I-glaucoma

Incazelo jikelele yalesi sifo

Yisifo esingalapheki esingavela noma nini, kepha sivame kakhulu kubantu asebekhulile. I-Congenital glaucoma yenzeka ezinganeni ezisanda kuzalwa eziyizinkulungwane ezi-1, ezineminyaka engama-20, izehlo ze-glaucoma cishe ziyi-45%, phakathi kwabantu abaneminyaka engama-0,1-50 ubudala lesi sibalo sifinyelela ku-60%, naseqenjini leminyaka 1,5+ ngaphezulu kuka-70%.

Ngeshwa, i-glaucoma ayelapheki, amafomu ayo abucayi aholela ekungaboni okungahlehliseki, okunikeza lesi sifo isimilo senhlalo.

Izinhlobo ze-glaucoma

I-glaucoma ihlukaniswa ngeminyaka:

• i-glaucoma yokuzalwa izingane ezisanda kuzalwa ziyahlupheka. Njengomthetho, lesi sifo sibhekene nokuxilongwa kwangaphambili, ngokushesha ngemuva kokuzalwa sitholakale ku-60% yeziguli. I-glaucoma yokuzalwa ingazibonakalisa ezinyangeni zokuqala zobuntwana, futhi ezimweni ezingavamile kamuva kakhulu, ngemuva kweminyaka eminingana;
• i-glaucoma yentsha kutholakale ezinganeni ezifinyelele eminyakeni emithathu ubudala kuze kube yiminyaka engama-3;
• i-glaucoma eyinhloko kubantu abadala okuvame kakhulu. Ihlotshaniswa nezinguquko ezihlobene nobudala ezithweni zombono. Amafomu alo angaphansi kokuhlukaniswa kwezokwelapha, lapho uhlobo lwemithi yokwelashwa luncike khona. I-glaucoma eyinhloko ingazibonakalisa nge-angle evulekile, i-angle evaliwe, amafomu axubekile ne-glaucoma, lapho ingcindezi ye-intraocular ihlala ngaphakathi kwemikhawulo ejwayelekile;
• i-glaucoma yesibili kubantu abadala eba ngenxa yezifo zamehlo ezidlulisiwe.

Izimbangela ze-glaucoma

Izimbangela ze-glaucoma yokuzalwa zingaba yizici ezihlukahlukene, ezifana ne-genetic predisposition, kanye nokuhlukunyezwa kwe-embryonic nokuzalwa. Uma umama ehlushwa izifo ezifana ne-mumps, i-syphilis, i-rubella, uvendle ngesikhathi sokukhulelwa, khona-ke lokhu kungavusa i-glaucoma ku-fetus. Ukuphuza ngokweqile, ubuthi, ukuntuleka kwamavithamini, ukuchayeka emisebeni, nokulimala kwesisu kombungu nakho kungaba yizici eziyingozi.

Kubantu abadala, isizathu esiyinhloko sokuthuthukiswa kwe-glaucoma ukukhuphuka kwengcindezi yamehlo, okuholela ekwephuleni kokunikezwa kwegazi emehlweni nokuguqulwa kwe-nerve optic. Ngaphezu kwalokho, lesi sifo sicindezela umfutho wegazi ophakeme, isifo sikashukela, i-osteochondrosis yomgogodla womlomo wesibeletho, izifo zesimiso somzimba sokuzivikela ezifweni, i-myopia enamandla kanye nefa.^[3].

Ukuthambekela kwefomu le-angle evaliwe kubonakala kakhulu kubulili obulungile. Kulokhu, izici zokwakheka kwezitho zombono zibaluleke ngokukhethekile: usayizi omncane weso kanye nelensi enkulu.

I-glaucoma yesibili ingacasulwa ukusetshenziswa kwesikhathi eside kwezidakamizwa ze-hormonal, ezikhonjiswe ngesifo se-asthma se-bronchial kanye nezifo ezizimele.

Izinto eziyingozi zokuthuthukisa i-glaucoma

Imvamisa, i-glaucoma itholakala lapho kukhona lezi zinto ezimbi ezilandelayo:

1. ukuguga (ngemva kweminyaka engama-70);
2. ukubona kude;
3. ukukhuphuka kwe-IOP ngezikhathi ezithile;
4. umfutho wegazi ophansi;
5. isifo sikashukela;
6. ukungasebenzi kahle kwesistimu ye-hormonal kanye nezinzwa;
7. izifo zesistimu yenhliziyo;
8. ukulimala kwamehlo;
9. ukuhlinzwa kanye nezinqubo zokuvuvukala ezedlule;
10. ukuba khona kwe-glaucoma ezihlotsheni;
11. ukusetshenziswa isikhathi eside kwezidakamizwa ze-hormonal.

Ngokusho kwe-WHO, i-glaucoma iyi-pathology ehamba phambili yezinto ezibukwayo, okuholela ekulahlekelweni kokusebenza kokubuka. Bangaphezu kuka-14% abantu abangaboni emehlweni emhlabeni wonke ngenxa ye-glaucoma.

Izimpawu ze-glaucoma

Imvamisa, inkambo yalesi sifo ayibonisi izimpawu futhi ayibangeli ukungakhululeki inqobo nje uma amandla okubuka angawohloki kakhulu. Njengomthetho, isiguli sibonana nodokotela wezifo zamehlo esikhathini esedlule ekuthuthukiseni lesi sifo. Ubuqili besifo bulele eqinisweni lokuthi ezigabeni zokuqala, ubuhlungu nezimpawu cishe azikho ngokuphelele.

Abantu asebekhulile kufanele bavakashele njalo i-ophthalmologist futhi balinganise ingcindezi ye-intraocular, okuyisifo esihamba phambili se-glaucoma. Akunakwenzeka ukuthola ngokuzimela izinguquko kwingcindezi ye-intraocular, ngoba ukwanda kwenzeka kancane kancane futhi ubuchopho buzivumelanisa nezinguquko. Iqembu elincane kuphela labantu elinokubonakaliswa okunjengobuhlungu endaweni yamashiya nebunzi, ukuwohloka kokubukhali kokubona, izikhalazo ngokubonakala kwemibuthano enombala lapho ubheka imithombo elula.

Esinye isibonakaliso esibalulekile ukuncipha kwensimu yombono, eqala ukusuka endaweni yamakhala, kanye nokwephula ukuguqulelwa okusheshayo kweso ekushintsheni kokukhanya. Ukwehla kobunzima obubonwayo kukhombisa ushintsho olungalungiseki esakhiweni se-morphological ye-optic nerve, engenakubuyiselwa futhi yelashwe.

Ifomu le-angle evaliwe alivamile, kepha lihlukaniswa yizimpawu ezishiwoyo: iso elibi nekhanda, ukubomvu kweso.

Izimpawu zomtholampilo ze-glaucoma

Ukulimala kwesitho sokubukwa kungase kuboniswe uphawu olulodwa noma ngaphezulu. Kubalulekile ukuthintana ne-ophthalmologist ngesikhathi ukuze uhlolwe kanye nokuxilongwa okuphelele.

Izimpawu ze-glaucoma:

1. ukuzwa okuphindaphindiwe kobuhlungu, ubuhlungu kanye nobunzima endaweni yeso elithintekile;
2. ukwehla emkhakheni wokubuka;
3. inkungu phambi kwamehlo;
4. amabala anemibala nemibuthano lapho ubheka umthombo wokukhanya okukhanyayo;
5. ukuncipha kombono lapho kuhwalala (kusihlwa nasebusuku);
6. umswakama wamehlo;
7. ubuhlungu obuncane ngezikhathi ezithile;
8. i-hyperemia ye-eyeball.

Izinkinga ze-glaucoma

Ukwelashwa okungazelelwe kwe-glaucoma kungadala ukuhlaselwa okunamandla kwalesi sifo, esigcwele ukukhubazeka okubukwayo okunzima kuze kuphele ubumpumputhe. Ucwaningo olusebenzayo lukhombisa ukuthi ukwelashwa kwe-glaucoma kungama kuphela futhi kunciphise ukwehla kombono, kepha akukwazi ukukubuyisela.

Ukuvimbela i-glaucoma

1. 1 ukuhlolwa okuvamile kwezokwelapha nodokotela kanye ne-endocrinologist ukuze kutholakale ngesikhathi kanye nokuvimbela izifo ezingase zibangele ukuthuthukiswa kwe-glaucoma (umfutho wegazi ophezulu, i-hypotension, isifo sikashukela, ukungasebenzi kahle kwe-thyroid gland);
2. 2 ukuvakasha okuhlelekile kudokotela wamehlo ngesilinganiso esiyisibopho sokucindezela kwe-intraocular;
3. 3 ukwelashwa okufika ngesikhathi kwezifo zamehlo ukuvimbela ukuthuthukiswa kwe-glaucoma yesibili;
4. Omama abakhulelwe abangu-4 kufanele baqaphele ngokukhethekile ukuvimbela ingozi yokuba ne-glaucoma ezinganeni ezisanda kuzalwa;
5. 5 ungadebeseleli ukuzihlola. Ukuzithiba kwenziwa kalula: vala amehlo akho ngamunye ngamunye futhi uqhathanise ubukhali nekhwalithi yesithombe;
6. I-6 yenza umthetho wokwenza njalo izivivinyo zasekuseni ngokuzivocavoca okuphoqelekile komgogodla womlomo wesibeletho. Ukuvivinya umzimba okusesilinganisweni kukhuthaza ukunikezwa kwegazi ezithweni zombono;
7. 7 ungaphakamisi izinto ezisindayo ukuze ungacasuli ukwanda kwe-IOP;
8. 8 ukudla okuhlanganiswe kahle.

Izindlela zokuxilonga

Ukuze kutholakale ngokushesha izinqubo ze-pathological, i-IOP iyakalwa, ngosizo lwamathuluzi akhethekile i-fundus nenhloko ye-optic nerve iyahlolwa, inkambu yokubuka iyahlolwa ukuze kutholakale amaphutha embonweni ophakathi nendawo kanye ne-peripheral.

Ukuze kutholakale ukuxilongwa kwe-glaucoma, ukuhlolwa okuphelele kuyanqunywa, okuhlanganisa i-refractometry, i-perimetry ezenzakalelayo, i-tonometry, i-ultrasound, ukuhlolwa kokujula kwekamelo langaphambili, ukunqunywa kobukhulu nobubanzi be-lens, i-gonioscopy (ucwaningo lwe-engeli phakathi kwe-cornea. kanye ne-iris), ukunqunywa kokuqina kwe-cornea.

Ukwelashwa kwe-glaucoma emithini ejwayelekile

Ngeshwa, akukakenzeki ukuthola ikhambi eliphelele le-glaucoma, kepha kufanele lilawulwe futhi liphathwe. Ngemuva kokuthola uhlobo nesigaba se-glaucoma, udokotela wezifo zamehlo uzobeka indlela yokwelashwa efanelekile, engadla ngoludala, ihlinze noma i-laser. Ngayinye yalezi zinhlobo zokwelashwa ihlose ukujwayelekile izinkomba zengcindezi ye-intraocular.

Izindlela zokwelapha zokwelashwa zihilela ukusetshenziswa kwamaconsi akhethekile e-antiglaucoma, angagcini nje ukwehlisa izinga le-IOP, kepha futhi athuthukise nokuhlinzekwa kwegazi kulwelwesi lwangaphakathi lwezitho zombono. Udokotela wezifo zamehlo kuphela ongakhetha futhi akhansele amaconsi, futhi anikeze nomthetho wokufaka; ukuzelapha i-glaucoma kungadala ukulimala okungenakulungiseka emehlweni. Kulokhu, isiguli kufanele sicabangele ukuthi izidakamizwa ezilwa neglaucomatous zingenza ngendlela ehlukile ku-IOP:

1. 1 ingcindezi ye-intraocular iyancipha ngokushesha ngemuva kokufakwa kwamaconsi;
2. 2 IOP iyancipha kancane, kodwa ngaphansi kwesimo sokufakwa njalo komuthi, umphumela wawo uyanda ngokuhamba kwesikhathi;
3. Amaconsi ama-3 angabangela umphumela ophambene futhi akhulise izinga le-IOP;
4. 4 ukumelana kwesiguli kumaconsi e-antiglaucoma kungenzeka, kulokhu umuthi awuthinti imingcele ye-IOP.

Uma ukwelashwa okulondolozayo kungazange kuveze imiphumela, khona-ke udokotela wezifo zamehlo uncoma ukuhlinzwa.

Ukuhlinzwa nge-Laser ekwelapheni i-glaucoma kwaqala ukwenziwa emuva ngawo-70s wekhulu elidlule. Ngosizo lwemisebe ye-laser, amabhlogo we-intraocular asusiwe, aphazamisa ukuphuma kwe-intraocular fluid. Kunobuhle nobubi ekuhlinzweni kwelaser.

Izinzuzo zokuhlinzwa kwelaser:

• izindleko eziphansi kakhulu zokusebenza;
• isikhathi esifushane sokuvuselela;
• asikho isidingo se-anesthesia ejwayelekile, i-anesthesia yendawo yanele;
• ukungenelela kokuhlinzwa nge-laser kungenziwa ngesifo sokugula;
• azikho izinkinga ezijwayelekile zokuhlinzwa kwendabuko kwe-glaucoma.

Okubi ngokuhlinzwa kwe-laser:

• ingozi yokulimala ku-capsule lens;
• kungenzeka ukulimala kwemikhumbi ye-iris;
• emahoreni ambalwa okuqala ngemuva kokuhlinzwa, kungenzeka ukwanda kwe-IOP.

Ukuhlinzwa kwe-glaucoma kunomlando weminyaka engaphezu kwengu-150. Njalo ngonyaka ezikhona ziyathuthukiswa, izindlela ezintsha zokusebenza kwe-antiglaucomatous ziyakhiwa futhi zethulwe. I-ophthalmologist yamukela umbuzo wokwelashwa okuhlinzekwayo kwe-glaucoma (iridectomy), kucatshangelwa isimo esijwayelekile sesiguli, imingcele ye-IOP kanye namandla we-data yomtholampilo.

Umsebenzi we-iridectomy ukulungisa izinga le-IOP, ukuthuthukisa umsoco kanye nezicubu zomzimba ku-nerve optic. Njengomphumela wokuhlinzwa, ingcindezi esemagumbini wamehlo iyalinganiswa ngokususa i-pupillary block.

Qaphela!

Abaphathi abanacala nganoma yimuphi umzamo wokusebenzisa imininingwane oyinikiwe, futhi akuqinisekisi ukuthi ngeke ikulimaze wena uqobo. Izinto zokwakha azinakusetshenziselwa ukunquma ukwelashwa nokwenza ukuxilongwa. Njalo thintana nodokotela wakho onguchwepheshe!