An eye for eye care

The ophthalmologist may only be 40 years’ old but she has already created a name for herself in the medical community both locally and abroad. Pang’s accolades form a long list. For one, she is among the few doctors with multiple fellowships in the fields of medical retina and vitreoretinal surgery. Another badge of honour is that Pang was the first woman in the world to receive the highly coveted William H Ross Fellowship given out by the University of British Columbia in Vancouver.

As groundbreaking as this may be, Pang recalls that her peers were far from encouraging when she applied for the programme some seven years ago. Many even asked if she knew what she was doing. “I replied, ‘yes, why?’ [to which they said] ‘your application would be shot down for sure. They’d never give it to a woman’”.

Pang reasons that there was cause for her friends’ scepticism given that all the recipients of the fellowship had been males since its inception in 1986. A plausible reason could be that the programme came with a patient load that may have been considered too back-breaking, she mulls.

Even as the odds were seemingly stacked against her, Pang decided to go ahead. She was eventually selected after a vigorous process that spanned two days and involved several interviews and tests. “I was the 48th fellow to be awarded that position and the only female and the only Singaporean to date,” she says. Pang reckons she secured the position thanks to a glowing recommendation from her bosses during an 18-month stint at the renowned Manhattan Eye, Ear and Throat Hospital. She took up a stint there in 2013, after realising that New York was the most progressive in the sub-speciality fields of medical retina and vitreoretinal surgery.

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Having spent some two and a half years abroad in New York, Vancouver and London, Pang says it was useful to work in different environments. While the eye conditions that patients face are similar across countries, she says differences lie in the techniques used for treatment. For instance, eye surgeries are typically done via keyhole surgery that requires three holes to be created — the first for fluid infusion, the second for light and the last to perform the procedure. In procedures done in Singapore, the three holes are created in the shape of a triangle — unlike the practice in some countries where the holes are created in a straight line under the eyelid. “[The latter] is neater and less invasive, so patients can walk out of the surgery without their eyes being red,” says the medical director at the Asia Retina Centre.

The exposure to the working styles of different ophthalmologists has led Pang to create her own way of doing things. “Many people are impressed when they see my technique in the operating theatre because it is different from what is taught in Singapore,” she chuckles.

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A desire to help others

Pang’s journey to becoming an ophthalmologist started from a childhood dream to help others. “I have always wanted to help others,” she tells Options. This interest saw her spending much of her teenage years volunteering at nursing homes and tutoring children. She also went on trips abroad to build schools and help marginalised communities.

Through these experiences, Pang realised that she is a good listener and someone who can relate to people easily. “If I hadn’t become a doctor, I would probably have become a social worker,” she professes.

A self-proclaimed problem solver, Pang was drawn to medicine because of its ability “to make a tangible difference”. “What I like about medicine is that you can solve people’s problems by investigating the illness or discomfort a patient is experiencing and then look for solutions on how to solve it,” she explains.

Pang also liked that she could apply the skills she learnt from medicine across countries. “I was impressed by people going abroad to help and I reckoned if I had medical skills, I could do the same, especially for people who did not have access to medical care”.

Her decision to become a doctor was well received by her parents, who were in the real estate and construction business before their retirement. “My mother has a lot of respect for her doctors. So she did encourage her kids to become doctors,” she shares candidly.

Pang also drew inspiration from her elder brother, an ENT (ear, nose and throat) specialist, who is 10 years her senior. “My brother being in medicine set a precedence for me so I had someone from the field to look up to,” she muses.

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Windows to one’s soul

Pang’s foray into ophthalmology is an adage to the cliché that the eyes are the windows to one’s soul. “You can tell a lot of things about a person’s health just by looking at the retina,” says the retina specialist. Some ailments that can be detected from the eyes include hypertension, anaemia, heart disease and autoimmune diseases. For instance, hardened or leaking blood vessels in the eyes could be a tell-tale sign of high blood pressure while bleeding spots typically show diabetes, says Pang.

Talking about her first time looking into the eye brings a smile to Pang’s face. “It was a very special moment,” she gushes, adding that it was a different experience from looking at a picture. “It was very beautiful and fascinating to me, just like a piece of art”.

A natural in handling the equipment used in the diagnosis of eye conditions, Pang decided to specialise in ophthalmology after her housemanship. She went on to spend eight years in training and even signed up for attachments at hospitals abroad during vacations. Through this, she hoped to pick up new skills and keep up with the developments in the field.

Pang acknowledges that the job of an eye surgeon is no mean feat. “It is a big job — everything I do affects my patients and whether or not they can have better vision. There is no margin for error,” she says. The nights before a major surgery are the hardest, says the perfectionist. Her coping mechanism is to run through the procedure multiple times, just to make sure she is well prepared.

“Maybe it takes a few years off my life but I want to make sure that I perform well,” she laughs. Pang is quick to add that there are good moments too — like when the patient can see perfectly post-surgery. “The instant joy on their faces makes my day,” she says with a wide smile.

A common condition that Pang sees among Singaporeans is myopia or short-sightedness. The condition occurs when an individual spends too much time on near-vision work. Given the increase in screen time, she notes that children — if left on their own — will see a 100-degree increase in their power every year. While myopia is corrected through spectacles, Pang cautions that patients who are very short-sighted are more prone to diseases later in life. For instance, people whose degree is higher than 500 have a higher risk of retinal tears, cataracts and glaucoma.

Pang — who has perfect vision — says it is no longer about myopia correction. The doctor is looking to spread awareness on proper eye care habits such as taking frequent eye breaks and keeping the laptop at least one arms’ length away.

Another phenomenon that Pang is seeing is: people getting their cataracts at a younger age. Previously, cataracts — which occur from a natural change in the lens protein — were seen amongst patients between the ages of 60 and 80; these days patients as young as 40 are coming in for treatment. Reasons for this include pre-existing conditions like high myopia and diabetes. To delay the onset of cataracts, Pang recommends that people keep healthy and avoid excessive UV exposure.

In any case, she recommends people above the age of 40 get their eyes checked at least once a year. “People don’t know that there are a lot of silent eye conditions,” laments Pang. “We all know that we need to visit the dentist annually, but nobody knows that the same holds for eyes”.

Pang has authored a book in a bid to increase awareness of eye health. Entitled Eye Care For All, the easy-to-understand book is a Wikipedia of sorts on common eye concerns and conditions. Pang does not intend for the book to be read from cover to cover. Instead, she suggests that readers refer to it as and when they are experiencing something to understand what they are going through and then decide whether to seek professional help.

Pang’s team has also been providing free eye screening to members of the Muscular Dystrophy Association (Singapore), many of whom have not had their eyes checked in a long time (Images: Pang's personal photos)

Giving back

Even as Pang has her hands full with her clinic, writing a book and as a mother to two children, she is on a mission to make eye care more accessible. “Everyone should have access to eye care, even if they can’t afford it,” she stresses. A desire to bring eye care to more people saw Pang offering free eye screening in Singapore and rural parts of Southeast Asia. Her efforts soon morphed into Eye Care Without Borders, a non-profit set up in 2019.

One of Pang’s most recent medical mission trips was to Phnom Penh, Cambodia, where she and her team screened and treated some 1,000 villagers over four days. Many of these villagers were walking around “sort of blind” because of their cataracts which can easily be taken out, recalls Pang. With no WiFi and access to electricity, performing such a procedure is an uphill task that may even involve renting a power generator to power up the equipment needed. Other challenges include getting a cleanroom because “dust is typically flying around everywhere”.

As arduous as this may be, Pang says that the trips are humbling and a reminder of the luxuries we have in Singapore.

With the health measures imposed to curb the spread of the coronavirus, Pang and her team have been looking at ways to give back at home. For one, they have been providing free eye screening to members of the Muscular Dystrophy Association (Singapore) — many whom have not had their eyes checked in 20 years because of difficulties in moving around.

More recently, Pang partnered with the non-profit Beyond Social Services to give out care packs to 1,000 families. Each pack contained food supplies, stationery, a jigsaw puzzle and a book on myopia prevention. Going forward, Pang plans to give out spectacles to children from lower-income families. “Many of these families get vouchers to buy glasses but end up not using them because it can also be used for other things like food and books,” she notes.

Pang’s volunteering activities are also a way to expose her kids — aged nine and six — to the importance of giving back to society. While it is her hope for them to follow in her footsteps and become doctors, she says that medicine is a calling.

Some days are tougher than others, says Pang. “Patients can be demanding — you try so hard to help but they can still blame you. It is demoralising,” she says. On the flip side, there are times where the patients do cheer her up. “Sometimes they can put a smile on my face, even without knowing it. It is in those times that I think, yes, I’m making a difference and remember why I’m doing what I do”.

Cover image: Albert Chua/The Edge Singapore