Ingaba umntwana wakho omncinci unalo olu hlobo lotshintsho emehlweni akhe? Masifunde nge (Congenital Glaucoma)!

Xa sijonga amehlo abantwana bethu abancinci, ngamanye amaxesha sibona into engaqhelekanga okanye eyahlukileyo, akunjalo? Amanye amehlo abantwana abonakala emakhulu kancinci, okanye adla ngokuba neenyembezi emehlweni abo, okanye abathandi ukujonga ukukhanya. Ngamanye amaxesha ezi zinokuba zilula kakhulu kwaye ziqhelekile. Kodwa kwangaxeshanye, ngamanye amaxesha zinokuba luphawu lwento efuna ingqalelo encinci. Namhlanje siza kuthetha ngesifo samehlo esinokwenzeka kubantwana abancinci, ingakumbi ekuzalweni okanye kwiminyaka embalwa yokuqala yobomi, kodwa ukuba siqatshelwe kwangethuba, sinokulawulwa kakuhle kwaye umbono womntwana unokukhuselwa. Oku kubizwa ngokuba yi -congenital glaucoma .

Yintoni i-glaucoma yokuzalwa?

Ngamafutshane, i-congenital glaucoma yimeko ekhoyo ekuzalweni okanye kwasebuntwaneni (kwiminyaka emi-2-3) ngenxa yezinto ezithile zemfuza. Ngoku usenokuba uzibuza, "Yintoni i-glaucoma?" I-Glaucoma ligama eliqhelekileyo laso nasiphi na isifo samehlo esonakalisa i-optic nerve, i-nerve ephambili engaphakathi kweliso esinceda sibone. Lo monakalo unokukhokelela ekulahlekelweni kokubona kancinci kancinci.

Abantwana abane-glaucoma yokuzalwa banoxinzelelo oluphezulu ngaphakathi kwamehlo abo, olubizwa ngokuba yi -ocular hypertension . Amehlo ethu avelisa ulwelo olukhethekileyo olubizwa ngokuba yi-aqueous humor . Olu lwelo lubaluleke kakhulu ekugcineni amehlo ephilile. Ngokwesiqhelo, olu lwelo luveliswa kwaye lukhutshwa ngokufanelekileyo liliso. Nangona kunjalo, kubantwana abane-congenital glaucoma, olu lwelo aluphumi ngokufanelekileyo. Olu lwelo luqokelelana ngaphakathi kweliso, kwaye uxinzelelo olungaphakathi kweliso luyanda kancinci kancinci. Olu xinzelelo lunyukayo lubangela ukuba umthambo we-optic endiwukhankanyileyo ngaphambili ucinezelwe. Ekuhambeni kwexesha, oku kunokubangela utshintsho kwimo yamehlo. Ungaqaphela ukuba amehlo omntwana wakho abe makhulu, okanye i-iris (inxalenye yeliso enombala ngokwenene - iris) inokuba namafu kwaye itshintshe umbala.

Esi sisifo esinokunyangwa. Nangona kunjalo, ukuba asinyangwa, ukubona kusenokuwohloka kancinci kancinci kuze kukhokelele ekubeni yimfama. Kungoko ke, kubaluleke kakhulu ukuqaphela ezi mpawu nokuqala unyango ngokukhawuleza. Kulapho kuphela apho umonakalo ungancitshiswa khona kwaye umbono womntwana ukhuselwe kangangoko.

Zithini iimpawu zesi sifo? Sizibona njani?

Ukongeza kwiimpawu eziphambili ezibonakala kwesi sifo, kukho nezinye iimpawu ezongezelelweyo.

Kukho iimpawu ezintathu eziphambili:

Ezi ziimpawu ezintathu oogqirha abazinika ingqalelo kakhulu.

• Ukukrazula amehlo rhoqo (Epiphora): Ngokuchanekileyo, kubonakala ngathi iinyembezi ziyavuza emehlweni nangona umntwana engakhali.
• Uloyiko lokubona ukukhanya: Umntwana usenokungafuni ukujonga ukukhanya okuqaqambileyo, avale amehlo akhe okanye ajike ubuso bakhe xa ephuma phandle.
• I-Blepharospasm: Kuvakala ngathi iinkophe zibetha ngokukhawuleza, okanye ngathi zizama ukuvala amehlo azo ngokuqinileyo.

Ezinye iimpawu onokuzibona:

• I-Buphthalmos: Amehlo omntwana abonakala emakhulu kwaye evuvukele ngakumbi kunabanye abantwana. Abanye abazali bathi, "Amehlo omntwana afana namehlo amakhulu, anjengenkunzi."
• Imbonakalo eluhlaza okwesibhakabhaka yeliso: Inxalenye emhlophe yeliso (i-sclera) ingabonakala kwiinwebu ezingaphantsi, iyenze ibonakale iluhlaza okwesibhakabhaka.
• Ukumhlophe okanye ukubonakala okunamafu kwe-cornea: I-membrane ecacileyo phezu kweliso elimnyama (i-cornea) iba namafu, ijongeka njengenkungu eglasini.

Ungazibona ezi zinto njengotshintsho kwindlela umntwana wakho abona ngayo izinto:

• I-Astigmatism: Umntwana usenokungaziboni kakuhle izinto.
• I-Myopia: Imeko apho izinto ezikufutshane zinokubonakala ngokucacileyo, kodwa izinto ezikude azinakubonwa ngokucacileyo.
• I-Anisometropia: Ngenxa yokuba umbono kwelinye iliso wahlukile kwelinye, umntwana angazama ukusebenzisa kuphela iliso elibona ngcono.

Ezinye izinto ugqirha wakho anokuzifumana ngexesha lovavanyo lwamehlo ziquka:

• Ukudumba kwe-Corneal: Inxalenye ecacileyo yeliso ephambi kwayo idumbile.
• Ukukrazulwa kwe-cornea: I-cornea yoluliwe ngenxa yoxinzelelo olugqithisileyo, kwaye imikrwelo emincinci inokwenzeka kuyo.
• Ukuvaleka kwe-cornea: Umonakalo ohlala ixesha elide unokubangela ukuvaleka okungapheliyo kwe-cornea.

Ezi mpawu zihlala zibonakala emehlweni omabini, kodwa ngamanye amaxesha zinokubonakala kwiliso elinye kuphela.

Kutheni le nto (iCongenital Glaucoma) isenzeka? Yintoni unobangela?

I-Congenital glaucoma iqala ngesiphene ekukhuleni kweliso lomntwana. Isiphene esiqhelekileyo sisiphene ekukhuleni kwezicubu ezikhupha umswakama ongaphakathi kweliso, i-trabecular meshwork . Cinga ngayo njengomngxuma kwisinki. Ukuba loo mngxuma awuzange wenziwe kakuhle, amanzi akayi kuphuma kakuhle. Oku kuyafana nakule. Ngenxa yokuba i-trabecular meshwork ayiphumi kakuhle, ulwelo olungaphakathi kweliso aluphumi kakuhle. Emva koko olo lwelo luqokelelana ngaphakathi kweliso, lunyusa uxinzelelo ngaphakathi kweliso. Olu xinzelelo lunyukayo lulo olonakalisa i-optic nerve. Kwakhona, olu xinzelelo lunokubangela ukuba i-cornea, umphambili weliso, ikhule, yoluleke, ibe nemicu, kwaye ide ibe namanxeba.

Le nkqubo ithatha kancinci kancinci. Oko kukuthi, esi sifo siya sibi kancinci kancinci. Ukuba sibi ngokukhawuleza kangakanani kuxhomekeke kuhlobo lwesiphene esikwiliso lomntwana, ubungakanani bolwelo oluqokelelanayo, kunye nobungakanani boxinzelelo ngaphakathi kweliso.

Khawucinge, abanye abantwana babonisa ezi mpawu kanye xa bezalwa. Oko kukuthi, imeko ibikhula ngelixa besesesibelekweni (Uphuhliso lweNtsana). Kwabanye abantwana, iimpawu zinokuvela kamva kancinci, mhlawumbi kwiinyanga ezimbalwa okanye unyaka okanye emibini. Oku kungenxa yokuba isiphene sokuzalwa asibi kakhulu, kwaye kuthatha ixesha ukuba iimpawu zivele.

Ngaba kukho iintlobo ezahlukeneyo zeCongenital Glaucoma?

Ewe, kukho iindlela ezahlukeneyo oogqirha abahlulahlula ngazo esi sifo.

Uhlu ngokweminyaka yokuqalisa kweempawu:

• Uhlobo lwe-Neonatal: Iimpawu zibonakala xa umntwana ezalwa okanye kwinyanga yokuqala yobomi bakhe.
• Uhlobo losana: Iimpawu zibonakala kwiminyaka emibini ukuya kwemithathu yokuqala yobomi.

Uhlu ngokwesimo sesiphene esibangela isifo:

• Uhlobo oluphambili: Kolu hlobo, i-glaucoma yenzeka kuphela ngaphandle kwesinye isiphene esibonakalayo ngaphakathi kweliso. Abaphandi bafumanise utshintsho oluninzi lwezakhi zofuzo olunokubangela olu hlobo lwe-primary congenital glaucoma.
• Uhlobo lwesibini/lophuhliso: Kule meko, i-glaucoma yenzeka njengenxalenye yesifo esithile esichongiweyo semfuza, kunye nezinye iziphene ngaphakathi kweliso.

Ezinye zeemeko zemfuza ezinokubangela iSecondary Congenital Glaucoma:

• I-Aniridia: Ukulahleka okupheleleyo okanye okuncinci kwenxalenye enombala yeliso (iris).
• I-Axenfeld-Rieger syndrome: Yimeko ebangela iingxaki ezahlukeneyo ezinxulumene namehlo, amazinyo kunye nenkaba.
• I-Sturge-Weber syndrome: Imeko enokubangela iingxaki engqondweni namehlo, kunye nebala elikhulu elibomvu ebusweni (i-port-wine stain).

Sichongwa njani esi sifo ngokuchanekileyo?

Iingcali zamehlo, ingakumbi xa zibona iimpawu eziphambili ezikhankanyiweyo ngaphambili emehlweni omntwana omncinci, zirhanela ukuba umntwana une-glaucoma yokuzalwa. Ukuqinisekisa loo ngcinga, umntwana unikwa i-anesthesia (phantsi kwe-anesthesia) kwaye kwenziwa uvavanyo olupheleleyo lwamehlo. Ungakhathazeki, umntwana akayi kuva ntlungu ngenxa ye-anesthesia, kwaye kulula ukuba oogqirha bahlole amehlo ngokuchanekileyo.

Kolu vavanyo,

• I-Tonometry ilinganisa uxinzelelo ngaphakathi kweliso .
• I-Gonioscopy yenziwa ukujonga i-engile yokukhupha amanzi kweliso .

Ukongeza, ezinye iimvavanyo zingenziwa ezifana nezi:

• I-Optical Coherence Tomography (OCT): Oku kukuvumela ukuba ubone i-optic nerve ngokweenkcukacha.
• Uvavanyo lweMfuzo: Jonga utshintsho lwemfuza olunokubangela esi sifo.

Luluphi unyango lwale nto?

Kubantwana abaninzi abane-glaucoma yokuzalwa, lungisa isiphene esithintela ukuphuma kolwelo elisweni.Utyando lwamehlo luyafuneka. Unyango oluphambili nolusebenzayo kwesi sifo lutyando. Kwakhona, okukhona utyando lusenziwa ngokukhawuleza, kokukhona iziphumo ziba ngcono. Amayeza nawo adlala indima encinci. Ugqirha angakunika amayeza okusetyenziswa ngaphambi okanye emva kotyando. Amaxesha amaninzi, amayeza odwa ayanela njengonyango.

Utyando

Injongo ephambili yolu tyando kukunciphisa uxinzelelo oluphezulu ngaphakathi kweliso lomntwana (Itraocular Pressure). Oku kuya kunciphisa umonakalo kwi-optic nerve nakwezinye iindawo zeliso. Kuya kuthintela nomonakalo ongakumbi. Ngokuxhomekeke ekubeni umntwana uqala unyango ngokukhawuleza kangakanani, omnye umonakalo osele wenzeke unokubuyela umva. Ungakhathazeki, umntwana uya kuba phantsi kwe-anesthesia ngexesha lotyando lweliso, ngoko akayi kuva nto.

Ngokuxhomekeke kubudala bomntwana kunye nemeko yakhe, ugqirha uza kukhetha enye yezi ndlela zilandelayo zotyando:

• I-Goniotomy: Oku kuquka ukwenza umngxuma omncinci kwi-trabecular meshwork, izicubu ezihluza ulwelo, kwi-engile yokukhupha amanzi. Oogqirha benza oku besebenzisa isixhobo esibizwa ngokuba yi-gonioscope.
• Utyando lweTrabeculotomy: Ngamanye amaxesha, ukuba i-engile ephuma ngayo ulwelo kwi-cornea ayibonakali ngokucacileyo, oogqirha botyando baya kudlula kwinxalenye emhlophe yeliso (i-sclera) baze benze utyando kwesi zicubu besebenzisa isixhobo se-electrocautery esibizwa ngokuba yi-trabeculotome.
• Utyando lweTrabeculectomy: Ukuba olu tyando lungentla alusebenzi, ugqirha uza kudlula kwinxalenye emhlophe yeliso (i-sclera), asuse iqhekeza elincinci le-trabecular meshwork, aze enze indlela entsha yokukhupha ulwelo.
• Isixhobo Sokukhupha I-Glaucoma: Ngamanye amaxesha ugqirha wotyando ubeka isixhobo esincinci esifana netyhubhu (iTube Shunt) esweni lomntwana. Le tube ivumela ulwelo oluqokelelana esweni ukuba luqokelele kwidiski encinci phantsi kwe-membrane encinci (conjunctiva) phezu kweliso, aze alukhuphele emzimbeni.

Amayeza

Ngenxa yokuba amayeza anokuba nemiphumo emibi kubantwana abancinci, oogqirha bayawabhala ngononophelo olukhulu. Ugqirha wakho unokukunika amayeza okunciphisa uxinzelelo ngaphakathi kweliso lakho okanye ukwandisa ukucaca kwe-cornea yakho ngaphambi kotyando. Oku kunokuphucula iziphumo zotyando lwakho. Banokukunika amayeza okuthintela iingxaki ngexesha nasemva kotyando.

La mayeza alandelayo angasetyenziswa:

• Ii-Beta-blockers
• I-Diuretics (inciphisa ukwakheka kolwelo emehlweni)
• Iiprostaglandins
• Ii-agonists ze-Alpha-adrenergic
• Ii-antibiotics (ukuthintela usulelo)
• Ii-Corticosteroids (zinciphisa ukudumba)
• I-Mitomycin (ukunciphisa amanxeba emva kotyando)

Iza kuba njani imeko emva konyango? (Ingxelo yokuxela kwangaphambili)

Utyando lwe-glaucoma yokuzalwa ludla ngokuphumelela ekunciphiseni uxinzelelo ngaphakathi kweliso nasekumiseni inkqubo eyonakalisa umbono womntwana. Abantwana abafumana unyango kwangethuba, oko kukuthi, ngaphambi kokuba kwenzeke umonakalo omkhulu, banokukhula benombono oqhelekileyo. Nangona kunjalo, ngamanye amaxesha umonakalo usenokungabuyeki ngokupheleleyo. Kwakhona, abanye abantwana banokufuna unyango olongezelelweyo, olufana neeglasi. Eyona nto ibalulekileyo kukuhlala uhambisa umntwana wakho ukuze ahlolwe njengoko ugqirha wakho ecebisa.

Ngaba ikho indlela yokuthintela esi sifo?

Enyanisweni, nangona i-glaucoma yokuzalwa inokwenzeka kwiintsapho, idla ngokuvela ngokungacwangciswanga. Uvavanyo lwe-genetic lunokukuxelela ukuba une-genetic mutation kwaye kunokwenzeka kangakanani ukuba uyidlulisele ebantwaneni bakho. Nangona kunjalo, asinakuthintela ukuba ii-genes zethu zingadluliselwa ebantwaneni bethu. Nangona kunjalo, singakulungela ukuba kukho ithuba lokuba umntwana afumane esi sifo se-genetic. Umzekelo, sinokuqonda iimpawu size sithathe inyathelo ngokukhawuleza.

Kuqhelekile ukuziva uxinezelekile xa ufumanisa ukuba umntwana wakho unesifo sokuzalwa esifuna unyango olukhawulezileyo. Kwelinye icala, kufuneka wenze izigqibo ngokukhawuleza malunga nonyango lomntwana wakho, kwaye kwelinye icala, kufuneka ulawule uloyiko lwakho kunye nokuxhalaba kwakho. Ukuthumela umntwana omncinci ukuba aye kutyando kwaye umnike amayeza yinto enzima kakhulu. Kodwa, yiba nokholo kwiqela lakho lezonyango. Eli xesha linzima liza kuphela kungekudala, kwaye umntwana wakho uza kuba sendleleni eya ekupholeni.

Okokugqibela, umyalezo oya ekhaya:

Ukuba ubona naziphi na izinto ezingaqhelekanga okanye utshintsho emehlweni omntwana wakho – njengokuba amehlo akhe ekhula, ukukrazuka rhoqo, okanye ukungafuni ukuphuma ngaphandle – musa ukungayinaki loo nto. Isenokuba yinto elula, kodwa isenokuba luphawu lwemeko efana ne-congenital glaucoma.

• Ukufunyanwa kwangoko kunye nonyango olukhawulezileyo zezona zinto zibalulekileyo, ukuze umbono womntwana ugcinwe kangangoko kunokwenzeka.
• Kukho unyango oluphumeleleyo lotyando lwesi sifo.
• Qhubeka nokusa umntwana wakho kuvavanyo lwezonyango njengoko ugqirha ecebisa.
• Ukuba uneengxaki okanye amathandabuzo, thetha nogqirha.

Khumbula, inkathalo yakho kunye nesenzo sakho esikhawulezileyo zezona zinto zinamandla amakhulu kumbono womntwana wakho wexesha elizayo.

I- Glaucoma, i-Congenital Glaucoma, Izifo Zamehlo, Izifo Zamehlo Ebantwaneni, Uxinzelelo Lwamehlo, I-Optic Neuropathy, I-Optic Neuropathy