Keratoconus Non-surgical Treatment
錐形角膜 非手術治療
羅暢星博士 Dr. Samuel Law Cheung-Sing
吳耀輝博士 Dr. Forrest Ng Yiu-Fai
美國眼科視光學院院士 Fellowship of the American Academy of Optometry
查詢，請至電 21530008
For more information please contact Tel: 21530008
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，引至嚴重視力受損。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2000人就有
1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 per 2000.
Keratoconus protrudes more than normal cornea. 錐形角膜較正常角膜凸出
‧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
The keratoconus cornea is much thinner than normal cornea. 錐形角膜較正常角膜薄
Computerized scanning (Corneal topography) depicting the shape of the protruded cone. 角膜地形圖顯示錐體變形的情況
‧
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: 軟性 或 硬性隱形眼鏡
- 中期: 軟硬混合隱形眼鏡
- 晚期: 鞏膜鏡，膠厚聯繫手術 或 角膜移植
Treatment options:
- no full cure at this moment
- early stage: soft or rigid contact lenses
- middle stage: hybrid contact lens
- end stage: scleral lens, corneal cross-link surgery or corneal transplantation
Contact Lens for Keratoconus: the goal is to mask the corneal irregularity to improve vision
錐形角膜隱形眼鏡：掩蓋角膜變形，矯正視力
Because of conventional soft contact lens warp according to the
irregular keratoconus cornea, thus the light rays cannot be focus well
on the retina. In order to mask the corneal irregularity, a smooth and
regular cornea has to be mimicked. Thus, rigid contact lenses will be
the ideal choice for keratoconus treatment.
因為傳統軟性隱形眼鏡跟隨不規則的錐形角膜變形，未能聚焦光線，未能改善視力。如要改善視力，就需要掩蓋錐形角膜的不規則表面，使光線重新聚焦到視網膜。
所以不會依隨不規則角膜變形的硬性隱形眼鏡就正是首選。
Because
of difference in severity for individual cases, difference types of
rigid contact lenses are now available to treatment keratoconus. For,
more severe cases, the contact lens is needed to vault a bigger cone.
Accordingly, a bigger lens will be needed. For example, the bigger the
obstacle in road, the bigger the bridge will be needed. For that
purpose, hybrid lens and scleral lens are now available to improve vision and comfort.
由於每個錐形角膜患者的情況各有不同，需要用上不同的硬性隱形眼鏡。於較嚴重的個案，如要跨越凸起的角膜，較大的鏡片就較為有利。例如要跨越愈大的障礙物，就得建造愈大的橋梁。因此，患者可以透過軟硬混合鏡或鞏膜鏡改善視力和提升舒適的感覺。
大約在
2000人中就有1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 person per 2000 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.
相關連結 References: 
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info@eye.hk
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查詢，請致電 21530008
For more information please contact Tel: 21530008
Eyesight Hong Kong Optometry Center
香港視覺護眼中心
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Synergeyes - Hybrid contact lens 混合隱形眼鏡 - ClearKone
Specially for keratoconus and cornea after LASIK surgery
軟硬混合隱形眼鏡：錐形角膜患者及LASIK手術後角膜變形患者專用隱形眼鏡
透過Hybrid隱形眼鏡這個平台，使用者能回復清晰視力、穩定性、中央定位及全日舒適。這專利拱形設計在 改善視力的同時不需要使用者與舒適度妥協。
By use of hybrid lens platform, it provides superior visual acuity,
stability, centration and all-day comfort. The patent-pending design is
optimized to vault the irregularities of distorted cornea, thus, restoring vision without compromising comfort.
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Scleral lens - the therapeutic contact lens
鞏膜鏡 - 治療專用隱形眼鏡
Scleral
lenses are contact lenses designed to treat a variety of eye conditions
which may not be treated any other type of therapy. Scleral lenses are
made from a highly oxygen permeable materials. They are different from
other contact lenses because they rest onto sclera (eye-white) instead
of the cornea.
鞏膜隱形眼鏡設計適用於多種不能治療的眼晴問題或情況。鞏膜隱形眼鏡由高透氧物料製造。它與其他一般隱形眼鏡的不同之處是它配戴在眼球的鞏膜(眼白位置)而非角膜。