認識糖尿病視網膜病變 (Diabetic Retinopathy)

糖尿病視網膜，俗稱糖尿病上眼，是因糖尿病影響視網膜內的微絲血管，令到血管膨脹擴大，滲出血液，引起黃斑點水腫，甚至玻璃體出血，視網膜脫落和青光眼等眼疾。它是導致失明最普遍的眼疾之一。

(1) 糖尿病視網膜病變的普及性

患上糖尿病的時間越長，產生視網膜病變的機會就越高，例如患上糖尿病十年或以上，約有一半患者會產生視網膜病變;而患上糖尿病三十年或以上，約九成病人會有這病變。

(2) 糖尿病視網膜病變的病徵

包括視力下降及飛蚊，但早期的病變會出現沒有病徵的情況。

(3) 糖尿病視網膜病變的治療方法

可使用激光手術。當病變發展到某一階段，激光手術可有效地預防病情惡化；但當病情巳到了後期，激光便再無效，而需要複雜的手術治療，包括玻璃體切除手術及視網膜脫落手術。

(4) 糖尿病患者注意事項

l   留意視力有沒有出現衰退或改變的現象

l   預防勝於治療

l   好好控制血糖及其他相關的疾病，如高血壓等

l   如有需要，必須儘快轉介眼科醫生診治

l   如巳接受眼科專科的服務，謹記定期到眼科醫生處檢查眼底，並從醫生指示覆診和及早治療

參考資料: 《長者護眼常識100分》 http://eyedoc.org.hk  

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的眼科醫生查詢，而不應單倚賴以上提供的資料。

近視的治療方法

參考資料: 《21世紀近視療法話您知》

玻璃鏡片與塑膠鏡片的比較

	玻璃鏡片	塑膠鏡片
優點	清澈 薄身	輕身 不會碎裂
缺點	較重 會碎裂	不夠清澈 厚身 容易刮花
使用對象	成人	兒童 運動愛好者
其他用處	防紫外光 太陽鏡	防紫外光 太陽鏡

註：基於上述原因，厚身膠鏡片最多用於七百或八百度近視度數以下，而超薄片膠片會十分昂貴，深近視者多用超薄玻璃鏡片。

配眼鏡最重要是準確地驗出眼睛的度數。當我們坐在電腦驗眼機前面，檢驗度數時，眼睛會處於看近物體的狀態，眼球的近距調節便會即時令度數增加，而這個度數並非真正的度數。所以，在我們驗眼時，縱然望著電腦儀器裹的影像，也要盡可能放鬆眼球，儼如向遠處望一樣。

驗完之後試戴鏡片，才真正定下度數。兒童驗眼時，比較難於集中和放鬆，所以眼科醫生通常會使用擴瞳孔眼藥水，令眼睛近距調節的肌肉放鬆才進行檢驗，得出的度數比較準確。

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的眼科醫生查詢，而不應單倚賴以上提供的資料。

認識白內障(2)

參考資料: www.eye.123.com.hk

白內障的徵狀

早期的白內障不會有任何徵狀，但當白內障的情況變得嚴重時，便會有以下的病徵：

s 視力隨光線明暗而有所變化

s 眼鏡度數轉變頻密

s 視力模糊

白內障的治療

i) 藥物治療

市面上有許多號稱可溶解或使白內障惡化程度停頓下來的眼藥水，但直至目前為止，沒有證據支持其實際效果。

ii) 白內障手術

眼科手術是醫治白內障唯一直接有效的方法。手術的過程是 : 將混濁的晶體摘除，並植入人工水晶體，再縫合傷口，需時約半小時至一小時。 大多使用局部麻醉即可。若無嚴重外傷，晶體也不會移位或脫落。若同時伴有神經病變，或視網膜病變等患者，手術後視力的改善程度，會比較有限。

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的眼科醫生查詢，而不應單倚賴以上提供的資料。

認識白內障(1)

(1) 什麼是白內障

眼球晶體是位於虹膜與玻璃體之間，在正常的情況下，晶體是透明的，當光線透過角膜後，須經晶體的拆射，才能將影像清晰地呈現在視綱膜上，就好像照相機的鏡頭一般，使光線聚焦在底片一樣。白內障是一種常見的眼疾，即透明的晶體變得混濁時，會令觀看的事物模糊不清，便是白內障。

(2) 白內障的成因

白內障的主因是眼球晶體隨著年齡的增長而老化。除此之外，糖尿病、眼外傷、眼內炎、藥物的副作用和先天性因素等亦會引致白內障。

(3) 老年性白內障

為最常見的一種白內障，隨著年齡的增加，當成年人達至四、五十歲以後，眼球晶體便會慢慢發生硬化、混濁等情況，漸而造成視力的障礙。

據統計資料顯示，白內障的罹患率，六十歲以上人士約有50%，七十歲以上人士則高達70%，所以，對於長者來說，老年性白內障可以說是普遍的疾病。根據美國的資料顯示，每年至少有四十萬以上的病人，因患上白內障而需要接受手術。

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的眼科醫生查詢，而不應單倚賴以上提供的資料。

Amblyopia and Your Child's Eyes (continued...)

How Is Amblyopia Treated?

The most common treatment for amblyopia is to force the brain to start using the "bad" eye by putting a patch over the "good" eye. At first, the child will have a hard time seeing with just the weaker eye. However, it is very important that your child wear the patch diligently because this will eventually improve vision. It can take weeks or months for an eye patch to improve vision.

As the child keeps using only the eye with amblyopia, his or her vision will continue to improve. After the doctor determines that vision is back to normal, your child will not have to wear the patch. Some children may again lose some vision and need to undergo another round of patching. In cases of mild amblyopia, the doctor might recommend using an eye drop called atropine in the "good" eye instead of a patch. Atropine blurs the vision in the "good eye," forcing the "bad" eye to do most of the work while the child is playing with toys, eating, drawing, or reading.

Most children with amblyopia will also need glasses to help focus. If there is something blocking light from getting into the eye, the doctor might recommend surgery to remove the blockage. If strabismus is preventing the eyes from moving together correctly, your doctor might recommend surgery on the muscles of the eye. Your doctor will discuss with you what treatment is most appropriate for your child.

What Is the Outlook for Children With Amblyopia?

If existing underlying problems are treated and the amblyopia is detected and treated early, most children will gain vision. Because amblyopia becomes much more difficult to treat after about 7-9 years of age, early childhood exams are very important. It is important that you follow your doctor's advice about treatment. This can be very difficult, because many children do not want to wear an eye patch every day. With the use of atropine as an alternative method of treatment, success is now possible in a larger proportion of children with amblyopia.

Reference information: http://www.webmd.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Ophthalmologist for diagnosis and treatment.

Amblyopia and Your Child's Eyes

Amblyopia is a condition that occurs in children when vision has not developed properly in each eye. If amblyopia is left untreated, a child's vision will not develop correctly. The child's brain, as it matures, will start "ignoring" the image coming from the bad eye. This causes vision in the affected eye to become poor. Because amblyopia can result in permanent vision loss in one eye, it is important to have a child with amblyopia regularly tested by an eye doctor.

What Causes Amblyopia?

Amblyopia usually starts when one eye has much better focus than the other eye. For example, one eye might be very nearsighted or have a lot of astigmatism, while the other does not. When the child's brain is confronted with both a blurry image and a clear image, it will begin to ignore the blurry image. If this goes on for months or years, the vision in the eye that sees the blurry image will deteriorate.

Another cause of amblyopia is strabismus. Strabismus is an ocular misalignment, meaning that one eye turns inward or outward. This prevents the eyes from focusing together on an image and can cause double vision. In order to combat this, the child's brain generally chooses to ignore the image from the deviated eye, causing the vision in that eye to deteriorate. Because one of the eyes is misaligned, some people refer to this as a "lazy eye."

Other children cannot see well in one eye because something blocks light from getting through. This could be due, among other causes, to a cataract or a small amount of blood or other material in the back of the eye.

How Is Amblyopia Diagnosed?

All children should be screened before they are school age. Your child's doctor or the vision program at school will check three aspects of your child's eye health:

s   That your child's eyes let light all the way through.

s   That both eyes see equally well.

s   That the eyes are moving normally.

If there's a problem in any of those three areas, the doctor or school nurse may recommend a visit to an eye specialist. If you feel that something could be wrong with your child's vision, call your doctor even if he or she has been screened at school.

Family history of amblyopia is a risk factor for amblyopia. Parents cannot tell just by looking at their child if they have amblyopia. Early diagnosis and treatment are the keys to the best visual outcome.

Reference information: http://www.webmd.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Ophthalmologist for diagnosis and treatment.

眼科

一種名為Argon Laser 的激光治療，是預防視網膜脫落的唯一方法。這種激光做法簡單，每隻眼睛大約需時十分鐘，病人坐在激光儀器前,滴了麻醉眼水後，便把一個激光鏡放在眼球上，引導激光通過角膜、晶體及玻璃體，直達視網膜，令激光在視網膜上產生類似發炎的效果；三星期後，那些接受過激光治療視網膜退化的地方及小洞的周圍將會穩固下來，防止視網膜繼續惡化。

接受Argon Laser 激光治療後，漂浮物及閃光的情況或會繼續出現，因為仍有退化及小洞存在，不過情況已受控制，不會惡化不去而變成視網膜脫落。病人須每年定期接受檢查，確保視網膜其他未接受激光治療的部位沒有出現退化問題。

視網膜脫落的病徵同樣會出現飛蚊或閃光，它們突然大量增多，視力也開始受影響，如像銀幕慢慢垂下來，漸漸看不見東西，造成失明的時間由幾天至幾星期不等，視乎脫落的速度。Argon Laser 激光治療只可用在未脫落的視網膜上，如果已經脫落，就只有動手術，把穿孔用海綿體封閉，撫平視網膜。視網膜脫落的復原時間漫長，有些個案長達半年或一年，如果黃斑點也脫落了，視力會大不如前。如果脫落的時間太長，視網膜收縮了，手術可能不成功，最終不幸失明。

任何近視病人，無論有沒有病徵，都應該定期到眼科醫生進行擴瞳檢查視網膜，診斷視網膜的情況。眼科醫生便可以根據病人的情況，作出診治或定出將來需要檢查的頻密程度。須知道病徵輕微或普遍，並不反映病情的嚴重性。

參考資料: 《長者護眼常識100分》

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的眼科醫生查詢，而不應單倚賴以上提供的資料。