Summary
- Two-thirds of Singaporeans with visually significant cataracts were undiagnosed because symptoms are gradual and easily mistaken for tiredness or ageing.
- Frequent prescription changes can be a cataract sign, not a glasses problem: as the lens clouds, it temporarily alters how light bends through the eye.
- During a cataract assessment, your doctor may cover your vision history before doing a slit-lamp assessment and a retinal imaging scan.
Have you been cleaning your glasses more often than usual?
In meetings, the projection screen looks slightly washed out no matter how many times you wipe the lenses. You update your prescription, and wait for things to improve.
They do not.
What you may not have considered is that the problem is not sitting on the bridge of your nose. It may be inside your eye.
You may have cataracts.
Why Is Your Vision Still Blurry After a New Prescription?
A cataract (a progressive clouding of the eye’s natural crystalline lens) develops gradually, often over months or years. Proteins within the lens break down and form clumps with age, causing the lens to become less transparent over time. (National Eye Institute, 2023)
UV exposure and conditions such as diabetes further accelerate this process. (Diaz-Torres et al., 2024) The result is the blurry vision that cataracts are known for — and that no lens prescription can correct.
There are several patterns worth paying attention to. Returning to the optician every few months because your vision keeps shifting may suggest something other than a straightforward refractive error (the technical term for the kind of focusing problem that glasses correct).Â
As a cataract develops, it temporarily alters how light bends through the lens, producing prescription changes that feel like improvement but are actually a sign of progression. (Hashemi et al., 2016; Iribarren, 2015)
If wiping your lenses makes no difference to clarity, the cloudiness is almost certainly internal — cataracts produce a diffuse blurring that does not shift with cleaning, blinking, or changes in lighting.
What to watch for
- Returning to the optician more than once in 12 months for prescription changes
- Blurry or hazy vision that cleaning your lenses does not relieve
- Difficulty resolving fine detail, particularly under artificial lighting
Cataracts vs. Glasses Problems: How to Tell the Difference
The most consistent signal is that new glasses do not hold. If a fresh prescription feels helpful for a few weeks and then vision seems to worsen again, it is worth seeking an assessment that looks beyond the prescription.
Cataracts also become especially disruptive in low-contrast conditions: driving at night is often the first activity to feel difficult, with headlights producing halos or starbursts.
A 2022 review in the Annual Review of Vision Science found that contrast sensitivity showed stronger associations with driving performance than standard visual acuity tests in most studies assessed. (Wood, 2022)Â
Beyond this, colours may appear yellowed or washed out, and whites take on a cream cast — changes so gradual that most patients attribute them to tiredness rather than their eyes. (National Eye Institute, 2023)
What to watch for
- A prescription that feels correct at the optician but needs to be replaced after just a few weeks
- Halos, starbursts, or glare around lights, particularly when driving after dark
- Colours that appear less vivid or whites that have taken on a yellow or cream cast
Why Do Most People Not Realise They Have Cataracts?
By the time vision deterioration from a cataract becomes significant, most patients have already reorganised their lives around it — moving their reading chair closer to the window, relying on family members to read labels, avoiding restaurants with dim lighting.
Each adjustment feels like a practical fix rather than a symptom. Blurry vision and light sensitivity are so commonly attributed to ageing that patients often do not mention them at appointments at all. However, progressive blurring that affects daily life is not something that you should accept without investigation.
What to watch for
- Adjusting lighting, seating position, or screen settings more frequently than before
- Relying on other people for tasks that involve reading or judging detail
- Dismissing worsening vision as tiredness or a normal part of growing older
If you recognise your habits in this section, it may be worth getting an eye examination. Book a cataract assessment with Dr Allan Fong.
What to Expect at a Cataract Assessment in Singapore
Vision history and symptoms
Slit-lamp and retinal imaging
Treatment options
The slit-lamp examination (a specialised microscope that illuminates the eye’s internal structures) assesses the clarity and position of the lens directly. Retinal imaging uses the ZEISS CIRRUS PathFinder, an AI-guided OCT platform trained on over 75,000 B-scan images, which help identify macular changes that may affect surgical planning and IOL selection. If cataracts are confirmed, the specialist will discuss cloudy vision treatment options.
Cataract surgery in Singapore at Angel Eye & Cataract Centre is performed as a day procedure under topical anaesthesia. The clouded lens is removed using phacoemulsification and replaced with an IOL.
For complicated cases, femtosecond laser-assisted cataract surgery (FLACS) (a bladeless laser technique) may be recommended.
Several IOL types are available depending on your prescription, lifestyle, and visual needs:
| Lens type | Best suited to | Glasses after surgery? |
| Monofocal IOL | Clear vision at one fixed distance (near or far) | Likely for some tasks |
| Multifocal IOL | Patients needing to switch between near and distance tasks frequently | Often not required |
| EDOF IOL | Good distance and intermediate vision with minimal glare risk | Rarely for distance; may need for fine near work |
| Toric IOL | Patients with astigmatism requiring correction alongside cataract removal | Reduced dependence |
Frequently Asked Questions About Cataracts
Why is my vision still blurry even after changing glasses?
Are cataracts reversible without surgery?
No. There are currently no eye drops, supplements, or medications with credible clinical evidence to reverse or halt cataract formation. The only effective treatment for a cataract that is affecting quality of life is surgical removal of the clouded lens. Not every cataract requires immediate treatment — the decision is always made in the context of how much symptoms are affecting daily life.
Is cataract surgery painful or risky?
The procedure is performed under topical anaesthesia (numbing drops), so it is not painful — most patients report feeling pressure rather than pain. Data from the Royal College of Ophthalmologists’ National Ophthalmology Database, covering over 1.2 million operations, found intraoperative complications in approximately 2.9% of standard cases, with posterior capsule rupture occurring in around 1.4% overall. (Day et al., 2022)
Ready to Find Out What Is Happening to Your Vision?
If your glasses no longer seem to be correcting your vision issues, the next step is to find out why.
Dr Allan Fong is a Senior Consultant Eye Surgeon and Medical Director at Angel Eye & Cataract Centre, with over 26 years of experience in ophthalmology, and the former Head of the Cataract & Comprehensive Ophthalmology Department at Singapore National Eye Centre (SNEC). He is ready to help you!
Medical References
Chua, J., Lim, B., Fenwick, E.K., Gan, A.T., Tan, A.G., Lamoureux, E., et al. (2017). Prevalence, Risk Factors, and Impact of Undiagnosed Visually Significant Cataract: The Singapore Epidemiology of Eye Diseases Study. PLOS One, 12(1), e0170804. DOI: 10.1371/journal.pone.0170804. PMID: 28129358.
Day, A.C., Norridge, C.F.E., Donachie, P.H.J., Barnes, B., & Sparrow, J.M. (2022). Royal College of Ophthalmologists’ National Ophthalmology Database Study of Cataract Surgery: Report 8, Cohort Analysis of the Relationship Between Intraoperative Complications of Cataract Surgery and Axial Length. BMJ Open, 12(8), e053560. DOI: 10.1136/bmjopen-2021-053560. PMID: 35985773.
Diaz-Torres, S., Lee, S.S., GarcÃa-MarÃn, L.M., Campos, A.I., Lingham, G., Ong, J.S., et al. (2024). Uncovering Genetic Loci and Biological Pathways Associated with Age-Related Cataracts Through GWAS Meta-Analysis. Nature Communications, 15(1), 9116. DOI: 10.1038/s41467-024-53212-6. PMID: 39438440.
Hashemi, H., Khabazkhoob, M., Iribarren, R., Emamian, M.H., & Fotouhi, A. (2016). Five-Year Change in Refraction and Its Ocular Components in the 40- to 64-Year-Old Population of the Shahroud Eye Cohort Study. Clinical and Experimental Ophthalmology, 44(8), 669–677. DOI: 10.1111/ceo.12753. PMID: 27059537.
Iribarren, R. (2015). Crystalline Lens and Refractive Development. Progress in Retinal and Eye Research, 47, 86–106. DOI: 10.1016/j.preteyeres.2015.02.002. PMID: 25683786.
National Eye Institute. (2023). Cataracts. Retrieved from https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts
Wood, J.M. (2022). Vision Impairment and On-Road Driving. Annual Review of Vision Science, 8, 195–216. DOI: 10.1146/annurev-vision-100820-085030. PMID: 36108105.
World Health Organisation. (2023). Blindness and Vision Impairment. WHO Fact Sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment
