Ke nānā aku nei anei kou mau maka me he mea lā e puʻupuʻu ana? (Proptosis) E kamaʻilio kākou e pili ana i kēia!

Ua manaʻo paha ʻoe ua nui iki kou mau maka a ua puka mai paha? Malia paha ua haʻi aku kekahi hoaaloha a ʻohana paha iā ʻoe e pili ana i kēia. He ʻano maoli kēia i ʻike ʻia i kekahi poʻe. Kāhea mākou iā ia (Proptosis) a i ʻole (Exophthalmos) ma nā huaʻōlelo lapaʻau. ʻAʻohe mea e makaʻu ai, inā ʻike ʻoe i kēia, hiki iā ʻoe ke kaohi iā ia e like me nā mea ʻē aʻe.

He aha ka proptosis?

I ka ʻōlelo maʻalahi, ʻo ka proptosis ka wā e puka mai ai kekahi a i ʻole nā ​​maka ʻelua mai ko lākou kūlana maʻamau. E noʻonoʻo i kou mau maka, a i ʻole kekahi maka, e ʻike ʻia ana he ʻoi aku ka mamao ma mua o ka maʻamau. Hiki i kēia ke hoʻololi iki i kou helehelena. I kekahi manawa, hiki ke like me ke nānā aku nei kekahi iā ʻoe me ko lākou mau maka e hāmama ana me ke kahaha, a hiki nō hoʻi ke noho pēlā.

I kēia manawa aia ka maka i mua ou, hiki ke paʻakikī iki ke ʻimo. ʻIke ʻoe, ʻimo mākou e mālama i ko mākou mau maka i ka pulu a me ka palekana. ʻO ka membrane pale ma luna o ko mākou mau maka , i kapa ʻia ʻo cornea , loaʻa iā ia ka makū e pono ai ke ʻimo mākou. Ke hiki ʻole iā mākou ke ʻimo pono, maloʻo kēlā cornea a he nui ka manawa e hōʻino ʻia ai.

No kekahi poʻe, hiki i kēia ke kumu i ka ʻike maka pōwehiwehi, a i ʻole ka ʻike pālua - kapa mākou ia he diplopia - a me nā mea like ʻē aʻe. Ua kapa pinepine ʻia kēia ʻano he "hoʻonui maka" a i ʻole "pūpū maka."

He aha nā hōʻailona o kēia?

I kēia manawa, e nānā kākou i nā hōʻailona ʻē aʻe āu e ʻike ai a ʻike i ka wā e puka mai ai kēia mau maka.

Ke puʻupuʻu kou mau maka, ʻike nui ʻia nā keʻokeʻo o kou mau maka ma mua o ka maʻamau. Puka pū kekahi kou mau maka mai ko lākou mau lua. E ʻike paha ʻoe ʻaʻole ʻike nui ʻia kou mau lihilihi maka o luna, e like me kou mau maka e hāmama nui ana.

Ma waho aʻe o kēia hōʻailona nui, aia kekahi mau hōʻailona ʻē aʻe:

• Ke hoʻoneʻe ʻoe i kou mau maka, manaʻo ʻoe ua paʻa lākou i loko, e like me nā huna one .
• Nā maka maloʻo, ʻulaʻula, a i ʻole ka haehae pinepine ʻana. Kāhea pū mākou i kēia (Epiphora) .
• Ka pehu ʻana a me ka ʻulaʻula o nā lihilihi maka.
• Manaʻo e like me ke ʻano o ka paʻa ʻana o nā ʻiʻo i ka hoʻāʻo ʻana e hoʻoneʻe i ka maka, a i kekahi manawa ʻaʻole hiki ke hoʻoneʻe iki i ka maka.
• ʻO ka ʻike i ka mālamalama, ʻo ia hoʻi ka paʻakikī i ka nānā ʻana i ka mālamalama, i ka lā.
• ʻEha poʻo.
• Kuni.

He aha nā hōʻailona e pono ai ke kōkua koke ʻia e ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​pono ʻoe e ʻike koke i ke kauka. E hoʻomanaʻo he mau mea maʻamau kēia, ʻeā?

• He manaʻo ʻūlū i loko o nā maka.
• I ka manawa koke, manaʻo ʻoe e puka i waho kou mau maka.
• Loaʻa ka ʻeha nui a i ʻole ka ʻulaʻula o nā maka.
• ʻIke wale ʻia kēia mau hōʻailona ma hoʻokahi maka.
• Ka nalowale ʻana o kou ʻike a i ʻole ka emi mālie ʻana o kou ʻike.
• ʻIke pōwehiwehi a i ʻole ka ʻike ʻana i ʻelua mau mea i ka manawa hoʻokahi (ʻike pālua).
• ʻO ka nānā pono ʻana i kahi mea, ʻo ia hoʻi ka paʻakikī i ka nānā ʻana.

No ke aha e puka mai ai koʻu mau maka penei? He aha nā kumu?

ʻĀ, e nānā kākou no ke aha e puka mai ai nā maka e like me kēia, a he aha paha ke kumu o kēia.

ʻO ka hapa nui o ka manawa, ʻo ke kumu nui o kēia he pilikia me kāu ʻōnaehana pale ponoʻī. I ka ʻōlelo maʻalahi, hoʻouka hewa nā koa e pale ana i ko mākou kino mai ka maʻi i kekahi o kā mākou mau cell ponoʻī. I kēia hihia, hoʻouka kēlā ʻōnaehana pale i nā cell o kou thyroid gland a me nā ʻiʻo ma hope o kou mau maka.

ʻO kēia pehu ʻana o nā maka i ka poʻe me nā pilikia thyroid ua kapa ʻia ʻo Thyroid Eye Disease (TED) . ʻO ka ʻoiaʻiʻo, ʻike pinepine ʻia kēia ʻano i ka poʻe me nā maʻi e pili ana i ka thyroid.

Aia paha kekahi mau kumu ʻē aʻe:

• ʻO ka maʻi Graves: Pili pū kēia i ka hyperthyroidism, kahi kūlana i hana nui ai ke kelepa thyroid. Hoʻokumu ʻia kēia e ka maʻi ʻōnaehana pale like i ʻōlelo ʻia ma luna.
• Hyperthyroidism: Hiki ke hana i kēia kūlana me ka ʻole o ka maʻi Graves, i ka wā e hana nui ai ka ʻōpū thyroid.
• Nā maʻi ʻōpū maka: Inā loaʻa kahi maʻi bacteria a viral paha i loko o ka lua maka, hiki i ka pehu ke hoʻokuke i ka maka i mua.
• Nā ʻeha: Inā he kahe koko ma hope o ka maka, ʻoiai ma muli o ka ʻeha i ka maka a i ʻole ke poʻo, hiki i kēlā koko ke hōʻiliʻili a hoʻokuke i waho i ka maka.
• Nā Puʻupuʻu: Inā ulu kahi puʻupuʻu (maikaʻi a ʻino paha) i loko a i ʻole a puni ka lua o ka maka, hiki iā ia ke hoʻoulu i ka maka e pehu i mua. No ka laʻana, nā puʻupuʻu e pili ana i nā aʻalolo, e like me ka neuroblastoma , a i ʻole kekahi mau sarcomas palupalu . Eia nō naʻe, he mea kakaikahi kēia ʻano kumu kanesa.

He aha nā pilikia e hiki mai ana? Aia kekahi mau hopena lōʻihi?

He mea hopohopo iki paha kēia iā ʻoe, akā ʻo ka ʻoiaʻiʻo, no ka hapa nui o nā kānaka, ʻaʻole kēia kūlana e hoʻoulu i nā pilikia nui a i ʻole nā ​​hopena lōʻihi. ʻAʻole anei ia he mea hōʻoluʻolu?

Eia nō naʻe, he mea kākaʻikahi loa, hiki ke loaʻa kekahi mau pilikia. No ka laʻana, hiki ke loaʻa mau ka ʻike pālua a i ʻole ka nalowale loa o ka ʻike. Eia kekahi, e like me kaʻu i ʻōlelo ai ma mua, inā ʻaʻole hiki iā ʻoe ke ʻimo a ʻaʻole kōkua nā kulu maka lubricating , hiki ke ʻeha kou maka.Hiki ke hōʻino ʻia ka papa luna, ʻo ia hoʻi ka cornea. Ua kapa ʻia kēia he corneal ulceration. No laila he mea nui e ʻimi koke i ka lāʻau lapaʻau inā loaʻa iā ʻoe nā hōʻailona.

Pehea ʻoe e ʻike ai i kēia? Pehea e hōʻoia ai nā kauka i kēia?

ʻAe, inā loaʻa iā ʻoe nā hōʻailona e like me kēia, pehea lā e ʻike ai ke kauka inā he Proptosis maoli kēia a i ʻole kekahi mea ʻē aʻe?

ʻO ka mea mua, e nīnau ke kauka iā ʻoe i kahi nīnau kikoʻī e pili ana i kāu mau hōʻailona. E nīnau lākou iā ʻoe i nā kikoʻī e pili ana i ka lōʻihi o kou loaʻa ʻana o kēia mau hōʻailona, ​​pehea lākou i hoʻomaka ai, he aha nā pilikia ʻē aʻe āu, nā maʻi āu i loaʻa ai ma mua, a inā paha ua loaʻa i kekahi o kou ʻohana nā kūlana like.

Ma hope o kēlā, e loaʻa iā ʻoe kahi hoʻokolokolo maka. Hiki i kēia ke komo pū me nā mea e like me:

• Hoʻohana ʻia kahi mea hana kūikawā (kukui slit) e hoʻonui a nānā pono i nā ʻano ma luna o ka ʻili a ma loko o kou maka . Hiki i kēia ke ʻike i nā mea e like me nā ʻeha a me ka maloʻo ma ka cornea.
• Hoʻāʻo ʻia ke ʻano āu e neʻe ai i kou mau maka a me kou mau lihilihi, a inā hiki iā ʻoe ke kuhikuhi i nā maka ʻelua ma ke ala like.
• Nānā pono lākou e ʻike inā he ʻulaʻula nā maka, inā he ʻeha, inā he pehu, a inā he waimaka.

He aha nā hoʻokolohua ʻē aʻe e pono e hana ʻia?

Ma hope o ka hoʻokolokolo mua ʻana, hiki i ke kauka ke hana i nā hoʻokolohua hou aʻe e hoʻoholo hou i ke kumu, e like me:

• Exophthalmometer: He mea maʻamau ʻole paha kēia, akā hoʻohana ia i kahi mea hana kūikawā (exophthalmometer) e ana i ka mamao o kou maka i puka mai ai mai ka lua maka ma nā millimeters. Hiki i kēia ke kōkua i ka hoʻoholo ʻana i ke koʻikoʻi o ke kūlana.
• Nā hoʻāʻo koko: E nānā pono kēia i nā pae hormone (TSH, T3, T4) e nānā i ka hana o ka ʻōpū thyroid. No ka mea (ʻO ka maʻi maka Thyroid) ke kumu nui.
• Nā haʻawina kiʻi: I mea e pololei ai, hana ʻia kahi scan MRI (Magnetic Resonance Imaging) a i ʻole kahi scan CT (Computed Tomography scan) e ʻike maopopo inā he pehu, puʻupuʻu, hōʻailona o ka maʻi, a i ʻole ke kahe koko ʻana i loko o nā ʻiʻo, nā aʻalolo, a me nā ʻiʻo momona ma hope o ka maka.
• Nā hoʻokolohua lab ʻē aʻe: I kekahi manawa hiki ke lawe ʻia kahi hāpana o ka hoʻokahe ʻana o ka maka a i ʻole ka ʻiʻo (culture) e hōʻoia inā he maʻi.

He aha nā lāʻau lapaʻau?

ʻAe, e nānā kākou i nā lāʻau lapaʻau no kēia. ʻO ka lāʻau lapaʻau āu e loaʻa ai e pili ana i ke kumu o kou mau maka puʻupuʻu a me ke koʻikoʻi o ke kūlana.

• Nā waimaka hana: Hiki ke hoʻohana ʻia kēia mau mea i nā manawa he nui i ka lā ma ke ʻano he kulu a i ʻole gel e hōʻemi i ka maloʻo o ka maka a pale i ka cornea . Hiki ke kūʻai ʻia kēia mau mea ma ka hale kūʻai lāʻau lapaʻau.
• Nā lāʻau antibiotic:Inā ua hoʻoholo ʻia ua hoʻokahe ʻia kou maka ma muli o kahi maʻi bacteria, e hāʻawi ʻia ʻoe i nā antibiotics kūpono (waha a IV paha).
• Ka mālama ʻana i nā maʻi kumu: No ka laʻana, inā hana nui ka ʻōpū thyroid (hyperthyroidism), hāʻawi ʻia nā lāʻau anti-thyroid e kāohi iā ia. Hoʻomaʻamaʻa ʻia ka maʻi Graves ma ke ʻano like.
• Nā lāʻau lapaʻau intravenous (IV): No ka pehu nui a me nā pilikia ʻike i hoʻokumu ʻia e ka maʻi maka thyroid (TED), hiki ke hāʻawi ʻia nā corticosteroids (e.g., methylprednisolone) ma ke ʻano intravenous (IV pulse therapy) e hōʻemi koke i ka pehu. Ua ʻike ʻia hoʻi he lāʻau lapaʻau hou i kapa ʻia ʻo Teprotumumab (Tepezza®) he mea maikaʻi loa ia ma TED.

Aia kekahi mau lāʻau lapaʻau ʻē aʻe me ke ʻoki ʻole ʻana?

ʻAe, i kekahi manawa hiki ke hana ʻia nā lāʻau lapaʻau ʻē aʻe me ke ʻoki ʻole ʻana, e like me:

• Nā lāʻau lapaʻau ʻike pālua: ʻO kēia mau mea e komo pū me nā aniani kūikawā, e like me nā prism, i hoʻopili ʻia i kāu mau aniani. Hana kēia mau mea ma ka hoʻohuli ʻana i ka mālamalama e komo ana i ka maka ma kahi ʻaoʻao ʻē aʻe, e hoʻoponopono ana i kāu ʻike. Hiki ke manaʻo ʻia nā hoʻomaʻamaʻa maka.
• Nā lāʻau pale kino: Hiki i kēia mau lāʻau (e.g., Mycophenolate, Rituximab) ke kōkua i ka hōʻemi ʻana i ka pōʻino a ka ʻōnaehana pale kino e hana ai i nā maka, ʻoiai ma nā kūlana e like me (TED).
• Corticosteroids: Hiki ke hāʻawi ʻia nā steroids ma ke ʻano he mau pila waha, nā inikini, a i ʻole intravenous e hōʻemi i ka pehu a hoʻihoʻi i ka ʻike. Eia nō naʻe, hiki i kēia mau mea ke loaʻa nā hopena ʻaoʻao ke hoʻohana ʻia no ka manawa lōʻihi, no laila e lawe wale ʻia ma lalo o ka nānā ʻana o ke kauka.

E pono anei iaʻu ke ʻoki kino?

ʻAʻole pono nā kānaka a pau i ke ʻoki kino. Akā, aia kekahi mau kūlana kahi e pono ai ke ʻoki kino. Eia kekahi laʻana:

• ʻO ke ʻoki kino decompression orbital: Hana ʻia kēia ʻoki kino e hana i kahi ākea ma ka orbit ma hope o ka maka . ʻAe kēia i ka maka e paheʻe hou i loko. Hana ʻia kēia inā he hoʻoweliweli i ka ʻike, a inā ua puka nui ka maka e hōʻino i ka cornea.
• ʻO ke ʻoki ʻana i ka Strabismus: Hiki ke hana ʻia ke ʻoki ʻana ma nā ʻiʻo maka e kuhikuhi i nā maka ʻelua i ka ʻaoʻao hoʻokahi.
• ʻO ke ʻoki maka: Inā ʻaʻole hiki i nā maka ke pani pono, hana ʻia ke ʻoki e hoʻololi i ke kūlana o nā maka e pale ai i ka cornea .
• Ka wehe ʻana i ka puʻupuʻu: Inā he puʻupuʻu, pono e wehe ʻia ma ke ʻoki ʻana.

He aha ka mea e hiki mai ana? Pehea ka lōʻihi e ho'ōla ai?

Inā ʻike ʻoe i ke kumu o kēia mau hōʻailona a mālama koke iā lākou, ʻoi aku ka maikaʻi o nā hopena. Inā loaʻa iā ʻoe ka lāʻau kūpono nou, hiki iā ʻoe ke pale aku i nā pilikia.

"E hoʻi hou anei koʻu lohe i ka maʻamau?" ke nīnau nei paha ʻoe. ʻAe,I ka hapanui o nā hihia, hiki i ka maka ke hoʻi i ke ʻano maʻamau. Eia nō naʻe, ma hope o ka mālama ʻana i ka holomua, hiki ke lōʻihi ka manawa no ka maka e hoʻi i kona ʻano mua. I kekahi manawa hiki ke hala i nā mahina, i kekahi manawa he mau makahiki. Aia ia i ke kumu, ke koʻikoʻi o ke kūlana, a me ka pane ʻana i ka mālama ʻana.

Pehea lā e hiki ai iā kākou ke pale aku i ka lilo ʻana o ke kūlana i mea ʻino aʻe?

ʻAe, i kēia manawa ua loaʻa iā ʻoe kēia maʻi (Proptosis), aia kekahi mau mea nui hiki iā ʻoe ke hana e pale aku ai i ka lilo ʻana i mea ʻino:

• E kāohi i kou pae thyroid: Inā loaʻa iā ʻoe kahi maʻi thyroid, ʻoiai ka maʻi Graves, e hahai pololei i nā ʻōlelo a kāu kauka. E lawe i kāu lāʻau lapaʻau i kēlā me kēia lā i ka manawa kūpono, a e loaʻa i nā hoʻāʻo koko maʻamau e mālama i kāu pae hormone thyroid i loko o ka pae maʻamau.
• E hoʻōki loa i ka puhipaka: Inā he mea puhipaka ʻoe, ʻo kēia ka mea maikaʻi loa hiki iā ʻoe ke hana. ʻAʻole wale ka puhipaka e hoʻonui i ke kūlana (Maʻi Maka Thyroid), akā hoʻemi nui hoʻi i ka holomua o ka lāʻau. ʻO ka hoʻōki ʻana i ka puhipaka e hoʻomaikaʻi nui i ka pane a kou kino i ka lāʻau. No laila, e hana i kēlā hoʻoholo i kēia lā.

Pehea ʻoe e noho ai me kēia kūlana? Pehea ʻoe e noho ikaika ai i ka noʻonoʻo?

Hiki i kou mau maka ke hoʻololi i kou helehelena. Hiki i kēia ke loaʻa ka hopena nui i kou hilinaʻi iā ʻoe iho a me kou manaʻo ponoʻī. Hiki iā ʻoe ke hopohopo nui a hopohopo e pili ana i kēia. Manaʻo paha ʻoe, "He aha ka manaʻo o ka poʻe?" a i ʻole "Ua loli koʻu helehelena." Inā pili kēia i kou ʻike maka, hiki ke loli koke kekahi mau mea i kou ola o kēlā me kēia lā a me nā pilina pilikanaka. Hiki i kēia mau loli ke hoʻonāukiuki iā ʻoe, hopohopo, a kaumaha paha. He mea maʻamau ia, a ʻaʻole ʻoe hoʻokahi i ke alo ʻana i kēia mau mea.

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi i kēia huakaʻi. ʻAʻole he nāwaliwali ka noi ʻana i ke kōkua, he ikaika ia.

ʻO nā hana e like me kēia e kōkua iā ʻoe e hoʻoponopono i kēia mau pilikia:

• E ʻimi i ke kōkua mai kahi loea olakino noʻonoʻo : He mea nui e kamaʻilio me kekahi e like me ke kauka noʻonoʻo a i ʻole ke kākāʻōlelo. Hiki iā lākou ke kōkua iā ʻoe e ʻimi i nā ala e hana ai, e hoʻomanawanui, a hoʻokele i kou mau manaʻo a me nā manaʻo maikaʻi ʻole ma o nā lāʻau lapaʻau e like me Cognitive Behavior Therapy (CBT) .
• E kiʻi i ke kōkua mai kahi limahana hana kaiaulu: Inā ʻaʻole hiki iā ʻoe ke hoʻokele ma muli o nā pilikia maka a i ʻole he mau pilikia kūpono ʻē aʻe, hiki iā lākou ke kōkua iā ʻoe e ʻimi i nā hui kākoʻo ma kou wahi a i ʻole nā ​​​​kumuwaiwai pūnaewele ma ka pūnaewele. Ua piha kēia mau hui me ka poʻe i loaʻa i nā ʻike like me ʻoe, no laila hiki i ke kamaʻilio ʻana me lākou ke kōkua nui.

ʻO ka mea hope loa, pono ʻoe e ʻōlelo ...

Hiki i ka proptosis ke lilo i mea hoʻonāukiuki a weliweli hoʻi ke loaʻa. Maopopo iā mākou kēlā. Akā, mai hoʻokuʻu iā ia e hōʻino i kou ola. ʻO ka wikiwiki o kou ʻike ʻana i ke kauka, ʻoi aku ka maʻalahi iā lākou ke ʻike i ke kumu. A laila hiki iā ʻoe ke hoʻomaka i ka lāʻau e pono ai, pale i ke kūlana mai ka ʻino ʻana, a pale i nā pilikia hiki.

He mea nui hoʻi ka mālama ʻana i kou olakino noʻonoʻo. E like me kou olakino kino, pono ʻoe e mālama i kou olakino noʻonoʻo. ʻO ka ʻimi ʻana i ke kōkua mai kahi kākāʻōlelo olakino noʻonoʻo hiki ke kōkua iā ʻoe e hoʻokele i kou mau manaʻo a kū i kēia pilikia me ka ikaika. Hiki i kahi limahana hana kaiaulu ke kuhikuhi iā ʻoe i nā wahi e hiki ai iā ʻoe ke loaʻa ke kākoʻo āu e pono ai.

No laila, mai hopohopo i kekahi mea a mai makaʻu e ʻimi i ke kōkua. Makemake wau iā ʻoe e ho'ōla koke!

proptosis , exophthalmos, maka puʻupuʻu, maʻi maka thyroid, maʻi Graves, hyperthyroidism, pilikia maka