眼角膜有事!

配戴隱形眼鏡, 是有一定性的風險, 我見到你的問題, 亦替你辛苦.
既然你已看醫生, 就應該相信他和服從他.

什麼是真菌性角膜炎
真菌性角膜炎是一種致盲率較高、治療較為棘手的感染性眼病。角膜是透明、無血管組織，一旦感染真菌後，真菌就會以垂直和平行生長的特性，加速角膜病變的發展。藥物不能通過血管直接作用於角膜病變區，因此真菌性角膜病變往往頑固不愈，甚至導致角膜潰瘍、穿孔。一旦出現角膜潰瘍、穿孔，應及時行角膜移植手術治療。由於我國同種異體角膜來源匱乏，重症患者仍難以保住眼球。
能引起真菌性角膜炎的病菌
一般情況下，真菌不會侵犯正常角膜，但當有眼外傷、長期局部使用抗生素、角膜炎症及幹眼症等情況時，非致病的真菌就可能變為致病菌，引起角膜繼發性真菌感染。常見的致病菌為曲黴菌，其次是鐮刀菌、白色念珠菌、頭芽孢菌及鏈絲菌等。
真菌性角膜炎表現症狀
真菌性角膜炎起病緩慢、病程長，病程可持續達２至３個月，常在發病數天內出現角膜潰瘍。因致病菌種不同，角膜潰瘍形態不一。
真菌性角膜炎主要發病人群
在我國，真菌性角膜炎的發病情況是，南方多於北方，多見於青壯年、老年及農民。
真菌性角膜潰瘍的治療
治療以抗真菌藥物為主，常用0.25%二性黴素B（該藥球結膜下注射易致結膜壞死，臨床上要特別注意）、金褐黴素眼膏、制黴菌素眼膏及10%大扶康、1%咪康唑、1 % 克霉唑等，每日3～4次點眼，並全身應用抗真菌藥。皮質類固醇無論全身或局部單獨使用均屬禁忌。由於本病多引起虹膜炎，須經常注意散大瞳孔。
穿透性角膜移植術是近年比較肯定的手術治療方法，其適應症主要是藥物治療無效，或角膜潰瘍穿孔，發生眼內容物脫出或繼發青光眼等嚴重並發癥，是為挽救眼球而採取的一種搶救性手術。由於真菌菌絲可垂直生長，加上真菌毒素、蛋白分解酶及可溶真菌的抗原作用，真菌菌絲可向深部生長，甚至侵入眼內，手術難以清除乾淨眼內的真菌，故術後常出現復發。因此對無手術適應症者，強調先行抗真菌藥物治療。
中醫認為本病多因濕熱所致，治療時要分辨濕熱的偏重，選用清熱祛濕藥，常用的方劑有除濕湯、甘露飲等。此外，還可採用中藥熏洗或霧化治療。 （就醫網）
如何預防真菌角膜炎
使用隱形眼鏡的市民應遵從以下守則，以預防與隱形眼鏡有關的角膜炎：
·處理隱形眼鏡、隱形眼鏡護理藥水及有關配件前，應適當地用皂液及水洗手；
·切勿用唾液、樽裝水或水喉水潤滑鏡片；
·遵從視光師/眼科醫生的建議，包括連續配戴隱形眼鏡的時限及更換鏡片的時間表；
·儲存鏡片的容器必須定期清潔、洗凈及保持幹爽，以免滋生細菌；
·所有隱形眼鏡、護理藥水及有關配件應放置於陰涼處；
·每星期應將儲存鏡片的容器放在剛煮沸的熱水中浸十分鐘，以作消毒；
·儲存鏡片的容器應每三個月更換一次；
·遵從視光師/眼科醫生的建議來清潔及消毒隱形眼鏡；
·隱形眼鏡護理藥水應于開啟後一個月棄置；
·配戴隱形眼鏡的時間不應長過建議的時間，並應遵從視光師/眼科醫生的建議定期更換鏡片；
.定期接受視光師/眼科醫生檢查；
.若眼部感到不適或眼紅，應立刻除掉隱形眼鏡。如眼部不適持續，應立刻求診；
.如眼部有角膜炎的病徵，如眼痛及眼紅，應立即看眼科醫生。（

Keratitis


Keratitis
Classification & external resources





圖片參考：http://upload.wikimedia.org/wikipedia/en/thumb/0/0d/Clare-314.jpg/190px-Clare-314.jpg


An eye with non-ulcerative sterile keratitis.






Keratitis is a condition in which the eye's cornea is inflamed.





Types
Superficial keratitis involves the superficial layers of the cornea. After healing, this form of keratitis does not generally leave a scar.
Deep keratitis involves deeper layers of the cornea, leaving a scar upon healing that impairs vision if on or near the visual axis.

Causes
Keratitis has multiple causes, one of which is an infection of a present or previous herpes simplex virus secondary to an upper respiratory infection, involving cold sores.

Pathogens

Amoebic keratitis. Amoebic infection of the cornea is the most serious corneal infection, usually affecting soft contact lens wearers. It is usually caused by Acanthamoeba. On May 25, 2007, the CDC issued a health advisory due to increased risk of Acanthamoeba keratitis (AK)infection associated with use of Advanced Medical Optics (AMO) Complete Moisture Plus Multi-Purpose eye solution. See CDC Advisory
Bacterial keratitis. Bacterial infection of the cornea can follow from an injury or from wearing contact lenses. The bacteriums usually involved are Staphylococcus aureus and for contact lens wearers Pseudomonas aeruginosa. *Fungal keratitis (cf. Fusarium, causing recent incidences of keratitis through the possible vector of Bausch & Lomb ReNu with MoistureLoc contact lens solution)
Viral keratitis



Herpes simplex keratitis. Viral infection of the cornea is often caused by the herpes simplex virus which frequently leaves what is called a 'dendritic ulcer'.
Herpes zoster keratitis

Other

Exposure keratitis
Photokeratitis - keratitis due to intense ultraviolet radiation exposure (e.g. snow blindness or welder's arc eye.)
Ulcerative keratitis
Contact lens acute red eye (CLARE) - a non-ulcerative sterile keratitis associated with colonization of Gram-negative bacteria on contact lenses
Severe allergic response may lead to corneal inflammation and ulceration (i.e. vernal keratoconjunctivitis).[1]

Symptoms
The symptoms are often very similar to those of conjunctivitis, an inflammation of the conjunctiva, and photophobia. The eye turns very red and there may be sensitivity to light, and the eye may feel uncomfortable. In the later stages of more severe cases, there can be strong pain, loss of vision/blurriness, and pus may form.

Diagnosis
Effective diagnosis is important in detecting this condition and subsequent treatment as keratitis is sometimes mistaken for an allergic conjunctivitis.

Treatment
Treatment depends on the cause of the keratitis.
Infectious keratitis generally requires antibacterial, antifungal, or antiviral therapy is to treat the infection. This treatment can involve prescription eye drops, pills, or even intravenous therapy. Over-the-counter eye drops are typically not helpful in treating infections. In addition, contact lens wearers are typically advised to discontinue contact lens wear and discarding contaminated contact lenses and contact lens cases. Antibacterial solutions include Quixin (levofloxacin), Zymar (gatifloxacin), Vigamox (moxifloxacin), Ocuflox (ofloxacin — available generically). Steroid containing medications should not be used for bacterial infections, as they may exacerbate the disease and lead to severe corneal ulceration and corneal perforation. These include Maxitrol (neomycin+polymyxin+dexamethasone — available generically), as well as other steroid medications. One should consult a qualified Ophthalmologist for treatment of an eye condition.
Some infections may scar the cornea to limit vision. Others may result in perforation of the cornea, endophthalmitis (an infection inside the eye), or even loss of the eye. With proper medical attention, infections can usually be successfully treated without long-term visual loss.