Loaʻa i kāu keiki liʻiliʻi kēia ʻano loli ma ko lākou mau maka? E aʻo kākou e pili ana i ka (Congenital Glaucoma)!

Ke nānā aku kākou i nā maka o kā kākou mau keiki liʻiliʻi, i kekahi manawa ʻike kākou i kahi mea ʻē a ʻokoʻa paha, ʻeā? He nui iki ke ʻano o nā maka o kekahi mau pēpē, a i ʻole he mau waimaka pinepine ko lākou i loko o ko lākou mau maka, a ʻaʻole makemake lākou e nānā i ke kukui. Hiki i kēia mau mea ke maʻalahi a maʻamau i kekahi manawa. Akā i ka manawa like, hiki iā lākou ke lilo i hōʻailona o kahi mea e pono ai ka nānā iki. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi maka e hiki ke loaʻa i kēlā mau keiki liʻiliʻi, ʻoi aku hoʻi i ka wā hānau a i ʻole i nā makahiki mua o ke ola, akā inā ʻike mua ʻia, hiki ke hoʻomalu maikaʻi ʻia a hiki ke pale ʻia ka ʻike o ke keiki. Ua kapa ʻia kēia he glaucoma congenital .

He aha ka glaucoma hānau?

I ka ʻōlelo maʻalahi, ʻo ka glaucoma congenital kahi maʻi i loaʻa i ka wā hānau a i ʻole i ka wā mua o ke ola (i loko o 2-3 mau makahiki) ma muli o kekahi mau kumu genetic. I kēia manawa ke nīnau nei paha ʻoe, "He aha ka glaucoma?" ʻO Glaucoma kahi inoa maʻamau no kekahi maʻi maka e hōʻino ana i ke aʻalolo optic, ke aʻalolo nui i loko o ka maka e kōkua iā mākou e ʻike. Hiki i kēia hōʻino ke alakaʻi mālie i ka nalowale o ka ʻike.

ʻO nā keiki me ka glaucoma hānau he kiʻekiʻe ke kaomi i loko o ko lākou mau maka, ʻo ia hoʻi ka hypertension ocular . Hoʻopuka ko mākou mau maka i kahi wai kūikawā i kapa ʻia ʻo aqueous humor . He mea nui loa kēia wai no ka mālama ʻana i ke olakino o nā maka. ʻO ka maʻamau, hana ʻia kēia wai a hoʻokahe pono ʻia mai ka maka. Eia naʻe, i nā keiki me ka glaucoma hānau, ʻaʻole e kahe pono kēia wai. A laila hōʻiliʻili kēia wai i loko o ka maka, a piʻi mālie ke kaomi i loko o ka maka. ʻO kēia kaomi i hoʻonui ʻia ke kumu o ke aʻalolo optic aʻu i ʻōlelo ai ma mua e paʻa. I ka hala ʻana o ka manawa, hiki i kēia ke hoʻololi i ke ʻano o nā maka. E ʻike paha ʻoe ua nui aʻe nā maka o kāu keiki, a i ʻole e lilo ka iris (ka ʻāpana o ka maka i loaʻa ke kala - ka iris) i ao a me ke kala ʻole.

He maʻi hiki ke mālama ʻia kēia. Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki i ka ʻike ke hōʻino mālie a hiki i ka makapō. No laila, he mea nui loa ka ʻike ʻana i kēia mau hōʻailona a hoʻomaka i ka mālama ʻana i ka wā hikiwawe loa. A laila wale nō e hiki ai ke hoʻēmi ʻia ka pōʻino a pale ʻia ka ʻike o ke keiki i ka hiki.

He aha nā hōʻailona o kēia maʻi? Pehea mākou e ʻike ai?

Ma waho aʻe o nā hōʻailona nui i ʻike ʻia ma kēia maʻi, aia kekahi mau hōʻailona ʻē aʻe.

ʻEkolu mau hōʻailona nui:

ʻO kēia nā ʻano ʻekolu a nā kauka e nānā nui ai.

• Ka haehae pinepine ʻana o nā maka (Epiphora): I ka pololei, me he mea lā e kahe ana nā waimaka mai nā maka mai ʻoiai me ka ʻole o ke keiki e uē ana.
• Photophobia: ʻAʻole makemake paha ke keiki e nānā i ka mālamalama ʻālohilohi, e pani ana i ko lākou mau maka a e hoʻohuli paha i ko lākou alo ke hele lākou i waho.
• Blepharospasm: Manaʻo ia e like me ka wikiwiki o ke kuʻi ʻana o nā lihilihi, a i ʻole e hoʻāʻo nei lākou e pani pono i ko lākou mau maka.

Nā hōʻailona ʻē aʻe āu e ʻike ai:

• Buphthalmos: ʻIke ʻia nā maka o ka pēpē he nui a ʻoi aku ka puʻupuʻu ma mua o nā pēpē ʻē aʻe. Wahi a kekahi mau mākua, "Ua like nā maka o ka pēpē me nā maka bipi nui."
• ʻAno polū o ka maka: Hiki i ka ʻāpana keʻokeʻo o ka maka (sclera) ke ʻike ʻia ma o nā membrane ma lalo, e hoʻohālike ana ia me he polū lā.
• Ke keʻokeʻo a ʻōpua paha ke ʻano o ka cornea: Lilo ka membrane maopopo ma luna o ka maka ʻeleʻele (cornea) i ao, e like me ka noe ma ke aniani.

Hiki paha iā ʻoe ke ʻike i kēia mau mea e like me nā loli i ka ʻike o kāu keiki:

• Astigmatism: ʻAʻole paha e ʻike maopopo ke keiki i nā mea.
• Myopia: ʻO ke ʻano o ka maka e ʻike maopopo ʻia ai nā mea kokoke, akā ʻaʻole hiki ke ʻike maopopo ʻia nā mea mamao.
• Anisometropia: No ka mea, ʻokoʻa ka ʻike ma kekahi maka mai kekahi, e hoʻāʻo paha ke keiki e hoʻohana wale i ka maka e ʻike maikaʻi aʻe.

ʻO nā mea ʻē aʻe e ʻike ai kāu kauka i ka wā o ka hoʻokolokolo maka:

• ʻEdema Corneal: Ua pehu ka ʻaoʻao moakaka o ka maka ma mua.
• Nā ʻūlū ʻana o ka cornea: Ua kīkoʻo ʻia ka cornea ma muli o ke kaomi nui, a hiki ke hana ʻia nā ʻōpala liʻiliʻi ma luna.
• ʻO ka ʻeha o ka cornea: ʻO ka hōʻino lōʻihi e hiki ke hana i ka ʻeha mau loa o ka cornea.

ʻIke pinepine ʻia kēia mau hōʻailona ma nā maka ʻelua, akā i kekahi manawa ʻike ʻia ma hoʻokahi wale nō maka.

No ke aha e hana ai kēia (Congenital Glaucoma)? He aha ke kumu?

Hoʻomaka ka glaucoma hānau me kahi kīnā i ka ulu ʻana o ka maka o ke keiki. ʻO ka hemahema maʻamau ka hemahema i ka ulu ʻana o ka ʻiʻo e hoʻokahe ana i ka wai wai i loko o ka maka, ʻo ia ka trabecular meshwork . E noʻonoʻo e like me ka lua i loko o kahi poho holoi. Inā ʻaʻole i hana pono ʻia kēlā lua, ʻaʻole e kahe pono ka wai. Pēlā nō kēia me kēia. No ka mea, ʻaʻole i hoʻomohala pono ʻia ka trabecular meshwork, ʻaʻole e kahe pono ka wai i loko o ka maka. A laila hōʻiliʻili kēlā wai i loko o ka maka, e hoʻonui ana i ke kaomi i loko o ka maka. ʻO kēia kaomi i hoʻonui ʻia ka mea e hōʻino ai i ke aʻalolo optic. Eia kekahi, hiki i kēia kaomi ke hoʻonui i ka cornea, ke alo o ka maka, e kīkoʻo, e lilo i kaha, a me ka ʻōpala.

He mālie kēia kaʻina hana. ʻO ia hoʻi, e ʻoi aku ka ʻino o ka maʻi. ʻO ka wikiwiki o kona ʻino ʻana, ma muli ia o ke ʻano o ke kīnā i ka maka o ke keiki, ka nui o ka wai e hōʻiliʻili ana, a me ka nui o ke kaomi i loko o ka maka.

E noʻonoʻo, hōʻike kekahi mau pēpē i kēia mau hōʻailona i ka wā hānau. ʻO ia hoʻi, ua ulu aʻe ke ʻano i ko lākou wā i loko o ka ʻōpū (Fetal Development). No nā keiki ʻē aʻe, hiki ke ʻike ʻia nā hōʻailona ma hope iki, malia paha he mau mahina a i ʻole hoʻokahi a ʻelua paha makahiki. ʻO kēia no ka mea ʻaʻole koʻikoʻi loa ka hemahema hānau, a he manawa pōkole ia e ʻike ʻia ai nā hōʻailona.

Aia kekahi mau ʻano like ʻole o ka Congenital Glaucoma?

ʻAe, aia kekahi mau ala e hoʻokaʻawale ai nā kauka i kēia maʻi.

Hoʻokaʻawale ʻana e like me ka makahiki o ka hoʻomaka ʻana o nā hōʻailona:

• ʻAno pēpē hānau hou: ʻIke ʻia nā hōʻailona i ka wā hānau a i loko paha o ka mahina mua o ke ola.
• ʻAno pēpē: Hōʻike ʻia nā hōʻailona i loko o nā makahiki ʻelua a ʻekolu paha o ke ola.

Ka hoʻokaʻawale ʻana e like me ke ʻano o ke kīnā i hoʻokumu ai i ka maʻi:

• ʻAno mua: Ma kēia ʻano, loaʻa wale ka glaucoma me ka ʻole o kekahi kīnā ʻē aʻe i loko o ka maka. Ua ʻike nā kānaka noiʻi i kekahi mau hoʻololi gene e hiki ai ke hana i kēia ʻano glaucoma hānau mua.
• ʻAno lua / Hoʻomohala: Ma kēia, kū mai ka glaucoma ma ke ʻano he ʻāpana o kahi maʻi genetic ʻē aʻe i ʻike ʻia, me nā kīnā ʻē aʻe i loko o ka maka.

ʻO kekahi mau kūlana genetic e hiki ai ke hana i ka Secondary Congenital Glaucoma:

• Aniridia: Ka nalowale piha a hapa paha o ka ʻāpana kala o ka maka (iris).
• ʻO ka maʻi Axenfeld-Rieger: He kūlana e hoʻoulu ai i nā pilikia like ʻole e pili ana i nā maka, nā niho, a me ka piko.
• ʻO ka maʻi Sturge-Weber: He kūlana e hiki ai ke hoʻopilikia i ka lolo a me nā maka, me kahi ʻulaʻula nui ma ka maka (ʻili waina awa).

Pehea e ʻike pono ʻia ai kēia maʻi?

ʻO nā kauka maka, ʻoiai ke ʻike lākou i nā hōʻailona nui i ʻōlelo ʻia ma mua i nā maka o kahi keiki liʻiliʻi, kānalua lākou i ka glaucoma hānau. No ka hōʻoia ʻana i kēlā kānalua, ua hoʻomaʻemaʻe ʻia ke keiki (ma lalo o ka anesthesia) a ua hana ʻia kahi hoʻokolokolo maka piha. Mai hopohopo, ʻaʻole e ʻeha ke keiki ma muli o ka anesthesia, a ʻoi aku ka maʻalahi i nā kauka ke nānā pono i nā maka.

Ma kēia hoʻāʻo,

• Ana ʻo Tonometry i ke kaomi i loko o ka maka .
• Hana ʻia ʻo Gonioscopy e nānā i ke kihi hoʻokahe o ka maka .

Eia kekahi, hiki ke hana ʻia nā hoʻokolohua ʻē aʻe e like me:

• Optical Coherence Tomography (OCT): ʻAe kēia iā ʻoe e ʻike i ke aʻalolo optic me nā kikoʻī hou aku.
• Hoʻāʻo Genetic: E nānā i nā hoʻololi genetic e hiki ai ke hoʻoulu i ka maʻi.

He aha ka lāʻau lapaʻau no kēia?

No nā keiki he nui me ka glaucoma hānau, e hoʻoponopono i ke kīnā e pale ai i ke kahe ʻana o ka wai mai ka maka.Pono ke ʻoki maka . ʻO ke ʻoki kino ka lāʻau lapaʻau nui a maikaʻi loa no kēia maʻi. Eia kekahi, ʻo ka wikiwiki o ka hana ʻana i ke ʻoki kino, ʻoi aku ka maikaʻi o nā hopena. He kuleana liʻiliʻi nō hoʻi nā lāʻau lapaʻau. Hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e hoʻohana ʻia ma mua a ma hope paha o ke ʻoki kino. He mea kākaʻikahi loa, ua lawa nā lāʻau lapaʻau wale nō ma ke ʻano he lāʻau lapaʻau.

ʻoki kino

ʻO ka pahuhopu nui o kēia mau ʻoki kino, ʻo ia ka hoʻēmi ʻana i ke kaomi kiʻekiʻe i loko o ka maka o ke keiki (Itraocular Pressure). E hōʻemi kēia i ka hōʻino ʻana i ke aʻalolo optic a me nā ʻāpana ʻē aʻe o ka maka. E pale aku nō hoʻi i ka hōʻino hou aʻe. Ma muli o ka wikiwiki o ka hoʻomaka ʻana o ke keiki i ka lāʻau lapaʻau, hiki ke hoʻohuli ʻia kekahi o nā pōʻino i hana mua ʻia. Mai hopohopo, e hoʻomaʻamaʻa ʻia ke keiki i ka wā o ke ʻoki maka, no laila ʻaʻole ʻo ia e manaʻo i kekahi mea.

Ma muli o ka makahiki a me ke kūlana o ke keiki, e koho ke kauka lapaʻau i kekahi o kēia mau ʻano hana:

• Goniotomy: Pili kēia i ka hana ʻana i kahi ʻoki liʻiliʻi ma ka trabecular meshwork, kahi ʻiʻo e kānana i ka wai, ma ke kihi hoʻokahe. Hana nā kauka lapaʻau i kēia me ka hoʻohana ʻana i kahi mea hana i kapa ʻia he gonioscope.
• Trabeculotomy: I kekahi manawa, inā ʻaʻole ʻike maopopo ʻia ke kihi e kahe ai ka wai ma o ka cornea, e hele nā ​​​​kauka ma ka ʻaoʻao keʻokeʻo o ka maka (sclera) a hana i kahi ʻoki ma kēia ʻiʻo me ka hoʻohana ʻana i kahi mea electrocautery i kapa ʻia he trabeculotome.
• Trabeculectomy: Inā ʻaʻole holo pono nā ʻokiʻoki i luna, e hele ke kauka ʻoki ma ka ʻāpana keʻokeʻo o ka maka (sclera), e wehe i kahi ʻāpana liʻiliʻi o ka trabecular meshwork, a hana i ala hou no ka wai e kānana ai.
• Mea Hana Hoʻokahe Wai Glaucoma: I kekahi manawa e kau ke kauka lapaʻau i kahi mea hana liʻiliʻi e like me ka paipu (Tube Shunt) i loko o ka maka o ke keiki. ʻAe kēia paipu i ka wai e hōʻiliʻili ana i loko o ka maka e hōʻiliʻili i loko o kahi diski liʻiliʻi ma lalo o ka membrane lahilahi (conjunctiva) ma luna o ka maka, a laila hoʻokahe i loko o ke kino.

Nā lāʻau lapaʻau

No ka mea hiki i nā lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao i nā keiki ʻōpio, kuhikuhi pono nā kauka iā lākou. Hiki i kāu kauka ke hāʻawi iā ʻoe i nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke kaomi i loko o kou maka a i ʻole e hoʻonui i ka moakāka o kou cornea ma mua o ke ʻoki ʻana. Hiki i kēia ke hoʻomaikaʻi i nā hopena o kāu ʻoki ʻana. Hiki iā lākou ke kuhikuhi i nā lāʻau lapaʻau e pale aku i nā pilikia i ka wā a ma hope o ke ʻoki ʻana.

Hiki ke hoʻohana ʻia nā lāʻau lapaʻau:

• Nā mea pale beta
• Diuretics (hoʻēmi i ka hōʻiliʻili ʻana o ka wai i loko o ka maka)
• Nā Prostaglandins
• Nā agonists Alpha-adrenergic
• Nā lāʻau antibiotic (pale i nā maʻi)
• Corticosteroids (e hōʻemi i ka pehu)
• Mitomycin (e hōʻemi i ka ʻeha ma hope o ke ʻoki ʻana)

Pehea lā ke kūlana ma hope o ka mālama ʻana? (Wānana)

ʻO ke ʻoki kino no ka glaucoma hānau ʻana he mea kūleʻa pinepine ia i ka hoʻēmi ʻana i ke kaomi i loko o ka maka a me ka hoʻōki ʻana i ke kaʻina hana e hōʻino ai i ka ʻike o ke keiki. Hiki i nā keiki i loaʻa ka lāʻau lapaʻau i ka wā mua, ʻo ia hoʻi, ma mua o ka hiki ʻana mai o ka pōʻino nui, ke ulu aʻe me ka ʻike maʻamau. Eia nō naʻe, i kekahi manawa ʻaʻole paha e hoʻohuli loa ʻia ka pōʻino. Eia kekahi, pono paha kekahi mau keiki i ka lāʻau lapaʻau hou aʻe, e like me nā aniani. ʻO ka mea nui loa, ʻo ia ka lawe mau ʻana i kāu keiki no nā nānā ʻana e like me ka ʻōlelo a kāu kauka.

Aia kekahi ala e pale aku ai i kēia maʻi?

ʻO kaʻoiaʻiʻo, ʻoiai hiki i ka glaucoma hānau ke holo i loko o nā ʻohana, hiki pinepine ia i ka wā maʻamau. Hiki i ka hoʻāʻo ʻana i ka genetic ke haʻi iā ʻoe inā he mutation genetic kou a pehea ka hiki ke hoʻoili iā ia i kāu mau keiki. Eia naʻe, ʻaʻole hiki iā mākou ke pale aku i kā mākou mau genes mai ka hoʻoili ʻia ʻana i kā mākou mau keiki. Eia nō naʻe, hiki iā mākou ke mākaukau inā he manawa kūpono e loaʻa ai i kahi keiki kēia maʻi genetic. No ka laʻana, hiki iā mākou ke ʻike i nā hōʻailona a hana koke.

He mea maʻamau ke kaumaha ke ʻike ʻoe he maʻi hānau ʻia kāu keiki e pono ai ka mālama koke ʻana. Ma kekahi ʻaoʻao, pono ʻoe e hoʻoholo koke e pili ana i ka mālama ʻana o kāu keiki, a ma kekahi ʻaoʻao, pono ʻoe e kāohi i kou mau makaʻu a me kou hopohopo. He mea paʻakikī loa ka hoʻouna ʻana i kahi keiki liʻiliʻi no ke ʻoki kino a me ka hāʻawi ʻana iā lākou i ka lāʻau lapaʻau. Akā, e hilinaʻi i kāu hui lapaʻau. E pau koke ana kēia manawa paʻakikī, a e hele ana kāu keiki ma ke ala e hoʻōla ai.

ʻO ka mea hope loa, leka lawe i ka home:

Inā ʻike ʻoe i kekahi mau mea ʻē aʻe a i ʻole nā ​​loli i nā maka o kāu keiki - e like me nā maka i hoʻonui ʻia, ka haehae pinepine ʻana, a i ʻole ka makemake ʻole e hele i waho - mai hoʻowahāwahā iā ia. Hiki ke lilo i mea maʻalahi, akā hiki nō hoʻi ke lilo i hōʻailona o kahi maʻi e like me ka glaucoma hānau.

• ʻO ka ʻike mua ʻana a me ka mālama koke ʻana nā mea nui loa, i hiki ai ke mālama ʻia ka ʻike o ke keiki i ka hiki.
• Aia kahi lāʻau lapaʻau kūleʻa no kēia maʻi.
• E hoʻomau i ka lawe ʻana i kāu keiki no nā hoʻokolohua lapaʻau e like me ka ʻōlelo a ke kauka.
• Inā he mau hopohopo a kānalua paha kāu, e kamaʻilio me ke kauka.

E hoʻomanaʻo, ʻo kāu mālama a me kāu hana wikiwiki ka ikaika nui loa no ka hihiʻo o kāu keiki i ka wā e hiki mai ana.

ʻO Glaucoma, Glaucoma hānau, Nā maʻi maka, Nā maʻi maka i nā keiki, Kaomi maka, ʻaʻalolo maka, ʻaʻalolo maka