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錐形角膜 (keratoconus)

錐形角膜(keratoconus)是一種非炎症(non-inflammatory)的角膜發育性異常病變，過程中角膜的中央組織續漸變薄、擴張形成圓錐形狀，引至嚴重眼力受損。由於角膜的功能有如相機的鏡頭是給光線穿透進入眼球，所以角膜的異常變化會引至視力減弱，影響日常生活。大約每1000人就有1-5個人患有 錐形角膜。

Keratoconus is a non-inflammatory corneal ectasia (expansion, distortion). It involves thinning and distortion of central cornea resulting cone shape cornea and impaired vision. The prevalence of keratoconus is approximate 1-5 per 1000.

•成因:
         -        不明 / 直至目前，引致錐形角膜病發的成因仍未有定論
         -        錐形角膜有小數為遺傳個案
         -        可能和遺傳性過敏症 (atopy) 有關
         -        經常性擦眼睛亦可能有關
         -        男性患者較多於女性

Causes:
-unknown
-some cases have family history of keratoconus
-some may be related to severe skin allergy or atophy
-Rubbing eye may also contribute keratoconus
-male cases more than female

•徵狀:
         -        錐形角膜多於青春期發病，亦有遲至三十歲左右才被發現
         -        錐形角膜病發時並沒有發炎，眼紅等症狀
         -        而且進展緩慢，患者不易發覺
         -        多數錐形角膜患者雙眼受影響，有時一邊眼睛發病較快，亦會經多年停頓後而特然病變加劇
         -        錐形角膜患者近視不斷加深
         -        及形成不規則散光，以致視力(Visual Acuity)下降
         -        畏光

Symptoms:
- mostly teenage onset
- no sign of ocular inflammation and redness
- slow progression
- usually bi-lateral with one eye more severe
- increase of myopia and astigmatism
- irregular astigmatism
- photophobia

但在一些嚴重的錐形角膜個案中，變形及變薄了的角膜部份會出現水腫，最後在角膜造成疤痕，若疤痕在視軸上，則會嚴重影響視力，到此階段，唯一可恢復視力的方法是進行角膜移植！

Corneal endothelium rupture may experienced in some severe cases and resulting with corneal scares. Corneal transplantation may be considered in very severe cases (around 10-20% of cases).

•治療:
         -        目的是改善患者視力，現時尚未有方法根治錐形角膜
        -        初期: 眼鏡或軟性隱形眼鏡
        -        中期: 透氣硬性隱形眼鏡
        -        晚期: 角膜移植

Treatment options:
- no full cure at this moment
- early stage: spectacles or soft contact lenses
- middle stage: Rigid gas permeable contact lens
- End stage: corneal transplantation

大約在1000人中就有1-5人會患上錐形角膜病變，但大部份都是初期及中期的症狀，當中只有大約一至兩成的患者會嚴重到需要進行角膜移植，所以若能有正確的診斷和適當的護理，當能減少 對患者的影響。

Approximate 1-5 person per 1000 suffers keratoconus, but most cases are mild stage. There only 10-20% of sufferers needs corneal transplantation. Hence, proper diagnosis and choose of visual aids are important to improve the live quality of sufferers.


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