions and Treatments
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Clouding of the lens, leading to blurry vision, glare sensitivity, and difficulty seeing at night.
Treatments:
Prescription glasses (for early stages).
Cataract surgery (removal of the cloudy lens and replacement with an artificial intraocular lens).
Dr Teo has extensive experience in cataract surgery for both simple cases where eyes have no concomitant eye conditions as well as complex cases in eyes with other underlying eye disease.
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Deterioration of the central part of the retina (macula), causing central vision loss.
Treatments:
Early/Dry AMD:
Lifestyle changes (healthy diet, smoking cessation).
Nutritional supplements (AREDS2 formula).
Novel therapeutic option: Photobiomodulation laser
Photobiomodulation (PBM) is a light-based therapy that helps improve energy production in cells. In dry age-related macular degeneration (AMD), problems with cell energy systems contribute to the disease. PBM has shown promising results in improving vision and eye health in early to intermediate stages of dry AMD, offering a new and innovative treatment option.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10885856/
Advanced neovascular (wet) AMD:
Dr Teo remains at the forefront for the treatment of advanced neovascular AMD. His expertise in diagnosis and treatment ensures that other conditions that mimic AMD are excluded. By carefully subtyping AMD with his suite of advanced diagnostic tools, he is able to ensure targeted, personalised treatment for the condition.
Treatment includes:
Anti-vascular endothelial growth factor injections (e.g., ranibizumab, aflibercept, or vabysmo) to reduce abnormal blood vessel growth.
Photodynamic therapy
Novel therapeutic options: Therapeutic port delivery system
The Port delivery system (PDS) by Roche is a permanent refillable implant roughly the size of a small pellet. It is surgically implanted into the eye and continuously delivers a customized formulation of ranibizumab over a period of months. In pivotal phase 3 trials of this implant, most patients were sustained on few anti VEGF treatments over 6 or more months. This implant is currently FDA approved and may be sitable for selected patients.
https://pubmed.ncbi.nlm.nih.gov/34597713/
Advanced atrophic AMD or Geographic Atrophy:
Dr Teo is an advisor and key opinion leader to several pharmaceutical companies that have launched novel therapies to address geographic atrophy (GA) from AMD.
This previously untreatable condition resulted in progressive blindness in the elderly. New therapies today that target the inflammatory pathways have been shown to slow the progression of GA. This is particularly important for patients who have lost vision to GA in one eye and wish to preserve vision in the fellow, only eye.
Anti-complement factor injections are a very new therapy approved by the FDA only in August of 2023. These therapies are currently only available in the USA. Early access to these treatments may be possible for select patients.
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Damage to the retinal blood vessels due to high blood sugar levels, causing vision changes or loss.
Treatments:
· Strict blood sugar, blood pressure, and cholesterol control.
· Laser therapy (pan-retinal photocoagulation) to seal leaking blood vessels.
· Anti-VEGF injections or corticosteroids to reduce swelling.
· Vitrectomy surgery (for advanced cases with bleeding or scarring).
Dr Teo has extensive experience treating diabetic related eye conditions. He was instrumental in the formulation of guidelines for the national diabetic eye screening programme in Singapore’s healthier SG initiative.
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Retinal Vein Occlusion
A “stroke” in the eye, this condition occurs most commonly in patients with hypertension or ongoing cardiac conditions. Poor supply of blood and oxygen to the retina result in partial blindness that can occur suddenly.
Treatments:
Strict blood sugar, blood pressure, and cholesterol control.
Laser therapy
Anti-VEGF injections or corticosteroids to reduce swelling.
Vitrectomy surgery (for advanced cases with bleeding or scarring).
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Damage to the optic nerve often caused by increased intraocular pressure, leading to peripheral vision loss.
Treatments:
Eye drops (e.g., prostaglandin analogs, beta blockers, or carbonic anhydrase inhibitors) to reduce intraocular pressure.
Laser treatments (e.g., selective laser trabeculoplasty).
Glaucoma surgery (e.g., trabeculectomy or drainage implants) for advanced cases.
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Insufficient tear production or poor-quality tears, causing irritation, redness, and blurred vision.
Treatments:
Artificial tears or lubricating eye drops.
Prescription medications (e.g., cyclosporine eye drops or lifitegrast).
Punctal plugs to conserve tears.
Lifestyle changes (humidifier use, limiting screen time).
Novel therapies: Photobiomodulation light therapy for dry eyes
PBM is applied directly to the eyelids, providing heat to the meibomian glands. This improves the function of the glands by secreting more meibum and replenishing the tear film, which subsequently reduces inflammation and dry eye symptoms. PBM may be suitable for select patients.
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The retina separates from its underlying supportive tissue, potentially causing vision loss if untreated.
Treatments:
Laser photocoagulation (to seal small tears or holes).
Pneumatic retinopexy (injection of a gas bubble to reattach the retina).
Vitrectomy (removal of the vitreous gel and repair of the retina).
Scleral buckle surgery (to physically support the retina).
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Refractive errors where light does not focus correctly on the retina, causing blurred vision.
Treatments:
Prescription glasses or contact lenses.
Refractive surgery (e.g., LASIK, SMILE, ICL) for permanent correction.
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Childhood myopia is prevalent worldwide and in particular the Asian region. Uncontrolled myopia can result in severe thining and adult onset complications of the retina.
Treatments: Current therapies include eyedrops and glasses or contact lenses that are specially designed to control myopia.
Dr Teo manages severe complications of myopia in adults and hence has a vested interest in preventing this progression in children.
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Age-related loss of near focusing ability due to reduced lens flexibility.
Treatments:
Reading glasses or bifocal/multifocal lenses.
Multifocal contact lenses.
Refractive surgery (e.g., LASIK monovision or ICL).
Novel therapies: new eye drops have been shown to improve the depth of focus hence reducing the need for presbyopic glasses.
New designed extended depth of focus implantable contact lenses (ICL) have the ability to aid in overcoming presbyopia. These options (drops and ICLs) may be suitable for select patients.