A curable condition that causes blindness - Andrew Bastawrous

譯者: Ming Gui Tan 審譯者: Ann Chen

An estimated 20 million cases of blindness worldwide are caused by cataracts,

全球大約兩百萬的失明是白內障造成的，

a curable condition affecting the lens that focuses images onto the eye's retina.

是一種可以治愈的眼疾 影響能夠聚焦影像到視網膜上的水晶體

A cataract occurs when proteins in the lens lose their normal arrangement,

白內障的發生始於水晶體內的蛋白質 失去了正常的排列

clumping together in a way that causes discoloration or clouding,

叢聚在一起 造成變色或渾濁

and eventually blocks most vision.

最終遮蔽了大部分視力

Cataracts can be caused by eye injury,

白內障可以是因為眼睛創傷、

certain medications,

某些藥物、

ultraviolet radiation,

紫外線、

diabetes,

糖尿病、

smoking,

吸煙、

or some genetic disorders.

或者是一些遺傳疾病造成。

But the most common cause is aging.

但最常見的成因是老化。

In the United States, more than 50% of people over the age of 80 develop them.

在美國，80歲以上的老人 超過一半患有白內障。

Cataracts were treated over 2,500 years ago in India,

早在2500多年前 印度就有治療白內障的方法，

though similar procedures may have existed even earlier

雖然類似的術式在更久以前已經問世於

in Ancient Egypt and Babylon.

古埃及和巴比倫。

The most common procedure, called couching,

最常見的術式 稱為白內障摘除術(couching)，

involved pressing a sharp instrument into the eye

是把尖銳的器械推入眼睛

to loosen and push the clouded lens out of the way.

將渾濁的水晶體鬆開推出

Although this could increase the amount of light entering the eye,

雖說這樣能夠增加進入眼睛的光線，

the lack of a lens would leave the patient's vision out of focus.

失去了水晶體 會讓病人的視力失去對焦能力。

Despite its low success rate, and high risk of infection or injury,

即便成功率低， 而且感染或受傷風險高，

couching is still performed in some parts of the world.

這術式於某些地區仍在使用。

Later procedures would also focus on removing the cloudy lens,

後來的術式主要也是針對 渾濁水晶體的摘除，

for example, by making an opening in the cornea to pull out the lens

譬如，切開角膜取出水晶體

along with the membrane capsule surrounding it.

和包覆著它的囊膜。

While the invention of eyeglasses allowed for some restoration of focus,

雖然眼鏡的發明能夠恢復 部分的對焦能力，

they had to be extremely thick to help.

但是鏡片必須很厚才能發揮作用。

Furthermore, such techniques still caused complications,

再者，這些術式還是會有併發症，

like damaging the retina,

像損傷視網膜，

or leaving the eye with uncomfortable stitches.

或在眼睛裡留下造成不適感的縫線。

But in the 20th century, something unexpected happened.

但是在二十世紀， 意外的事情發生了。

Eye surgeon Sir Harold Ridley was treating World War II casualties

當年眼科醫生Harold Ridley爵士 在第二次世界大戰治療傷患時

when he noticed that acrylic plastic from a shattered aircraft cockpit

他發現損壞的駕駛艙上的 壓克力碎片

had become lodged in a pilot's eyes without triggering an adverse reaction.

插入了飛行員的眼睛 而且沒有引起不良反應。

This led him to propose surgically implanting artificial lenses into the eye

這讓他提出透過手術 把人工水晶體置入眼睛的方式

to replace cataracts.

來替換白內障。

And despite initial resistance,

雖然初期一波三折，

the method became standard practice by the 1980s.

在 1980 年代，這已變成 標準治療手術的方法。

Since Ridley's discovery,

自從Ridley的發現開始，

the intraocular lens has undergone several improvements.

人工水晶體經過了多次改良。

Modern lenses can fit into the membrane capsule

近代的人工水晶體已能

that the cataract is extracted from,

置入白內障原本的囊膜，

leaving more of the eye's natural anatomy intact.

保留更多眼睛原有的構造

And the ability to fine-tune the lens curvature

而能夠微調水晶體弧度的能力

allows the surgery to restore a patient's normal vision

讓病人在手術後 不用依靠眼鏡

without the need for glasses.

就能恢復正常的視力。

Of course, surgical techniques have also progressed.

當然，手術的方法也在進步。

Microscopic procedures use small instruments or lasers

顯微手術利用 小型的器械或雷射

to make precise incisions of one or two millimeters in the cornea,

準確的在角膜上切割1或2mm，

while an ultrasound probe breaks up and removes the cataracted lens

同時使用超音波探頭 震碎並移除渾濁的水晶體

with minimal trauma to the eye.

而過程中的創傷降至最小。

Low-tech versions of this operation have made the surgery quick and inexpensive,

這術式的簡版減少了 手術時間和成本，

helping it spread across the developing world.

增加了術式在發展中國家的普遍性。

Places like Aravind Eye Hospital in India

像在印度的Aravind眼科醫院

have pioneered high-volume, low-cost cataract surgery

早就開始推行大量 而且廉價的白內障手術，

for as little as six dollars.

費用只要6美金。

Why then, with all these advances,

那為什麼 有了這些新技術，

are there still so many blind people in the world?

世上還是有那麼多 失明的人？

The main issue is access to health care,

最主要的問題是 醫療的普遍性，

with poor infrastructure and a shortage of doctors

落後的設施 和醫療人員的短缺

being a major barrier in many regions.

在很多地區也是主要的障礙。

But this is not the only problem.

但這不是唯一的難題。

In many rural areas with poor education,

在很多缺乏教育的偏遠地區，

blindness is often accepted as an inevitable part of aging,

失明常被認定為 老化過程中無可避免的部分，

for which someone might not think to seek treatment.

所以有些人根本就不會想去治療。

This is why information is crucial.

這就是為什麼資訊是那麼的重要。

Increased community awareness programs and the spread of mobile phones

公眾意識活動的增加和 手機的廣泛運用

mean that many of those

代表了很多

who might have remained blind for the rest of their lives due to cataracts

有可能因為白內障而終生失明者

are now reachable.

已經能夠接受到訊息。

And for them, a brighter future is in sight.

對於他們而言， 光明的未來指日可待。