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  • Glaucoma is one of the leading causes of blindness in the world,

    青光眼是世界上失明的主要原因

  • and 50% of people who have it don't even know they do.

    然而 50% 得到青光眼的人卻都不知情。

  • That's because it often has few symptoms

    因為青光眼會有些症狀,

  • and these symptoms can appear after it's too late.

    而這些症狀的出現都是為時已晚。

  • So why is this such a stealth disease?

    那為什麼這是個癮性的疾病?

  • There are two main types of Glaucoma:

    青光眼有兩種類型

  • open angle and closed angle.

    開角度與閉合角度

  • Open angle is the most common and tends to be less severe.

    開角度是比較常見的,比較沒那麼嚴重。

  • It can develop slowly, over time, and go largely undetected unless it's routinely screened for.

    它形成的速度比較慢,隨著時間流逝,基本上是感覺不出來,除非平時有在做例行性檢查。

  • Closed angle, while less common - can appear suddenly and be quite painful.

    閉合角度,相對的就比較少見,它會突然出現且非常地疼痛。

  • Both can eventually can lead to vision loss.

    兩者都會導致失明。

  • - My name's John Flanagan, I'm a professor

    我的名字是 John Flanagan,我是一位

  • at the School of Optometry at the University of California, Berkeley.

    加利福尼亞大學柏克萊分校,視光學系的教授。

  • I'm also dean of the School of Optometry there.

    我也是視光學系的院長。

  • And for the last 40 years I've spent a lot of time researching into the problem of glaucoma.

    40 年來我在青光眼的問題上投入了很多時間。

  • So glaucoma is a neurodegenerative disease,

    青光眼是個神經退化疾病,

  • probably the world's most common neurodegenerative disease,

    是世界上最常見的神經退化疾病,

  • but it's really very specific to the eye.

    特別是針對眼睛。

  • To understand Glaucoma, it helps to know the basics of how the eye works.

    了解青光眼,也會讓我們知道眼睛的基本運作。

  • When light reflects an object, it enters your eye, and its first stop is the cornea.

    當光線反射到一個物體上,它會進入你的眼睛,首先會接觸到我們的角膜。

  • Then it's on through the pupil and ultimately the retina where the image is communicated

    接著會通過瞳孔,最後會到視網膜,也就是大腦透過視神經

  • with your brain by way of the optic nerve.

    互相傳達影像的地方。

  • It's then interpreted as what you see.

    也就是轉換成你所看到的東西。

  • And all of this action is aided by the presence of clear fluids and a complex network of nerves.

    這所有的運作都是由眼睛裡透明液體與複雜的網絡神經偕同輔助的。

  • If you just think for a moment about the eye, and we have this layer called the

    你稍微想一下,我們的眼睛都有這一層稱作角膜的東西

  • cornea where you would put a contact lens, for example, that's clear.

    就你是你戴隱形眼鏡時會接觸到的,例如,很透明的。

  • And it has to be clear, otherwise light can't get in and we can't see.

    它必須是很透明的,不然光線會進不來,我們會看不到。

  • Therefore it can't have blood and blood vessels throughout it feeding that tissue.

    也因此它沒有血液,沒有血管來供給細胞組織。

  • So the way that the eye feeds that tissue is by producing this fluid with all the nutrients;

    所以眼睛才會自體產生養分液體

  • the oxygen and different nutrients bathe the back to help feed it.

    浸泡著氧氣和不同的養分液體幫助供給細胞組織。

  • This all takes place in a network of fibers that surround the wall of the eye

    這供給的運作是由圍繞在眼壁的纖維網

  • and funnel into the optic nerve.

    傳輸到到視神經。

  • When the fluid at the front of the eye stops draining efficiently, pressure increases.

    當眼睛外層開始停止有效排水時,壓力會增加。

  • This can cause problems with blood flow to the optic nerve, which

    這會對視神經的血流造成問題,

  • kills off nerve fibres.

    並破壞纖維網。

  • The eye, to stay in the correct shape, needs fluid to keep it inflated.

    眼睛要維持正確的形狀,需要液體讓它保持膨脹。

  • We need pressure in the eye because otherwise it would collapse.

    我們眼睛需要壓力,不然會支撐不住。

  • So it's always this balance between the pressure inside the eye and the pressure in our capillaries.

    所以眼睛裡裡的壓力與毛細血管壓力會一直維持在一個平衡。

  • And for most of our lives, that balance is fine.

    對於大部分的生命,平衡是好的。

  • But as we get older, the blood supply may become obstructed, and the fluid drainage not as efficient.

    但隨著年紀增長,血液供應受阻,液體排放效率變差。

  • This extra fluid increases the pressure on your eye, which in turn damages the cells

    多於液體提升了眼壓,反而破壞細胞組織

  • and fibers that make up your optic nerve which then leads to vision loss.

    以及破壞組成視神經的纖維,它會讓你失明。

  • This is glaucoma.

    這就是青光眼。

  • The most prone area, the areas that we expect damage first are actually fibers that come

    最脆弱的區域,會最先受到損害的區域其實是

  • in from peripheral vision, the damage happens more with these big fibers as they loop into the top and bottom.

    周邊視覺的纖維,當他們進到循環上方與下方時,損壞多數是這些大的纖維。

  • So 12 o'clock and 6 o'clock on the optic nerve,

    所以是視神經是在 12 點鐘與 6 點鐘,

  • they're the ones that seem to be most prone

    它們才是最容易受到青光眼的損壞

  • to this damage in glaucoma and die off first,

    會最先死亡,

  • and give us very specific patterns of loss in the eye.

    且會給我們造成特定的失明模式。

  • You'd think with drainage problems and eye pressure, you would feel it,

    你會認為一切都是排水問題以及你所感受到到的眼壓

  • but that's not always the case.

    但也不全然都是。

  • That's what makes the symptoms of Glaucoma so difficult to recognize.

    因為青光眼的症狀沒這麼好被查覺到,

  • If your disease is more advanced, in primary open angle glaucoma you would just start to

    如果你的病情已經發展了一陣子,且是開角度的,你便會開始注意到

  • notice areas of vision missing.

    部分是視覺已失去。

  • Or you know, you miss that person walking on the sidewalk or across the street initially.

    或者,一開始你會看不見走在路邊或是過馬路的人。

  • So they can be quite subtle.

    它們是相當細微的。

  • You really don't feel pain other than in the much rarer acute angle glaucoma attacks.

    除非是眼比較罕見的銳角青光眼,不然你不會感覺到疼痛。

  • And it's not that you just feel no pain, your brain is actually overcompensating, adding

    那也不是不會痛就沒事,你的大腦其實在過度補償,

  • to the illusion that nothing is wrong.

    添增錯覺。

  • We often have this idea that if somebody is going blind or losing vision that they

    我們常有這種想法,如果別人要瞎了或是失明

  • have sort of dark or gray areas in their vision.

    他們部份的視覺會是黑色或灰色的。

  • And it just doesn't happen like that.

    但並不是像我們所想的這樣。

  • Most of the time these sort of diseases, particularly glaucoma, will slowly affect small areas of

    大部分所謂的疾病,特別是青光眼,會緩慢影響小部份的視覺,

  • vision, and affect them unequally in the two eyes.

    會不平均的影響在兩隻眼睛上。

  • So your brain is very good at merging what we receive, the view of the outside world

    你的頭腦善於合併我們眼睛所接收到的畫面,外面世界的畫面,

  • from each eye, and merges them together to give our percept of the world.

    並將他們合併在一起,給予我們對世界的認知。

  • Just as an example, if you're looking at a house,

    例如,你正在看著一間房子,

  • and the house has five windows and two doors,

    那房子有 5 個窗戶、2 個門,

  • if you have glaucoma, your brain would make you see that house

    如果你有青光眼,你的大腦會讓你看到那房子

  • just as well as anybody else.

    跟一般人沒有兩樣。

  • But two of the windows might be missing.

    但會有 2 個窗戶消失。

  • Your brain would fill in the brick work or the siding

    你的大腦會填補磚瓦或補外牆,

  • and you would just misinterpret

    然後你會對你實際看到的場景

  • the actual scene that you're looking at.

    有所誤解。

  • So the brain just has this amazing ability to help you feel as though nothing's wrong

    所以當你的大腦形成這些缺陷時,它有這神奇的能力

  • as you develop these defects.

    幫助你覺得沒有什麼錯覺。

  • So since there are very few symptoms with Glaucoma,

    因為青光眼的症狀非常少,

  • you can't identify it on your own.

    你無法自己確認。

  • And your brain is filling in the gaps.

    你的大腦一直在填補這些漏洞。

  • So, how do you know if you have it?

    那你要如何知道你有青光眼呢?

  • Routine screenings and knowing your risk factors, such as family history and high eye pressure, are a start.

    例行檢查,了解你的風險因子,像是家族病史與高眼壓都是很好的開始。

  • And treatment, if caught early, can include drops, medication, laser and other surgeries.

    在治療方面,發現得早,可以使用眼藥水、藥物、雷射、以及其他相關手術。

  • One treatment however, doesn't appear to pass the smell test, just yet.

    有一項治療方式,似乎還沒有通過真實性。

  • We know that marijuana will actually reduce the pressure in the eye.

    我們知道大麻其實可以降低眼壓,

  • The problem is, it's very quick and very short-lived.

    但問題是它的效用是短暫的。

  • So the therapeutic value of marijuana is a complete failure for glaucoma.

    所以大麻的治療價值對青光眼完全是沒有用的。

  • You would literally just have to be smoking continuously

    你會得要一直吸菸

  • to have an effect that might be therapeutic.

    來維持治標不是本的作用。

  • So that's a very long-winded way of saying, don't bother with marijuana with your glaucoma.

    雖然是個非常冗長的說法,但對你的青光眼完全不用去考慮大麻。

  • But there is some hope on the horizon.

    但還是有希望曙光。

  • Especially when it comes to neurological disorders, and Glaucoma is in that category.

    特別是講道神經系痛疾病,青光眼正屬於這類型的。

  • We're seeing all sorts of really amazing discoveries about neurodegenerative disease and glaucoma.

    我們看過個種關於神經退化與青光眼的新發現,

  • that opens up the potential for new therapeutic

    對於能停止傷害的新治療方法

  • treatments that will arrest the damage.

    打開了潛在的可能性。

  • I think there's genuine reason for optimism that we'll start having some treatments for

    我認為比較樂觀的部分是,我們對於整體神經退化疾病

  • neurodegenerative disease as a whole.

    將會有治療的方法。

  • And specifically for glaucoma.

    特別是青光眼。

Glaucoma is one of the leading causes of blindness in the world,

青光眼是世界上失明的主要原因

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