Welcome back to The Vision Gallery, our dedicated series where we investigate various eye diseases, how they develop, and what they mean for our community.
歡迎回到 【The Vision Gallery】！在這個專屬的網誌系列中，我們將為您深入調查各種眼疾的成因，以及它們對我們社區的影響。
Have you ever covered one eye and noticed that your side vision isn't quite as wide as it used to be? For many people, the answer is no—and that is exactly the problem. Glaucoma is often called the "silent thief of sight," quietly stealing away your vision without any warning or pain. In Hong Kong, this irreversible condition is escalating into a hidden public health crisis that demands our immediate attention, especially as our population ages.
您是否曾遮住一隻眼睛，卻發現自己的側邊視野似乎不如以前寬闊？對許多人來說，答案是沒有——而這正是問題的所在。青光眼常被稱為「無聲的視力小偷」，它會在沒有任何警告或疼痛的情況下，悄悄奪走您的視力。在香港，這種不可逆轉的眼疾正在演變成一場隱形的公共衛生危機，尤其是隨著人口老化，它迫切需要我們的關注。
What is Glaucoma and Why Does It Happen?
什麼是青光眼？為什麼會發生？
Glaucoma is a group of eye conditions that damage the optic nerve, which is the vital cable that sends visual information from your eye to your brain. This damage is most commonly caused by abnormally high pressure inside your eye (intraocular pressure, or IOP).
青光眼是一組會損害視神經的眼部疾病。視神經就像一條重要的電纜，負責將視覺訊息從眼睛傳送到大腦。這種損害通常是由於眼內壓力（眼壓，IOP）異常升高所引起的。
The eye constantly produces a fluid called aqueous humor. If the drainage channels in the eye become blocked or function poorly, this fluid builds up, causing pressure to rise and crush the delicate fibers of the optic nerve.1 However, it is crucial to understand that there are different types, driven by various factors:
我們的眼睛會不斷分泌一種稱為「房水」的液體。如果眼內的排水通道受阻或功能不良，這些液體就會積聚，導致眼壓上升，進而壓迫並損害脆弱的視神經纖維。1 然而，我們必須了解青光眼有不同的類型，其成因也各不相同：
Primary Open-Angle Glaucoma: The most common form globally, where the eye's drainage system slowly becomes clogged over time, leading to a gradual increase in pressure.
原發性開角型青光眼： 這是全球最常見的類型。眼睛的排水系統會隨著時間緩慢堵塞，導致眼壓逐漸升高。
Angle-Closure Glaucoma: More prevalent in Asian populations, this occurs when the iris bulges forward to narrow or block the drainage angle entirely. This can happen suddenly (acute) or gradually (chronic).2
閉角型青光眼： 在亞洲人群中較為常見。當虹膜向前凸出，使排水角變窄或完全堵塞時就會發生。這種情況可能是突然發生（急性）或逐漸發生（慢性）。2
Normal-Tension Glaucoma: A unique variation heavily seen in Asian populations where the optic nerve becomes damaged even though the eye pressure remains within the "normal" range. This is often linked to poor blood flow to the optic nerve.
正常眼壓性青光眼： 這是在亞洲人群（包括香港）中非常普遍的變異型。患者的眼壓雖然保持在「正常」範圍內，但視神經依然會受損。這通常與視神經血液供應不足有關。
Risk Factors: Age (over 40, sharply increasing after 50), genetics/family history, high myopia (severe nearsightedness), and underlying health conditions like diabetes or hypertension significantly increase your chances.3
風險因素： 年齡（40歲以上，50歲後風險急增）、遺傳/家族病史、深度近視，以及糖尿病或高血壓等潛在健康問題，都會大大增加患病機率。3
Symptoms and Diagnosis: How Do You Know?
症狀與診斷：如何得知自己有青光眼？
The most terrifying aspect of glaucoma is its stealth. By the time a patient notices a change in their vision, the damage is already permanent. Key signs, when they do appear, include:
青光眼最可怕的地方在於它的隱蔽性。當患者察覺到視力出現變化時，往往已經造成了永久性的損害。當症狀真正出現時，主要徵兆包括：
- Slow loss of peripheral (side) vision: Often starting as blind spots and progressing to "tunnel vision" in the advanced stages.
周邊（側邊）視力緩慢喪失： 通常從視野盲點開始，在晚期會發展成「隧道視覺」（只能看到正前方的景物）。
- Acute symptoms: In the case of acute angle-closure glaucoma, symptoms are severe and sudden. They include intense eye pain, severe headache, nausea, blurred vision, and seeing rainbow-colored halos around lights. This is a medical emergency.4
急性症狀： 如果是急性閉角型青光眼，症狀會非常劇烈且突然。包括眼睛劇痛、嚴重的頭痛、噁心嘔吐、視力模糊，以及看燈光時出現彩虹般的光暈。這是醫療急症，必須立即處理。4
Diagnosis requires a comprehensive eye examination. Because you cannot feel early glaucoma, doctors rely on Tonometry (measuring inner eye pressure), Ophthalmoscopy and OCT Scans (examining the shape and microscopic thickness of the optic nerve), and Perimetry (mapping the complete field of vision to check for blind spots).1
診斷青光眼需要進行全面的眼科檢查。由於早期青光眼沒有感覺，醫生主要依賴眼壓測量、眼底檢查與OCT掃描（精確測量視神經的形狀和纖維厚度），以及視野測試（繪製完整的視野圖以檢查盲點）。1
Treatments and Management
治療與管理
Vision loss from glaucoma is completely irreversible. The goal of all treatments is to lower eye pressure to stop or slow down further nerve damage.
青光眼造成的視力喪失是完全不可逆轉的。所有治療的目標都是降低眼壓，以停止或減緩視神經的進一步損害。
Prescription Eye Drops: The most common and early form of treatment. They work by either reducing the creation of fluid in the eye or helping it drain better.
處方眼藥水： 最常見的早期治療方法。它們的作用原理是減少眼內房水的分泌，或幫助房水更順暢地排出。
Laser Therapy: Procedures like Selective Laser Trabeculoplasty (SLT) for open-angle, or Laser Peripheral Iridotomy (LPI) for angle-closure, help clear or bypass blocked drainage pathways.
激光治療： 例如針對開角型的選擇性激光小梁成形術（SLT），或針對閉角型的激光虹膜邊緣切除術（LPI），有助於打通排水通道。
Surgery: If drops and lasers are insufficient, doctors may perform surgical procedures (like Trabeculectomy or Minimally Invasive Glaucoma Surgery - MIGS) to create new drainage channels for the fluid.2
手術： 如果眼藥水和激光治療效果不佳，醫生可能會進行手術（如小梁切除術或微創青光眼手術 MIGS），為眼內液體建立新的排水通道。2
Why Glaucoma is a Major Issue in Hong Kong
為什麼青光眼在香港是一個重大問題？
Hong Kong is facing a unique "perfect storm" when it comes to glaucoma, making it a severe public health challenge. It is currently responsible for roughly 23% of all irreversible blindness cases in the city.5
在青光眼問題上，香港正面臨一場獨特的「完美風暴」，使其成為嚴峻的公共衛生挑戰。目前，青光眼佔全港不可逆轉失明病例的約 23%。5
Firstly, Hong Kong has a rapidly aging population, and the risk of glaucoma spikes dramatically after the age of 50. Secondly, Hong Kong has one of the highest rates of myopia in the world. High myopia physically stretches the eyeball, which weakens the structures supporting the optic nerve, making myopic individuals far more susceptible to glaucoma later in life.
首先，香港人口老化迅速，而患上青光眼的風險在 50 歲後會急劇上升。其次，香港是全球近視率最高的地區之一。深度近視會使眼球拉長，從而削弱支撐視神經的結構，使得近視患者在日後更容易患上青光眼。
The most alarming data comes from recent landmark community screening projects conducted by the University of Hong Kong (HKUMed) and Orbis. The studies revealed an "alarmingly high" prevalence: roughly 8% of tested residents over the age of 50 had glaucoma. More shockingly, over 90% of those diagnosed were completely unaware they had the disease until they were screened.6 Because normal-tension glaucoma is highly prevalent here, many routine "air puff" pressure checks miss the disease entirely unless paired with optic nerve imaging.
最令人擔憂的數據來自香港大學醫學院（HKUMed）與奧比斯（Orbis）的社區篩查項目。研究顯示，患病率「高得令人震驚」：在接受測試的 50 歲以上居民中，約有 8% 患有青光眼。更令人震驚的是，超過 90% 的確診者在接受篩查前完全不知道自己患有此病！6 由於正常眼壓性青光眼在香港非常普遍，如果不配合視神經影像檢查，許多傳統的「噴氣式」量眼壓檢查往往會漏診。
The Personal Impact: A Stolen Quality of Life
個人影響：被奪走的生活質素
On a personal level, glaucoma is devastating because it robs individuals of their independence. It is not like cataracts, which can be surgically reversed. When the optic nerve fibers die, they are gone forever.
就個人而言，青光眼的破壞性在於它會剝奪患者的獨立生活能力。它不像白內障可以透過手術恢復視力；視神經纖維一旦死亡，就永遠消失了。
Losing peripheral vision means navigating crowded Hong Kong streets becomes dangerous. It drastically increases the risk of falls and injuries for the elderly, prevents them from driving, and heavily impacts their ability to read, recognize faces, or participate in physical activities. The anxiety of slowly losing one's sight—and the strict, lifelong regime of daily eye drops—takes a profound psychological toll on patients.
周邊視力的喪失意味著在香港擁擠的街道上行走會變得危險。這會大幅增加長者跌倒和受傷的風險，使他們無法駕駛，並嚴重影響他們閱讀、認人或參與體育活動的能力。眼睜睜看著視力慢慢流失的焦慮感，加上需要終生每天嚴格滴眼藥水，都會對患者造成沉重的心理負擔。
Conclusion
總結
In Hong Kong, we cannot afford to turn a blind eye to the "silent thief of sight." Because early glaucoma has absolutely no symptoms, the only defense is proactive screening. If you are over the age of 40, or if you have a family history or high myopia, a comprehensive eye exam with optic nerve imaging is not a luxury—it is a necessity. By catching it early, we can protect our vision and maintain our quality of life for decades to come.
在香港，我們不能再對這位「無聲的視力小偷」視而不見。由於早期青光眼絕對沒有任何症狀，唯一的防禦方法就是主動進行篩查。如果您年過 40 歲，或者有家族病史或深度近視，進行包含視神經影像掃描的全面眼科檢查不再是一種奢侈——而是必需品。透過及早發現，我們才能保護視力，在未來的歲月裡維持良好的生活質素。