Ngaba amehlo akho avakalelwa ngolu hlobo? Makhe sithethe nge-Uveitis!

Ngaba wakha waba namehlo abomvu, abuhlungu, nafiphele kancinci? Okanye wakha waziva ngathi izinto zihamba phambi kwamehlo akho? Ezi ziimpawu ngamanye amaxesha esingazinaki kangako, kodwa zinokuba ziimpawu zesinye isifo sokudumba ngaphakathi kweliso. Leyo yimeko esiza kuthetha ngayo namhlanje, ebizwa ngokuba yi-uveitis. Oku kunokuba yinto embi kakhulu, ngoko ke kubalulekile ukuba uyiqaphele.

Yintoni i-Uveitis? Masiyiqonde ngokulula!

Ngamafutshane, i-uveitis kukudumba, okanye ukudumba, kwe-uvea, umaleko ophakathi weliso. Cinga ngayo njengekhamera. I-uvea yinxalenye ebaluleke kakhulu yekhamera. Ngamanye amaxesha, oku kudumba kunokuba yinto engaqhelekanga, oko kuthetha ukuba kunokubangelwa zizifo ezininzi ezaziwayo. Le meko inokuchaphazela indawo enye kuphela yeliso , okanye inokuchaphazela iindawo ezininzi. Iimpawu ziyahluka ngokuxhomekeke kwindawo ekuchaphazeleke kuyo. Unokufumana iintlungu zamehlo, ukubomvu, okanye ukudumba. Okanye umbono wakho unokuchaphazeleka. Inokuchaphazela iliso elinye, okanye omabini amehlo ngaxeshanye. Ngoku, khangela, akukho ndawo ingako yokudumba ngaphakathi kwamehlo ethu. Ngoko ke nokuba kukudumba okuncinci kunokutshintsha imo yangaphakathi kweliso. Ubusazi ukuba imo yangaphakathi kweliso ibaluleke kakhulu ekuboneni kwethu? Ngoko ke nokuba lutshintsho oluncinci olubangelwa koku kudumba lunokuba nempembelelo enkulu ekuboneni.

Kwezinye iimeko ezinzima, i-uveitis inokukhokelela ekulahlekelweni kokubona okungapheliyo okanye nokuba yimfama. Ngoko ke oku akuyonto yokuyithatha lula.

Ixhaphake kangakanani i-Uveitis?

Esi sisifo esixhaphakileyo ngokwenene. Ehlabathini lonke, malunga nezigidi ezi-4 zamatyala amatsha, okanye malunga nezigidi ezi-4 zabantu, bafunyanwa benesi sifo minyaka le. Kwanakwilizwe elifana ne-United States, phakathi kwama-80,000 kunye nama-168,000 amatyala axelwa minyaka le. Oku kuxhaphake kakhulu kubantu abadala. Umngcipheko wokufumana esi sifo uyanda ngokukhula. Asixhaphakanga kangako kubantwana abancinci, apho abantwana baphakathi kwe-2% kunye ne-20% yazo zonke izigulana.

Ziziphi iimpawu ze-uveitis?

Iimpawu ze-uveitis zixhomekeke ekubeni leliphi icala leliso elichaphazelekileyo kukudumba. Iingcali ziyahlulahlula zibe ziinxalenye ezintathu eziphambili: ngaphambili, phakathi, nangasemva. Ngamanye amaxesha zonke ezi ndawo zintathu ziyachaphazeleka, kwaye oku kubizwa ngokuba yi-panuveitis.

Iimpawu ze-Anterior Uveitis

Kwezi zintathu , i-anterior uveitis yeyona ixhaphakileyo.Oku kuchaphazela umzimba we-iris kunye ne-ciliary yeliso. Rhoqo, wena okanye abanye abantu niyakwazi ukubona iimpawu. Ezi mpawu ziquka:

• Intlungu yamehlo: Inokuba buhlungu kakhulu.
• Ubomvu okanye ukutsha kwamehlo: Amehlo asenokuvakala ebomvu, erhawuzelela, kwaye etsha.
• Umbono ofipheleyo: Imeko apho ungakwazi ukubona kakuhle.
• Uvelwano ekukhanyeni (photophobia): Ubunzima bokujonga ukukhanya, uzive ngathi amehlo ajika abe luhlaza okwesibhakabhaka.
• Ukudumba kwenwebu emhlophe yeliso (i-conjunctiva evuvukileyo).
• Utshintsho kwimilo yendandatho emnyama: Indandatho emnyama, edla ngokuba yingqukuva, inokuba nemilo engalinganiyo.
• Ingqokelela yolwelo olumhlophe ngaphambili kweliso (hypopyon) okanye isangqa esimhlophe esijikeleze iliso elimnyama.

Iimpawu ze-Intermediate and Postterior Uveitis

Kwimeko ye-middle and posterior uveitis, iimpawu zihlala zingabonakali lula kuwe okanye kwabanye. Endaweni yoko, iimpawu zichaphazela kakhulu oko ukubonayo kunye nendlela obona ngayo. Iimpawu zezi meko zingabandakanya:

• Imbonakalo yezinto ezincinci ezidada phambi kwamehlo ( ii-floaters okanye ii-myodesopsias) iyanda, okanye ziyanda ngakumbi kunangaphambili.
• Iziphene zebala lokubona: Ezinye iindawo zeliso azibonakali xa zijongwa kwiliso elichaphazelekayo.
• Ukubona okunciphileyo .

Zithini izizathu ze-Uveitis?

Zininzi izinto ezinokubangela i-uveitis. Okumangalisayo kukuba, kwi-50% ukuya kwi-70% yamatyala, ugqirha wamehlo akakwazi ukufumana unobangela. Oku kuthetha ukuba yimeko "engaqhelekanga". Nangona kunjalo, izizathu eziphambili ezinokufunyanwa zezi:

• Iintsholongwane
• Iimeko zezifo ezichaphazela umzimba wonke (Iingxaki ezicwangcisiweyo)
• Ukulimala Kwamehlo
• Amanye amayeza

1. Iintsholongwane

Usulelo lubangelwa kukungena kwento ethile emzimbeni, efana nentsholongwane, emzimbeni ize ibangele umonakalo. I-Uveitis ebangelwa lusulelo idla ngokuchaphazela iliso elinye kuphela. Ingabangelwa ziintlobo ezahlukeneyo zeentsholongwane:

• Iintsholongwane: Iintsholongwane ezifana neHerpes Simplex Virus (HSV), iVaricella-Zoster Virus (VZV), ebangela i-chickenpox kunye ne-herpes zoster, kunye neCytomegalovirus (CMV). Zinokubangelwa zizifo ezinokuthintelwa ngokugonywa ezifana ne-rubella.
• Iintsholongwane:Iintsholongwane ezibangela izifo ezifana ne-syphilis kunye nesifo sephepha.
• Iifungi: Iimbotyi ezifana neCandida (ebangela i-candidiasis) kunye neAspergillus (ebangela i-aspergillosis).
• Iintsholongwane: Ezi zinokudluliselwa kuwe zisuka kwizilwanyana zasekhaya, ingakumbi iikati (i-toxoplasmosis, edluliselwa yindle yeekati eyosulelekileyo) kunye nezinja (i-toxocariasis). Ungayifumana le meko ngokutya inyama yengulube engaphekwanga kakuhle (i-cysticercosis okanye i-toxoplasmosis).

2. Izizathu ezichaphazela umzimba wonke (Izizathu ezicwangcisiweyo)

Ngamanye amaxesha i-uveitis ayibangelwa yinto echaphazela amehlo kuphela. Inokuba yimpembelelo ecaleni yamayeza okanye uphawu lwesifo esichaphazela umzimba wonke. Kwimeko enjalo , omabini amehlo adla ngokuchaphazeleka. Nazi ezinye zeemeko zokuzikhusela komzimba kunye nokuvuvukala okunxulunyaniswa ne-uveitis:

• `Isifo samathumbu esidumbileyo ( IBD )`
• `I-Sarcoidosis`
• Isifo sikaBehçet
• `Lupus (Systemic Lupus Erythematosus - SLE)`
• I-Tubulo-interstitial nephritis (TINU)

Abantu abanotshintsho oluthile lwe-DNA olubizwa ngokuba yi-'HLA-B27' banokufumana izifo zamalungu ezivuthayo ezinyusa umngcipheko wokuba ne-uveitis. Imizekelo ibandakanya:

• ` Isifo samathambo esingaqhelekanga sabantwana`
• I-Ankylosing Spondylitis
• 'Isifo samathambo sePsoriatic'
• `I-Axial Spondyloarthritis`
• `Isifo samathambo esibizwa ngokuba yi-Enteropathy`
• `Isifo samathambo esisabelayo`

3. Ukwenzakala

Ukulimala kweliso kungonakalisa izihlunu kunye/okanye imithambo yegazi kwi-uvea. Xa kwenzeka ukwenzakala, inkqubo yethu yokuzikhusela isebenzisa inkqubo ebizwa ngokuba yi-inflammation ukuyiphilisa. Ngenxa yesi sizathu , i-uveitis inokwenzeka nasemva kotyando lweliso. Kwanotshintsho oluncinci kwisakhiwo esingaphakathi kweliso, njengotshintsho olubangelwa kukudumba, lunokubangela iimpawu ze-uveitis. Ubunzima beempawu buxhomekeke kwizinto ezifana nendawo kunye nobunzima bokwenzakala.

4. Amayeza

Umngcipheko wokuba ne-uveitis unokwanda xa kusetyenziswa amayeza athile. Eminye imizekelo ibandakanya:

• `I-Cidofovir`
• `Rifabutin`
• `Ii-Bisphosphonates`
• `Amathontsi eliso eBrimonidine`
• `Iinhibitors zeTyrosine Kinase`

Ingaba esi sisifo esosulelayo?

I-Uveitis ayisuleli ukusuka komnye umntu ukuya komnye. Nangona kunjalo, ezinye izifo (umz. iintsholongwane, iibhaktheriya) ezibangela le ngxaki zinokosulela. Kwakhona, inokubangelwa zizifo ezinokudluliselwa zizilwanyana ukuya ebantwini (umz. i-toxoplasmosis), ngoko ke kufuneka ukwazi oko.

Ziziphi iingxaki ezinokubakho ze-Uveitis?

Eyona ngxaki iphambili neyingozi kakhulu ye-uveitis kukulahlekelwa kukubona nokungaboni. Le meko ibangela utshintsho ngaphakathi kweliso, kwaye olo tshintsho lubangela iingxaki. Ezinye zezi nguqu zezi:

• IiCataracts
• I-Cystoid Macular Edema
• I-retina ehlukanisiweyo okanye umonakalo kwi-retina
• I-Glaucoma (umonakalo kwi-optic nerve ngenxa yoxinzelelo lwamehlo oluphezulu)
• Uxinzelelo oluphezulu lwangaphakathi kweso
• I-Macular pucker - i-epiretinal membrane
• Ukudumba kwemithambo-luvo ye-optic kunye nomonakalo
• I-Synechiae (oku kwenzeka xa iris yeliso inamathela kwilensi okanye kwi-cornea)

Ifunyanwa njani i-Uveitis?

Ingcali yamehlo inokuxilonga i-uveitis. Iza kukubuza ngeempawu zakho, kuquka imbali yakho yezonyango kunye nazo naziphi na izifo okanye ukwenzakala kwakutshanje. Ukongeza, isenokuhlola amehlo akho kwaye yenze uvavanyo olukhethekileyo ukukhangela iimpawu ze-uveitis. Uvavanyo lwe-uveitis ludla ngokuqala ngovavanyo lwamehlo. Oku kubandakanya uvavanyo lwe-visual acuity kunye novavanyo lwe-slit lamp . Ugqirha wakho unokuyalela uvavanyo lwe-tonometry ukulinganisa uxinzelelo lwamehlo kunye ne-optical coherence tomography (OCT) scan ukujonga utshintsho ngasemva kweliso lakho. Ezinye iimvavanyo zinokuyalelwa, kuxhomekeke kwiimpawu zakho kunye nezizathu ezirhanelwayo. Umzekelo:

• Uvavanyo lwegazi: Olu vavanyo lunokubona utshintsho egazini olubonisa usulelo, iimpawu zenkqubo yomzimba yokuzikhusela, okanye ezinye iimeko zonyango.
• Iiskeni zemifanekiso: Izinto ezifana ne-X-ray yesifuba okanye i-MRI (Magnetic Resonance Imaging) yobuchopho zinokunceda ekujongeni iingxaki kwezinye iindawo. Ezinye iiskeni zemifanekiso zisebenzisa idayi ekhethekileyo, efana ne-fluorescein, ukubonisa imithambo yegazi ngaphakathi kweliso. Utshintsho kwindlela yokwenza idayi lunokunika oogqirha izikhokelo ezibalulekileyo malunga nesizathu se-uveitis.

Ngenxa yokuba iimvavanyo zinokwahluka ngokuxhomekeke kwiimpawu zakho kunye nemeko yakho, ingcali yamehlo yakho yeyona mntu ufanelekileyo ukukuchazela zona. Ingakuxelela okungakumbi ngezi mvavanyo kunye nesizathu sokuba zinconywe.

Inyangwa njani i-Uveitis?

Ngenxa yokuba zininzi izizathu ze-uveitis, unyango lunokwahluka kakhulu. Akukho ndlela ithile yonyango lwe-uveitis. Nangona kunjalo, ezinye zeemeko ezibangela oku zinokunyangwa. Ukuba kunjalo, ukunyanga unobangela kunokunceda ukususa i-uveitis. Ukuba akukho sizathu sifumanekayo, ugqirha wakho wamehlo unokusebenzisa unyango oluqhelekileyo. Unyango lunokubandakanya amayeza, utyando, kunye nezinye iindlela zokunceda ukunciphisa iimpawu zakho kunye nokuthintela iingxaki zexesha elizayo. Unyango olusekelwe kwiimpawu luhlala lugxila ku:

• Ulawulo lweentlungu: Ngenxa yokuba i-uveitis inokuba buhlungu, unyango lokunciphisa iintlungu luqhelekile. Oku kungabandakanya amayeza (i-cycloplegics) akhubaza izihlunu ze-iris okwethutyana (ingakumbi umfundi).
• Ukunciphisa ukudumba: Amayeza anjengee-steroids kunye neziyobisi ezichasene nokudumba ezingezizo ii-steroidal (NSAIDs) anokunceda ukunciphisa iintlungu kunye nokudumba okubangelwa yi-uveitis.
• Unyango oluhambelana nemeko ethile: Umzekelo, amayeza okulwa neentsholongwane anyanga iintsholongwane awancedi kwiintsholongwane zebhaktiriya, ifungus, okanye iincukuthu.

Ngenxa yokuba kukho iindlela ezininzi zonyango, ugqirha wakho wamehlo ngoyena mntu ulungileyo onokuthetha naye malunga neendlela zakho.

Ngaba i-uveitis ingathintelwa?

Ngelishwa, i-uveitis ayinakuthintelwa ngokupheleleyo. Izinto ezininzi ezibangela oku azilindelwanga okanye zisebenza ngeendlela iingcali ezingaziqondiyo ngokupheleleyo. Nangona kunjalo, kukho izinto ezimbalwa onokuzenza ukunciphisa umngcipheko wakho wokufumana iimeko okanye iziganeko ezinokukhokelela kwi-uveitis. Izinto eziphambili onokuzenza zezi:

• Fumana uhlolo lwamehlo rhoqo ukuze ufumane iingxaki zamehlo kwangethuba (oko kuthetha ukuba ubuncinane kabini ngonyaka, okanye rhoqo ukuba unesigulo esifuna uhlolo oluqhubekayo).
• Nxiba izikhuseli zamehlo ukuze uthintele okanye unciphise ubukhali bokwenzakala kwamehlo.
• Ukuba unezifo (ukuba kunokwenzeka), zinyange ngaphambi kokuba zibe mandundu okanye zisasazeke.

Yintoni endimele ndiyilindele ukuba ndine-Uveitis?

Ukuba une-uveitis, amava akho aya kuxhomekeka kwizinto ezininzi. Ezinye zezona zibalulekileyo zezi:

• Ixesha elithathayo ukufumana uxilongo kunye nonyango.
• Inxalenye ethile yeliso echaphazelekileyo.
• Isizathu esiyintloko (ukuba ugqirha wakho angasifumana).
• Impilo yakho iyonke kunye nazo naziphi na ezinye izifo onokuba nazo.

Ngenxa yokuba ezi zinto zinokuba nefuthe elikhulu, ingcali yamehlo ingakuxelela ngcono into omawuyilindele. Ingalungisa ulwazi ukuze luhambelane nemeko yakho kunye neenkcukacha zetyala lakho. Ingakunika neengcebiso ngezinto onokuzenza ukuze uzincede.

Iyintoni ingqikelelo ye-uveitis?

I-Uveitis yimbangela eqhelekileyo yokulahlekelwa kukubona kunye nobumfama obusemthethweni. E-United States, ukuya kuthi ga kwi-10% yabantu ababa ziimfama ngokusemthethweni babangelwa okanye banxulumene ne-uveitis. Ukulibaziseka ekuxilongweni nasekunyangweni kunokukhokelela kwiziphumo ezimbi. Yiyo loo nto kubalulekile ukungazihoyi iimpawu ze-uveitis okanye "ukuba nomonde nje." Ukuba uxilongiwe kwaye unyangwa kwangethuba, amathuba okuba ube neengxaki zokubona ixesha elide anciphe. Ukuba wenza njalo, amathuba okuba uphile ngokupheleleyo kwaye uphephe iingxaki zokubona ezingapheliyo.

Ndingazinyamekela njani?

Ukuba une-uveitis, ingcali yamehlo yakho iya kukukhokela kunyango kwaye ikuxelele into ekufuneka uyenze njengenxalenye yonyango lwakho. Kubaluleke kakhulu ukulandela imiyalelo yengcali yamehlo, kuba oku kunokunciphisa umngcipheko wokulahlekelwa yimbono ngokusisigxina.

Ndifanele ndimbone nini ugqirha wam?

Ugqirha wakho wamehlo uza kucwangcisa utyelelo olulandelayo kuwe, kwaye kubalulekile ukuba uhlale nalo. Ezi ntlanganiso zivumela ugqirha wakho ukuba ajonge iimpawu zakho kunye nempumelelo yonyango lwakho. Ugqirha wakho uza kukuxelela ukuba zeziphi iimpawu okanye iimpawu omele uzibonele ugqirha okanye ufune unyango olungxamisekileyo ukuba ukhe waba nazo. Nazi ezinye zeempawu zokulumkisa zokuba kufuneka ubone ugqirha okanye ufune unyango olungxamisekileyo:

• Ukuba intlungu iyanda.
• Ukuba umbono wakho uba mandundu okanye ngequbuliso ulahlekelwa ngumbono wakho (ngokupheleleyo okanye ngokuyinxenye).
• Ukuba ubona ukukhanya phambi kwamehlo akho.
• Ukuba ngequbuliso uqala ukubona ii-floaters, okanye ukuba ii-floaters ezikhoyo ziya zisiba mbi okanye ziya zibonakala ngakumbi.
• Ukuba unesifo sokucaphuka ngenxa ye-photophobia, oko kuthetha ukuba amehlo akho abuhlungu okanye azive engakhululekanga ekukhanyeni okuqaqambileyo.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungabuza ugqirha wakho imibuzo efana nale:

• "Luhlobo luni lwe-Uveitis endinalo?"
• "Uyayazi isizathu sale nto? Ngoko ke yintoni?"
• "Zeziphi iindlela zonyango endinazo? Ucebisa ntoni?"
• "Ngaba kukho naziphi na iingozi okanye iziphumo ebezingalindelekanga zonyango?"
• "Ingaba oku kungabuya emva konyango?"
• "Ndingenza ntoni ukukhusela umbono wam, ukuthintela ukulahleka kombono, okanye ukuthintela oku ukuba kungenzeki kwakhona?"
• "Ngaba kufuneka ndizazi iimpawu zeengxaki? Ukuba kunjalo, zeziphi ezo mpawu?"

Kuqhelekile ukuba noloyiko xa usiva ngemeko efana ne-uveitis, kwaye uve ukuba ungalahlekelwa kukubona. Kodwa zininzi izinto onokuzenza ukuphucula imeko yakho. Ukufunyanwa kwangoko kunye nonyango kunokuthintela iingxaki ezinkulu ezifana nokulahlekelwa kukubona okungapheliyo. Ngoko ke, ukuba uneempawu ze-uveitis, ungazihoyi. Emva kokuxilongwa, ukulandela imiyalelo kagqirha wamehlo yeyona ndlela ilungileyo yokufumana iziphumo ezilungileyo. Ukuba kukho into ongayiqondiyo, buza ugqirha wakho. Ukusebenzisana yeyona ndlela ilungileyo yokukunceda nokuthintela iingxaki zexesha elizayo.

Zeziphi izinto ezibalulekileyo esifanele sizikhumbule kweli bali?

Kulungile, masishwankathele ezinye zezinto esithethe ngazo ekufuneka uzikhumbule:

• I-Uveitis kukudumba komaleko ophakathi weliso (i-uvea). Ingayichaphazela kakhulu indlela obona ngayo.
• Ukuba uneempawu ezifana namehlo abomvu, iintlungu zamehlo, ukubona izinto ezingacacanga, ukungakwazi ukubona ukukhanya, okanye ukubona izinto zihamba phambi kwamehlo akho , ungaze uzityeshele. Bona ugqirha wamehlo ngokukhawuleza.
• Zininzi izizathu zoku; usulelo, ezinye izifo emzimbeni, ukwenzakala, amayeza athile, njl. Ngamanye amaxesha, akukho sizathu sifumanekayo.
• Eyona nto ibalulekileyo kukuqaphela isifo kwangethuba uze uqale unyango olufanelekileyo. Oku kunokunceda kakhulu ekuthinteleni iingxaki eziyingozi ezifana nokulahlekelwa yimbono ngonaphakade.
• Landela imiyalelo kagqirha wakho wamehlo kunye nonyango ngokuchanekileyo. Sebenzisa amayeza akho ngokuchanekileyo, kwaye ungawaphosi amadinga kagqirha wakho.
• Nangona ingenakuthintelwa ngokupheleleyo, ukuvavanywa kwamehlo rhoqo, ukunxiba izikhuseli zamehlo (ingakumbi emsebenzini onobungozi), kunye nokunyanga izifo emzimbeni ngokukhawuleza kunokunceda ukunciphisa umngcipheko wale meko ukuya kuthi ga kwinqanaba elithile.

Khumbula, amehlo akho axabiseke kakhulu, ngoko ke luxanduva lwakho ukuwanyamekela.