Eye health represents a critical component of overall well-being, yet it often receives attention only when problems arise. Among eye conditions, cataracts significantly impact quality of life, particularly for older adults. In Hong Kong, cataracts affect approximately 7% of seniors, with a concerning trend of younger patients now developing this condition. The prevalence of cataract cases has increased dramatically, with numbers rising from 600,000 in 2020 to a projected 900,000 by 2025, representing a compound annual growth rate of 6.9%. This substantial increase underscores the importance of understanding cataract development, symptoms, and treatment options available in Hong Kong's healthcare system.

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What are Cataracts?

A cataract is a cloudy or opaque area that develops in the lens of the eye. The lens, positioned behind the iris (the colored part of the eye), plays a key role in focusing light onto the retina, the light-sensitive tissue at the back of the eye.

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The development of cataracts typically begins around age 40, when proteins within the lens start to break down and clump together. The protein clumps create cloudy areas that gradually expand and thicken over time. As cataracts progress, the lens becomes increasingly opaque and may develop a yellowish or brownish tint, reducing visual clarity and possibly affecting color perception.

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Cataract Treatment Options by Stage of Severity

The approach to cataract treatment depends significantly on the stage and severity of the condition. In the earliest stages, non-surgical interventions can effectively manage symptoms. As cataracts progress, it’s important to know that surgery is the only definitive treatment, as no medication or therapy can reverse the protein clumping in the lens.

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Very Early Stage Cataract Treatment

When cataracts are in the early stages of development, surgery is not immediately required. During this phase, symptom management like updating prescription eyeglasses or contact lenses can compensate for early visual changes caused by cataracts. Patients can consider anti-glare coatings on eyeglasses to help reduce light scattering and improve contrast, which is particularly beneficial for driving at night.
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Moderate Stage Cataract Treatment

When cataracts worsen to interfere with daily activities, surgical treatment becomes appropriate. Phacoemulsification represents the standard in modern cataract surgery and is the most commonly performed procedure in Hong Kong.

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Phacoemulsification is a minimally invasive procedure that begins with a micro-incision (typically less than 2.8mm) in the cornea. Through this tiny opening, the surgeon inserts an ultrasonic probe that emits high-frequency sound waves to break the clouded lens into smaller fragments, which are then gently suctioned from the eye. After removing the natural lens, the surgeon implants a folded intraocular lens (IOL) through the same small incision, replacing the original lens. Once positioned within the lens capsule, the IOL unfolds to its full size.

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There are various IOLs patients can choose from based on their needs and lifestyle:

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The entire phacoemulsification procedure typically takes 20-30 minutes per eye, with most patients experiencing minimal discomfort. Recovery involves using prescribed eye drops for several weeks to prevent infection and reduce inflammation. Most patients notice improved vision within days, though complete healing may take 4-6 weeks.
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Advanced or Mature Cataract Treatments

As cataracts continuously worsen without medical intervention, the protein in the lens becomes dense and hard, making phacoemulsification unsuitable as a treatment option. Manual Small-Incision Cataract Surgery (MSICS) provides an alternative approach at this stage. This procedure requires a slightly larger incision (5-7mm) in the cornea or sclera than phacoemulsification. Through this opening, the surgeon removes the entire hardened cataract in one piece rather than fragmenting it. As with phacoemulsification, an artificial intraocular lens (IOL) is implanted to replace the removed natural lens.

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Recovery from MSICS typically takes longer than phacoemulsification due to the larger incision, with patients requiring additional healing time before resuming normal activities. Despite the longer recovery time, MSICS offers excellent outcomes for advanced cataracts that would be challenging to treat with ultrasonic fragmentation.

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Costs & Insurance Coverage for Cataract Surgery in HK

The financial aspects of cataract surgery in Hong Kong vary significantly between the public and private healthcare systems. Before surgery, specialized measurements called IOL calculations must be performed to determine the correct power for the artificial lens. These preoperative assessments typically cost between HK$1,000 and 1,500 in private settings. In Hong Kong's private healthcare clinics, the total cost of cataract surgery can range from HK$15,000 to HK$35,000 per eye, depending on the surgeon's experience, facility fees, and the type of intraocular lens selected. Premium options like multifocal or toric IOLs substantially increase costs but may reduce long-term expenses for glasses or contact lenses.

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The Hospital Authority offers lower-cost elective cataract surgery, typically costing between HK$800 and HK$1,200 per eye. Opting for treatment with the public healthcare system will come with significant wait times, with about 69,000 elderly persons currently awaiting cataract surgery in the public system. Wait times are now extending up to four years at some facilities across Hong Kong.
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Cataract Care in HK: Navigating Treatment Options

As cataracts continue to be a growing health concern in Hong Kong, understanding the different treatment options is crucial amongst the general population. While early-stage cataracts can be managed with prescription glasses and lifestyle adjustments, surgery remains the only effective treatment for advanced cases. Phacoemulsification is the standard procedure for most patients, being a highly effective solution, while Manual Small-Incision Cataract Surgery (MSICS) provides an alternative for severe cases. Understanding cataract treatment options in Hong Kong is essential to empower individuals to make informed decisions for their eye health, ensuring clearer vision and an improved quality of life.

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備註:

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1. Source : Industry overview. (2022). HKEX. https://www1.hkexnews.hk/listedco/listconews/sehk/2022/0218/10124491/sehk21110901295.pdf

2. Source : Causes of Cataracts. (2022). National Eye Institute.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts/causes-cataracts
3. Source : Cataract surgeries. (2024). The Government of Hong Kong Special Administrative Region Press Releases. https://www.info.gov.hk/gia/general/202411/20/P2024112000463.htm?fontSize=1

4. Source : Phacoemulsification. (2022). https://www.hkah.org.hk/storage/media/Brochure/A31990-HKAK%20Phacoemulsification%20Leaflet_02%20Web.pdf