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角膜云翳、斑翳(一)

西医的认识:

正常人的黑眼球即角膜是清亮透明的,如果将眼睛比作一架照相机的话,那么角膜就好比照相机的镜头。当角膜受到病菌的感染或外伤,清亮透明的角膜就会变得混浊,影响视物的清晰性,也就是俗话所说的“眼睛起蒙”,就好象透过有呵气的玻璃看物体一样,雾蒙蒙的。角膜混浊经过炎症修复过程后形成的癜痕即为角膜翳,它是角膜炎症痊愈的标志,多为永久性,不易消退。角膜翳薄厚不一,依据侵犯角膜的深浅及形态,分为云翳、斑翳和白斑三种。云翳侵犯角膜组织浅层,癜痕薄,尤由如天上的浮云,只有通过特殊检查才有发现;白斑侵犯角膜组织全层,癜痕厚,呈瓷白色,肉眼即能发现;斑翳介于云翳和白斑两者之间。

中医的认识:

黑睛疾患初愈或近愈,红退痛止,留有形状不一、厚薄不等之瘢痕翳障,视物昏朦,眼内干涩,可无全身症状。黑睛疾患后期,邪退正复,病变修复,故红退痛止。遗留瘢痕翳障,致黑睛失去晶莹清澈,阻碍神光发越,故视物昏朦,甚则视力严重下降。津液亏耗,阴津不足,故眼内干涩。

简要临床分类:

角膜翳多是角膜炎症或外伤治愈后遗留的瘢痕,根据瘢痕的形状、范围、深浅程度而命名,一般浅层瘢痕性混浊薄如云雾状,通过混浊的部位仍能看清后面虹膜纹理者称为角膜云翳;混浊较厚略呈白色,但仍可透见虹膜者称为角膜斑翳;混浊很厚呈瓷白色,不能透见虹膜者称为角膜白斑。如果角膜瘢痕组织中镶嵌有虹膜组织称之为粘连性角膜白斑,提示病变角膜有穿透史。角膜翳中医称之为宿翳,历代中医眼科文献主要将其分为冰瑕翳、云翳、厚翳、斑脂翳四种.

起病要点:

常见因素有:角膜病变,常为浅层或深层角膜病变炎症、角膜外伤及化学性酸碱烧伤愈后留下的瘢痕形式存在,中医认为肝阴不足,虚火上炎,火邪灼津,灼伤角膜后而使角膜呈白色翳。

预防及注意事项:

一、关键是预防角膜炎症的发生或避免角膜受到损伤,因此要思想重视,做到预防为主;要及早治疗,早期治疗可以使视力得到保护;中医治疗为主,角膜营养治疗为辅;要锻炼身体,增强体质,提高免疫力;治疗用药要连续、有效、科学。 二、不要乱用眼药水,因为目前为止,要药水多是消炎抗病毒及润滑作用,没有褪翳的眼药水。许多角膜云翳斑翳患者的发生是因为很多患者因为眼部的一时不适,没用及时检查,而是自己随意使用眼药水来缓解症状,最终引起角膜损伤。 三、不要饮酒,酒精使眼血管扩张充血,加重病情;不要吃羊肉、牛肉、狗肉。由于病毒性角膜炎是免疫异常所致,而吃羊肉牛肉狗肉可加重这种免疫反应,导致病情加重;不要随意减少用药次数,要按时遵医嘱用药。不要吹风受凉感冒,感冒后免疫力下降,尤其像病毒性角膜炎易复发的特点,反复发作加重病情;不要过早停药,炎症控制后继续遵医嘱用药用药,巩固治疗效果,防止卷土重来;不要随意用激素,尤其角膜溃疡期用激素可能使角膜穿孔的危险。因为过劳和熬夜使免疫力下降,也会使治疗效果打折扣。 四、忌用药偷工减料,一天要保证早晚各一次不能减少,道理很简单用药如用兵这就好比打仗攻克一个城市本来需要数万精兵如果兵力减少结果可想而知;(除非感冒发烧或其他急症)详情咨询主治医师。 五、忌见好就收,可遵医嘱停药。

西医治疗方法:

目前西医医疗界尚无药物治疗方案,只有做光学角膜移植,需要了解的是角膜移植有一定的局限性和危险性和明显的弊端。 1、光学性角膜移植手术存在一定风险:这也是不可避免客观存在的 2、做了角膜移植并不是终生的:具体因眼部情况而定。有的可以保持终身,有的仅仅可以维持几个月或几年

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