To mark National Eye Week, Dr Nathan Ng – a junior doctor embarking on a career in ophthalmology – gives his thoughts on why good eye health should be seen as a public health priority, and his hopes for his chosen specialism in the years ahead.

Our sight and vision are an important tool for connecting with our surroundings. The world around consists of a spectrum of colours, shapes, and patterns. Sight gives us the ability to perceive movement, and vision gives us the ability to make assessments about that movement. Your eyesight is one of your most important senses and as much 80% of what we perceive comes through our sense of sight.

Growing up in Singapore, I grew up amongst a population uniquely vulnerable to eye diseases and disorders. In Singapore, as many as one in two children develops myopia by the age of 12, with 83% of people turning myopic by 18.  At the age of 10, I was diagnosed with myopia.

The process of developing myopia was so subtle, and the changes to my sight so gradual, that I did not notice it. Only due to yearly eye screenings was my myopia picked up. Thankfully, as my dad was an optometrist, the whole process of having my myopia managed was a seamless one. Back then, I did not think much the whole process. Most of my friends were wearing glasses as well, and so 10-year-old me did not feel like a sore thumb in the classroom.

On reflection, I now realise how fortunate I was. Having my myopia picked up early and managed well enabled me to participate in my education more, enjoy the world around me more and most importantly helped slowed its progression. Studies have shown that the risk of sight-threatening conditions appear to be proportionate to the degree of myopia. Individuals with moderate to high myopia are found to be nearly 50% more likely to develop glaucoma compared to those with low myopia. Higher rates of cataract surgery are also seen in individuals with high myopia.

With an ageing global population, vision impairment is increasingly a public health concern. Chronic eye diseases such as glaucoma, age-related macular degeneration, and diabetic retinopathy now account for a greater proportion of blindness and vision impairment globally. There is also increasing amount of evidence showing how that vision loss affects not only how people see, but also carry with it implications on our physical, cognitive, and mental health.

During my training as a doctor, I have personally seen how eye conditions can affect patients. They increase the risk of falls; hinder rehabilitation and affect independence. Interestingly, the eyes function like a window of the whole body and a thorough eye examination can reveal signs of other significant health conditions such as diabetes, high blood pressure and cardiovascular disease.

As with my experience with myopia, eye conditions can be an insidious process and therefore easy to neglect. Therefore, the most important thing we can do for our eyes is to have a regular NHS-funded eye examination. Keeping our eyes healthy are also a crucial component of having good overall health. A great resource that everyone should refer to is eyes.scot, which is Scotland’s national website for eye care services and eye health information. They provide guidance on how we can look after eyes better, available screening options and also information on available support for the visually impaired and those at risk of sight loss.

Going into the future, I will be applying for ophthalmology as a specialty because this is a branch of medicine that I find extremely interesting, rewarding and close to my heart.

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