老人的眼表層疾病保養預防與治療

Prevention, Care and Treatment of Ocular Surface Diseases in the Elderly

隨著台灣邁入超高齡社會，老年族群的眼表層疾病，特別是乾眼症，已成為高度盛行，且臨床重要性可能被低估的健康問題。眼表層疾病不僅造成眼部不適，亦可能影響視覺品質、日常功能表現與整體生活品質。其形成多為多因素交互作用的結果，與老化相關的眼表層功能退化、全身共病狀態、多重用藥，以及生活型態與環境因素密切相關，並常導致淚膜穩定性破壞與慢性發炎反應，呈現反覆、慢性病程。在老年族群中，乾眼症的診療不單需要處理症狀的即時緩解，更應視為眼表層功能失衡的長期照護問題。有效的臨床管理，須以病因與主要病理機轉為基礎，結合人工淚液、眼瞼板腺照護、發炎控制、環境與生活型態調整，以及必要時的營養補充，採取多模式、可持續的治療策略。透過整合評估、用藥檢視與持續追蹤，多數老年眼表層疾病可獲得穩定控制，進而維持視覺功能，並提升生活品質。

As Taiwan has entered a super-aged society, ocular surface diseases, particularly dry eye disease, have become highly prevalent health conditions among older adults, yet their clinical significance is often underestimated. Ocular surface diseases not only cause ocular discomfort but may also adversely affect visual quality, daily functional performance, and overall quality of life. The development of these conditions is typically multifactorial, involving age-related deterioration of ocular surface function, systemic comorbidities, polypharmacy, as well as lifestyle and environmental factors. These interacting factors frequently lead to tear film instability and chronic inflammation, resulting in a recurrent and chronic disease course. In older adults, the management of dry eye disease should extend beyond short-term symptomatic relief and be regarded as a long-term care issue related to ocular surface functional imbalance. Effective clinical management should be based on etiological assessment and underlying pathophysiological mechanisms, integrating tear substitutes, meibomian gland dysfunction–directed care, control of inflammation, environmental and lifestyle modifications, and nutritional supplementation when appropriate. Through comprehensive evaluation, medication review, and ongoing follow-up, ocular surface diseases in older adults can often be stably controlled, thereby preserving visual function and improving quality of life.