視力不良勿輕忽 嚴重恐失明
2022-07-18 記者 蘇旋/報導
玻璃體出血眼底不清楚（圖/安南醫院提供）
台南市一位55 歲敏先生因視力不良來安南醫院眼科門診看診，敏先生雖年紀尚屬年輕但卻已有長者常好發的白內障症狀，敏先生表示其以前身體狀況都不錯，亦無糖尿病病史。眼科主任徐聖曜醫師安排其視網膜眼底檢查，發現雙眼都有很多出血點，此情況常在有糖尿病視網膜病變的病人眼睛內看到，但敏先生明確表示自身無糖尿病！因此醫師再安排抽血檢查，報告中血糖數值超過300，因此可以確定敏先生就是糖尿病所引發的視網膜病變且已有一段很長時間。
發病前玻璃體沒有出血眼底很清楚（圖/安南醫院提供）
徐聖曜主任指出，像敏先生這樣的病人，不知自己罹患糖尿病或者是知自身有糖尿病但卻血糖控制不良，除了會傷害視網膜造成病變外，也會加速白內障的形成，導致視網膜病變合併白內障視力不良，故趕緊安排敏先生接受糖尿病血糖的控制療程，再輔以眼科視網膜雷射治療，進而再施予白內障手術，術後視力改善許多，而糖尿病也獲得良好控制，飯後血糖都沒有超過200，未料敏先生就沒再回診追蹤，卻在經過一年多的某天突然現身在眼科門診，表示一早起床後眼睛突然看不到。經眼睛檢查後發現其有玻璃體出血情形，視力因被血塊遮住，故眼前一片陰暗視力模糊，徐聖曜主任說這很明顯的就是糖尿病視網膜病變再度復發，敏先生也說這一年多時間沒有做血糖的控制，抽血檢查後發現這次血糖值比上次高，已超過500，所以趕緊施行玻璃體出血的血塊清除手術及血糖控制，清除血塊後檢查視網膜中心區域黃斑部，發現黃斑部並沒有在此次糖尿病視網膜病變復發合併玻璃體出血的情形下而受到傷害，術後敏先生說這次真的要好好認真持續做好血糖控制工作了，萬一失明人生真的黑了。
徐聖曜主任醫師檢查示意圖，病人非文當事人（圖/安南醫院提供）
徐聖曜主任提醒，糖尿病的病人需按時服藥切勿自行中斷，並建議三餐時間盡量規律，如此可避免血糖因延後用餐而忽高忽低。此外，也要定時紀錄飯前飯後血糖值，以便能即時知悉自身血糖值最新狀況，而定期檢查眼睛則是預防視網膜病變的最重要關鍵所在，有追蹤就能發現異狀早處理，至少每半年接受一次眼部檢查為宜。
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