視網膜剝離的檢查和中西醫治療

據了解,用眼過度或者年齡增長或視網膜失常,都會造成視網膜變薄,當玻璃體變形塌陷,拖拽著視網膜,就會將變薄的視網膜撕破,形成裂孔。視網膜剝離的區域失去血液供應,失去養分的視網膜停止工作,進而失去視力。相關報導:「飛蚊症」是可逆轉的!中醫師:先要搞清楚,你看到的飛蚊是透明或灰黑色?

小編司馬儀本身因為工作關係,日日需要長時間使用電腦(但我盡量不使用手機避免藍光對眼睛的傷害),但也有一度因為晚睡使身體過勞,而出現類似乾眼症的症狀。療效最好的就是按壓顧肝的護眼穴道<太衝穴>,左腳對右眼,右腳對左眼。非常有用,大力推薦。基本上,乾眼症,眼藥水對我來說完全無用,但按壓穴道卻非常非常有用。

視網膜剝離的檢查

1.用眼底鏡來檢查視網膜,check是否有視網膜裂孔、撕裂或脫離等異常。

2.超聲波影像學:如果眼睛內部有出血,醫生無法通過眼底鏡清晰看到視網膜,需用超聲波圖像檢查。如果檢查暫時沒有視網膜撕裂,那麼醫生會要求你在數周後複診,確定玻璃體分離有無發展至延後性的視網膜撕裂。

視網膜剝離的治療
視網膜撕裂、裂孔和脫離幾乎都需要用手術治療

● 視網膜撕裂治療如下:
激光手術(photocoagulation):引導激光穿過瞳孔進入眼底,激光使視網膜撕裂的傷口發生灼傷,形成疤痕粘合,這樣使得視網膜被「焊接」至下一層組織,目的是固定撕裂處視網膜的作用。

冷凍術(cryopexy):眼睛局部麻醉後,醫生直接用冷凍探針放在眼球外面(位置對應眼內視網膜撕裂處)。冷凍使視網膜產生疤痕,目的是讓視網膜撕裂的地方安全固定在眼壁上。

上述兩項都屬於門診手術。約兩周甚至更長時間需應避免像跑步等運動或重體力勞動,避免視網膜撕裂再次發生。

● 視網膜剝離
若視網膜已經發生脫落,就需要手術修複,最佳治療時間是在診斷的幾天內。手術類型取決於視網膜剝離的嚴重程度等。

  • 氣體視網膜固定術(pneumatic retinopexy):將空氣或氣體注入玻璃體腔內,如果定位準確的話,可以將脫離的視網膜推到眼球壁固定,阻止玻璃體內的液體流入視網膜下層。同時醫生還會用冷凝術來修複視網膜裂孔。視網膜下面積累的液體會自行吸收,注射進去的氣體也會慢慢自行吸收。
  • 鞏膜扣帶術(scleral buckling):縮小眼球表面。外科醫生在受影響的鞏膜區域縫合一塊矽膠材料,使眼球表面的體積相應縮小,目的減輕玻璃體對視網膜形成的牽拉力。
  • 玻璃體切除術(vitrectomy):排出並更換眼中液體。醫生將對視網膜形成牽拉力量的玻璃體內纖維化或液化組織切割掉,將空氣、氣體或矽油注入到玻璃體腔內,幫助將視網膜撐回原位。氣體填充物和液體會被吸收,玻璃體內也會漸漸重新充盈體液。若用矽油,則無法吸收,可能需要在數月之後通過手術移除。玻璃體切割術也可能和鞏膜扣帶術相結合使用。手術後的數個月,視力可能會有改善,可能需要進行第二次手術。部分患者也許永遠無法恢複失去的視力。

Wise Library 1985

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