Jul - Sep 05 - NHG Eye Institute

IN
AU
IS GU
SU R
E AL
J U L - S E P
TEInsight
INSIDE
DELIVERING THE FINEST QUALITY EYECARE
2 0 0 5
A publication of
MITA (P) 107/02/2005
IN THE SPOTLIGHT Refractive Surgery and Oculoplastics
2
3
6
4 Oculoplastics
Iris Tracking
Aesthetic Eye
Surgery
Artifical Eye
Service
6 Test Your EyeQ
A growing field in
ophthalmology
Customised ocular
prostheses in under
10 hours
A world’s first for TEI
P U L L O U T
7 What’s On
8 TEI Profile
INTRALASE
- Safer LASIK
HOW INTRALASE IS DONE
BEFORE
Mechanised
surgical
blade
Cornea
In the standard method, the
surgeon does a circular cut using
a mechanical surgical blade on
the surface of the cornea and
folds back the flap.
Conventional LASIK
LASIK is currently the most commonly performed laser procedure to correct
myopia, astigmatism and hyperopia (far-sightedness) worldwide, as well as
in Singapore. It has been proven to be safe, predictable and effective.
1
Traditionally, LASIK involves 2 steps:
1. An automated mechanical surgical blade is used to cut a thin hinged
corneal flap which is then folded aside;
2. A computer-controlled laser beam is then applied onto the
underlying corneal bed to change the shape and thickness of the
cornea, thereby eliminating myopia, astigmatism or far-sightedness.
The corneal flap is then flipped back into place.
While results remain excellent and complications rare, some of them
may be related to how precisely and uniformly the corneal flap is made by
the blade.
Blade-less, All-Laser LASIK with Intralase
With Intralase, there is no need for surgical blades. Instead, the computercontrolled Intralase machine emits very short wavelengths of laser energy
(femto-seconds or 10-15 seconds) to precisely and uniformly fashion the
corneal flap. This converts the partial-laser approach to the new all-laser
approach, thus bringing LASIK to an even higher level of safety.
The shape and size of the flap can be precisely pre-determined and
created with this all-laser approach. Furthermore, with such precision, an
even thinner 100 micron corneal flap can be fashioned, instead of the
conventional 160 microns. This makes it possible to treat people with
high degrees of myopia but thin corneas, who were previously excluded
from LASIK.
Intralase was approved by the US Food & Drug Administration (FDA)
for use in LASIK three years ago. Since then, more than 100,000
Intralase procedures have been successfully and safely performed
worldwide. By Dr Lee Hung Ming
In Intralase,
a computercontrolled
machine uses a
laser to create
microscopic
cavities within
the cornea and,
by connecting
these areas into
a single plane,
a very
precise flap is
created.
Corneal
Flap
2
Computer-controlled
laser beams then reshape
the underlying tissue of
the cornea. The flap is
flipped back into place.
No stitching is needed as
the flap will adhere
naturally to the cornea
and will re-attach itself
within months.
Illustration: Artmedica@gmail.com
B
reakthrough technology that has made LASIK surgery even safer and
more precise is now available at TEI. In fact, TEI @ Tan Tock Seng
Hospital remains the first and only restructured hospital to offer
Intralase for myopia and astigmatism correction in Singapore.
Since the introduction of Intralase last year, more than 1000 myopic
eyes have been successfully corrected with this all-laser approach.
REFRACTIVE SURGERY
It gives me great pleasure to present to
you the inaugural issue of TEInsight – the
official publication of The Eye Institute,
National Healthcare Group, Singapore.
As we would all agree, keeping abreast
of the latest investigations and treatment is
of paramount importance in providing our
patients with the best care possible.
Unfortunately, browsing through peer
review journals can be very time-consuming.
Most articles are heavy on research but may
not be directly applicable in our day-to-day
clinical practice.
With TEInsight, we aim to provide
regular updates of what is considered latest
standard care in ophthalmology today. For
the benefit of the busy practitioner, these
updates are kept intentionally concise.
These articles are dedicated to family
physicians, optometrists and non-ophthalmic
physicians. Future issues will feature a
growing emphasis on practical diagnostic
approaches, differential diagnoses, pitfalls
and referral criteria. These articles
complement TEI’s disease flipchart, entitled
“Practical Approaches to Common Problems
in Ophthalmology”, which you may have
already received.
We have also decided to focus on 2
subspecialties per issue, so that our readers
get exposed to an even spread of subject
matter. In this, our maiden effort, the
spotlight falls on refractive surgery and
oculoplastics.
It is our ultimate goal that this
newsletter proves to be a useful tool to our
readers and we hope it will be a helpful
guide in your practice.
I wish you and your family good health
and a productive year ahead.
Dr Lim Tock Han
Director, The Eye Institute
National Healthcare Group
2 TEInsight JUL-SEP05
TEInsight Editorial Team
Dr Wong Hon Tym (Chief Editor)
Mr Christopher Koh (Secretariat)
Dr Gangadhara Sundar
Dr Christopher Khng
Dr Ronald Chung
Iris Tracking
A World’s First for
TEI: Iris tracking
technology and the
promise of even
better LASIK
outcomes
T
he TEI Refractive Surgery team launched the world’s first iris tracking
technology that promises to bring the safety and precision of Laser Assisted
In-Situ Keratomileusis (LASIK) to a new level. LASIK is currently the most
common method of correcting myopia and astigmatism worldwide.
During wavefront-guided LASIK, patients have their corneas mapped prior to the
operation. However, lying down may cause their eyes to cyclotort (rotate), misaligning
the mapping and thereby reducing the accuracy of the procedure. In some patients,
the centre of the pupil may also shift, depending on whether it is dilated or miosed.
Iris recognition and tracking can compensate for these misalignments.
Dr Lee Hung Ming, head of TEI’s Refractive Surgery division, was the principal
investigator of a landmark study which was the first in the world to utilise iris
recognition and tracking technology to compensate for eye cyclotorsions and
pupillary shifts that may occur during the laser treatment. This multi-dimensional
and multi-directional tracker ensures that all the laser pulses are precisely applied
on the cornea.
The trial was carried out using 60 eyes of 30 patients and resulted in almost
90 per cent of them achieving 20/20 or better vision without glasses or contact
lenses. A predictable improvement within 1 dioptre of the target refraction was
also found in 97 per cent of all eyes.
SPOTLIGHT ON
TEI’s Refractive Surgery Team
Many firsts mark TEI’s Refractive Surgery team: first in the world to
perform LASIK with iris recognition technology, first in Asia to study the
Optical Coherence Pachymetry (OCP) for real-time measurement of
corneal thickness in LASIK, and first in Singapore to embrace
Femtosecond Intralase, and to implant iris-fixated intra-ocular lenses as
well as implantable contact lenses for high myopia.
Aesthetic Eye Surgery
A growing field in Ophthalmology
T
he eyes are the centre of attraction of the face. However,
aging changes around the eyes can lead to a less appealing
and haggard look, which may be amenable to correction by
aesthetic eye surgery. TEI’s Oculoplastic Surgeons have garnered
considerable collective experience in this emerging field and are
increasingly being called upon by patients to manage changes in
their eyebrows, eyelids and midface, restoring a youthful
appearance and confidence.
The four most common areas of concern are eye bags, sagging
upper lids and eyebrows, droopy eyelids and wrinkles.
Eye Bags can be due to any or all of the following causes:
• Orbital fat prolapse can be improved with lower blepharoplasty
using hidden sutureless conjunctival incisions. (Fig 1)
Ptosis can be identified easily by torch light illumination of the
cornea to observe the distance between the upper eyelid margin
and the corneal light reflex (normal: 3-4mm). Ptosis surgery is
achieved via an external approach through the blepharoplasty skin
incision. (Fig 1), or via a posterior route (trans-conjunctivally) with no
cutaneous incision.
Wrinkles around the eyes
The aging skin around the eye often manifests as pigment changes
and wrinkles. A good skin care regime is recommended, and this
can be augmented with chemical peels, Botox injections, dermal
fillers and lasers, all office-based procedures.
Aging changes around the eyes are disturbing problems that
can be addressed by the Oculoplastic surgeon who is in a unique
position, with the training and knowledge of the eye, to specifically
manage these concerns. By Dr Yip Chee Chew
All clinical photographs are the property of TEI @ TTSH
Fig 1. Before and after bilateral ptosis correction, with upper &
lower blepharoplasty
• Fluid Festoons are areas of fluid accumulation along the lower
eyelids that are managed with fluid-salt restriction and/or heat
therapy (sponge thermoplasty).
• Prominent orbicularis oculi muscles lead to bulging of the lower
eyelids when smiling. It can be effectively relaxed with Botox
injections (Fig 2).
SPOTLIGHT ON
TEI’s Oculoplastics Team
The Ophthalmic Plastic & Reconstructive Surgery
Service of The Eye Institute, located at all three centres
of the National Healthcare Group, offers the full
spectrum of treatment for disorders of the eyelid,
lacrimal and orbits. The TEI Oculoplastics fellowship is
emerging as one of the most sought after in the
region, attracting surgeons from Myanmar, China,
Indonesia, India and the Philippines.
Fig 2. Prominent obicularis oculi muscles, before and after Botox
injections
Sagging upper eyelids (dermatochalasis) or eyebrows
(eyebrow ptosis) may result in problems such as blocked vision
and a tired, sleepy look.
Dr Lee Hung Ming
Senior Consultant,
Head, Refractive
Surgery Service
Dr Fam Han Bor
Senior Consultant,
Head, Cataract,
Implant & Anterior
Segment Service
Dr Heng Wee Jin
Consultant,
Head, Cornea
Service and Training
& Education
Dr Voon Li Wern
Consultant
Dr Lee Sao Bing
Associate Consultant
Dr Lee has
performed thousands
of refractive
procedures and
continues to lead this
field, involving
himself in many
research projects
such as wavefrontguided ablation,
iris-recognition,
optical coherence
pachymetry for LASIK
and phakic IOLs.
He has also been an
invited speaker to
numerous regional
and international
conferences on
refractive and
cataract surgery.
Dr Fam completed his
15-month fellowship
in Cornea &
Refractive Surgery at
the University of
British Columbia,
Vancouver, Canada.
He is currently Head
of Cataract & Implant
Services at TTSH. Also
a Senior Consultant
in Refractive Surgery
at TEI, Dr Fam is
actively involved in
the teaching of
refractive and
cataract surgery in
the region, with a
particular interest in
corneal topography,
visual optics and
wavefront sciences.
Dr Heng is a highly
experienced cataract
and refractive
surgeon, and is
involved in many
research projects in
this field. He has
also been an
instructor in LASIK
and microsurgical
courses, and trained
international fellows
in cornea and
refractive surgery.
He is co-author of
the book “Colour
Atlas & Synopsis of
Clinical
Ophthalmology Cornea”.
With a fellowship at
Oxford Eye Hospital
under her belt,
Dr Voon has been
extensively trained in
cornea, contact
lenses and refractive
surgery, encompassing
LASIK, phakic IOLs,
dry eyes and corneal
transplants. Dr Voon
is actively involved in
training and
education and has
conducted numerous
talks in the above
topics.
The winner of four
Young Investigator
Awards, Dr Lee had
his fellowship
training at Bascom
Palmer Eye Institute
in USA where he
performed laboratory
and clinical research
in ocular surface
reconstruction and
stem cell biology of
the eye.
• Dermatochalasis results from lax upper eyelid skin and can be
treated with upper blepharoplasty.
• Eyebrow ptosis is often confused with dermatochalasis, which
frequently co-exists. The normal eyebrow position should rest at
the superior orbital rim for males and slightly above it for
females. Mild degrees can be elevated with Botox injections to
the brow depressors. Moderate to severe cases require
endoscopic eyebrow lift from beneath the hairline.
Fig 3. A patient with Crow’s feet wrinkles, improved dramatically
with Botox injection.
Dr Shantha Amrith
Senior Consultant,
Head of Oculoplastic Service
Dr Yip Chee Chew
Consultant
Dr Gangadhara Sundar
Consultant
Obtained her FRCS from the
Royal College of Surgeons,
Edinburgh in 1979, followed
by two Ophthalmic Plastic
and Reconstructive Surgery
fellowships in Sydney Eye
Hospital, Australia and
University of Cincinnati
Hospitals, USA. Now
Dr Shantha heads TEI’s
Oculoplastic Service. She
possesses a breadth of
experience in managing lid,
lacrimal and orbital
pathologies for reconstructive
as well as cosmetic surgery.
Dr Yip underwent a two-year
Ministry of Health scholarship
at the University of Cincinnati
and the University of
California, Los Angeles. He
publishes widely and is also a
reviewer for the American
Journal of Ophthalmology as
well as a course instructor at
the Americam Academy of
Ophthalmology Annual
Meeting. Dr Yip has a special
interest in aesthetic surgery
of the eyes.
Dr Ganga underwent a
dedicated 2 year fellowship in
Ophthalmic Plastic &
Reconstructive Surgery at
Henry Ford Hospital in
Detroit, USA. He is also active
in furthering the cause of the
specialty in the South and
East Asian region. His special
interests include pediatric
oculoplastics, anophthalmic
sockets and orbital
reconstruction.
Visiting Consultant
Dr Liew Geok Cheng
TEI @ TTSH
3 TEInsight JUL-SEP05
A Message
from Our
Director
OCULOPLASTICS
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Reconstructive & Plastic
Surgery for the Eye
R
econstructive and plastic surgery is a growing
area in eye care. Specialists known as
oculoplastic surgeons are skilled in treating
certain eye deformities (which may be inborn or
caused by injury). They also treat sightthreatening infections and even tumours of the
surrounding tissues, such as the eyelids, bone and muscle.
Parts of the Eye Treated by Oculoplastic Surgeons
The Eyelids protect the eyeball and may be abnormally
turned in (entropion) or out (ectropion). This results in
irritation, tearing and infections. Strokes or weakness of
certain nerves can lead to an inability to fully close the
eyes (lagophthalmos), thus putting the cornea, also
known as the windscreen of the eye, at great risk of
infection. Eyelid surgery can correct this problem.
Epiblepharon is a condition where the lower
eyelashes turn towards the eye, occurring in children who
have an extra-thick fold of skin and muscle on the lower
eyelids. These children rub
their eyes frequently
because of the irritation.
They often have wet, teary
eyes as well. This can be
surgically corrected by an
oculoplastic surgeon.
Droopy eyelids (Ptosis,
Fig 1 & 2) could occur at
birth or with age. In
children, they may cause a Fig 1 & 2. Congenital ptosis –
before (above) and after surgery
child to develop lazy eyes
(amblyopia), where the brain does not properly learn to
interpret signals sent by the eyes. In adults, droopy eyelids
could be due to aging, injury or rare nerve and muscle
diseases. Surgery helps
not only to correct this
and improve the person’s
sight, but generally
improves the person’s
appearance as well.
Fig 3. Lacrimal abscess from chronic
The Tear Drainage
nasolacrimal duct obstruction
System Excessive tearing
can affect a patient’s
quality of life, causing
blurred vision due to
pooling of tears. In some
cases, blocked tear ducts
near the nose can become
Fig 4. Child with congenital
severely infected (Fig 3).
nasolacrimal duct obstruction
Infants with tearing
problems (Fig 4) should be seen early by an oculoplastic
surgeon to ensure that this does not worsen.
There are many methods to treat the blockage of the
tear drainage system without surgery, but stubborn cases
may require an operation.
The Eye Socket (also
called the orbit) is the
bony cavity in the skull
that protects the eyeball
and other vital structures
Fig 5. Orbital cellulitis from
like nerves, blood vessels
chronic sinusitis
and muscle. Diseases of
the orbit could be both sight- and life-threatening.
Patients with orbital
cellulitis, a severe
infection that rapidly
spreads within the orbit
(Fig 5), if not properly
Fig 6. Orbital fracture
treated, may develop
blindness, meningitis and even find their lives at risk.
Orbital fractures (Fig 6) are common, especially in
motorcycle accidents. If treated early, sight loss and facial
deformity can be prevented. Tumours of the orbit may
be removed safely through minimally-invasive approaches
to visually and cosmetically rehabilitate patients.
...and Beyond Because of their expert knowledge of
diseases of the eye and methods of protecting the
underlying vital structures, oculoplastic surgeons also have
a special advantage to offer reconstructive and
cosmetic procedures of the face, including the
forehead, the eyebrows, the upper and lower eyelids
(including the creation of “double” eyelids), and the midface. The territory continues to expand everyday for this
group of eye specialists.
All clinical material and photographs are the property of TEI @ NUH
TEInsight
J U L - S E P
2 0 0 5
Public Education Material with compliments of
PROFILE
WHAT’S ON
Express Artificial Eye Service at TEI
IN UNDER 10 HOURS
Dr Low has developed a technique in the fabrication of customised
ocular prostheses, allowing a patient to receive an artificial eye
replacement in under 10 hours within the same day.
>
>
EYEQ
This 10 year-old boy presented with double vision and
vomiting after accidentally bumping his head and face
forcefully against his friend while playing in school. His vision
was 6/6 in each eye, with normal pupils, slit lamp and fundus
examination for both eyes.
The MRCS/MMed exam was held at TEI @ NUH
in April, with examiners (front row, left to
right): Dr Caroline Chee, A/Prof Paul Chew,
Dr Alistair Adams, Dr Brian Fleck, Clin/Prof Ang
Chong Lye, Dr Sharon Tow, Dr Shantha Amrith.
Adjunct A/Prof Au Eong Kah Guan, TEI Deputy
Director (Clinical Quality) and Head of Research
attending the AMD Alliance International
Scientific Advisory Board meeting in Florence,
Italy in May 2005.
Adjunct A/Prof Au Eong gives a talk "Eye on
Vision Health" with NewsRadio FM 93.8.
Conditions and treatment of cataracts and
age-related macular degeneration were
discussed.
TEI Doctors in the Research Journals
1. Han-Bor Fam, E-Shawn Goh, Hung-Ming Lee,
Kooi-Ling Lim
Post-LASIK myopic shift after a trek in the North Pole
Journal of Cataract & Refractive Surgery. 2005 Jan:
31: 198 - 201
2. Ronaldo R Jarin, Teoh SCB, Lim ATH
“Resolution of Severe Macular Oedema in Adult
Coat’s Syndrome Treated with High-dose Intravitreal
Triamcinolone”
Eye, Feb 11 2005. Epub ahead of print
3. Tan CSH, Au Eong KG.
Surgical drainage of submacular haemorrhage from
ruptured retinal arterial macroaneurysm.
Acta Ophthalmologica Scandinavica Apr 2005;
83(2):240-241.
What do the photographs demonstrate?
4. Yip CC, Gonzalez-Candial M, Jain A, Goldberg
RA, McCann JD. "Lagophthalmos in enophthalmic
eyes."British Journal of Ophthalmology. 2005
Jun;89(6):676-8.
7. Yip LW, Yong VK, Hoh ST, Wong HT.
Optical coherence tomography of optic disc
swelling in acute primary angle-closure glaucoma.
Archives of Ophthalmology. 2005 Apr;123(4):567-9.
5. Teoh SCB, Thean LSY, Koay ESC
“Cytomegalovirus in Aetiology of Posner-Schlossman
Syndrome: Evidence from Quantitative Polymerase
Chain Reaction”
Eye, Oct 29 2004. Epub ahead of print.
8. Khng C. Pupil Dilatation Methods.
Ophthalmology. May 2005; 112(5): 949-950
6. Teoh SCB, Lim JWK, Koh AHC, Lim ATH,
Fu ERY
Abnormalities on the Multifocal Electroretinogram
may Precede Clinical Signs of Hydroxychloroquine
Retinotoxicity
Eye, Feb 25 2005. Epub ahead of print.
11. Wagle AA, Wagle AM, Eong KG.
Pulmonary embolism following ocular surgery.
Journal of Anesthesia. 2005;19(1):91.
12. Shabana N, Cornilleau-Peres V, Droulez J, Goh
JCh, Lee GS, Chew PT. "Postural stability in
primary open angle glaucoma."
Clinical Experiment Ophthalmology. 2005
Jun;33(3):264-73.
Upcoming Events
What are the appropriate steps to take in the initial management?
Date
A CT Scan was subsequently ordered - what does it show?
For GPs
30 Jul
Venue
Contact
Tan Tock Seng Hospital
Theatrette
Ms Lalitha K / Ms Annie Liew
T: 6357 7648 / 7726, F: 6357 7718
lalitha_k@ttsh.com.sg
For Optometrists
9:00am - 11:00am Continuing Optometric Education
14 Sept
9:00am - 11:00am Continuing Optometric Education
16 Nov
Alexandra Hospital, Seminar Room
Alexandra Hospital, Seminar Room
Ms Alice How
T: 6379 3741, F: 6379 3540
alice_how@alexhosp.com.sg
For Ophthalmologists
23 Jul
8:30am - 5:30pm
National University Hospital
Ms Jennifer Dodd
T: 6772 5391, F: 6777 7161
ophv12@nus.edu.sg
Time
Title
12:30pm - 4:30pm GP Symposium: Eye Needs – Everything You
Ever Need for the Family Physician
What is the recommended treatment?
Quiz master: Dr Gangadhara Sundar
3. A fractured left orbital floor (blow-out
fracture) with herniation of orbital
contents into the maxillary sinus. Air is
also seen in the orbit.
2. Initial management
a. Consider admitting under Neurosurgery
for observation (vomiting after head injury)
b. Arrange for urgent CT of orbits and
brain (axial and coronal if possible)
c. Prescribe a short course of steroids and
antibiotic drops
1. A sunken left eye (enophthalmos) and
limitation of upgaze in the same eye –
signs of typical ‘white-eyed’ blowout in
children.
ANSWERS
4. Urgent referral to an ophthalmologist
for fracture repair to prevent permanent
ocular mobility disorder. The child
should also be advised not to blow his
nose, otherwise orbital emphysema
may occur.
6 TEInsight JUL-SEP05
Dr Inez Wong, TEI Registrar at the 31st Annual
Meeting of American Association for Pediatric
Ophthalmology and Strabismus, Orlando, Florida,
USA in March 2005 with her poster, "Surgical
Treatment of Myopic Strasbismus Fixus".
An ocular prosthesis being fitted (below).
YOU MAKE THE DIAGNOSIS!
1
2
3
4
Dr Michael Ramirez Munoz, TEI Oculoplastics
Fellow at the Asia Pacific Academy of
Ophthalmology Congress in Kuala Lumpur,
Malaysia in March 2005 with his poster,
"Levator Muscle Biopsy: Is it necessary?’
>
TEST YOUR
QUIZ
Dr Christopher Khng (right), TEI Consultant,
received a Best Paper of the Session Award for
his presentation "Predicting Capsular Size from
Limbus Dimensions" in Washington DC, USA,
May 2005. With him is Dr John Polansky, a
surgeon and good friend from Oregon.
Glaucoma Symposium
Combined Scientific Meeting 2005
On 4 - 6 November at the Raffles City Convention Centre, the first Combined Scientific Meeting 2005 of Singapore Health Service (SingHealth), the National Healthcare
Group (NHG) and the National University of Singapore (NUS) will bring together Singapore's leading medical institutions on a shared platform to showcase the best
in our medical research and teaching. We invite you to be part of this exciting inaugural event. See you at CSM05!www.csmsingapore.com
7 TEInsight JUL-SEP05
F
or the unfortunate few of our patients who have experienced
the loss of an eye, the psychological distress can linger long
after, with lifelong social and functional problems, not to
mention the impact on their families.
Dr Low Huey Moon is responding to the tragic plight of this
group with her distinctive skill. She has developed a technique in
the fabrication of customised ocular prostheses, allowing a patient
to receive an artificial eye replacement in under 10 hours. This
speedy response is of particular benefit to patients from overseas,
saving them both time, travel and lodging costs.
Dr Low is a Senior Consultant at TEI @ Alexandra Hospital and
National University Hospital. She is also a Visiting Consultant at the
Singapore National Eye Centre.
Dr Low is a highly respected authority in maxillo-facial
prothodontics, and has over 15 years of working experience with
eye patients. She has been actively involved in the field following
her fellowship at the MD Anderson Cancer Center, University of
Texas in USA.
By collaborating with TEI eye surgeons, Dr Low has been
providing artificial eye services for infants and adults who have eye
socket complexities. She provides them with ocular prostheses that
are customised for maximum comfort and mobility, with a natural
appearance. The pictures here are testimony to the dramatically
positive effect that this service can have on our patients’ lives.
TEI Doctors in the Limelight
INTRODUCING
The Eye Institute
TEI brings together the Ophthalmology Departments from three National Healthcare Group hospitals (from left): Alexandra Hospital, National
University Hospital and Tan Tock Seng Hospital.
To serve our patients better and meet the
rising demand for quality eye services, The
Eye Institute was established to oversee
the provision of eye care throughout the
National Healthcare Group.
All existing eye units and services from
Alexandra Hospital, National University
Hospital and Tan Tock Seng Hospital have
merged horizontally across the cluster, and
are vertically integrated with primary and
community units under one umbrella.
As a result, patients can now travel to
the hospital nearest their homes for any
eye services.
The Eye Institute allows for medical
cross-accreditation between departments,
continuing medical education, training,
quality benchmarking and research.
Harnessing the experience and expertise of
34 trained ophthalmologists, ably
supported by our team of optometrists,
technicians and nurses, TEI is more than
capable of handling the entire spectrum of
eye diseases.
A: Alexandra Hospital
N: National University Hospital
T: Tan Tock Seng Hospital
Our Doctors by Subspecialty
Cataract, Implant &
Anterior Segment Service
Dr Fam Han Bor (Head) N,T
Dr Christopher Khng Yen Wei T
All other TEI Consultants &
Associate Consultants
Refractive Surgery Service
Dr Lee Hung Ming (Head) N,T
Dr Fam Han Bor N,T
Dr Heng Wee Jin N,T
Dr Lee Sao Bing N
Dr Voon Li Wern T
Cornea Service
Dr Heng Wee Jin (Head) N,T
Dr Fam Han Bor N,T
Dr Lee Hung Ming N,T
Dr Lee Sao Bing N
Dr James Pan T
Dr Voon Li Wern T
Dr Wang Jenn Chyuan N
Glaucoma Service
Assoc. Prof Paul Chew Tec
Kuan (Head) N
Dr Lim Boon Ang T
Dr Loon Seng Chee N
Dr Jovina See Li Shuen N
Dr Lennard Thean N
Dr Wong Hon Tym T
Dr Leonard Yip Wei Leon T
Dr Vernon Yong Khet Yau T
Oculoplastics Service
Dr Shantha Amrith (Head) N,T
Dr Gangadhara Sundar N
Dr Yip Chee Chew A,T
Paediatric Ophthalmology
& Adult Strabismus
Service
Dr Khoo Boo Kian (Head) T
Dr Leo Seo Wei T
Dr Gangadhara Sundar N
Uveitis Service
Dr Lennard Thean N
Neuro-Ophthalmology
Service
Dr Goh Kong Yong (Head) T
Dr Lim Su Ann T
Dr Clement Tan Woon Teck N
Surgical and Medical Retina Service
Dr Billy Tan Ban Hock (Head, Surgical Retina) T
Dr Chee Ka Lin, Caroline (Head, Medical Retina) N
Adjunct Assoc Prof Au Eong Kah Guan A,T
Dr Lee Jong Jian T
Dr Lim Tock Han T
Dr Nikolle Tan Wan Hui T
Dr Zaw Minn-Din N,T
Our Clinics
8 TEInsight JUL-SEP05
Alexandra Hospital Ophthalmology and Visual Sciences
GP Hotline: 9369 3912
OVS Line:
6379 3500
OVS Fax:
6379 6292
National University Hospital Eye Clinic
GP Hotline: 6772 2000
Clinic Line:
6772 5408
Clinic Fax:
6772 5508
Tan Tock Seng Hospital Eye Centre
GP Hotline: 6357 8383
Centre Line: 6357 8000
Centre Fax: 6357 8675
General Enquiries by E-mail: tei@nuh.com.sg
In our quest to constantly improve ourselves, we would appreciate your frank feedback on any part of this newsletter, be it on the format or content.
Please email your comments to tei@nuh.com.sg or mail to Ms Izyani Ayik, The Eye Institute, National Healthcare Group, 6 Commonwealth Lane,
Level 6, GMTI Building, Singapore 149547. Please indicate if you would grant us the permission to publish your letter. If you would like to receive our
upcoming quarterly e-newsletter, please send an e-mail with your name to tei@nuh.com.sg with the subject heading ‘TEInsight Subscribe’.