Have you ever sat down to play a game of Mahjong, or tried to read a menu at your local cha chaan teng, only to find that the very center of your vision is blurry or the straight lines of the tiles look warped? You might dismiss it as just another inevitable part of getting older. But in a city like Hong Kong, where we boast some of the longest life expectancies in the world, this symptom could be the early warning sign of a hidden public health crisis: Age-Related Macular Degeneration (AMD).

您是否曾在打麻雀，或在茶餐廳看餐牌時，發現視野的正中央變得模糊，或者麻雀上的直線看起來彎曲變形？您可能會認為這只是無可避免的「退化」或「老花」。但在香港這個擁有全球最高預期壽命的城市，這個症狀可能是一個隱藏的公共衛生危機的早期警號：老年黃斑病變（Age-Related Macular Degeneration, AMD）。

Here is a comprehensive look at why AMD happens, how to recognize the symptoms, and why protecting our vision as we age has become a critical issue for Hong Kong.

以下我們將全面探討老年黃斑病變的成因、如何辨識其症狀，以及為什麼保護長者的視力已成為香港一個刻不容緩的重大議題。

What is AMD and Why Does It Happen?
什麼是老年黃斑病變？為什麼會發生？

Age-Related Macular Degeneration is a disease that affects the macula—the small, highly sensitive central portion of the retina located at the back of the eye. We rely on a healthy macula for sharp, detailed central vision, which allows us to read, drive, and recognize faces. When the macula deteriorates, our central vision is compromised, though peripheral (side) vision usually remains intact.¹

老年黃斑病變是一種影響「黃斑點」的疾病。黃斑點位於眼底視網膜的中央，範圍雖小但非常敏感。我們依賴健康的黃斑點來獲得清晰、銳利的中央視力，使我們能夠閱讀、駕駛和辨認人的面孔。當黃斑點退化時，我們的中央視力會受損，不過周邊（側邊）視力通常會保持正常。¹

AMD generally develops in two forms and is driven by several factors: / 老年黃斑病變通常分為兩種，並由多個因素引起：

• Dry AMD: This is the most common form, accounting for up to 90% of cases. It occurs when the macula gradually thins with age and tiny protein clumps called "drusen" accumulate under the retina, slowly degrading central vision.²

  乾性黃斑病變： 這是最常見的類型，佔病例的 90%。隨著年齡增長，黃斑點逐漸變薄，一種稱為「玻璃膜疣」（drusen）的微小蛋白質沉積物在視網膜下積聚，慢慢損害中央視力。²

• Wet AMD: Though less common, this form is much more severe and progresses rapidly. It happens when abnormal blood vessels grow underneath the retina. These vessels leak blood and fluid, causing sudden and severe damage to the macula.³

  濕性黃斑病變： 雖然較少見，但病情嚴重得多且惡化迅速。當視網膜下長出異常的新生血管時就會發生。這些血管會滲漏血液和液體，對黃斑點造成突然且嚴重的破壞。³

• Key Risk Factors: Aging is the primary cause, mostly affecting people over 50. However, genetics, a history of smoking (which can double the risk), obesity, high blood pressure, and prolonged exposure to UV light also significantly increase your chances of developing AMD.²

  主要風險因素： 年老是主因，主要影響 50 歲以上人士。然而，遺傳、吸煙習慣（會使風險增加一倍）、肥胖、高血壓以及長期暴露於紫外線下，都會大大增加患上黃斑病變的機率。²

Symptoms and Diagnosis: How Do You Know?
症狀與診斷：如何得知自己患病？

In its early stages, particularly with Dry AMD, you may not notice any symptoms at all. Because we see with both eyes, a healthy eye can often compensate for the diseased one. Key signs to watch for include:

在疾病的早期階段（尤其是乾性病變），您可能完全不會察覺任何症狀。因為我們用雙眼看東西，健康的眼睛往往能補償患病眼睛的視力缺損。需要注意的主要徵兆包括：

• Blurry or hazy central vision, making it difficult to read or see fine details.

  中央視力變得模糊或朦朧，難以閱讀或看清微小的細節。

• Straight lines appearing wavy, bent, or distorted (a symptom known as metamorphopsia).

  直線看起來呈現波浪狀、彎曲或變形（這種症狀稱為視物變形症）。

• A dark, empty, or blind spot appearing directly in the center of your vision.

  視野正中央出現一個黑暗、空白或盲點。

• Difficulty adjusting from bright to low-light environments.¹

  難以適應從光亮到昏暗的光線環境變化。¹

Diagnosis requires a comprehensive eye examination by an ophthalmologist. Doctors often use an Amsler Grid (a grid of horizontal and vertical lines) to test for wavy lines or blind spots. For a definitive diagnosis, they use advanced imaging like Optical Coherence Tomography (OCT), which scans the retina to detect fluid, blood, or drusen buildup.⁴

診斷需要由眼科醫生進行全面的眼科檢查。醫生經常使用阿姆斯勒方格表（Amsler Grid，一種由橫直交錯線條組成的方格）來測試患者是否看到波浪線或盲點。為了作出確診，他們會使用先進的影像技術，如光學相干斷層掃描（OCT），以掃描視網膜並檢測是否有液體、血液或沉積物的積聚。⁴

Treatments and Management
治療與管理

While there is currently no absolute cure for AMD, early detection can save your remaining sight and significantly slow down the disease's progression:

雖然目前老年黃斑病變無法徹底治癒，但及早發現可以挽救您剩餘的視力並大幅減緩病情惡化：

• Management of Dry AMD: Doctors often recommend specific high-dose vitamin and mineral supplements (known as the AREDS2 formula) to slow the progression of moderate to advanced dry AMD. Quitting smoking, wearing UV-protective sunglasses, and eating a diet rich in dark leafy greens and omega-3s are also strongly advised.²

  乾性黃斑病變的管理： 醫生通常會建議服用特定的高劑量維生素和礦物質補充劑（稱為 AREDS2 配方），以減緩中度至重度乾性病變的惡化。此外，強烈建議患者戒煙、佩戴防紫外線的太陽眼鏡，並多進食富含深綠色葉菜和 Omega-3 的食物。²

• Treating Wet AMD: The golden standard of treatment involves Anti-VEGF (Vascular Endothelial Growth Factor) injections. These are medications injected directly into the eye by a specialist to stop the growth of abnormal blood vessels and reduce fluid leakage. In some cases, Photodynamic Therapy (PDT) or laser surgery may also be used to seal leaking vessels.³

  濕性黃斑病變的治療： 目前的黃金標準治療是眼內注射抗血管內皮生長因子（Anti-VEGF）。這是由專科醫生將藥物直接注射入眼內，以阻止異常血管生長並減少滲漏。在某些情況下，也可能會使用光動力療法（PDT）或激光手術來封閉滲漏的血管。³

Why AMD is a Major Issue in Hong Kong
為什麼老年黃斑病變在香港是一個重大問題？

Hong Kong is home to a rapidly aging population. With one of the highest life expectancies globally, eye diseases driven by age are accumulating at an unprecedented rate. According to a landmark 2025 screening study by the University of Hong Kong (HKUMed) covering residents aged 50 and above, over 27% of participants suffered from mild visual impairment, uncovering a hidden public health crisis in our aging demographic.⁵

香港正面臨人口迅速老化的挑戰。由於擁有全球最高的預期壽命，與年齡相關的眼疾正以史無前例的速度累積。根據香港大學醫學院（HKUMed）在 2025 年進行的一項標誌性篩查研究顯示，在 50 歲及以上的居民中，超過 27% 患有輕度視力障礙，揭示了老年人口中一個隱藏的公共衛生危機。⁵

Despite these alarming numbers, awareness of AMD remains incredibly low. Many elderly citizens in Hong Kong mistakenly believe that deteriorating vision is simply a natural, untreatable part of aging. This misconception leads to delayed diagnoses, meaning patients often miss the "golden window" for treatments like Anti-VEGF injections, resulting in irreversible vision loss.⁴

儘管數字令人擔憂，但大眾對黃斑病變的認知仍然極低。香港許多長者錯誤地認為視力衰退只是衰老的自然現象，無法醫治。這種誤解導致延誤診斷，意味著患者往往錯過了接受抗血管內皮生長因子（Anti-VEGF）注射等治療的「黃金期」，最終導致無法逆轉的視力喪失。⁴

The Personal Impact: More Than Just "Old Eyes"
個人影響：不僅僅是「老花眼」

On a personal level, AMD is devastating because it steals a person's independence. It is not a condition that can be fixed with a simple pair of reading glasses.

就個人而言，老年黃斑病變的破壞力在於它剝奪了一個人的獨立性。這不是戴上一副老花眼鏡就能解決的問題。

Losing your central vision means losing the ability to read a newspaper, safely navigate the bustling streets of Mong Kok without a high risk of falling, or clearly see the faces of your grandchildren. The psychological toll is profound; the loss of autonomy frequently leads to severe social isolation, a loss of mobility, and depression among the elderly.

失去中央視力意味著無法閱讀報紙、無法在人多車多的旺角街道上安全行走（大幅增加跌倒的風險），也無法清楚看見孫兒的臉龐。這種心理打擊是巨大的；失去自主能力往往會導致長者陷入嚴重的社交孤立、行動不便以及抑鬱。