E noʻonoʻo koke i ka ʻike ʻana ua mae kou ʻike ma kekahi maka, me ka ʻeha ke neʻe ʻoe i kou maka. Hiki ke ʻike ʻia nā kala he palalulu a holoi ʻia paha. He mea maʻamau loa ka hopohopo ʻana i ia ʻano loli. ʻO kēia ka mea a mākou e kūkākūkā nei i kēia lā: nā hōʻailona mua o kahi maʻi i kapa ʻia ʻo Optic Neuritis. ʻOiai ʻaʻole paha ia he kumuhana maʻamau o ka home, he mea nui ka hoʻomaopopo ʻana iā ia no ka mea e pili pololei ana ia i kou ʻike. Aia ʻo Nirogi Lanka ma aneʻi e kōkua iā ʻoe e hoʻokele i kēia.
I ka ʻōlelo maʻalahi, he aha ka Optic Neuritis?
ʻO ka Optic Neuritis (ON) kahi maʻi neurological kahi e pehu ai ke aʻalolo optic - ke kaula e hoʻopili ana i kou maka i kou lolo. E noʻonoʻo i kēia aʻalolo e like me ke kaula e hoʻouna i nā kiʻi mai kou maka i kou lolo i hiki iā ʻoe ke wehewehe i kāu mea e ʻike nei.
Ua kāʻei ʻia kēia mau hunaola aʻalolo i loko o kahi uhi pale momona i kapa ʻia ʻo ka ʻupena myelin , e like me ka insulation a puni kahi uea uila. Ke hiki mai ka Optic Neuritis, ua hōʻino ʻia kēia uhi pale. Hoʻopilikia kēia i nā hōʻailona e hele ana i kou lolo, ʻo ia ke kumu e ʻike ai ʻoe i ka ʻike maka pōwehiwehi, ka ʻeha, a me nā hemahema ʻike ʻē aʻe.
He aha nā ʻano nui o ka optic neuritis?
Ua hoʻokaʻawale nui ʻia kēia kūlana i ʻekolu ʻano. E nānā kākou pehea lākou e ʻokoʻa ai.
| ʻAno | Wehewehena |
|---|---|
| Maʻamau | ʻO kēia ke ʻano maʻamau, hoʻopilikia pinepine i hoʻokahi maka wale nō. ʻIke ka nui o nā maʻi i ka hoʻomaikaʻi ʻana i loko o kekahi mau lā me ka ʻole o ka mālama ʻia, akā e ʻōlelo pinepine nā loea lapaʻau i kahi hoʻolālā lapaʻau i hana kūikawā ʻia e hōʻoia i kou olakino lōʻihi. |
| ʻAʻole maʻamau | Hoʻopilikia pinepine kēia ʻano i nā maka ʻelua a ʻaʻole paha e hoʻōla koke. Hōʻike ka noiʻi ua pili pinepine ia i nā kūlana neurological paʻakikī ʻē aʻe. |
| Nā keiki | Hana ʻia kēia i nā keiki. ʻOiai ua like ia me nā hihia makua, he mau ʻano lapaʻau kūikawā kona. ʻO ka nūhou hoʻoikaika, he nui ka manawa kūpono o nā keiki e hoʻōla piha ai. |
He aha nā hōʻailona?
Pili pololei ka hapa nui o nā hōʻailona i kou mau maka a me ka ʻike. ʻO ka maʻamau, ʻo ia ka hopena o ka mumū ma hope o ka maka (`retrobulbar`). Eia nā hōʻailona koʻikoʻi e makaʻala ai:
| Hōʻailona | Wehewehena |
|---|---|
| ʻEha maka | ʻO kēia ka hōʻailona pinepine loa, e pili ana ma luna o 90% o nā maʻi. Hoʻonui pinepine ka ʻeha ke neʻe ʻoe i kou mau maka. Eia nō naʻe, hiki i kekahi mau hihia atypical ke ʻeha ʻole. |
| Hoʻemi ʻia ka ʻike maka | Hiki ke ʻike ʻia nā mea he blurry a nele paha i nā kikoʻī ʻoi. I nā hihia pediatric, hiki ke koʻikoʻi loa kēia nalowale o ka ʻike. |
| Poho o ke kahua ʻike maka | Hiki paha iā ʻoe ke ʻike i kahi "wahi makapō" a i ʻole nā āpau ma kāu kahua ʻike, ka mea e kū pinepine ana ma waenakonu o kāu ʻike. |
| ʻO ka maʻi Dychromatopsia | Hiki ke ʻike ʻia nā kala ua mae a nalowale paha ka ʻulaʻula. ʻOi aku ka paʻakikī o ka ʻike ʻana i ka ʻōlinolino o ke kala ʻulaʻula . |
He aha ke kumu o ka optic neuritis?
Ua ʻike mākou ua hoʻokumu ʻia ka Optic Neuritis e ka mumū o ke aʻalolo optic, akā hiki i kekahi mau kumu kumu ke hoʻoulu i kēia kaʻina hana.
Nā kūlana Autoimmune a me ka mumū
Ua manaʻo ʻia kēia he kumu nui. I nā kūlana autoimmune, hoʻouka hewa kāu ʻōnaehana pale i nā hunaola olakino ponoʻī o kou kino.
- ʻO ka Neuritis Optic Maʻamau: Hoʻopili pinepine ʻia kēia me ka Multiple Sclerosis (MS) . ʻO kaʻoiaʻiʻo, no nā mea he nui, ʻo kahi hanana o ka Optic Neuritis ka hōʻailona mua o MS. Hōʻike ka noiʻi ma kahi o 50% o ka poʻe me Optic Neuritis e loaʻa paha iā MS i loko o 15 mau makahiki.
- ʻO ka Neuritis Optic Atypical: Hoʻopili pinepine ʻia kēia me nā kūlana e like me Neuromyelitis Optica (NMO) a i ʻole ka maʻi pili i ka antibody MOG (MOGAD) .
Nā maʻi
Hiki i nā maʻi viral a bacteria like ʻole ke hōʻino i ke aʻalolo, kahi e alakaʻi ai i ka mumū o ke aʻalolo optic. He mea maʻamau kēia, ʻoi aku hoʻi i nā keiki. Inā loaʻa iā ʻoe ka nalowale koke o ka ʻike, e ʻoluʻolu e kelepona i nā lawelawe ulia pōpilikia a i ʻole e kipa koke i ka haukapila kokoke loa.
- Nā maʻi viral: Nā maʻi e like me ka chickenpox, herpes, cytomegalovirus, HIV, nā maʻi i lawe ʻia e ka makika, a me ka measles.
- Nā maʻi bacteria: Ka wela o ka ʻōpala pōpoki, ka maʻi Lyme (mai nā nahu ʻupena), ka maʻi puʻupuʻu, a me ka syphilis.
- Nā maʻi fungal: Nā ʻano fungal e like me cryptococcosis a me candidiasis.
- Nā maʻi Parasitic: Toxoplasmosis mai nā pōpoki a me ka toxocariasis mai nā ʻīlio.
Kekahi mau lāʻau lapaʻau a me nā mea ʻawahia
Hiki i kekahi mau lāʻau lapaʻau āu e lawe ai a me nā mea ʻawahia ʻē aʻe ke hana i kēia ʻano.
- Nā lāʻau antibiotic kikoʻī i hoʻohana ʻia no nā maʻi (e like me ka ethambutol).
- Nā lāʻau lapaʻau no ka puʻuwai (e.g., amiodarone).
- Nā lāʻau anti-malarial (e like me chloroquine, hydroxychloroquine).
- Nā lāʻau lapaʻau chemotherapy.
- Nā huahana paka a me ka nikotine.
- ʻAila a me ka methanol.
Nā Kumu ʻē aʻe
- Hoʻemi ʻia ke kahe koko (ischemia): Inā ʻaʻole lawa ke kahe koko i ke aʻalolo optic, hiki i nā pūnaewele nerve ke hōʻino ʻia.
- Nā hemahema o ka wikamina: ʻO ke kikoʻī, ʻo ka hemahema o ka wikamina B12 hiki ke hōʻeha nui i nā aʻalolo mau loa.
- ʻO ke kaomi ʻana o ke aʻalolo: ʻO ke kaomi ʻana o ke aʻalolo optic ma muli o kahi puʻupuʻu lolo a i ʻole nā kumu ʻē aʻe.
- ʻO ka maʻi diabetes ʻano 2: Inā ʻaʻole i kaohi maikaʻi ʻia ka maʻi diabetes, hoʻonui nui ke kiʻekiʻe o ke kō koko i ka pilikia o ka hōʻino ʻana i nā aʻalolo.
ʻO wai ka mea i ʻoi aku ka pilikia no kēia maʻi?
Hiki i kekahi mau kumu ke hoʻonui i kou likelika o ka hoʻomohala ʻana i ka Optic Neuritis.
- Kāne: ʻOi aku ka maʻamau o ke ʻano maʻamau i nā wahine ma mua o nā kāne. Eia nō naʻe, ʻoi aku ka maʻamau o ke ʻano atypical i nā kāne.
- Makahiki: ʻO ke ʻano maʻamau i ʻike pinepine ʻia ma waena o 20 a me 40 mau makahiki. ʻO ke ʻano atypical e pili pinepine i ka poʻe ma lalo o 18 a ʻoi aku paha ma mua o 50.
- Lāhui: ʻOi aku ka nui o ka pilikia o ka poʻe Caucasian i ka hoʻomohala ʻana i kēia maʻi.
- Hoikehonua: ʻO ka poʻe e noho ana ma kahi mamao aku mai ka equator (ma nā ʻāina anuanu) he kiʻekiʻe iki ka pilikia o ka loaʻa ʻana o ka Optic Neuritis e pili ana me MS. Ua manaʻo ʻia ua pili kēia i ka ʻike ʻana o ka lā a me nā pae wikamina D.
- Nā maʻi autoimmune ʻē aʻe: ʻOi aku ka nui o ka pilikia o ka poʻe me nā maʻi e like me ka lupus a i ʻole ka sarcoidosis.
Pehea e hana ai kāu kauka i kahi hōʻike pololei?
Inā loaʻa iā ʻoe kēia mau hōʻailona, pono ʻoe e ʻike mua i kahi loea mālama maka. E nīnau lākou e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino, a laila e hana i kahi hoʻokolokolo maka piha.
E hoʻomanaʻo, mai hoʻowahāwahā i nā loli i kou ʻike, ʻoiai inā hele pū me ka ʻeha. E ʻike koke i ke kauka.
Hiki i ke kaʻina hana diagnostic ke komo pū me:
- Ke hoʻāʻo ʻana i ka ʻike maka.
- Ke nānā nei i kāu kahua ʻike.
- Ke hoʻāʻo ʻana i ka ʻike kala.
- Ke loiloi ʻana i nā reflexes haumāna.
Ma hope o kēia mau hoʻokolohua, inā kānalua kāu kauka i ka Optic Neuritis, hiki iā lākou ke kuhikuhi iā ʻoe no nā hōʻailona hou aku. He mea nui loa ka MRI scan .
Hiki i kahi scan MRI ke hōʻike maopopo inā he mumū o ke aʻalolo optic. Hiki iā ia ke ʻike inā he mau ʻeha o ka lolo, kahi e hōʻike ai ua pili ke ʻano i ka MS.
Eia kekahi, hiki ke hana ʻia nā hoʻāʻo koko a me nā hoʻāʻo mimi e nānā i nā maʻi a i ʻole nā antibodies kikoʻī e pili ana i nā kūlana e like me NMO a i ʻole MOGAD. I kekahi mau hihia, pono paha kahi lumbar puncture (spinal tap).
He aha nā koho lapaʻau?
ʻElua mau ala nui e mālama ai i ka optic neuritis.
1. Nā Steroid e hōʻemi i ka mumū: I ka manawa pinepine, hāʻawi ʻia nā steroid intravenous (IV) kiʻekiʻe no 3-5 mau lā. Kōkua kēia i ka hōʻemi koke ʻana i ka pehu ʻana o ke aʻalolo a me ka mumū, hōʻoluʻolu i ka ʻeha, a hoʻihoʻi i ka ʻike. Ma hope o kēia, hiki i kāu kauka ke kuhikuhi i nā steroid waha no kahi manawa pōkole. He mea nui e lawe ʻoe i kēia mau lāʻau lapaʻau e like me ke kauoha a kāu kauka.
2. Ke mālama ʻana i ke kumu kumu: Inā loaʻa ke ʻano ma muli o kahi maʻi, e hāʻawi ʻia nā antibiotics. Inā ma muli o kahi ʻano autoimmune e like me NMO a i ʻole MOGAD, pono paha nā lāʻau lapaʻau kūikawā e like me ka plasma exchange (PLEX).
Na kāu kauka e hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa e pili ana i kou kūlana kikoʻī.
Pehea ka lōʻihi o kēia, a e hoʻi mai anei koʻu ʻike?
ʻO ke kaʻina hana hoʻōla e pili ana i ke ʻano o ke kūlana, ka lāʻau āu e loaʻa ai, a me ke ʻano o ka pane ʻana o kou kino.
- ʻO ka Neuritis Optic Maʻamau: He pilikia pōkole kēia. Nalo pinepine ka ʻeha i loko o kekahi mau lā. Hiki ke hala ka ʻike ma waena o ʻelua pule a ʻekolu mahina e hoʻōla piha ai. Ma kahi o 90% o nā maʻi e hiki i ka ʻike maʻamau a kokoke paha i ka maʻamau i loko o hoʻokahi makahiki.
- ʻO ka Neuritis Optic Atypical: ʻOi aku ka koʻikoʻi o kēia. Hiki i nā hōʻailona ke hoʻomau no ka manawa lōʻihi, a ʻaʻole paha e hoʻi mau ka ʻike i kona kūlana mua. No laila, he mea nui ka ʻike mua ʻana a me ka mālama koke ʻana i kēia ʻano.
- Pediatric (Nā Keiki): ʻOi aku ka maikaʻi o ka hoʻōla ʻana o nā keiki ma mua o nā pākeke. He kākaʻikahi nā hopena lōʻihi. Eia nō naʻe, nānā pono nā kauka i nā keiki no ka mea he hōʻailona mua paha ia o MS.
He aha ka mea e hana ai i ka wā pilikia?
Inā ʻike koke ʻoe i ka nalowale ʻana o ka ʻike , he pilikia olakino ia. Pono ʻoe e hele koke i ka lumi pilikia haukapila kokoke loa (ER). Eia kekahi, mai hoʻowahāwahā i nā loli o ka ʻike, ka ʻeha, a i ʻole ka pohihihi; e ʻike koke i ke kauka. ʻO ka hoʻomaka mua ʻana o ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka loaʻa ʻana o ka palekana o kou ʻike.
Leka Lawe-Home
- ʻO ka ʻeha me ka neʻe ʻana o ka maka a me ka ʻike pohihihi a emi paha ka ʻike ʻana nā hōʻailona koʻikoʻi o ka Optic Neuritis.
- Mai hoʻowahāwahā i kēia mau hōʻailona. E ʻike koke i kahi loea maka. Inā nalowale koke ka ʻike, e hele koke i ka ER kokoke loa.
- ʻO ka Optic Neuritis paha ka hōʻailona mua o nā maʻi koʻikoʻi ʻē aʻe e like me ka Multiple Sclerosis (MS). He mea nui ka ʻike pololei.
- Loaʻa nā lāʻau lapaʻau kūpono. Hoʻomaikaʻi nui ka lāʻau lapaʻau mua i ka hiki ke hoʻōla hou i ka ʻike.
- E hahai pono i nā ʻōlelo a kāu kauka. E lawe i nā lāʻau lapaʻau ma ke ʻano i kuhikuhi ʻia a no ka lōʻihi e pono ai.
ʻO ka neuritis optic, ka mumū o ke aʻalolo optic, ka ʻeha o ka maka, ka nalowale o ka ʻike, MS, ka sclerosis maha, nā maʻi neurological
