隐形眼镜是如何致我失明的

文章作者： Claire Bates

文章来源：BBC

文章翻译：冰清

When Irenie Ekkeshis's eye started to itch she assumed it would soon settle down. It didn't. Before long, she found herself in excruciating pain and lost her sight in that eye. And the cause may have been nothing more than handling her contact lenses with wet fingers.

Irenie Ekkeshis的眼睛开始发痒时她以为很快会好，但是没有。不久，她的眼睛开始剧烈的疼痛，直到最后彻底失明。其罪魁祸首，不是任何其他因素，而是她用湿手佩戴隐形眼镜。

One Saturday morning in January 2011, Irenie Ekkeshis woke up to find her right eye was streaming with tears. So she went to the chemist's and picked up some eye drops.

2011年一月一个星期六的早晨, Irenie Ekkeshis 醒来发现她的右眼莫名的流泪。于是她去药店买了眼药水。

."I thought I had a little infection that would clear up by Monday. But by that evening I couldn't bear to go in my kitchen because I found the fluorescent lights too bright. It was painful."

“起初我想这只是一点小毛病，周一会好的，但是到了当天晚上，我进入厨房，发现我的眼睛已经无法忍受厨房的荧光灯了，亮亮的灯光刺的眼睛非常的痛。”

Ekkeshis went straight to Moorfield's Eye Hospital where doctors gave her a corneal scrape - a procedure that involves taking cells from the surface of the eyeball.

于是，Ekkeshis直接去了穆尔菲尔德眼科医院, 医生给她做了一个角膜刮擦——这一过程涉及到从眼球表面提取细胞。

"It was as horrible as it sounds - you see the needle heading towards your eye. It was excruciatingly painful, even though they use numbing eye drops," she says.

“听着很恐怖，但确实如此，你可以看到针戳入你的眼睛，简直痛不欲生。尽管医生用了麻醉神经的眼药水也没用”，她说。

Within days she was told she had Acanthamoeba Keratitis (AK), a rare but serious eye infection caused by a micro-organism that's common in tap water, sea water and swimming pools.

几天后，她被告知她患的是棘阿米巴角膜炎 (AK), 一种很罕见但很严重的眼部感染病，这种感染由某种微生物引起,而这种微生物大量存在于自来水, 海水和游泳池中。

"I was feeling very shocked and frightened, as by then I had lost the vision in my right eye. It was like looking through a foggy bathroom mirror. I could see colours and shapes but not much else," she says.

"我感到非常震惊，也很恐怖,那时我的右眼视力已经很模糊，看东西这就像是在雾气腾腾的浴室照镜子一般，除了能看到颜色和形状之外,什么也看不见”，她说。

The illness affects about 125 people in the UK every year - and the vast majority of cases are associated with the use of contact lenses.

每年，英国有大约125人会患这种疾病, 绝大多数病例都与隐形眼镜的使用有关。

"I hadn't had a shower or gone swimming in my lenses," Ekkeshis says. "But I learned that even washing your hands and not drying them properly before handling lenses can cause it." Ekkeshis

“我从来不会戴着隐形眼镜洗澡或者游泳”， Ekkeshis 说。“但我知道，洗完手没擦干就接触隐形眼镜也会导致这种眼部感染”。

It was at the age of 12, that Ekkeshis decided to swap her thick "bottle-top" glasses for contact lenses.

12岁的时候，Ekkeshis 决定告别她那厚重的“瓶底”眼镜，换上了隐形眼镜。

"I suppose I was a self-conscious pre-teen," she says.

“青少年时总是感觉自惭形秽”，她说。

By the time she was 30 she wore daily disposable lenses, the kind you throw away each evening, and she had never had any trouble with them.

But AK, in which an amoeba invades the cornea - the clear front part of the eye - turned out to be a major problem.

30岁前, 她每天都戴一次性隐形眼镜,晚上摘下来就可以扔掉，从来没有遇到过任何麻烦。但是当一种变形虫入侵到恰好位于眼球前方的眼角膜时，棘阿米巴角膜炎这一大疾病就产生了。

At first, Ekkeshis was given antiseptic eye drops to take every hour. She was told that as the infection had been caught early it should be cured in a matter of weeks.

起初，医生给她使用了消炎眼药水，一个小时滴一次。医生告诉她，感染发现的比较早，几个星期后就可以治愈。

But her eye didn't respond to the treatment, and because the cornea has the highest density of pain receptors in the body, she was soon in agony.

"The pain got worse as the infection developed," she says. "At times it was unbearable and was almost impossible to control, even with the strongest painkillers."

但这种治疗没有任何效果，因为角膜是整个身体痛觉感受器分布最多的部位，药效过后很快又会疼痛 。“眼部感染越来越严重，疼痛也越来越加剧，”她说，“有时痛的令人忍无可忍，也无法控制，即使很强的止痛药也无济于事。”

She could not work and eventually quit her job as a travel company director.

疼痛已经让她无法工作, 最终她辞去了旅游公司董事的职务。

Her eye streamed for months until doctors started to get the infection under control. The pain also started to subside. But by now the cornea of her right eye was scarred, leaving her vision in this eye blurred.

几个月后，终于在医生的治疗下感染得到了控制，眼睛不再流泪，疼痛也开始消退。但右眼角膜已经伤痕累累,视力变得更加模糊。

In May 2013 she had a corneal transplant, which appeared to be a success.

2013年，她进行了眼角膜移植手术，手术貌似成功。

"It was amazing to be able to see through both eyes for the first time in a long time," she says.

“很长时间以来，我第一次能双眼看世界了，感觉很奇妙”，她说。

However, after 10 days Ekkeshis noticed the sight in her right eye was becoming cloudy again.

然而，十天后，Ekkeshis 发现她的右眼视力再次模糊。

"I had a scan which confirmed the AK had moved in to the new transplant. I was back to square one. It was devastating."

“医生用机器扫描了我的眼睛，确认是顽固的AK开始入侵新移植的眼角膜，一切都前功尽弃，这简直是灭顶之灾。”

A second transplant followed in 2014.

2014年，她又接受了第二次眼角膜移植。

"My eye stabilised and I was no longer in pain," she says.

“我的眼部感染终于得到巩固，我再也没感觉到痛”，她说。

However, something then went wrong with her retina and she completely lost her vision in that eye. Doctors have told her they suspect that inflammation caused by AK was the source of the problem - and that her sight is unlikely to return.

可悲的是，好景不长，她的视网膜却出现了问题，最终，她的右眼彻底失明。医生怀疑，AK是导致问题的根源，而且视力不可能再恢复。

During her illness, Ekkeshis discovered that none of her friends or family, many of whom wore contact lenses, knew about the risks of exposing them to water. So she decided to set up a campaign from her sofa to tackle the issue.

病痛期间, Ekkeshis 发现, 她的许多朋友或家人都配戴隐形眼镜, 但却无人知道隐形眼镜一旦触水的危险。因此, 她决定就在她的论坛上进行宣传活动来解决这个问题。

She discovered that while a safety leaflet was produced it wasn't usually included inside the lens boxes, so the information rarely reached lens wearers.

她发现，隐形眼镜的使用安全手册一般都是和隐形眼镜的盒子分开的，并没有附在盒子内部，所以很少被用户注意到。

She asked the British Contact Lens Association why there was no warning on the boxes. When told there simply wasn't room she designed her own "No Water" graphic.

她向英国隐形眼镜协会发出质问，为何在盒子内部不附任何警告说明，结果答案很简单，没有足够的空间。于是，她自己设计了“禁止触水”的图案。

"At that point the industry realised I was serious and they became supportive. We produced these No Water stickers that opticians could stick on boxes," she says.

“在这点上，隐形眼镜生产商意识到我是认真的，他们转而支持我。我们一起制作了能贴在盒子内部的 ‘禁止触水’标签，”她说。

Ekkeshis spoke at conferences to promote the campaign and it spread to the US too, after she attracted the attention of the American Academy of Optometry.

Ekkeshis 在媒体上发表了促进这一活动的演说，得到了美国验光学院的广泛关注，这场活动也开始在美国扩散。

She hopes one day the "No Water" graphic will be automatically printed on all contact lens boxes.

她希望有一天，“禁止触水”标签能约定俗成的打印在每一个隐形眼镜盒内。

Using her campaigning experience, she has co-founded an enterprise called The New Citizenship Project.

利用这场活动获得的经验，她与合伙人一起创立了新公民计划项目。

"Our purpose is to get people more involved in society. When you think and behave like a citizen you feel able to create change," she says.

“我们的目的是让人们参与更多的社会活动。当你带着公民意识思考和行动的时候，你就在改变这个世界，”她说。

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Meanwhile Ekkeshis, now 36, has had to adapt to her impaired sight.

"You do things to help cope day to day. So if I'm going to a meal with friends I try to sit closer to the wall on my right side so I can see everyone," she says.

如今，Ekkeshis已经36岁，在被动接受中，慢慢适应了她那只失明的眼睛。

“你要设法解决一只眼睛带来的不便。所以，当我和朋友吃饭的时候，我总是试图坐在我右手边最靠近墙的那个位置，以便我可以看见所有人。”

"But it is hard. Sometimes people can get huffy on public transport if you bump in to them because you can't see your right side."

“但这真的很难，有时候在公交车上，无意撞到我右边看不到的人，他们便会火冒三丈。”

“The eyelid is now droopy, which is common in AK.”

“我的右眼睑现在已经下垂，这是棘阿米巴角膜炎很常见的后遗症。”

"My advice to people is simple. Never let your lenses come into contact with water - in the shower, swimming or when washing.

"Although infections like AK are rare, I'm proof they can happen and the results can be devastating."

我对大家的忠告很简单：千万不要让你的隐形眼镜接触到水，不管是在洗澡，游泳还是在清洗镜片时。虽然类似AK感染的机率很小，但是我以切肤之痛告诉你，一旦被感染，就是毁灭性的灾难。

                         

   

医学常识

棘阿米巴角膜炎(Acanthamoeba Keratitis，AK)是由棘阿米巴原虫引起的一种新的感染性角膜病，首先发现于1973年，近年来病例有逐年增多的趋势。导致眼部感染的阿米巴原虫主要有棘阿米巴科(family acanthamoebidae)的棘阿米巴属(Acanthamoeba spp)和双鞭毛阿米巴科(family dimastigamoeba)的耐格里属(Naegleria spp)，它们又统归为致病性自生生活阿米巴，其中以棘阿米巴属致病最常见。

致病性自生生活阿米巴性角膜炎患者多为年轻的健康人，男女比例均等，多数有角膜接触镜配戴史或眼外伤史。绝大多数为单眼受累，个别患者也可双眼发病，起病一般比较缓慢。炎症早期主要表现为角膜上皮的不规则，上皮粗糙或反复上皮糜烂，有时可表现为假树枝状改变(图7，8)。患者常有明显的眼痛，其程度往往超出体征，形成“症状与体征分离”的现象。

随着病情发展，炎症逐渐侵及基质层，形成角膜前基质层的斑状、半环状或环状浸润。有些病变类似于盘状角膜炎的改变，部分患者可有放射状角膜神经炎。

如未得到及时诊断与治疗，角膜浸润很快发展成角膜溃疡、基质脓肿，并有卫星灶形成和前房积脓，严重者发生角膜坏死穿孔。如果角膜溃疡累及到角膜缘，常导致角膜缘炎，甚至巩膜炎。

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