對眼睛長痘痘“麥粒腫”的認識

　　麥粒腫是一種在瞼板腺、睫毛底部之蔡氏(Zeis)皮脂腺遭受到感染所引起的眼部化膿性疾病。可表現為局部眼睛疼痛、紅腫、瘙癢、燒灼感而流淚，並對光敏感，在眼瞼的上下部會出現小小的黃色腫塊。自限性過程，但可通過治療縮短疾病過程。 　　麥粒腫(hordeolum，stye)，又稱針眼，是一種在瞼板腺、睫毛底部之蔡氏(Zeis)皮脂腺或莫氏(Moll)頂泌淚腺遭受到感染所引起的眼部疾病(hordeolum is an infection of the sebaceous glands of Zeis at the base of the eyelashes, or an infection of the apocrine sweat glands of Moll)。因感染部位不同，麥粒腫又分為內、外麥粒腫。外麥粒腫是Moll或Zeis腺發炎，常在眼瞼近睫毛處(External styes form on the outside of the lids and can be seen as small red bumps)；內麥粒腫是梅蓬氏瞼板腺(meibomian sebaceous glands)發炎。未經治療的患者症程常可持續約1~2週，若有正規治療，4天左右就可見到成效(Styes can last from one to two weeks without treatment, or as little as four days if treated properly) 　　關於誘發麥粒腫的原因，一般有以下幾種共識：

1. 細菌侵入：如用不乾淨的手去揉擦眼睛或共用毛巾(Sharing of washcloths or face towels)，引起金黃色葡萄球菌感染是最常見的原因(Styes are commonly caused by a Staphylococcus aureus bacterial infection)。
2. 眼睛疲勞過度：眼睛疲勞造成眼輪匝肌收縮而引起腺體開口之堵塞(blocking of an oil gland at the base of the eyelash)。
3. 與食物過敏有關。
4. 壓力和營養不良(triggered by poor nutrition)、剝奪睡眠(sleep deprivation)。

　　霰粒腫(chalazion)，又稱「瞼板腺囊腫」，是由於瞼板腺分泌功能旺盛，瞼板腺堵塞，導致腺體內分泌物無法排出，引起慢性炎症肉芽腫(Lipogranuloma)，並非細菌感染引起。若病灶較小且無症狀，也可通過熱敷等方法以促進吸收，通常在幾個月內會自然消失。較大的霰粒腫，則以手術處理。 (Styes are similar to chalazia, but tend to be of smaller size and are more painful and usually produce no lasting damage. Styes compared to chalazia that are chronic and usually do not resolve without intervention) 　　麥粒的併發症罕見，比較常見是影響外觀cosmetic deformity、角膜易激corneal irritation。另外有些是不乾淨的手術操作，破壞睫毛生與形成瘻管(improper surgical lancing, and mainly consist of disruption of lash growth, lid deformity or lid fistula)、眼瞼蜂窩組織炎(Eyelid cellulitis)，甚至造成全身感染(Progression of a stye to a systemic infection is extremely rare)等等。 　　麥粒腫有自限性過程，但通過一些簡單的治療，使疾病在一個星期內緩解。局部使用含抗生素或類固醇眼藥膏(如紅黴素Erythromycin ointment)、眼藥水(如Azasite, a topical eye drop form of azithromycin)(Topical antibiotic ointments or antibiotic/steroid combination ointments)是一種治癒的選擇，，如果麥粒腫破裂，應小心清潔傷口，防止二次感染(If a stye bursts, care must be taken to cleanse the wound to prevent reinfection)；若症狀超過一個星期的患者，可以給予口服Antibiotics，如阿莫西林或氯黴素，後者可能造成aplastic anemia (Antibiotics are normally given to patients with multiple styes or with styes that do not seem to heal, and to patients who also suffer from blepharitis)，若感染擴散，可予靜脈給Doxycycline(intravenous antibiotics, such as doxycycline, only when the infection has spread)，眼痛患者以acetaminophen治療。

　　其次，熱敷是一個很好的方式(The primary mode of treatment for a stye is application of warm compresses)，有助於眼部血液循環，排出膿液，方法是可以使用熱敷包或剛煮熟的熱雞蛋包在毛巾裏，然後敷在眼瞼上，敷10~15分鐘， 每天三至四次。另一種方法是用清水沖洗眼睛，可以減輕眼睛不適感(As a part of self-care at home, patients may cleanse the affected eyelid with tap water or with a mild, nonirritating soap or shampoo (such as baby shampoo) to help clean crusted discharge)。

　　有時專業醫生會消毒的針去刺開麥粒腫使其快速結痂(Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining)。也可incision & the pus is drained out of the gland，甚至組織病理檢查以除外腫瘤的可能性。但在沒有專業技術的情況下不建議切除麥粒腫(Patients are highly advised to not lance the stye, as serious infection can occur as a result)。另外，麥粒腫患者也不建議塗眼線、或戴隱形眼鏡，以免感染擴散，造成角膜炎，影響視力。(Eye stye sufferers should avoid eye makeup (e.g., eyeliner and wearing contact lenses, since these can aggravate and spread the infection to the cornea) 一、注意眼部清潔(proper hygiene)，不與別人共用化妝品(it is recommended to never share cosmetics or cosmetic eye tools with other people)，每晚應該徹底卸妝，做好故人衛生(It is recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup)。

二、保持眼部清潔，不用髒手揉擦眼睛，應勤加洗手(Proper hand washing can not only reduce the risks of developing styes, but also all other types of infections)。

三、注意休息，增加睡眠，避免過度疲勞。每天早上起床，可以熱敷眼瞼1~2分鐘，可以預防眼瞼腺賭塞而造麥粒腫的發生(Upon awakening, application of a warm washcloth to the eyelids for one to two minutes may be beneficial in decreasing the occurrence of styes and thereby preventing blockage)。

四、口服亞麻油補充劑(flaxseed supplementation)可預防麥粒腫的發生。

眼睛長痘痘、麥粒腫、針眼、眼部疾病、眼睛疲勞過度、食物過敏、蜂窩組織炎、臨床醫學資訊館