How to Manage Cataract - Doctor Q&A

Cataract is a condition where the natural lens in the eye becomes progressively cloudy.

It (cataract) affects one's vision and makes it difficult for one to go about performing your daily activities.

Most forms of cataract develop in adult life, causing the lens to harden and become cloudy as you age.

Although most cataracts are age-related, there are other types which include congenital (present at birth), drug induced (steroids), and traumatic cataracts (injury to the eye).

Cataracts are also more common in people who have certain other conditions such as diabetes (see this article), which tend to occur at an earlier age than those without the disease.

While cataracts cannot be prevented, it can be treated by a surgical procedure — cataract extraction and intraocular lens implantation, where the cloudy cataract lens is removed and replaced with an artificial lens implant. 

If the amount of cataract is little and does not disturb one's vision or daily activities (e.g. driving or reading), it can be left alone. Spectacles may help at this stage to allow one to see better. If using spectacles does not help, and the cataract interferes with one's vision, an eye doctor may suggest doing a cataract surgery.

In this month's 'Ask the Specialist' Q&A, Dr Yap Guan Hui answers your questions on the causes, symptoms and treatment for cataract. Submit your questions now!

Dr Yap Guan Hui is a Consultant with the Cataract & Comprehensive Ophthalmology Department at the Singapore National Eye Centre (SNEC).

He obtained his Medical Degree from the National University of Singapore with a Bachelor of Medicine and Bachelor of Surgery (MBBS) in 2014 and obtained his post-graduate Master of Medicine in Ophthalmology in 2021. In 2023, he attained his Ophthalmology Specialist accreditation and was admitted as a Fellow of the Academy of Medicine, Singapore.

He has also completed his fellowship at the Cataract and Comprehensive Department under the Advanced Clinical Specialist Programme.

His interest and expertise are in Cataract Surgery, and he also practices general and comprehensive ophthalmology, dealing with floaters and flashes, dry eye syndrome, diabetic retinopathy and glaucoma screening.

Dr Yap has published scientific papers in peer-reviewed medical journals and has presented his research work in local and international conferences.

Dr Yap also regularly volunteers at community eye screening projects. These projects screen for cataract, glaucoma, diabetic retinopathy for the elderly in various nursing homes and Senior Activity Centres.

1. Question by Karen

Dear Doctor,

Every now and then I may get vision loss for about 10 minutes and comes on suddenly but with no other symptoms.

I do have dry eyes and I am 63 years old. I either have missing vision in small spots or grey spots or flashing lights.

I was previously told it is aura migraine and to use eye drops or wet towel over my eyes.

I get panicky especially if I am driving and encounter missing spots of vision. Is there any permanent fix for this? Thank you for your advice.

Answer by Dr Yap Guan Hui

Hi Karen,

Cataracts do not cause intermittent visual blurring of vision.

With regards to your dry eyes, I would advice use of lubricant eye drops to moisturise your eyes. Preservative free lubricants would be more advisable if you want to use the lubricants more than 4 times a day.

With regards to your symptoms of intermittent blurring of vision, missing spots, grey spots or flashing lights, you will require an ophthalmological consultation and examination to work up the condition and get the appropriate treatment. If you have already been seen, do follow the medical advice and follow up with your doctor.

If you do have missing spots of vision, it may not be safe to drive and you may need further assessment to assess for safety, and if it meets legal standards of driving.

2. Question by Francine

Dear Dr,

My Optometrist recently pointed out that I have the early stages of cataracts forming, especially in my left eye.

What can I do to slow down their development? I'm presuming that what I have now is irreversible, correct?

Thank you for your advice.

Answer by Dr Yap Guan Hui

Hi Francine,

Yes, you are right that cataracts are reversible. In the meantime you can wear spectacles or contact lenses to correct for any refractive errors to optimise your vision. To slow down their development, ultraviolet (UV) protection such as sunglasses, wearing a hat and reducing outdoor exposure at peak hours of sunlight will be helpful.

3. Question by Margaret

Hi Dr,

I had both of my cataracts removed 3 years back. Today I am having difficulty in focusing in my right eye. It shifts about and I see crooked lines instead of straight. I am 80yrs this year. Pls advise if Pco or Yag is suitable or necessary.

Thank you for your advice!

Answer by Dr Yap Guan Hui

Hi Margaret,

Seeing crooked lines when you are looking at straight lines is called metamorphopsia, commonly due to causes in the retina, unlikely related to your cataract surgery.

Difficulty focusing may be due to multiple causes, posterior capsular opacification (PCO) may be one or them, and a YAG laser capsulotomy can be performed if you do have PCO. However, it may also be due to other common conditions like dry eyes or refractive error.

In view of both symptoms, I would recommend an ophthalmological evaluation to assess for the underlying condition, and then the appropriate treatment can be carried out.

4. Question by Peter

Dear Doctor,

I have opted for monovision for my cataract op.

Doctor has advised me that my dominant eye will be corrected for near vision, and the other one for distance vision.

I read from online that the dominant eye is the usual choice for distance vision.

Should I be concerned? Thank you for your advice.

Answer by Dr Yap Guan Hui

Hi Peter,

The monovision strategy is employed so one eye sees far and the other sees near, and the dominant eye is corrected for distance while the non-dominant eye is corrected for near.

If your doctor says otherwise, do clarify again with him, and also check with him if the underlying reason, and to ensure there is no miscommunication.

5. Question by TL

Dear Dr,

A Specialist Eye Surgeon would usually advise on when is the right time for cataract surgery. 

Very often, a patient who has some blurred vision at a distance would expect cataract surgery to correct the problem.

However, the specialist could view that the contract is not “ripe for harvest”.

On what basis would the specialist make that determination? Thank you for your advice.

Answer by Dr Yap Guan Hui

Hi TL,

Usually we evaluate the patient’s cataract and patient holistically, taking into account patient symptoms from the cataract such as blurring or glare, their visual requirements, how much their function has been affected, the visual acuity, and type and density of the cataract.

Other visual co-morbids and the fellow eye are all evaluated to formulate the best management plan for the patient.

It is difficult to comment on why your cataract is “not ripe” without seeing you in person, however common causes would be milder forms of cataract that are less likely to cause significant visual symptoms or good visual acuity — such that risks of surgery may outweigh the benefits.

6. Question by Taruvai

Hi Dr,

My right eye was operated for cataract on March 16 2026 and left eye on 23 March 2026 also for cataract.

Had follow up with eye surgeon following each cataract surgery, and during final appointment in April, Surgeon said both eyes good and next follow up only after one year.

My question is:

Is swimming in pool OK with swimming eyeglasses? Will accidental entry of pool water cause future problems, as I am told condo uses some chemicals in water.

So will accidental entry of chemicals used in pool water, can cause problem to implant/eye?

Looking forward to SNEC eye experts’ guidance in this regard. Thanks in advance.

Answer by Dr Yap Guan Hui

Hi Taruvai,

In general wounds following cataract surgery would have healed after 1 month of the surgery (assuming uneventful surgery). For swimming purposes, I generally err on the side of caution, and advice my patients to swim 2 months after cataract surgery.

If you have a toric intraocular lens implanted (astigmatism correcting), do consult your surgeon on the surgeon’s preference on when you can swim or exercise after the surgery.

In general after 2 months, the pool water should not be entering the eyeball itself through the corneal wounds or affect the implant. Thank you.

7. Question by Eileen

Hi Doctor, 

Is it safe to wash my face with soap and my hair with shampoo on the day after cataract surgery? When can I wash my face and hair after the cataract surgery?

Is there any method to wash my face and hair without getting infection in my eyes?

What happens if I accidentally get soap or shampoo in my eyes? Do I need to rush to the Accident and Emergency Department of the hospital?

Thank you for your advice.

Answer by Dr Yap Guan Hui

Hi Eileen,

In general I advise my post-operative patients to wash their face with a wet towel instead of with soap or splashing water onto their face. This is to prevent water which potentially could be contaminated from entering the eye. We do provide normal saline and cotton balls to perform hygiene around the post operated eye.

For hair washing, I would recommend washing it at a hair salon (so water flows backwards instead of down to the face) to prevent any water which can be contaminated by bacteria from entering the eye.

Following these instructions there should not be any soap or shampoo getting to your post operated eye. Thank you.

8. Question by Gunawan

Dear Doctor,

I’m a Singaporean / male / CHAS blue card holder / next birthday 72.

My optical shop recently told me that I have some minor cataract at the very initial stage & I may need to see an eyes doctor/ophthalmologist.

Do I need to visit a Polyclinic for referral? Or call / email your centre direct for an appointment?

Many thanks for your advice.

Answer by Dr Yap Guan Hui

Hi Gunawan,

For a subsidised clinic visit, do go to the polyclinic to obtain a referral. If you call or email the centre direct, we are happy to book an appointment to see you, but it may not be subsidised. Thank you.

9. Question by Michael

Hi Dr,

Thanks for this 'Ask the Specialist' Q&A, invite.

I am 60+ and both eyes have cataract; so the plan was for both eyes to have EDOF IOL (about a month apart) and to use glasses for near reading.

I did EDOF IOL on my left eye in 2025 (outside SNEC) and took a month to recover from eye infection - it was badly cloudy for a few weeks. Now far vision is OK - with a slight double vision and maybe over corrected by 50 degree from post-ops refraction test.

However, the intermediate EDOF IOL left vision was however very unstable - it needs bright light to be vision clear. E.g. driving into the CTE tunnel at noon time give me good (before entering tunnel) -bad (in the tunnel)-good (outside the tunnel) for intermediate vision on the dashboard.

It means, I am using unoperated right eye, for the intermediate vision for reading laptop & 27" monitor indoors.

My questions are:

a) Is there anything I can do to make the unstable intermediate EDOF IOL left vision better for my left eye? E.g. to redo the ops, change the lens, or any other good alternatives?

b) The right eye ops for EDOL IOL was stopped, because of unstable intermediate left vision. If i use EDOF IOL again - it means both eyes will have unstable intermediate EDOF IOL vision and i totally cannot read PC/laptop etc...

c) What would be the recommended solution for both eyes as I drive (far vision), use laptop/monitor (intermediate vision) and read books/mobile (near vision) quite a lot.

The surgeon had suggested maybe I use multi-focal IOL on my remaining unoperated right eye -  with EDOF IOL already in my operated left eye?

Finally, can SNEC recommend a good and experienced "IOL correction" surgeon for me? I will take the unsusidised treatment route for an experienced doctor to refix the vision correction.

Kindly advise please.

Answer by Dr Yap Guan Hui

Hi Michael,

Thank you for your questions.

a) For your “unstable” vision, I would advise an official evaluation to further understand problem and also find out the underlying cause. It could be due to slightly reduced contrast sensitivity from the lens used or just related to ocular surface problems/instability which could be due to dry eyes. Without an evaluation it is difficult to comment on the best cause of action.

b) In general the aim for EDOF lenses is to aid with both distance and intermediate vision. Again, an evaluation of the current status of your eye is required to assess your difficulty in using a PC/laptop and where the issue lies.

c) Using an EDOF lens in one eye and multifocal lens in the other is a possibility, however it has to be targeted to the patient. identifying why you are having difficulties with the EDOF lens will then guide us to what strategy is the most optimum for you.

d) I encourage you to approach your original ophthalmologist in the first instance; however if you do need a second opinion there are doctors in SNEC who will be able to tend to you. Thank you.

10. Question by Angela

Dear Doctor,

I naturally have mono vision - L eye near vision & R eye far. Should I opt for a combination of far and near vision monofocal lenses for each eye for cataract surgery?

I see starbursts around lights at night. Should I choose lenses that correct the astigmatism? Does insurance normally cover such lenses? Thank you.

Answer by Dr Yap Guan Hui

Hi Angela,

If you naturally already do have monovision, it is definitely an option for you to consider. To improve the chances of you being spectacle free, other alternatives would include multifocal intraocular lens implants or extended depth of field lens implants. Not everyone are suitable for these lenses, and they each have their drawbacks.

Multifocal lens implants in general have the widest range of vision from far to near, however they can also cause dysphotopsia, such as glares, haloes, starbursts and slightly decreased contrast sensitivity.

Extended depth of field lenses have slightly reduced range of vision compared to a multifocal lens, allowing one to see far and intermediate (more range of vision than a monofocal) – and reduced dysphotopsias compared to multifocal lenses.

As for starbursts, it can be explained by your astigmatism, or other ocular surface issues like dry eyes, or your cataracts. Without evaluating the amount of astigmatism and the ocular surface/rest of the eye it is difficult to comment on your suitability for lenses that correct for astigmatism (toric intraocular lenses). Insurance coverage will depend on the insurance you have – do check with your insurance provider.

I would advise you to seek a proper evaluation to see your suitability for these lenses. Thank you.

Ref: F26