文章作者： Claire Bates
文章來源：BBC
文章翻譯：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的眼睛開始發(fā)癢時她以為很快會好，但是沒有。不久，她的眼睛開始劇烈的疼痛，直到最后徹底失明。其罪魁禍首，不是任何其他因素，而是她用濕手佩戴隱形眼鏡。
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年一月一個星期六的早晨, Irenie Ekkeshis 醒來發(fā)現(xiàn)她的右眼莫名的流淚。于是她去藥店買了眼藥水。
."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."
“起初我想這只是一點小毛病，周一會好的，但是到了當天晚上，我進入廚房，發(fā)現(xiàn)我的眼睛已經(jīng)無法忍受廚房的熒光燈了，亮亮的燈光刺的眼睛非常的痛?！?/p>
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直接去了穆爾菲爾德眼科醫(yī)院, 醫(yī)生給她做了一個角膜刮擦——這一過程涉及到從眼球表面提取細胞。
"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.
“聽著很恐怖，但確實如此，你可以看到針戳入你的眼睛，簡直痛不欲生。盡管醫(yī)生用了麻醉神經(jīng)的眼藥水也沒用”，她說。
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.
幾天后，她被告知她患的是棘阿米巴角膜炎 (AK), 一種很罕見但很嚴重的眼部感染病，這種感染由某種微生物引起,而這種微生物大量存在于自來水, 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.
"我感到非常震驚，也很恐怖,那時我的右眼視力已經(jīng)很模糊，看東西這就像是在霧氣騰騰的浴室照鏡子一般，除了能看到顏色和形狀之外,什么也看不見”，她說。
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，英國有大約125人會患這種疾病, 絕大多數(shù)病例都與隱形眼鏡的使用有關(guān)。
"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
“我從來不會戴著隱形眼鏡洗澡或者游泳”， Ekkeshis 說?！暗抑?，洗完手沒擦干就接觸隱形眼鏡也會導(dǎo)致這種眼部感染”。
It was at the age of 12, that Ekkeshis decided to swap her thick "bottle-top" glasses for contact lenses.
12歲的時候，Ekkeshis 決定告別她那厚重的“瓶底”眼鏡，換上了隱形眼鏡。
"I suppose I was a self-conscious pre-teen," she says.
“青少年時總是感覺自慚形穢”，她說。
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歲前, 她每天都戴一次性隱形眼鏡,晚上摘下來就可以扔掉，從來沒有遇到過任何麻煩。但是當一種變形蟲入侵到恰好位于眼球前方的眼角膜時，棘阿米巴角膜炎這一大疾病就產(chǎn)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，醫(yī)生給她使用了消炎眼藥水，一個小時滴一次。醫(yī)生告訴她，感染發(fā)現(xiàn)的比較早，幾個星期后就可以治愈。
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."
但這種治療沒有任何效果，因為角膜是整個身體痛覺感受器分布最多的部位，藥效過后很快又會疼痛 ?！把鄄扛腥驹絹碓絿乐兀弁匆苍絹碓郊觿?，”她說，“有時痛的令人忍無可忍，也無法控制，即使很強的止痛藥也無濟于事?！?/p>
She could not work and eventually quit her job as a travel company director.
疼痛已經(jīng)讓她無法工作, 最終她辭去了旅游公司董事的職務(wù)。
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.
幾個月后，終于在醫(yī)生的治療下感染得到了控制，眼睛不再流淚，疼痛也開始消退。但右眼角膜已經(jīng)傷痕累累,視力變得更加模糊。
In May 2013 she had a corneal transplant, which appeared to be a success.
2013年，她進行了眼角膜移植手術(shù)，手術(shù)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.
“很長時間以來，我第一次能雙眼看世界了，感覺很奇妙”，她說。
However, after 10 days Ekkeshis noticed the sight in her right eye was becoming cloudy again.
然而，十天后，Ekkeshis 發(fā)現(xiàn)她的右眼視力再次模糊。
"I had a scan which confirmed the AK had moved in to the new transplant. I was back to square one. It was devastating."
“醫(yī)生用機器掃描了我的眼睛，確認是頑固的AK開始入侵新移植的眼角膜，一切都前功盡棄，這簡直是滅頂之災(zāi)。”
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.
“我的眼部感染終于得到鞏固，我再也沒感覺到痛”，她說。
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，好景不長，她的視網(wǎng)膜卻出現(xiàn)了問題，最終，她的右眼徹底失明。醫(yī)生懷疑，AK是導(dǎo)致問題的根源，而且視力不可能再恢復(fù)。
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.
病痛期間, Ekkeshis 發(fā)現(xiàn), 她的許多朋友或家人都配戴隱形眼鏡, 但卻無人知道隱形眼鏡一旦觸水的危險。因此, 她決定就在她的論壇上進行宣傳活動來解決這個問題。
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.
她發(fā)現(xiàn)，隱形眼鏡的使用安全手冊一般都是和隱形眼鏡的盒子分開的，并沒有附在盒子內(nèi)部，所以很少被用戶注意到。
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.
她向英國隱形眼鏡協(xié)會發(fā)出質(zhì)問，為何在盒子內(nèi)部不附任何警告說明，結(jié)果答案很簡單，沒有足夠的空間。于是，她自己設(shè)計了“禁止觸水”的圖案。
"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.
“在這點上，隱形眼鏡生產(chǎn)商意識到我是認真的，他們轉(zhuǎn)而支持我。我們一起制作了能貼在盒子內(nèi)部的 ‘禁止觸水’標簽，”她說。
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 在媒體上發(fā)表了促進這一活動的演說，得到了美國驗光學(xué)院的廣泛關(guān)注，這場活動也開始在美國擴散。
She hopes one day the "No Water" graphic will be automatically printed on all contact lens boxes.
她希望有一天，“禁止觸水”標簽?zāi)芗s定俗成的打印在每一個隱形眼鏡盒內(nèi)。
Using her campaigning experience, she has co-founded an enterprise called The New Citizenship Project.
利用這場活動獲得的經(jīng)驗，她與合伙人一起創(chuàng)立了新公民計劃項目。
"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.
“我們的目的是讓人們參與更多的社會活動。當你帶著公民意識思考和行動的時候，你就在改變這個世界，”她說。
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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已經(jīng)36歲，在被動接受中，慢慢適應(yīng)了她那只失明的眼睛。
“你要設(shè)法解決一只眼睛帶來的不便。所以，當我和朋友吃飯的時候，我總是試圖坐在我右手邊最靠近墻的那個位置，以便我可以看見所有人?！?/p>
"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."
“但這真的很難，有時候在公交車上，無意撞到我右邊看不到的人，他們便會火冒三丈?！?/p>
“The eyelid is now droopy, which is common in AK.”
“我的右眼瞼現(xiàn)在已經(jīng)下垂，這是棘阿米巴角膜炎很常見的后遺癥?！?/p>
"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."
我對大家的忠告很簡單：千萬不要讓你的隱形眼鏡接觸到水，不管是在洗澡，游泳還是在清洗鏡片時。雖然類似AK感染的機率很小，但是我以切膚之痛告訴你，一旦被感染，就是毀滅性的災(zāi)難。
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醫(yī)學(xué)常識
棘阿米巴角膜炎(Acanthamoeba Keratitis，AK)是由棘阿米巴原蟲引起的一種新的感染性角膜病，首先發(fā)現(xiàn)于1973年，近年來病例有逐年增多的趨勢。導(dǎo)致眼部感染的阿米巴原蟲主要有棘阿米巴科(family acanthamoebidae)的棘阿米巴屬(Acanthamoeba spp)和雙鞭毛阿米巴科(family dimastigamoeba)的耐格里屬(Naegleria spp)，它們又統(tǒng)歸為致病性自生生活阿米巴，其中以棘阿米巴屬致病最常見。
致病性自生生活阿米巴性角膜炎患者多為年輕的健康人，男女比例均等，多數(shù)有角膜接觸鏡配戴史或眼外傷史。絕大多數(shù)為單眼受累，個別患者也可雙眼發(fā)病，起病一般比較緩慢。炎癥早期主要表現(xiàn)為角膜上皮的不規(guī)則，上皮粗糙或反復(fù)上皮糜爛，有時可表現(xiàn)為假樹枝狀改變(圖7，8)。患者常有明顯的眼痛，其程度往往超出體征，形成“癥狀與體征分離”的現(xiàn)象。
隨著病情發(fā)展，炎癥逐漸侵及基質(zhì)層，形成角膜前基質(zhì)層的斑狀、半環(huán)狀或環(huán)狀浸潤。有些病變類似于盤狀角膜炎的改變，部分患者可有放射狀角膜神經(jīng)炎。
如未得到及時診斷與治療，角膜浸潤很快發(fā)展成角膜潰瘍、基質(zhì)膿腫，并有衛(wèi)星灶形成和前房積膿，嚴重者發(fā)生角膜壞死穿孔。如果角膜潰瘍累及到角膜緣，常導(dǎo)致角膜緣炎，甚至鞏膜炎。
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