老人的白內障保養預防與治療

Cataract Prevention, Care and Treatment in the Elderly

白內障為水晶體隨年齡老化而逐漸混濁的退化性疾病，是高齡族群最常見的眼科疾病之一，亦為造成視力下降的重要原因。其病理機轉主要與水晶體蛋白質變性、聚集及代謝能力下降有關，常見臨床症狀包括視力模糊、對比敏感度下降、夜間眩光及色彩感知改變。依混濁部位不同，可分為核型、皮質型及後囊下型白內障，各自對視覺功能產生不同影響。白內障的危險因子除年齡外，尚包括糖尿病、遺傳因素、長期類固醇使用、眼部外傷與紫外線曝露等。治療策略須依病程階段調整，早期可透過屈光矯正、濾光鏡片及視覺輔具改善生活功能；當視覺障礙影響日常活動與安全時，白內障手術為最有效的治療方式。現行主流為超音波乳化術，具備切口小、恢復快與併發症低等優點，並可依病人需求選擇合適的人工水晶體。完善的術前評估與個別化術後照護，對於降低併發症及提升術後視覺品質與生活品質，具有關鍵意義。

Cataract is a degenerative condition characterized by progressive opacification of the crystalline lens and represents one of the most common causes of visual impairment in the elderly population. The underlying pathology is primarily associated with age-related protein aggregation, structural changes, and reduced metabolic turnover within the lens. Common clinical manifestations include blurred vision, decreased contrast sensitivity, glare, and altered color perception. Cataracts can be classified into nuclear, cortical, and posterior subcapsular types, each exerting distinct effects on visual function. In addition to aging, major risk factors include diabetes mellitus, genetic predisposition, long-term corticosteroid use, ocular trauma, and chronic ultraviolet exposure. Management strategies depend on disease severity. In the early stages, non-surgical interventions such as refractive correction, glare reduction, and visual aids may help maintain functional vision and quality of life. When cataracts significantly interfere with daily activities or safety, surgical treatment becomes the most effective option. Phacoemulsification is currently the standard surgical technique, offering small incisions, rapid recovery, and a low complication rate. The selection of intraocular lenses should be individualized according to patients’visual needs. Comprehensive preoperative assessment and tailored postoperative care are essential to minimize complications and optimize visual outcomes and overall quality of life.