Cataract Surgery in Singapore
CATARACT SURGERY
What is a Cataract?
A cataract is a clouding of the natural lens inside the eye.
The lens, which sits behind the iris and pupil, is normally clear and helps focus light onto the retina. As we age, proteins within the lens can clump together, causing it to become cloudy or opaque. This scatters and blocks light from reaching the retina, leading to blurred, dim, or hazy vision.
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​Cataracts develop gradually and are most commonly age-related, though they can also occur due to diabetes, prolonged steroid use, eye trauma, or be present from birth (congenital cataracts).
Symptoms of Cataracts
Common signs that a cataract may be forming include:
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Blurred, cloudy, or hazy vision
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Increasing difficulty seeing at night or in low light
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Glare or halos around lights, especially when driving at night
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Colours appearing faded or yellowed
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Frequent changes in spectacle prescription
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Double vision in one eye
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Reduced contrast sensitivity (difficulty distinguishing objects of similar shades)
Cataracts typically progress slowly over months to years, though some types (such as those associated with diabetes or certain medications) can develop more quickly.
When is Cataract Surgery Needed?
Cataract surgery is generally recommended when the cataract begins to affect daily activities such as reading, driving, or recognising faces, despite updated spectacles. Unlike some retinal conditions, cataracts are rarely a medical emergency; the decision to proceed with surgery is usually based on how much the cataract is affecting your quality of life and visual function, in consultation with your eye surgeon.
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In certain situations, cataract surgery may be recommended earlier, including when:
The cataract is interfering with the management or monitoring of other eye conditions, such as diabetic retinopathy or age-related macular degeneration
The lens has become very dense (hypermature), which can increase surgical complexity if left too long
The cataract is contributing to raised eye pressure (a rare complication)
What Does Cataract Surgery Involve?
Cataract surgery is one of the most commonly performed surgical procedures, typically carried out as a day surgery under local or topical anaesthesia. The standard technique used today is phacoemulsification, in which:
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A small incision (typically around 2 to 3mm) is made at the edge of the cornea.
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An ultrasonic probe is used to break up (emulsify) the cloudy natural lens.
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The lens fragments are gently removed by suction.
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A folded intraocular lens (IOL) is inserted through the same small incision and unfolds into position within the lens capsule.
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Because the incision is so small, it is typically self-sealing and does not usually require stitches. Most patients can return home on the same day and resume light activities within a day or two.
Choosing an Intraocular Lens (IOL)
A key part of cataract surgery planning is selecting the most suitable intraocular lens for your visual needs and lifestyle. Options generally include:
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Monofocal lenses: provide clear vision at one distance (usually far), with reading glasses typically still needed for near tasks
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Multifocal or extended depth-of-focus (EDOF) lenses: designed to provide a functional range of vision at multiple distances, reducing dependence on spectacles
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Toric lenses: correct pre-existing corneal astigmatism in addition to treating the cataract.
The right choice depends on factors such as the health of your retina and optic nerve, the degree of any astigmatism, and your visual priorities (for example, prioritising night driving versus close-up reading). This is discussed in detail during your pre-operative assessment.
Cataract Surgery and Retinal Health
As a vitreoretinal surgeon, Dr Zhao pays particular attention to the health of the retina when assessing patients for cataract surgery. This is especially relevant for patients who:
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Have diabetic retinopathy or diabetic macular oedema
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Have age-related macular degeneration (AMD)
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Have a history of retinal detachment, retinal tears, or lattice degeneration
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Are highly myopic (short-sighted), which carries a higher lifetime risk of retinal tears and detachment
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In some cases, combined procedures may be appropriate, such as cataract surgery performed alongside vitrectomy for patients who also require retinal surgery. A thorough retinal examination, including imaging such as OCT (optical coherence tomography), is typically part of the pre-operative work-up to identify any retinal issues that may affect visual outcomes or require treatment before or after cataract surgery.
RecoveryAfter Cataract Surgery
Most patients notice an improvement in vision within a few days, with full stabilisation over several weeks as the eye heals. After surgery, you will typically be given:
Antibiotic and anti-inflammatory eye drops, used for a few weeks.
A protective shield to wear while sleeping for a short period.
Guidance on avoiding water exposure to the eye, heavy lifting, and strenuous activity during the initial recovery period.
A follow-up visit is usually scheduled within the first week, with further reviews as needed to monitor healing and visual recovery.