By Daphne Chiew Le Min, School of Medicine, Imperial College London

Professor Lim Tock Han, Deputy Group CEO (Education and Research), National Healthcare Group and Senior Consultant at the NHG Eye Institute, was invited to give a lecture at Singapore Primary Eye Care Symposium (SPECS) 2019 held from 23-24 July 2019 at One Farrer Hotel. His lecture, “Extending the Continuum of Eye Care”, focused on the growing role of primary eye care professionals within our community.

He began by sharing invaluable knowledge regarding myopia and the risks that this condition carries, which increase as myopia becomes more severe. Delay in presentation also leads to poorer outcomes post-surgery, which is alarming as elderly patients present only 2-3 weeks after becoming symptomatic, e.g. seeing floaters. Considering the widespread eye screening availability, as well as the imaging capabilities of most major healthcare providers, late presentations of common eye conditions should no longer occur.

Thus, this leads to the revelation that there is much more to be done in our society. With the overall increase in life expectancy and our undeniably ageing population, more attention must be paid towards the maintenance of vision in later years, as it is one of the main determinants of a patient’s quality of life.

Professor Lim then briefly outlined the criteria of a cost-effective screening programme, before highlighting several key ocular screening programmes in Singapore.

The Singapore Integrated Diabetic Retinopathy Program (SiDRP) is essential as it screens for ocular complications in patients already diagnosed with diabetes mellitus, whilst allowing for better treatment and management of patients that have already developed diabetic retinopathy. Project Silver Screen on the other hand, is a programme that provides subsidised screening for the elderly. It includes screening for poor vision, hearing and oral hygiene, and utilises community resources for basic screening, namely the determination of visual acuity. Referrals to primary eye care providers or eye specialists can then be done should visual deficits be found. Professor Lim also briefly mentioned newer artificial intelligence technologies that are being developed to diagnose ocular conditions.

Finally, Professor Lim emphasised the need to fully understand what patients need their vision for, be it for mobility, to socialise or to drive, so as to better determine what their needs are. He also brought up the idea of visual rehabilitation and its important role in patients who are ineligible for other treatments. He concluded by highlighting the importance of primary eye care practitioners in the maintenance of ocular health in the community, and encouraged the use of modern technology to aid with the management and improvement of patients’ quality of life.