Hong Kong is a city that never stops looking at screens. Whether residents are checking messages on the MTR or working late into the night, people's eyes are constantly under strain. While it is common to joke about the heavy dependence on glasses in this city, there is a hidden, much more severe consequence to this collective nearsightedness: retinal detachment.

香港是一個視線永遠離不開屏幕的城市。無論是在地鐵上查看訊息，還是熬夜工作，人們的眼睛經常處於勞損狀態。雖然大家常拿這座城市高度依賴眼鏡來開玩笑，但集體的近視問題背後，卻隱藏著一個更嚴重、更危險的後果：視網膜脫落。

This condition is a medical emergency that can lead to permanent blindness if not treated promptly. Here is a comprehensive guide to why retinal detachment happens, how to recognize the warning signs, its treatments, and why it has become a critical public health and personal issue in Hong Kong.

這是一種眼科急症，如果不及時治療，可能會導致永久性失明。以下我們將全面探討視網膜脫落的成因、如何辨識警告信號、治療方法，以及為什麼它在香港會成為一個重大的公共衛生與個人議題。

What is Retinal Detachment and Why Does It Happen?
什麼是視網膜脫落？為什麼會發生？

The retina is the light-sensitive layer of tissue lining the back of the inside of the eye, functioning much like the film in a camera. Retinal detachment occurs when this critical layer of tissue pulls away from its normal position, separating it from the blood vessels that provide essential oxygen and nourishment.¹

視網膜是位於眼球內部後方的一層感光組織，其功能就像照相機裡的底片。當這層關鍵的組織從正常位置剝離，並與提供重要氧氣和營養的血管分離時，就會發生視網膜脫落。¹

The most common causes include: / 最常見的成因包括：

• Retinal Tears or Holes: As people age, the gel-like fluid inside the eye (the vitreous) can shrink and pull away from the retina. Sometimes, this pulling is strong enough to create a tear. Fluid can then pass through the tear and accumulate underneath the retina, peeling it away like wallpaper falling off a damp wall.¹

  視網膜撕裂或穿孔： 隨著年齡增長，眼球內部的凝膠狀液體（玻璃體）會收縮並拉扯視網膜。有時候，這種拉扯的力量大到足以造成撕裂。眼內液體隨後會穿過裂孔並積聚在視網膜下方，使其像受潮的牆紙一樣剝落。¹

• High Myopia (Severe Nearsightedness): People with high myopia have elongated eyeballs. This physical stretching causes the retina to become abnormally thin and fragile, making it significantly more susceptible to tearing and detachment.²

  深度近視： 患有深度近視的人，其眼球會被拉長。這種結構性的拉長會導致視網膜變得異常纖薄和脆弱，使其發生撕裂和脫落的風險大幅增加。²

• Eye Trauma or Surgery: A direct blow to the eye, or previous eye operations (such as cataract surgery), can also sharply increase the risk.¹

  眼部創傷或手術： 眼部受到直接撞擊，或曾經接受過眼部手術（如白內障手術），也會大幅增加患病風險。¹

Symptoms and Diagnosis: How Do You Know?
症狀與診斷：如何得知自己有視網膜脫落？

Retinal detachment is completely painless, which means you must rely solely on visual warning signs. Recognizing these symptoms early is the difference between saving and losing sight. The key red flags include:

視網膜脫落是完全無痛的，這意味著您必須完全依靠視覺上的警告信號來判斷。及早識別這些症狀是挽救視力還是永久失明的關鍵。主要的危險信號包括：

• A Sudden Increase in Floaters: Seeing a sudden swarm of black spots, dots, or web-like lines drifting across your vision.

  飛蚊症突然增加：視野中突然出現大量黑點、斑點或網狀線條飄動。

• Flashes of Light: Experiencing sudden, brief flashes of light (photopsia) in one or both eyes, often most noticeable in dark environments.

  閃光幻覺：單眼或雙眼突然出現短暫的閃光，通常在黑暗環境中尤為明顯。

• A Dark Shadow or Curtain: A dark shadow creeping over your peripheral (side) vision or descending like a physical curtain across your field of view.

  黑影或窗簾遮擋：視野周邊（側邊）出現黑影蔓延，或者感覺像有一塊實體窗簾從視野中降下。

• Sudden Blurred Vision: A rapid and unexplained drop in visual clarity.¹

  視力突然模糊：視力清晰度突然不明原因地急劇下降。¹

If you experience any of these symptoms, you must see an ophthalmologist or visit an emergency room immediately. A specialist will use eye drops to dilate your pupils and perform a comprehensive fundus examination and an Optical Coherence Tomography (OCT) scan to carefully check the retina for tears, holes, or full detachment.¹

如果您出現上述任何症狀，必須立即尋求眼科醫生或前往急症室求診。專科醫生會使用眼藥水放大您的瞳孔，並進行全面的眼底檢查和光學相干斷層掃描（OCT），以仔細檢查視網膜是否有撕裂、穿孔或完全脫落的跡象。¹

Treatments: A Race Against Time
治療：一場與時間的競賽

A detached retina cannot heal on its own; it requires urgent surgical intervention. The specific treatment depends on the severity of the condition:

脫落的視網膜無法自行癒合；它需要緊急的手術干預。具體的治療方法取決於病情的嚴重程度：

• Laser Therapy or Cryotherapy (Freezing): If a retinal tear or hole is caught before detachment occurs, doctors can use a medical laser or a freezing probe to create a scar around the tear. This welds the retina to the underlying tissue, preventing fluid from leaking underneath.¹

  激光治療或冷凍治療： 如果在視網膜脫落前及時發現撕裂或裂孔，醫生可以使用醫療激光或冷凍探頭在裂孔周圍製造疤痕。這能將視網膜「焊接」在下層組織上，防止液體滲入。¹

• Pneumatic Retinopexy: For a minor detachment, the surgeon injects a small gas bubble into the eye. The bubble pushes the retina back into place, and laser or freezing therapy is used to seal the tear.

  充氣性視網膜固定術： 對於較輕微的脫落，外科醫生會在眼內注入一個小氣泡。氣泡會將視網膜推回原位，然後再配合激光或冷凍治療來封閉裂孔。

• Vitrectomy: In more severe cases, the surgeon removes the vitreous gel pulling on the retina, replacing it with a gas, air, or silicone oil bubble to flatten the retina against the back wall of the eye.

  玻璃體切除術： 在較嚴重的情況下，外科醫生會清除拉扯視網膜的玻璃體，並注入氣體、空氣或硅油氣泡，以將視網膜平壓回眼球後壁。

• Scleral Buckling: A tiny silicone band is sewn to the outside of the eyeball (the sclera) to gently press the eye inward, relieving the pulling force on the retina.¹

  鞏膜扣壓術： 將一條微小的矽膠帶縫在眼球外部（鞏膜）上，輕輕將眼球向內壓，從而減輕對視網膜的拉扯力。¹

Why Retinal Detachment is a Major Issue in Hong Kong
為什麼視網膜脫落在香港是一個重大問題？

Hong Kong is facing a unique set of circumstances that makes retinal detachment a ticking time bomb. The city has one of the highest prevalences of myopia globally, affecting over 50% of schoolchildren and up to 95% of university students.²

香港正面臨一種獨特的狀況，使視網膜脫落成為一枚定時炸彈。這座城市是全球近視率最高的地區之一，影響了超過 50% 的學童和高達 95% 的大學生。²

When myopia exceeds 600 degrees (high myopia), the physical elongation of the eyeball heavily thins the retinal tissue. Research indicates that highly myopic individuals are at a drastically elevated risk of developing retinal tears. Combined with an aging population where age-related vitreous changes naturally occur, Hong Kong's healthcare system is facing a massive influx of patients at high risk for this sight-threatening emergency.^{2, 3}

當近視超過 600 度（深度近視）時，眼球的物理性拉長會使視網膜組織嚴重變薄。研究指出，深度近視患者發生視網膜撕裂的風險急劇上升。加上人口老化（與年齡相關的玻璃體退化自然發生），香港的醫療系統正面臨大量處於這種威脅視力急症高風險中的患者。^{2, 3}

The Personal Impact: A Life-Altering Event
個人影響：改變一生的經歷

On a personal level, retinal detachment is far more than a medical inconvenience. If the macula (the central part of the retina responsible for detailed vision) detaches, the chances of fully restoring normal vision drop significantly, even with successful surgery.³

就個人而言，視網膜脫落遠不止是一種醫療上的不便。如果黃斑部（負責中央精細視力的視網膜中心部分）發生脫落，即使手術成功，完全恢復正常視力的機會也會大幅下降。³

The recovery process is also highly disruptive. Post-surgery, patients may have to maintain strict, uncomfortable head postures (often face-down) for weeks to ensure the gas bubble holds the retina in place. The resulting vision loss or long recovery periods can lead to a loss of independence, an inability to drive, prolonged absence from work, and profound psychological distress.¹

康復過程也極度影響生活。手術後，患者可能需要維持嚴格且不舒服的頭部姿勢（通常是面朝下）長達數週，以確保氣泡能將視網膜固定到位。由此導致的視力受損或漫長的康復期，會導致患者失去獨立生活能力、無法駕駛、需要長期請假停工，並帶來深刻的心理困擾。¹