It may begin with something subtle, a toddler who tilts her head when watching TV. A child who squints at the whiteboard in class. Or a parent who starts avoiding night driving because headlights seem unusually glaring. Eye problems rarely announce themselves. Often, the first sign is a simple squint.
Dr Fazilawati Binti A Qamarruddin, Consultant Ophthalmologist and Paediatric Ophthalmologist at Sunway Medical Centre, Sunway City says two common yet frequently overlooked conditions affecting Malaysians across all ages are squinting (medically known as strabismus) and cataracts.
“A squint happens when the eyes are not aligned and point in different directions. One eye may look straight while the other turns in, out, up or down,” she explains.
Squinting Is Not Just a Childhood Issue
Squinting (strabismus) is common and can occur at any age, affecting vision, depth perception, learning, and confidence. It often arises from uncorrected refractive errors but may also result from nerve problems, or neurological deficit, trauma and tumours in the brain or orbits. In adults, squints may persist from childhood or appear suddenly; if double vision occurs, seek medical attention promptly, especially to rule out any tumours of the brain and orbits.
Globally, studies estimate that between 2% and 4% of children have strabismus. While that may sound small, it translates into thousands of Malaysian children. Yet many cases remain undetected until academic performance or social confidence is affected.
“If a child is long-sighted and the power is high, the effort to focus can cause the eyes to turn inward. In many cases, once the correct glasses are prescribed, the eyes straighten. However, if a child suddenly develops a squint when previously there was none, we must investigate urgently,” says Dr Fazilawati. This is to rule out life-threatening conditions like tumour.
The Risk of “Lazy Eye” and Why Screening Matters
One serious consequence of untreated squinting is amblyopia, commonly known as lazy eye. When one eye sees clearly and the other does not, the brain begins to favour the stronger eye. Over time, the weaker eye becomes under-stimulated.
“The brain automatically uses the clearer eye. The poorer eye is ignored, and without stimulation, it becomes lazy,” Dr Fazilawati explains.
This is why early screening is critical. Dr Fazilawati recommends vision screening ideally by age three and again before starting primary school. In Malaysia, some studies have shown that refractive errors were among the most common eye problems and can be easily treated with glasses provided they are detected early.
“If a child tilts their head, squints frequently, sits too close to the TV, or complains of headaches, don’t wait for the school to flag it. Bring them for a proper eye examination. Early detection can mean the difference between simple glasses and lifelong visual impairment,” she says.
Cataracts: A Natural Ageing Process but Treatable
Cataracts are common in older Malaysians, causing cloudy vision, glare, faded colours, and difficulty driving at night. While most often affecting those over 60, they can develop earlier in people with diabetes, smokers, or those exposed to sunlight. In Malaysia, untreated cataracts, diabetic retinopathy, and glaucoma are leading causes of adult blindness.
According to Dr Fazilawati, early eye assessments are important, as glasses may help delay the need for surgery.
“When glasses no longer help and daily activities are affected, that’s when we consider surgery, However, many adults only seek treatment when their vision is already significantly impaired,” she explains.
Modern cataract surgery is far more advanced than many realise. Today’s phacoemulsification technique uses ultrasound to break up the cloudy lens through a small incision.
“Because the procedure involves a smaller incision, recovery is generally quicker and many cases can be performed as day surgery. Most patients return to light activities within a week, with full visual recovery typically within two weeks,” Dr Fazilawati explains.
Screen Time, Lifestyle and How to Preserve Eye Health
For adults, smoking, uncontrolled diabetes, and excessive UV exposure can also increase the risk of cataracts and other eye diseases but in today’s digital world, screen time is a growing concern, particularly for children and teenagers. Screen use can contribute to worsening short-sightedness.
Dr Fazilawati recommends the simple 20-20-20 rule.
“Every 20 minutes of screen time, take 20 seconds to look at something 20 feet away.”
Don’t Wait for Symptoms
Eye conditions often progress gradually, making early detection crucial for effective treatment.
“Schedule an eye exam at age 40, and for children, before school begins. Adults with diabetes should have annual screenings since diabetic retinopathy advances rapidly but is treatable if caught early,” she recommends.
Early detection supports better learning, independence, and quality of life. Postponing exams can lead to missed opportunities for simple treatment.