青光眼保養預防與治療

Prevention, Care and Treatment of Glaucoma

青光眼是一種進行性視神經病變，會隨時間造成不可逆的視野與視力喪失，因早期多無明顯症狀，常在不知不覺中惡化，而被稱為「沉默的視力殺手」。青光眼不一定伴隨眼壓升高，特別是在亞洲族群中，正常眼壓型青光眼比例甚高，因此僅量測眼壓不足以排除疾病。其視野缺損多由周邊開始，中心視力在晚期前仍可維持正常，導致患者延誤就醫。青光眼依隅角的型態與成因，可分為隅角開放型與隅角閉鎖型、原發性及次發性青光眼。高風險族群包括高齡者、具家族史、高度屈光不正、長期使用類固醇，及曾有眼部外傷者。完整診斷需綜合眼壓、角膜厚度、隅角、視神經結構與視野檢查。現階段唯一被證實可延緩病程的治療方式為降低眼壓，治療工具包含藥物、雷射及手術。由於受損視神經無法修復，早期發現、規律追蹤與長期治療是守住視力、維持生活品質的關鍵。

Glaucoma is a progressive optic neuropathy that causes irreversible loss of visual field and vision over time. Because it often presents with no obvious symptoms in its early stages and can worsen unnoticed, it is commonly referred to as the“silent thief of sight.”Glaucoma is not necessarily associated with elevated intraocular pressure (IOP); in particular, normal-tension glaucoma is relatively common among Asian populations. Therefore, measuring IOP alone is insufficient to exclude the disease. Visual field defects typically begin in the peripheral field, while central visual acuity may remain normal until the late stages, leading many patients to delay seeking medical care. Based on angle configuration and etiology, glaucoma can be classified into open-angle and angle-closure glaucoma, as well as primary and secondary glaucoma. High-risk groups include older adults, individuals with a family history of glaucoma, those with high refractive errors, long-term steroid users, and patients with a history of ocular trauma. A comprehensive diagnosis requires integration of IOP measurement, corneal thickness assessment, angle evaluation, optic nerve structural analysis, and visual field testing. At present, the only treatment proven to slow disease progression is reducing IOP, achieved through medications, laser therapy, or surgery. Because damage to the optic nerve is irreversible, early detection, regular follow-up, and long-term treatment are essential to preserving vision and maintaining quality of life.