Ua ʻulaʻula kou maka a ʻeha nui? He scleritis paha ia!

Ua ʻike anei ʻoe ua ʻulaʻula koke kou maka a manaʻo e hou ana kekahi iā ʻoe me kahi pliers? I kekahi manawa ʻeha loa ka ʻeha a hoʻāla iā ʻoe i ka pō. He paʻakikī paha iā ʻoe ke nānā aku i ke kukui? ʻAe, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​hiki ke lilo i maʻi i kapa ʻia ʻo scleritis, a mākou e kamaʻilio nei i kēia lā. Mai hopohopo, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī.

I ka ʻōlelo maʻalahi, he aha ka scleritis?

ʻAe, e nānā mua kākou i ke ʻano o ka Scleritis. Ke nānā ʻoe i kou maka, aia kahi ʻāpana o ka maka e like me ke keʻokeʻo, ʻo ia ka mea a mākou e kapa nei he sclera . ʻO ka ʻōlelo pololei, ʻo kēia sclera kahi uhi pale ikaika a puni ka maka. No laila, inā he mumū, ʻo ia hoʻi, ka pehu a me ka ʻulaʻula ma kēia ʻāpana i kapa ʻia ʻo sclera, ʻo ia ka mea a mākou e kapa nei he scleritis. I kēia hihia, ʻaʻole wale ka maka e lilo i ʻulaʻula, akā hiki ke ʻeha loa . I kekahi manawa e hoʻonui ʻia ka ʻeha ʻoiai ke neʻe ʻia ka maka i mua a i mua. ʻO ka mea nui loa, inā ʻaʻole mālama pono ʻia kēia ʻano, hiki iā ia ke hōʻeha mau loa i ka maka a me ka nalowale ʻana o ka ʻike . No laila, ʻaʻole ia he manaʻo maikaʻi e hoʻowahāwahā wale iā ia no ka mea he ʻulaʻula ka maka.

He aha nā ʻano nui o ka scleritis?

I kēia manawa, aia ʻelua ʻano nui o ka scleritis. ʻO kekahi ʻo ka anterior scleritis , kahi e kū nei ma ka ʻaoʻao mua o ka sclera. ʻO kekahi ʻo ka posterior scleritis , kahi e kū nei ma ka ʻaoʻao hope o ka sclera. Ua māhele ʻia kēia mau ʻano ʻelua ma nā ʻano like ʻole.

ʻO ka Scleritis mua

ʻO kēia ke ʻano maʻamau. Ua māhele ʻia hoʻi i ʻekolu ʻāpana:

• Diffuse scleritis: Ma kēia, hiki ke pālahalaha ka mumū ma loko o ka sclera holoʻokoʻa. ʻO kēia ke ʻano maʻamau.
• Nodular scleritis: Ma kēia, e hana ʻia kahi puʻupuʻu liʻiliʻi (nodule) ma kahi hoʻokahi ma ka sclera. I kekahi manawa hiki ke ʻike ʻia ka puʻupuʻu me ko mākou mau maka.
• ʻO ka scleritis necrotizing: ʻO kēia ke ʻano weliweli loa. Hoʻopau ia i nā ʻiʻo maka a hiki i kekahi manawa ke alakaʻi i ka nalowale ʻana o ka maka holoʻokoʻa . Aia kekahi ʻano weliweli ʻē aʻe o kēia i kapa ʻia ʻo scleromalacia perforans . ʻAʻohe ʻeha paha, akā hiki ke hana ʻia nā perforations i loko o ka maka. Loaʻa kēia ʻano ma kahi o 4% o ka poʻe e loaʻa ana i ka scleritis.

ʻO ka Scleritis Hope

Ma muli o ka loaʻa ʻana ma ke kua o ka sclera, hiki ke ʻokoʻa nā hōʻailona i kekahi manawa. Hiki ke loaʻa ka ʻeha mai loko mai o ka maka, ka ʻike maka pohihihi, a pēlā aku. ʻO kēia ʻano no kahi o 10% o nā maʻi scleritis āpau.

ʻO wai ka mea e loaʻa pinepine ai ka scleritis?

ʻO ka scleritis ka mea maʻamau i nā kānaka ma waena o 47 a me 60 mau makahiki. Eia nō naʻe, hiki ke loaʻa i nā poʻe ʻōpio a ʻoi aku paha ma mua o kēlā. ʻOi aku ka nui o ka loaʻa ʻana o nā wāhine ma mua o nā kāne . ʻO kekahi kumu no kēia, ʻo ka pili ʻana o ka scleritis me kekahi mau kūlana autoimmune . Eia nō naʻe, ʻoi aku ka maʻamau o ka scleritis i hoʻokumu ʻia e nā maʻi i nā kāne.

Pehea ka maʻamau o kēia kūlana?

Ma kahi ʻāina e like me ʻAmelika, ua ʻōlelo ʻia he 10,500 mau hihia hou o ka scleritis i ʻike ʻia i kēlā me kēia makahiki. ʻO ia hoʻi ma waena o ʻehā a me ʻeono no hoʻokahi haneli tausani. ʻIke ʻia kēia ʻano ma Sri Lanka, akā he paʻakikī ke hāʻawi i nā helu kikoʻī.

He aha nā hōʻailona o ka sclerosis?

E nānā kākou i nā hōʻailona e hiki mai ana ke ulu ka scleritis.

• ʻUlaʻula a me ka pehu ʻana o ka ʻāpana keʻokeʻo o kou maka (sclera) .
• He ʻeha ʻoi ma ka maka a me ka manaʻo ʻeha ke hoʻopā ʻia . Hiki i kēia ʻeha ke koʻikoʻi loa a hiki ke hoʻāla iā ʻoe i ka pō. I kekahi manawa hiki i kēia ʻeha ke laha i nā wahi ʻē aʻe o ka maka.
• Nā maka waimaka (nā waimaka) .
• Ka paʻakikī i ka nānā ʻana i ka mālamalama (photophobia) .

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​pono ʻoe e ʻike koke i ke kauka maka , no ka mea, ʻaʻole kēia he kūlana maikaʻi e pāʻani ai.

He aha ke kumu o ka scleritis?

I kekahi manawa, ʻaʻohe kumu kikoʻī e loaʻa ai no ka scleritis. Kāhea nā kauka i kēia he 'idiopathic'. Akā ʻoi aku ka pinepine, hiki i ka scleritis ke ulu inā loaʻa iā ʻoe kekahi maʻi olakino ʻē aʻe, ʻoiai he maʻi autoimmune . ʻO kekahi o nā maʻi e pili ana i kēia:

• ʻO ka ʻāʻī Rheumatoid: He maʻi kēia e hoʻopilikia ai i nā hono ma nā ʻaoʻao ʻelua o kou kino. ʻO ia ka maʻi ʻōnaehana pale e pili pinepine ʻia me ka scleritis.
• Nā maʻi pili o nā ʻiʻo , e like me ka systemic lupus erythematosus . Hiki i ka Lupus a me ka mumū mau loa ke hoʻopilikia i nā ʻāpana he nui o ke kino, me nā hono, ka ʻili, nā māmā, ka lolo, nā puʻupaʻa, a me ka puʻuwai.
• ʻO ka maʻi ʻōpū mumū (IBD): Pili kēia i kahi hui o nā maʻi e hoʻoulu ai i ka mumū mau loa i loko o kou ʻōpū.
• ʻO ka maʻi Sjögren: Hoʻopau kēia maʻi autoimmune i ka hoʻokuʻu ʻana o ka wai mai nā kelepa i loko o kou mau maka a me kou waha.
• Scleroderma: Ma kēia maʻi, ua pani ʻia nā ʻiʻo maʻamau e ka ʻiʻo fibrous mānoanoa a paʻakikī.
• Granulomatosis me ka polyangiitis: Hoʻokumu ʻia kēia maʻi e ka mumū o kou mau ʻiʻo (ka mumū granulomatous) a me nā kīʻaha koko (vasculitis). Hiki i kēia ke hōʻino i nā ʻōnaehana o loko o ke kino.

Eia kekahi, hiki ke pili pū ʻia ka scleritis me:

• Nā maʻi: Hiki ke hana ʻia ka scleritis e kekahi mau maʻi. Hiki i kēia ke bacteria , fungal, a viral paha . ʻO ka maʻamau, ʻoi aku ka lōʻihi o ka ho'ōla ʻana o nā maʻi fungal a ʻoi aku ka liʻiliʻi o nā hopena koʻikoʻi ma mua o nā maʻi bacteria a viral paha. Hiki ke hana ʻia ka scleritis e ka maʻi Lyme .
• ʻEha a ʻeha paha i kou maka, me ke ʻoki kino: Hiki i kēia ʻano ʻeha ke hana pinepine i ka scleritis. ʻO kahi laʻana he kūlana i kapa ʻia ʻo surgically induced necrotizing scleritis (SINS), kahi e hana ʻia ma hope o ke ʻoki kino .
• Nā lāʻau lapaʻau i hoʻohana ʻia e mālama ai a pale aku paha i nā maʻi iwi: ʻO kēia ʻano lāʻau lapaʻau, no ka laʻana bisphosphonates , ua ʻike ʻia e hoʻoulu i nā hopena mumū i ka maka.

Pehea e ʻike ai nā kauka i ka scleritis?

Ke ʻike ʻoe i ke kauka, e hana ʻo ia i kahi hoʻokolokolo maka a me kahi hoʻokolokolo kukui slit e hoʻoholo ai inā he scleritis kēia.

Inā loaʻa iā ʻoe ka posterior scleritis, hiki i kāu kauka ke kauoha i kahi CT scan (computed tomography - CT scan) a i ʻole ultrasound . Inā loaʻa kāu scleritis i kahi maʻi, hiki i kāu kauka ke lawe i kahi laʻana o kahi mea, e like me ka pus, mai kou maka a hoʻouna aku i kahi lab no ka hoʻāʻo ʻana. He mea kākaʻikahi loa, hiki i kāu kauka ke kauoha i kahi biopsy .

He aha nā lāʻau lapaʻau no ka scleritis?

Inā loaʻa iā ʻoe ka scleritis ʻoluʻolu loa, hiki i kāu kauka ke ʻōlelo aku e hoʻohana i nā lāʻau anti-inflammatory nonsteroidal (NSAID) . Eia nō naʻe, i ka hapanui o nā hihia, e kuhikuhi kāu kauka i kahi corticosteroid systemic, e like me ka prednisone, no kahi manawa lōʻihi (ʻehiku a ʻumi mau lā).

Mea nui: Mai hoʻohana i kēia mau lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a ke kauka. Hiki iā lākou ke hana i nā hopena ʻaoʻao.

Inā loaʻa iā ʻoe kahi ʻōhūhū, nā corticosteroids intravenousHe mea pono paha.

Inā loaʻa iā ʻoe ka scleritis i hoʻokumu ʻia e kahi maʻi, pono ʻoe i nā antibiotics , antifungals , a i ʻole nā ​​​​lāʻau antiviral .

I nā hihia koʻikoʻi e like me ka necrotizing scleritis, hiki i kāu kauka ke hana pū me kahi rheumatologist e kuhikuhi i nā lāʻau lapaʻau immunotherapeutic e like me cyclophosphamide , methotrexate , a me mycophenolate mofetil , a i ʻole nā ​​​​mea hana biologic e like me rituximab a me adalimumab .

Hiki ke hoʻohana ʻia nā lāʻau ʻē aʻe, e like me ka scleral patching a i ʻole nā ​​grafts, e like me nā ʻano hoʻoili ʻokoʻa ʻē aʻe.

He aha kā mākou e manaʻo ai ma kēia hihia o ka scleritis?

He maʻi hiki ke mālama ʻia a hiki ke mālama ʻia ʻo Scleritis. Inā ʻaʻole mālama ʻia, hiki i ka scleritis ke alakaʻi i ka nalowale o ka ʻike . ʻO ka posterior necrotizing scleritis ka mea koʻikoʻi loa. E hana pū kāu kauka me ʻoe e mālama i nā maʻi autoimmune ʻē aʻe āu e loaʻa ai.

Pehea e hiki ai iā ʻoe ke hōʻemi i ka pilikia o ka hoʻomohala ʻana i ka scleritis?

I ka hapanui o nā hihia, ʻaʻole hiki ke pale ʻia ka scleritis. Akā hiki iā ʻoe ke mālama pono i kou mau maka .

• ʻO ke kau ʻana i ka pale maka e pono ai i kou wā e hana ana a pāʻani paha i kekahi mau haʻuki pili hiki ke hōʻemi i ka pilikia o ka hōʻino ʻana i kou mau maka.
• Inā pono ʻoe e hoʻopā i kou mau maka, ʻo ka mālama mau ʻana i kou mau lima i ka maʻemaʻe hiki ke kōkua i ka hōʻemi ʻana i ka pilikia o nā maʻi maka. Eia kekahi, inā ʻoe e kau i nā aniani hoʻopili, mai poina e hoʻomaʻemaʻe pono iā lākou.

Āhea ʻoe e ʻike ai i ke kauka?

Pono ʻoe e ʻike i ke kauka i kēlā me kēia manawa āu e loaʻa ai ka ʻeha, ka ʻulaʻula, a i ʻole ka pehu ʻana i kekahi a i ʻole nā ​​​​maka ʻelua. He mea nui loa kēia inā he nāwaliwali kou ʻōnaehana pale a i ʻole kahi maʻi . ʻOi aku ka maikaʻi o ka hoʻomaka ʻana i ka lāʻau i ka wā hikiwawe.

He aha ka ʻokoʻa ma waena o ka scleritis a me nā maʻi maka ʻē aʻe?

ʻO kēia kahi e huikau ai nā kānaka he nui. E nānā kākou i nā ʻokoʻa nui.

ʻO ka ʻokoʻa ma waena o Scleritis a me Episcleritis

ʻO Scleritis kahi mea e hoʻopilikia ai i kou sclera. ʻO Episcleritis kahi mea e hoʻopilikia ai i kāu episclera, ka papa waho loa o ka sclera.ʻO kahi mea e hoʻopilikia ai. Hoʻōla pinepine ʻo Episcleritis iā ia iho , ʻaʻole ia he ʻeha e like me ka scleritis.

ʻO ka ʻokoʻa ma waena o Scleritis a me Uveitis

ʻO ka uvea ka papa ma lalo o ka sclera (ka ʻāpana keʻokeʻo o ka maka). Ua kapa ʻia ka mumū o kou uvea he uveitis . Hiki i kou uvea a me kou sclera ke mumū i ka manawa like, akā he ʻelua ʻāpana like ʻole lāua o kou maka.

ʻO ka ʻokoʻa ma waena o Scleritis a me Conjunctivitis

He maʻi ʻo Scleritis i ka sclera. ʻO ka Conjunctivitis , ʻo ia ka mea a mākou e kapa nei he 'maʻi maka,' he maʻi ia o kou conjunctiva. ʻO kou conjunctiva ka membrane e uhi ana i ka sclera a me loko o kou maka. Hiki i nā kūlana ʻelua ke hoʻolilo i kou mau maka i ʻulaʻula. Eia nō naʻe, ʻaʻole koʻikoʻi ka conjunctivitis e like me ka scleritis, a ʻaʻole hoʻi i ʻeha e like me ka scleritis .

ʻO ka leka lawe home mai kēia ʻatikala

No laila, he mea waiwai nui kou mau maka iā ʻoe. No laila, ʻo kou kuleana ke mālama iā lākou i ke olakino. Inā ʻulaʻula a ʻeha kou mau maka, e ʻike koke i kahi kauka maka a i ʻole ke kauka lapaʻau maʻamau . He mea nui loa ia e ʻike koke inā he maʻi ia e like me ka scleritis a i ʻole kekahi mea ʻē aʻe. ʻO ka mea maikaʻi loa e hana ai, ʻo ia ka ʻike a hoʻomaka i ka mālama ʻana no kekahi maʻi olakino i ka wā mua, inā he mea ia e hoʻopilikia ai i nā maka a i ʻole kekahi mea ʻē aʻe i loko o ke kino.

ʻO ka scleritis, ʻāpana keʻokeʻo o ka maka, sclera, ʻulaʻula maka, ʻeha maka, pehu maka, maʻi autoimmune, Scleritis, mumū maka