青光眼Glaucoma
青光眼会永久损害视神经,而绝大多数患者在早期没有任何不适,往往要等到视野已经缺损才察觉——那时的损伤已无法恢复。因此我们不靠症状判断,而是同时评估三项指标:眼压、视野与视神经形态,并把每次结果与过去比对,看病情是否在进展。Glaucoma permanently damages the optic nerve, and most people feel nothing in the early stages — it is often noticed only once the visual field is already lost, and that loss cannot be recovered. So we do not rely on symptoms: we assess eye pressure, visual field and the appearance of the optic nerve together, and compare each set of results with your previous visits.
确诊后,规律用药与按时复诊是保护视神经的关键。张敏医师在专栏中特别提醒,青光眼患者不可自行停药、减量或减少点药次数,即使当下没有症状也一样;若遇到药费或保险的困难,请先与医师讨论替代方案,不要自行中断。另外,房角狭窄等眼睛结构特征常有家族聚集性,家中若有一人确诊青光眼,建议其他成员也做一次完整检查。Once glaucoma is diagnosed, taking medication on schedule and keeping follow-up appointments is what protects the optic nerve. As Dr. Zhang stresses in her column, patients must never stop their drops, cut the dose or skip doses on their own, even when nothing feels wrong; if cost or insurance becomes a problem, discuss alternatives with your doctor rather than interrupting treatment. Structural traits such as a narrow drainage angle also run in families, so if one relative has glaucoma, the rest of the family should be examined too.
白内障Cataract
白内障是眼内的晶状体逐渐变得混浊。典型感受是视野像蒙上一层薄雾、夜间灯光出现光晕与眩光、颜色看起来变淡,以及阅读时需要比以前更亮的光线。它通常是随年龄缓慢发展的,不是突然发生的急症。A cataract is the gradual clouding of the eye's natural lens. It typically feels like a film over your vision, with haloes and glare around lights at night, colours looking washed out, and a need for brighter light to read. It usually develops slowly with age rather than appearing suddenly.
早期白内障通常只需定期观察,并透过更新眼镜处方维持清晰视力。我们会记录晶状体混浊的程度与位置、视力变化与眩光情况;当视力已经影响开车、阅读、工作或日常安全时,就是转诊给白内障手术医师评估手术的时机。手术的决定与执行由手术医师负责,术前的检查记录与术后的视力追踪、配镜调整仍可以在我们这里进行。Early cataracts are usually monitored, with an updated glasses prescription to keep vision clear. We document how dense the clouding is and where it sits, along with changes in acuity and glare. When your sight starts to affect driving, reading, work or everyday safety, that is the point to refer you to a cataract surgeon for a surgical assessment. The surgery itself is the surgeon's decision and procedure; the pre-operative record, post-operative vision checks and new prescription can stay with us.
老年性黄斑变性Age-related macular degeneration
黄斑负责中心视力——看清人脸、文字与细节都靠它,而老年性黄斑变性影响的正是这个区域。早期可能只是看东西略为模糊、阅读需要更强的光线;随着病情发展,可能出现直线看起来弯曲、字的中间有一小块看不清楚。周边视野通常仍在,所以单眼受影响时很容易被另一只眼掩盖。The macula is responsible for central vision — recognising faces, reading text, seeing fine detail — and age-related macular degeneration affects exactly that area. Early on there may only be slight blur and a need for stronger light to read; later, straight lines can look bent or a small patch in the middle of a word may drop out. Peripheral vision usually remains, so when one eye is affected the other can easily mask it.
我们会检查眼底并保存黄斑区影像作为日后比对的基准,同时教您使用阿姆斯勒方格表(Amsler grid)在家中遮住一只眼、逐眼自我监测。若您发现直线突然变弯、中心出现新的暗点或视物变形,请当天联系诊所——新出现的变形需要尽快评估,必要时我们会转诊视网膜专科医师。We examine the retina and keep macular images as a baseline for future comparison, and we show you how to self-monitor at home with an Amsler grid, covering one eye at a time. If straight lines suddenly bend, a new dark patch appears in the centre, or objects look distorted, contact us the same day — new distortion needs prompt assessment, and we will refer you to a retinal specialist if required.
糖尿病视网膜病变Diabetic retinopathy
糖尿病会损害视网膜的微血管,而这个过程在视力还完全正常时就可能已经开始。因此所有糖尿病患者都需要定期做散瞳或超广角的眼底检查,不能因为「看得很清楚」就认为不必检查——等到视力受影响,病变通常已进展一段时间。Diabetes damages the small blood vessels of the retina, and that process can begin while your vision is still perfectly normal. Everyone with diabetes therefore needs regular dilated or ultra-widefield retinal exams; good vision is not a reason to skip them, because by the time sight is affected the disease has usually been progressing for some time.
检查会记录视网膜有无微血管渗漏、出血、水肿或异常新生血管,影像存档后与往年逐一比对。我们会把结果整理给您的内科或家庭医生,让眼部情况与血糖、血压、血脂的控制互相配合;若出现需要眼内注射或激光治疗的病变,我们会转诊视网膜专科医师,并在治疗期间继续为您做定期追踪。The exam documents any leaking vessels, haemorrhage, swelling or abnormal new vessels, and the images are filed and compared against previous years. We pass the findings to your physician so that eye care and the control of blood sugar, blood pressure and lipids work together. If changes appear that call for intraocular injection or laser treatment, we refer you to a retinal specialist and keep monitoring you throughout.
干眼症Dry eye
干眼症的常见成因包括长时间盯着电子屏幕而忘记眨眼、干燥或长时间开空调暖气的环境、长期配戴隐形眼镜,以及年龄增长与荷尔蒙变化造成的泪液分泌减少、睑板腺油脂分泌不畅。症状是干涩、异物感、容易疲劳、发痒、黏性分泌物增多,有些人反而会迎风流泪;角膜表面受损时还会有刺痛感。Dry eye commonly stems from long screen sessions where you forget to blink, dry or air-conditioned and heated environments, long-term contact lens wear, and the reduced tear production and poor oil flow that come with age and hormonal change. It feels like grittiness, foreign-body sensation, fatigue, itching and stringy discharge — some people water excessively in the wind instead — and there can be stinging when the corneal surface is damaged.
干眼症是长期管理的疾病,不是一两天就能根治的问题。张敏医师在专栏中说明,仔细清洁眼睑后热敷,能让睑板腺的油脂在温度作用下顺畅流出,对缓解症状很有帮助。她同时提醒不要「自己做医生,给自己开药」:到药房自行购买眼药水或眼药膏来治疗眼病并不可取,有些成分反而会让干眼加重,该用哪一类药应由医师依病因决定。Dry eye is a condition to be managed over time, not cured overnight. As Dr. Zhang explains in her column, cleaning the lids carefully and then applying a warm compress lets the oil in the meibomian glands flow freely again, which relieves symptoms for many people. She also warns against 'being your own doctor and writing your own prescription': buying drops or ointments over the counter to treat an eye disease is a poor idea, some ingredients make dry eye worse, and which medication is appropriate depends on the underlying cause and should be decided by a doctor.
结膜炎与眼部感染(红眼)Conjunctivitis, eye infections and red eye
眼睛发红可能只是过敏或轻微的表面刺激,也可能是病毒性或细菌性结膜炎,甚至是角膜感染、隐形眼镜相关的炎症。这些情况外观相似,处理方式却完全不同,所以需要检查后才能判断,不该凭外观猜测。A red eye can be nothing more than allergy or mild surface irritation — or it can be viral or bacterial conjunctivitis, a corneal infection, or contact-lens-related inflammation. They look similar but are treated quite differently, so a red eye needs to be examined rather than guessed at.
若出现眼睛疼痛、怕光、视力下降、大量脓性分泌物,或您在配戴隐形眼镜期间眼睛发红,请立刻停戴镜片并当天联系诊所,这类情况需要尽快检查。我们会用裂隙灯检查眼睑、结膜与角膜,确认病因后再决定处理方式;在病因还不明确前,请不要使用家中留存的眼药水。If you have eye pain, light sensitivity, reduced vision or heavy purulent discharge — or your eye turns red while you are wearing contact lenses — stop wearing the lenses and contact us the same day; these need to be seen promptly. We examine the lids, conjunctiva and cornea at the slit lamp and decide on treatment once the cause is clear. Until then, please do not reach for leftover drops at home.
视网膜血管阻塞Retinal vascular occlusion
突然、不痛的视力下降或视野缺损,可能是视网膜的动脉或静脉发生阻塞。这属于需要立即处理的紧急情况,请尽快就医,不要抱着「看看会不会自己好」的心态等待——延误的时间会直接影响视力能保住多少。Sudden, painless loss of vision or of part of your visual field can mean an artery or vein in the retina has become blocked. This is urgent and needs to be seen immediately — please do not wait to see whether it clears up on its own, because delay directly affects how much vision can be saved.
视网膜血管阻塞也可能是全身血管问题的警讯,常与高血压、糖尿病、高血脂、心律不整或颈动脉狭窄有关。所以除了眼部检查与转诊视网膜专科医师之外,我们也会建议您尽快回到内科或家庭医生处做全身评估,把中风等风险一并管理起来。A retinal occlusion can also be a warning about your blood vessels generally, and is often linked to high blood pressure, diabetes, high cholesterol, an irregular heartbeat or carotid narrowing. Alongside the eye examination and referral to a retinal specialist, we will therefore urge you to see your physician promptly for a systemic work-up so that risks such as stroke are addressed as well.