Ngaba amehlo akho abonakala ngathi ayavuvukala? (Proptosis) Makhe sithethe ngale nto!

Ngaba wakha waziva ngathi amehlo akho makhulu okanye avele ngaphandle? Mhlawumbi umhlobo okanye ilungu losapho likuxelele ngale nto. Le yimeko enokubonwa kwabanye abantu. Siyibiza ngokuba yi- (Proptosis) okanye i-(Exophthalmos) ngokwezonyango. Akukho nto yokoyika, ukuba uyazi ngale nto, ungayilawula njengayo nayiphi na enye into.

Yintoni i-proptosis?

Ngamafutshane, i-proptosis iyenzeka xa elinye okanye omabini amehlo akho ephuma kwindawo yawo eqhelekileyo. Khawuthelekelele ukuba amehlo akho, okanye elinye iliso, libonakala libheke phambili kancinci kunesiqhelo. Oku kunokwenza inkangeleko yakho ibonakale yahlukile kancinci. Ngamanye amaxesha, kunokubonakala ngathi umntu ukujongile ngamehlo akhe evuleke kakhulu ngokumangaliswa, kwaye kungahlala kunjalo.

Ngoku ekubeni iliso liphambi kwakho, kunokuba nzima kancinci ukuqhwanyaza. Uyazi, siyaqhwanyaza ukuze sigcine amehlo ethu emanzi kwaye ekhuselekile. I-membrane ekhuselayo ephezu kwamehlo ethu , ebizwa ngokuba yi-cornea , ifumana umswakama ewudingayo xa siqhwanyaza. Xa singakwazi ukuqhwanyaza kakuhle, loo cornea iyoma kwaye kukho ithuba elikhulu lokuba yonakale.

Kwabanye abantu, oku kunokubangela ukubona okufipheleyo, okanye ukubona kabini – sikubiza ngokuba yi-diplopia – nezinye izinto ezinjalo. Le meko ikwabizwa ngokuba "kukukhulisa amehlo" okanye "ukudumba kwamehlo."

Zithini iimpawu zoku?

Ngoku makhe sibone ukuba zeziphi ezinye iimpawu onokuziva uze uzibone xa la mehlo ephuma.

Xa amehlo akho evuthuluka, amhlophe amehlo akho abonakala ngakumbi kunesiqhelo. Iibhola zamehlo akho nazo ziphuma kwimingxuma yazo. Ungaphawula ukuba iinkophe zakho ezingaphezulu azibonakali kangako, nto leyo eyenza kubonakale ngathi amehlo akho avuleke kakhulu.

Ukongeza kolu phawu luphambili, kunokubakho nezinye iimpawu ezininzi:

• Xa ushukumisa amehlo akho, uziva ngathi anamathele ngaphakathi, njengeentlabathi .
• Amehlo omileyo, ukuba bomvu, okanye ukukrazuka rhoqo. Sikwabiza oku ngokuba yi- (Epiphora) .
• Ukudumba kunye nokubomvu kweenkophe.
• Ukuziva ngathi izihlunu ziqinile xa uzama ukuhambisa iliso, kwaye ngamanye amaxesha awukwazi ukulihambisa kwaphela.
• Ukuba novelwano ekukhanyeni kuthetha ukuba kunzima ukujonga ukukhanya, kunye nokukhanya kwelanga.
• Intloko ebuhlungu.
• Ifiva.

Ziziphi iimpawu ezifuna unyango olukhawulezileyo?

Ukuba unayo nayiphi na kwezi mpawu, ngokuqinisekileyo kuya kufuneka ubone ugqirha ngokukhawuleza. Khumbula ukuba ezi zizinto eziqhelekileyo, akunjalo?

• Umsindo ohlabayo ngaphakathi kwamehlo.
• Ngequbuliso, uziva ngathi amehlo akho aza kuphuma.
• Ukuba neentlungu eziqatha okanye ukuba bomvu emehlweni.
• Ezi mpawu zibonakala kwiliso elinye kuphela.
• Ukungaboni kakuhle okanye ukubona kwakho kuyehla kancinci kancinci.
• Umbono ofipheleyo okanye ukubona izinto ezimbini ngaxeshanye (umbono ophindwe kabini).
• Ukujonga into ngokucacileyo kuthetha ukuba kunzima ukugxila.

Kutheni amehlo am ephuma ngolu hlobo? Zithini izizathu?

Kaloku, makhe sibone ukuba kutheni amehlo ephuma ngolu hlobo, kwaye yintoni enokubangela oku.

Ixesha elininzi, eyona nto ibangela oku yingxaki kwinkqubo yakho yokuzikhusela komzimba. Ngamafutshane, amajoni akhusela imizimba yethu kwizifo ahlasela ngempazamo ezinye zeeseli zethu. Kwimeko enjalo, loo nkqubo yokuzikhusela yomzimba ihlasela iiseli ze-thyroid gland yakho kunye nezicubu ezingasemva kwamehlo akho.

Oku kuvuvukala kwamehlo kubantu abaneengxaki ze-thyroid kubizwa ngokuba yi -Thyroid Eye Disease (TED) . Enyanisweni, le meko ixhaphake kakhulu kubantu abanezifo ezinxulumene ne-thyroid.

Kunokubakho ezinye izizathu ezininzi:

• Isifo sikaGraves: Oku kukwanxulumene ne -hyperthyroidism, imeko apho i-thyroid gland isebenza kakhulu. Oku kukwabangelwa sisifo esifanayo neso sistim yomzimba esikhankanyiweyo apha ngasentla.
• I-Hyperthyroidism: Le meko inokwenzeka nokuba ingenaso isifo sikaGraves, xa i-thyroid gland isebenza kakhulu.
• Usulelo lwesokisi yamehlo: Ukuba usulelo lwebhaktiriya okanye lwentsholongwane luvela ngaphakathi kwesokisi yamehlo, ukudumba kunokutyhala iliso phambili.
• Ukwenzakala: Ukuba kukho ukopha emva kweliso, ingakumbi ngenxa yokwenzakala kweliso okanye entloko, elo gazi lingaqokelelana lize likhuphe iliso.
• Iithumba: Ukuba kuvela ithumba (elingenobungozi okanye elibi) ngaphakathi okanye kufutshane nesokhethi yeliso, linokubangela ukuba iliso livuvuke phambili. Umzekelo, iithumba ezibandakanya imithambo-luvo, njenge- neuroblastoma , okanye ezinye ii-sarcomas zezicubu ezithambileyo . Nangona kunjalo, ezi ntlobo zezizathu zomhlaza azixhaphakanga.

Ziziphi iingxaki ezinokubakho? Ngaba kukho naziphi na iziphumo ezihlala ixesha elide?

Oku kusenokuvakala kusoyikisa kancinci kuwe, kodwa inyani yile, kubantu abaninzi, le meko ayibangeli naziphi na iingxaki ezinkulu okanye iziphumo zexesha elide. Ayikukhuthazi na loo nto?

Nangona kunjalo, kunqabile kakhulu ukuba kubekho iingxaki ezithile. Umzekelo, ukubona kabini okanye ukulahlekelwa ngokupheleleyo kokubona kunokubakho ngokusisigxina. Kwakhona, njengoko benditshilo ngaphambili, ukuba awukwazi ukuqhwanyaza kwaye amaconsi okuthambisa amehlo awancedi, iliso lakho lisenokubaUmaleko ongaphezulu, i-cornea, nawo unokonakala. Oku kubizwa ngokuba yi-cornea ulceration. Yiyo loo nto kubalulekile ukufuna unyango ngokukhawuleza ukuba uneempawu.

Uyifumana njani le nto? Oogqirha bayiqinisekisa njani le nto?

Kulungile, ukuba uneempawu ezinje, ugqirha angafumanisa njani ukuba le yiProptosis okanye enye into?

Okokuqala, ugqirha uza kukubuza imibuzo eneenkcukacha malunga neempawu zakho. Baza kukubuza ngokweenkcukacha malunga nokuba sele unexesha elingakanani unazo ezi mpawu, ziqale njani, zeziphi ezinye iingxaki onazo, naziphi na izifo okhe wanazo ngaphambili, kunye nokuba kukho umntu kusapho lwakho okhe waba neemeko ezifanayo.

Emva koko, ngokuqinisekileyo uza kuhlolwa amehlo. Oku kungabandakanya izinto ezifana nezi:

• Isixhobo esikhethekileyo (isibane esiqhekekileyo) sisetyenziselwa ukukhulisa nokuhlola izakhiwo ezikumphezulu nangaphakathi kweliso lakho ngokweenkcukacha. Oku kunokubona izinto ezifana namanxeba kunye nokoma kwi-cornea.
• Zivavanya indlela amehlo akho kunye neenkophe zakho ezihamba ngayo, kunye nokuba ungawakhomba na omabini amehlo kwicala elinye.
• Bajonga amehlo ngononophelo ukuze babone ukuba abomvu na, ukuba kukho iintlungu, ukuba kukho ukudumba na, nokuba kukho iinyembezi.

Zeziphi ezinye iimvavanyo ekuya kufuneka zenziwe?

Emva kovavanyo lokuqala, ugqirha angenza nezinye iimvavanyo ukuze afumanise unobangela, ezinje ngezi:

• I-Exophthalmometry: Oku kusenokuvakala kungaqhelekanga, kodwa kusetyenziswa isixhobo esikhethekileyo (i-exophthalmometer) ukulinganisa ukuba iliso lakho liphume kangakanani kwisokhethi yeliso ngeemilimitha. Oku kunokunceda ekufumaneni ubunzulu bemeko.
• Uvavanyo lwegazi: Oku kuya kujonga amanqanaba ehomoni (TSH, T3, T4) ukujonga ukusebenza kwendlala yegilo. Kuba (iSifo seGyroid Eye) sesona sizathu siphambili.
• Izifundo zokujonga imifanekiso: Ukuchaneka, kwenziwa i-MRI (Magnetic Resonance Imaging) okanye i -CT scan (Computed Tomography scan) ukuze kubonwe ngokucacileyo ukuba kukho na ukudumba, iqhuma, uphawu losulelo, okanye ukopha kwimisipha, imithambo-luvo, kunye nezicubu ezinamafutha emva kweliso.
• Ezinye iimvavanyo zelebhu: Ngamanye amaxesha isampuli yokukhupha amanzi emehlweni okanye izicubu (i-culture) ingathathwa ukuqinisekisa ukuba kukho usulelo na.

Zithini iindlela zonyango?

Kulungile, ngoku makhe sijonge unyango lwale nto. Unyango olufumanayo luya kuxhomekeka kwisizathu sokudumba kwamehlo akho kunye nobunzima bemeko.

• Iinyembezi ezingezizo ezendalo: Ezi zingasetyenziswa izihlandlo ezininzi ngemini njengeethontsi okanye ijeli ukunciphisa ukoma kwamehlo nokukhusela i-cornea . Ezi zingathengwa kwikhemesti.
• Amayeza okubulala iintsholongwane:Ukuba kufumaniseke ukuba ukuphuma kwamanzi emehlweni akho kubangelwa kusulelo lwebhaktheriya, uya kunikwa amayeza okubulala iintsholongwane afanelekileyo (omlomo okanye nge-IV).
• Unyango lweemeko ezingaphantsi: Umzekelo, ukuba i-thyroid gland isebenza kakhulu (i-hyperthyroidism), amayeza okulwa ne-thyroid anikwa ukulawula. Isifo se-Graves siphathwa ngendlela efanayo.
• Amayeza afakwa kwimithambo yegazi (IV): Kwiingxaki zokudumba okukhulu kunye nokubona okubangelwa sisifo samehlo se-thyroid (TED), ii-corticosteroids (umz., i-methylprednisolone) zinokunikwa ngemithambo yegazi (IV pulse therapy) ukunciphisa ukudumba ngokukhawuleza. Iyeza elitsha elibizwa ngokuba yiTeprotumumab (Tepezza®) nalo lifunyenwe lisebenza kakhulu kwiTED.

Ngaba kukho ezinye iindlela zonyango ngaphandle kotyando?

Ewe, ngamanye amaxesha ezinye iindlela zonyango zingenziwa ngaphandle kotyando, ezifana:

• Unyango lokubona kabini: Oku kuquka iilensi ezikhethekileyo, ezifana neeprism, ezincamatheliswe kwiiglasi zakho. Ezi zisebenza ngokuqondisa ukukhanya okungena elisweni kwicala elahlukileyo, ukulungisa umbono wakho. Kunokucetyiswa nokuzilolonga kwamehlo.
• Amayeza okuthintela ukuvuvukala: La mayeza (umz., iMycophenolate, iRituximab) anokunceda ukunciphisa umonakalo owenziwa yinkqubo yomzimba yokuzikhusela emehlweni, ingakumbi kwiimeko ezifana ne-(TED).
• IiCorticosteroids: Iisteroids zinganikwa njengeepilisi zomlomo, inaliti, okanye ngemithambo ukunciphisa ukudumba okanye ukubuyisela umbono. Nangona kunjalo, ezi zinokuba nemiphumo emibi xa zisetyenziswa ixesha elide, ngoko ke kufuneka zithathwe kuphela phantsi kweliso likagqirha.

Ngaba ndiza kufuna utyando?

Asinguye wonke umntu ofuna utyando. Kodwa kukho iimeko apho utyando luyimfuneko. Umzekelo:

• Utyando lokunciphisa uxinzelelo lwe-orbital: Olu tyando lwenziwa ukuze kudalwe indawo engakumbi kwi-orbit engasemva kweliso . Oku kuvumela iliso ukuba liphinde lingene. Oku kwenziwa ukuba kukho ingozi ekuboneni, okanye ukuba iliso liphume kakhulu ngokwaneleyo ukuba lonakalise i-cornea.
• Utyando lweStrabismus: Utyando lwemisipha yamehlo lunokwenziwa ukuze omabini amehlo akhombe kwicala elinye.
• Utyando lwe-eyelid: Ukuba iinkophe azikwazi ukuvala kakuhle, kwenziwa utyando lokutshintsha indawo yeenkophe ukuze kukhuselwe i -cornea .
• Ukususwa kwethumba: Ukuba kukho ithumba, kuya kufuneka lisuswe ngotyando.

Kuza kwenzeka ntoni emva koko? Kuza kuthatha ixesha elingakanani ukuba umntu aphile?

Ukuba ufumana unobangela wezi mpawu uze uzinyange ngokukhawuleza, iziphumo ziba ngcono kakhulu. Ukuba ufumana unyango olufanelekileyo, unokuthintela neengxaki.

"Ngaba ukuva kwam kuya kuze kubuye kube sesiqhelo?" mhlawumbi ubuza. Ewe,Kwiimeko ezininzi, iliso linokubuyela kwisimo salo esiqhelekileyo. Nangona kunjalo, nokuba sele lifumene unyango oluphumeleleyo, kungathatha ixesha elithile ukuba iliso libuyele kwisimo salo sokuqala. Ngamanye amaxesha kungathatha iinyanga, ngamanye amaxesha kwaneminyaka. Kuxhomekeke kwisizathu, ubukhali bemeko, kunye nempendulo yonyango.

Singayithintela njani imeko ukuba ingabi mbi ngakumbi?

Kulungile, ngoku ekubeni unale meko (Proptosis), kukho izinto ezibalulekileyo onokuzenza ukuze uyithintele ukuba ibe mandundu:

• Lawula amanqanaba akho e-thyroid: Ukuba unesifo se-thyroid, ingakumbi isifo sikaGraves, landela imiyalelo kagqirha wakho ngokuchanekileyo. Thatha amayeza akho emihla ngemihla ngexesha, kwaye ufumane uvavanyo lwegazi rhoqo ukuze ugcine amanqanaba akho e-thyroid ngaphakathi komlinganiselo oqhelekileyo.
• Yeka ukutshaya ngokupheleleyo: Ukuba ungumntu otshayayo, le yeyona nto ilungileyo onokuyenza. Ukutshaya akupheleli nje ekwenzeni imeko (i-Thyroid Eye Disease) ibe mandundu, kodwa kunciphisa kakhulu impumelelo yonyango. Ukuyeka ukutshaya kuya kuyiphucula kakhulu indlela umzimba wakho osabela ngayo kunyango. Ngoko ke, yenza eso sigqibo namhlanje.

Uphila njani nale meko? Uhlala njani uqinile engqondweni?

Amehlo akho anokutshintsha inkangeleko yakho. Oku kunokuba nefuthe elikhulu ekuzithembeni kwakho nasekuzithembeni kwakho. Ungaziva uxhalabile kakhulu kwaye ukhathazekile ngale nto. Ungacinga, "Baza kucinga ntoni abantu?" okanye "Ubuso bam butshintshile." Ukuba oku kuchaphazela umbono wakho, ezinye izinto kubomi bakho bemihla ngemihla kunye nobudlelwane bentlalo zinokutshintsha ngokungalindelekanga. Olu tshintsho lunokubangela ukuba uzive udanile, uxhalabile, okanye udandathekile. Kuqhelekile, kwaye awuwedwa ojongene nezi zinto.

Khumbula, awuwedwa kolu hambo. Ukucela uncedo akubobuthathaka, kukwamandla.

Izinto ezinjalo ziya kukunceda uhlangabezane nale mingeni:

• Funa uncedo kwingcali yezempilo yengqondo : Kubalulekile ukuthetha nomntu ofana nogqirha wengqondo okanye umcebisi. Banokukunceda ufumane iindlela zokujongana, ukujongana, kunye nokulawula iingcinga zakho ezimbi kunye neemvakalelo zakho ngokusebenzisa unyango olufana neCognitive Behavior Therapy (CBT) .
• Fumana uncedo kubasebenzi bezentlalo: Ukuba awukwazi ukuqhuba ngenxa yeengxaki zokubona okanye unezinye iingxaki ezisebenzayo, banokukunceda ufumane amaqela enkxaso kwindawo okuyo okanye izixhobo ezifumaneka kwi-intanethi. La maqela azaliswe ngabantu abaye badlula kumava afana nawe, ngoko ke ukuthetha nabo kunokuba luncedo olukhulu.

Ekugqibeleni, kufuneka uthi...

I-Proptosis inokuba yinto ecaphukisayo neyoyikisayo ukuba nayo. Siyaqonda loo nto. Kodwa musa ukuyivumela ukuba yonakalise ubomi bakho. Okukhona ubona ugqirha ngokukhawuleza, kokukhona kuya kuba lula kuye ukufumana unobangela. Emva koko ungaqala unyango olufunekayo, uthintele imeko ukuba ibe mandundu, kwaye uthintele iingxaki ezinokubakho.

Kubalulekile nokunyamekela impilo yakho yengqondo. Njengempilo yakho yomzimba, kufuneka ukhathalele impilo yakho yengqondo. Ukufuna uncedo kumcebisi wezempilo yengqondo kunokukunceda ulawule iimvakalelo zakho kwaye ujongane nalo mceli mngeni ngamandla. Unontlalontle unokukuthumela kwiindawo apho unokufumana khona inkxaso oyifunayo.

Ngoko ke, ungakhathazeki nganto kwaye ungoyiki ukufuna uncedo. Ndikunqwenelela ukuchacha ngokukhawuleza!

i- proptosis, i-exophthalmos, amehlo avuvukileyo, isifo samehlo e-thyroid, isifo se-Graves, i-hyperthyroidism, iingxaki zamehlo