How should Parkinson’s disease patients take care of their eyes on a daily basis?
巴金森氏症（PD）對眼睛的影響往往是「隱形」的。除了我們之前提到的青光眼風險，PD 患者最常遇到的問題其實是視力模糊、眼睛乾澀以及對比感下降。
由於 PD 會讓肌肉變得遲緩，連帶「眨眼」次數也會減少，這對眼部健康影響很大。以下是為 PD 患者整理的日常護理指南：
1. 解決「忘記眨眼」造成的乾眼症
PD 患者的眨眼頻率通常只有常人的一半，這會導致淚膜破裂，引起刺痛或視力模糊。
- 定時人工淚液： 不要等到「感覺乾」才點，建議採取「預防性點藥」（如早中晚固定時間），選擇不含防腐劑的單支裝人工淚液較佳。
- 眨眼練習： 每天有意識地進行「深呼吸＋深眨眼」練習，幫助淚液均勻塗抹眼球。
- 熱敷： 每天睡前使用溫熱敷眼罩 5–10 分鐘，可以軟化阻塞的瞼板腺油脂。
2. 改善「閱讀與聚焦」困擾
許多患者會抱怨看書跳行或看不清楚，這通常是因為眼球追蹤肌肉不協調（輻輳不足）。
- 使用閱讀架： 將書本固定在視線平齊的高度，減少頭部顫抖造成的視覺不穩。
- 增加光源對比： PD 患者對灰色的辨識能力會下降。閱讀時應使用高品質的 LED 檯燈，並選擇大字體或高對比度的電子書。
- 稜鏡眼鏡： 如果出現複視（看東西有重影），可以請眼科醫師評估是否配戴特殊的稜鏡眼鏡。
3. 安全的居家照明（預防跌倒）
PD 結合視力問題是跌倒的高風險因子。
- 消除陰影： 走廊、樓梯間應安裝感應式亮光，避免環境忽明忽暗，因為 PD 患者的大腦處理「光影變化」較慢，容易產生幻覺或凍結步態。
- 標記邊緣： 在樓梯踏板邊緣貼上鮮豔色彩（如黃色）的防滑條，增加視覺辨識度。
4. 點藥水的實務技巧（應對震顫）
對於有手部震顫的患者，點眼藥水是一大挑戰。
- 利用支撐點： 點藥時坐在靠背椅上，頭向後仰，將拿藥水的手的手肘靠在桌面上，另一隻手拉開下眼瞼，利用支撐點來抵消震顫。
- 輔助器： 市面上有販售「眼藥水輔助架」，可以固定在眼窩上，即使手抖也能準確滴入。
- 錯開藥物高峰期： 建議在服用 PD 藥物（如左旋多巴）藥效發揮、震顫最輕微的時候點藥。
定期檢查建議
建議 PD 患者至少每半年至一年進行一次眼科檢查，並確保檢查包含：
- 眼壓測量（監控青光眼）。
- 視網膜斷層掃描 (OCT)（觀察神經纖維層厚度）。
- 裂隙燈檢查（檢查角膜乾燥程度）。
您目前是否正幫長輩物色適合的眼藥水，或者長輩在閱讀、看電視時有提到特定的不適感（如：重影、字會跳動）嗎？
The effects of Parkinson’s disease (PD) on the eyes are often “invisible.” Besides the glaucoma risk we mentioned earlier, the most common problems encountered by PD patients are blurred vision, dry eyes, and decreased contrast.
Because PD causes muscle relaxation, the frequency of blinking also decreases, which has a significant impact on eye health. Below are daily care guidelines for PD patients:
1. Addressing Dry Eye Caused by “Forgetting to Blink”
PD patients typically blink only half as frequently as normal, which can lead to tear film breakage, causing stinging or blurred vision.
- Regular Artificial Tears: Don’t wait until you feel dryness before using them. It’s recommended to use preventative drops (such as at fixed times in the morning, noon, and evening). Choosing preservative-free, single-use artificial tears is preferable.
- Blinking Exercises: Consciously practice deep breathing and deep blinking daily to help the tears evenly coat the eyeballs.
- Warm Compress: Apply a warm compress to your eye mask for 5–10 minutes before bed each day to soften blocked meibomian gland oil.
2. Improve Reading and Focusing Difficulties
Many patients complain of skipping lines or having difficulty seeing clearly when reading. This is usually due to incoordination of the eye-tracking muscles (insufficient convergence).
- Use a Reading Stand: Fix the book at eye level to reduce visual instability caused by head tremors.
- Increase Light Contrast: PD patients have reduced ability to distinguish grayscale. Use a high-quality LED desk lamp when reading and choose e-books with large fonts or high contrast.
- Prism Glasses: If you experience diplopia (double vision), consult an ophthalmologist to assess whether you need special prism glasses.
3. Safe Home Lighting (Fall Prevention)
PD combined with vision problems is a high-risk factor for falls.
- Eliminating Shadows: Install motion-activated lighting in corridors and stairwells to avoid sudden changes in light and shadow, as the brains of PD patients process changes in light and shadow more slowly, which can easily lead to hallucinations or frozen gait.
- Marking Edges: Apply brightly colored (e.g., yellow) anti-slip strips to the edges of stair treads to increase visual visibility.
4. Practical Techniques for Instilling Eye Drops (Coping with Tremors)
Instilling eye drops is a significant challenge for patients with hand tremors.
- Utilizing Support Points: Sit in a chair with a backrest, tilt your head back, and rest the elbow of the hand holding the drops on a table. Use the other hand to pull down the lower eyelid, using this support point to counteract the tremors.
- Assistive Devices: Eye drop holders are available on the market. They can be fixed to the eye socket, allowing for accurate instillation even with tremors.
- Avoid Peak Medication Hours: It is recommended to use eye drops when the PD medication (such as levodopa) is at its most effective and the tremor is least severe.
Regular Check-up Recommendations
PD patients are advised to have an eye exam at least every six months to one year, ensuring the exam includes:
- Intraocular pressure measurement (to monitor glaucoma).
- Optical Coherence Tomography (OCT) (to observe the thickness of the nerve fiber layer).
- Slit-lamp examination (to check the degree of corneal dryness).
Are you currently looking for suitable eye drops for an elderly person, or has your elderly person mentioned specific discomfort (such as double vision, flickering text) when reading or watching TV?
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