Ngaba amehlo akho ahlala ebuhlungu? Masifunde ngokuKhukuliseka kweCorneal okuPhindaphindayo!

Ngaba nawe uziva iintlungu ezinganyamezelekiyo xa uvula amehlo akho kusasa? Ngaba uziva ngathi kukho into engaphakathi kweliso lakho, ngathi kukho into ekuhlabayo? Kunzima ukujonga ukukhanya, kwaye iinyembezi ziyaphuma nje? Ezi zisenokuba ngumonakalo kumaleko ongaphezulu kweliso lakho, oko kukuthi, i-cornea, imeko apho inxalenye ephezulu ye-cornea ixotyulwa khona. Siyibiza ngokuba yi- Recurrent Corneal Erosion (RCE) . Nangona eli gama liyinkimbinkimbi kancinci, le yimeko eqhelekileyo. Ungakhathazeki, masithethe ngale nto ngokweenkcukacha, ngokulula.

Yintoni kanye kanye iRecurrent Corneal Erosion (RCE)?

Ngamafutshane, inwebu ecacileyo engaphambili kweliso lakho, njengefestile yemoto, yileyo siyibiza ngokuba yi-cornea . Oku kukukhusela iindawo ezibuthathaka ngaphakathi kweliso kwihlabathi langaphandle. Kufana neglasi yokhuseleko ebekwe phezu kwamehlo ethu. Le cornea ineeleya ezintlanu, okanye iileya. Kwimeko ye-Recurrent Corneal Erosion (RCE), iileya ezimbini eziphezulu ziyachaphazeleka.

Ezo migangatho mibini zezi:

• I-Epithelium: Le yilaphu engaphandle ye-cornea. Ineziphelo ezininzi zemithambo-luvo, nto leyo eyenza ukuba ibe buthathaka kakhulu kunesikhumba sethu. Nokuba sisiqwenga sothuli sinokusiva.
• I-membrane kaBowman: Olu maleko lwenziwe kakhulu ngeproteni ebizwa ngokuba yi-collagen . Cinga ngalo njengejeli ehlala ihleli kwaye ibambene, kwaye yindlela esebenza ngayo. I-membrane kaBowman ibamba umaleko we-epithelial ongaphezulu kunye nomaleko ongezantsi kunye, nto leyo ebanceda bahlale kunye.

Ngoku, xa une-RCE, i-epithelium ngokwayo kunye ne-membrane kaBowman azinamatheliswanga kwaye azidityaniswanga ngokufanelekileyo. Elo qhagamshelo liyabuthathaka. Emva koko umaleko ophezulu, i-epithelium ngokwayo, unokukrazuka ngokulula, njengexolo. Xa oko kusenzeka, amaleko angaphantsi asengozini ayaphuma. Eli liva elibuhlungu kakhulu kuba i-epithelium igcwele iziphelo zemithambo-luvo.

Ixhaphake kangakanani le meko ye-RCE?

I-RCE yimeko eqhelekileyo kakhulu, kodwa kunzima ukutsho ukuba bangaphi abantu abayibangelayo. Uphononongo olwenziwe eLondon, eNgilani, lufumanise ukuba le meko ichaphazela malunga ne-1% yabemi beso sixeko minyaka le. Nangona kunjalo, elo nani lisenokuba liphantsi kunenani langempela. Oku kungenxa yokuba nokuba ngumkrwelo omncinci usenokungadingi nyango. Ii-cornea zethu zenzelwe ukuba ziziphilise ngokukhawuleza. Ngoko ke, imikrwelo emincinci inokuphola ngemizuzu okanye iiyure.

Zithini iimpawu ze-RCE?

Ukuba une-RCE, iimpawu zakho zihlala zibonakala xa uqala ukuvula amehlo akho kusasa . Umzekelo, ebusuku, unxibelelwano phakathi kwe-eyelid yakho kunye nolwelo oluphezulu lwe-cornea yakho lunokuba buthathaka. Xa uvula amehlo akho kusasa, indawo ebuthathaka inokubangela ukuba ulwelo oluphezulu lwe-cornea yakho lusuke kwi-eyelid. Ukuba oku kuyenzeka, unokufumana iimpawu ezifana nezi:

• Intlungu ebuhlungu:Intlungu isenokuvakala ngathi kukho into enamathele ngaphakathi kweliso, ngathi ihlatywa ngemela.
• Ububomvu bamehlo.
• Uloyiko lokubona ukukhanya: Nokuba kukukhanya okuncinci kunokuba nzima ukukuthwala.
• Ukukrazula kakhulu emehlweni (i-Epiphora).
• Kuvakala ngathi kukho isuntswana lothuli okanye into enamathele ngaphakathi kweliso, kodwa usenokungaboni nto ngaphakathi kweliso.

Kutheni le meko ye-RCE isenzeka?

Oku kufana nokufaka ipeyinti entsha eludongeni oluye lwaqhekeka ngaphandle kokuyicoca ngokufanelekileyo. Kuba umaleko wepeyinti ongaphantsi awucocekanga, kwaye ngenxa yeziphene ezikuwo, ipeyinti entsha ayinamathele kakuhle. Nokuba uyichukumisa nje, umaleko omtsha unokuphuma, akunjalo? Yiyo loo nto kunjalo. Ukuba kukho ubuthathaka okanye umonakalo kumaleko angaphantsi kwe-cornea, umaleko ophezulu awuyi kunamathela ngokufanelekileyo.

Kwiimeko ezininzi , imbangela ephambili ye-RCE kukwenzakala kweliso ngaphambili . Kungaba kukuncinwa okanye ukwenzakala yinto efana nozipho lwakho, ikona yephepha, okanye igqabi lomthi, isebe elincinci. Khawuthelekelele usebenza egadini kwaye isebe elincinci libetha ilihlo lakho. Nokuba akubonakali ngathi yinto enkulu ngelo xesha, emva kweentsuku ezimbalwa, okanye iminyaka, unokuvuka unentlungu enzima xa uvula amehlo akho kusasa. Le ngozi akufuneki ibe yeyakutshanje. Abanye abantu banokufumana i-RCE kwingozi yeliso eyenzeke kwiminyaka eyadlulayo. I-RCE ebangelwa kukwenzakala okunjalo idla ngokuchaphazela iliso elinye kuphela.

I-RCE inokubangelwa zizifo ezithile ze-cornea kunye neemeko ezingapheliyo ezichaphazela amehlo. Nangona ezi zihlala zichaphazela iliso elinye kuphela, abanye abantu banokufumana iimpawu emehlweni omabini.

Imizekelo yoku yile:

• I-Epithelial Basement Membrane Dystrophy (EBMD): Ikwabizwa ngokuba yi-map-dot-fingerprint dystrophy, obu bubuthathaka kwiindawo ezisezantsi ze-cornea.
• Isifo samehlo esomileyo: Le meko yenzeka xa ukuveliswa kweinyembezi emehlweni kuncipha.
• Uhlobo lwesibini lweswekile.
• Ukudumba kunye nokuvuvukala kweenkophe (i-Blepharitis).
• I-Ocular Rosacea: Le yingxaki yamehlo eyenzeka xa kukho ingxaki yesikhumba.

Ziziphi iingxaki ezinokubakho ze-RCE?

Iingxaki ezibangelwa yi-RCE azisoloko zibeka ubomi esichengeni, kodwa zinokuba zimbi kakhulu kwaye zibe yingozi.

Bazi:

• Umngcipheko ophezulu wokuphinda kwe-RCE kwixesha elizayo: Xa i-RCE isenzeka, amathuba okuba i-cornea yonakale kwakhona aphezulu.
• Ulusu lwe-cornea: Xa i-cornea yonakaliswa ngokuphindaphindiweyo yi-RCE, ukukhanya kwayo kunokuncipha. Oku kunciphisa ubungakanani bokukhanya okungena elisweni, okwenza kube nzima ukuba ubone.
• Umngcipheko okhulayo wosulelo:I-cornea yakho ngumqobo okhuselayo. Xa yonakele, iileya ezingaphantsi zichatshazelwa ziintsholongwane. Oku kunokukhokelela ngokulula kwiintsholongwane zamehlo . Ngamanye amaxesha ezi zinokuba yingozi.

Ungayichonga njani imeko ye-RCE?

I-RCE idla ngokuba lula ukuyixilonga. Ingcali yamehlo okanye ingcali yamehlo inokukukrokrela ngokukubuza ngeempawu zakho, imbali yakho yezonyango, kunye nayo nayiphi na ingozi yamehlo yangaphambili.

Emva koko kwenziwa iimvavanyo ezithile ukuqinisekisa oku. Ngaphambi kokuba wenze ezo vavanyo, unganikwa iyeza lokuthomalalisa iintlungu.

Uvavanyo olunokwenziwa zezi:

• Uvavanyo lwesibane esiqhekekileyo: Kolu vavanyo, ugqirha wakho uhlola iliso lakho ngemayikroskopu ekhethekileyo (isibane esiqhekekileyo). Ngexesha lovavanyo, kufakwa idayi eluhlaza okwesibhakabhaka ebizwa ngokuba yi-fluorescein esweni lakho (nokuba ngamaconsi eliso okanye ngomcu okhethekileyo). Oku kukuvumela ukuba ubone nayiphi na imikrwelo kwi-cornea.
• Uvavanyo lokuncamathela: Oku kubandakanya ukuchukumisa kancinci umphezulu we-cornea ngesiponji sotyando. Ukuba une-RCE, umaleko ophezulu we-cornea uya kuhamba nesiponji, unganamatheli kakuhle. Oku kuluncedo xa ezinye iimvavanyo zingabonisi ngokucacileyo umkrwelo.

Iphathwa njani i-RCE?

Oogqirha banyanga i-RCE ngendlela ethatha inyathelo nenyathelo. Badla ngokuqala ngonyango olulula lwezonyango baze baqhubekele kunyango olunzima ngakumbi ukuba aluncedi. Nangona kunjalo, ukuba i-RCE inzima, banokuya ngqo kunyango olunzima ngakumbi.

Ulawulo lwezonyango

Injongo ephambili kukudala indawo ekhululekileyo yokuba iliso lakho lizipholise lodwa. Unyango oluninzi luqhutywa nguwe. Ugqirha wakho uza kukunika imiyalelo ethile malunga nento omawuyenze.

Ezinye iindlela zonyango zingathatha iintsuku okanye iiveki. Ngokuxhomekeke kubukhali be-RCE, ezinye zingathatha iinyanga.

Ulawulo lwezonyango lungabandakanya enye okanye ezingaphezulu kwezi zilandelayo:

• Ulawulo lweentlungu: I-RCE yimeko ebuhlungu. Iipilisi zokunciphisa iintlungu ezifana neziyobisi ezichasene nokuvuvukala ezingezizo ii-steroidal (NSAIDs) zinokunceda ekunciphiseni iintlungu. Kwakhona, amafutha akhethekileyo kunye neelensi zokunxibelelana zebhandishi zinokunceda ekunciphiseni iintlungu.
• Ukuthambisa amehlo: Iinyembezi zokwenziwa, amathontsi etyuwa, iijeli, okanye amafutha okugcoba anokunikwa emehlweni. Oogqirha bacebisa ukuba bawasebenzise ebusuku ngaphambi kokuba balale. Oku kwenzelwa ukuthintela ukuqala okanye ukuba mandundu kwe-RCE xa uvula amehlo akho kusasa.
• I-Hypertonic saline:Olu lwelo lunyusa ukufunxwa kolwelo oluvela kumphezulu weliso. Oku kunceda i-epithelium ukuba inamathele ngcono kwiileya ezingaphantsi. Oogqirha bacebisa ukuba usebenzise oku emini, kunye namafutha owasebenzisayo ebusuku.
• Amaconsi okanye amafutha okubulala iintsholongwane: La maconsi anikwa ukunceda ekunyangeni naluphi na usulelo lwamehlo olubangela i-RCE, okanye ukuthintela usulelo ukuba lungenzeki de iliso liphole.
• Iilensi zokunxibelelana ezipeyintwayo okanye ezibotshwayo: Zombini ezi zinto zibonelela ngokhuseleko olongezelelekileyo de iliso liphole. Ilensi yebhandishi yibhandishi ebekwa esweni, njengelensi yokunxibelelana. Inceda iliso ukuba liziphilise.
• I-Cycloplegia: Izihlunu ezilawula amehlo akho zitshintsha kancinci indlela ajongeka ngayo. Yile nto ikwenza ubone izinto ngendlela eyahlukileyo ngokucacileyo. I-Cycloplegia iyenza buthathaka okwethutyana izihlunu ezikwiliso elichaphazelekayo. Oku kuvumela iliso ukuba lihlale likwimo efanayo, nto leyo eyenza kube lula ukuphola.
• Amathontsi e-serum: La mathontsi akhethekileyo aqulethe iiproteni zokuzikhusela komzimba kunye nezinye izithako ezinceda iliso ukuba liphile. Anokuba yi -autologous , oko kuthetha ukuba enziwe ngegazi lakho, okanye angenziwa ngegazi elinikelweyo.
• Amayeza athile: La anokuba ngamayeza athintela iiproteni eziphazamisa ukuphiliswa kwe-cornea, njenge -corticosteroids okanye i-doxycycline , okanye amayeza aqulethe izinto ezikhulisayo ezivuselela ukuphiliswa.

Unyango lotyando

Unyango lotyando lubandakanya ukususa iindawo ezonakeleyo ze-epithelium kwaye uyivumele ukuba ikhule kwakhona ngendlela efanayo, engenamanxeba. Olu tyando ludla ngokwenziwa phantsi kwe-anesthesia yangaphandle, ngoko ke akukho ntlungu.

Kwanasemva kolu nyango, ugqirha wakho unokukunika amayeza njengoko kukhankanyiwe apha ngasentla. I-epithelium idla ngokukhula kwakhona kwiintsuku ezimbalwa. Nangona kunjalo, kungathatha iiveki okanye iinyanga zonyango oluqhubekayo ukuze i-epithelium inamathele ngokufanelekileyo kwiileya ezingaphantsi.

Unyango lotyando lunokubandakanya enye okanye ezingaphezulu kwezi zilandelayo:

• Ukususwa kwezicubu ze-epithelial ezonakeleyo ngezixhobo ezikhethekileyo.
• Ukupholisha idayimani: Ugqirha usebenzisa isixhobo esikhethekileyo ukukhuhla izicubu ze-epithelial kwindawo echaphazelekayo ye-cornea, okuvumela yonke indawo ukuba ikhule ngokulinganayo.
• Ukubhoboza kwe-stromal: Ugqirha usebenzisa inaliti encinci kakhulu okanye i-laser ukwenza imingxunya emincinci kwi-stroma , umaleko weliso ongaphantsi kwe-membrane kaBowman. Xa le mingxunya ibekwe kwiindawo ezifanelekileyo, iliso liyaziphilisa kuloo mingxunya. Oku kuqinisa umanyano phakathi kwale mingxunya ingaphezulu.
• Ukubekwa kwe-amniotic membrane: Oku kusebenza njengelensi yebhandishi, kodwa kusebenzisa izicubu ezithathwe kwi-placenta. I-placenta isuswa nge-cesarean section ize emva koko ibulawe iintsholongwane. Ugqirha uyibeka ngqo phezu kwendawo echaphazelekayo yeliso. Izicubu ze-placenta zikhusela iliso kwaye zinceda ukuba iileya zangaphandle ze-cornea zikhule kwakhona.

Iingxaki/iziphumo ebezingalindelekanga zonyango

Iingxaki kunye nemiphumo emibi yonyango yahluka kakhulu ngokuxhomekeke kunyango olufumanayo. Ugqirha wakho angakuxelela ngcono ukuba zeziphi iziphumo ebezingalindelekanga onokuzifumana kunye nento onokuyenza ukunciphisa okanye ukuthintela ezo ziphumo.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Ixesha lokuchacha emva konyango lixhomekeke kwizinto ezininzi. Umaleko we-epithelial we-cornea yakho unokukhula kwakhona kwaye uphole ngokukhawuleza. Nangona kunjalo, kungathatha iiveki okanye iinyanga ukuba amaleko angaphantsi aphole ngokupheleleyo kwaye ahlangane kakuhle. Ugqirha wakho angakuxelela ukuba kuza kuthatha ixesha elingakanani ukuba uphole kwaye nini na onokulindela ukubona utshintsho kwiimpawu zakho, umbono, okanye indlela amehlo akho aziva ngayo.

Yintoni endimele ndiyilindele ukuba ndine-RCE?

Ukuba une-RCE, uphawu oluphambili ziintlungu . Ezinye iimpawu ziqhelekile, azikhululeki, kwaye ziphazamisana nemisebenzi yemihla ngemihla. Kodwa imikrwelo emincinci idla ngokuphola ngokukhawuleza. Uninzi lwabantu lufuna uncedo lwezonyango xa imikrwelo yabo iphakathi ukuya kweqatha.

Ingxaki ephambili oza kujongana nayo kukuba ezi zinto zinokuphinda zivele . Ukuba oku kuyenzeka, kukho amathuba aphezulu okuba kubekho iingxaki ezichaphazela umbono wakho.

Kungoko ke, kungcono ukubona ingcali yamehlo ukuba ubona iimpawu ze-RCE, ingakumbi xa uqala ukuvula amehlo akho kusasa . Unyango olukhawulezileyo lunokunciphisa umonakalo obangelwe yi-RCE kwaye lunciphise umngcipheko wokuba iphinde yenzeke kwixesha elizayo.

I-RCE ingahlala ixesha elingakanani?

I-cornea yakho inamandla amangalisayo okuziphilisa. Umonakalo omncinci ungaphola kwiiyure ezimbalwa, kwaye umonakalo omkhulu ungathabatha iintsuku ezimbalwa.

Kodwa khumbula, i-RCE yenzeka kuphela xa amehlo akho engapholi kakuhle. Ukuba oko kuyenzeka, kuya kufuneka uqhubeke nokusebenzisa amayeza akho amehlo okanye ezinye iindlela zonyango njengoko ugqirha wakho ekuyalele kangangeeveki okanye iinyanga. Oku kungabonakala ngathi ngumsebenzi odinisayo nodinisayo, kodwa yeyona ndlela ilungileyo yokuqinisekisa ukuba amehlo akho aphiliswa kakuhle kwaye uthintele i-RCE ukuba ingenzeki kwixesha elizayo.

Iyintoni imbonakalo yesimo se-RCE?

I-RCE ibuhlungu, ayikhululeki, kwaye ngamanye amaxesha imbi kakhulu, kodwa ayisongeli ubomi. Ngamanye amaxesha iyabuya, kodwa ukuphinda ibuyele kwimeko yayo kunokunyangeka. Ngethamsanqa, iingxaki ezichaphazela umbono wakho ixesha elide okanye ngokusisigxina azixhaphakanga.

Ngaba i-RCE ingathintelwa okanye umngcipheko uncitshiswe?

Ii-RCE zinokwenzeka ngequbuliso. Azinakuthintelwa ngokupheleleyo, kodwa kukho izinto onokuzenza ukunciphisa amathuba okuba zenzeke.

Yintoni enokwenziwa ukuthintela i-RCE?Eyona nto ibalulekileyo kukuthintela ukwenzakala kwamehlo. Nxiba iiglasi zokukhusela amehlo, izikhuselo zobuso, okanye iiglasi zokhuseleko nanini na xa amehlo akho esengozini yokwenzakala. Oku kubaluleke kakhulu xa usebenza ngezixhobo okanye kwindawo apho kukho umngcipheko wokufumana izinto emehlweni akho.

Ukuthambisa amehlo akho ngeenyembezi, iijeli, okanye amafutha okufakelwa ngaphambi kokuba ulale kunokuba luncedo kakhulu, ingakumbi ukuba uvuka amehlo akho ebuhlungu kusasa. Ukugcina umphezulu we-cornea kunye ne-eyelid zimanzi kunceda ukuthintela ukunamathelana okubangela ukukrazuka.

Ndingazinyamekela njani?

Ukuba ucinga ukuba une-RCE, kungcono ukufuna unyango kwangethuba . Oku kuya kukunceda ukulawula iimpawu zakho kwaye kunciphise umngcipheko weengxaki ezizayo.

Ukuba une-RCE, ugqirha wakho uya kukubonisa indlela yokulawula le meko. Kubaluleke kakhulu ukulandela imiyalelo yabo ngqo. Ukuba ulandela imiyalelo ngqo kwaye uthatha amayeza okanye unyango njengoko kuyalelwe, unethuba elikhulu lokuchacha ngaphandle kweengxaki.

Ndifanele ndimbone nini ugqirha wam okanye ndifune ingcebiso kagqirha?

Ukuba une-RCE, kufuneka uye kutyelelo olulandelayo njengoko kucetyisiwe ngugqirha wakho. Oku kuya kubavumela ukuba bajonge indlela i-cornea yakho ephola ngayo kwaye balungise unyango lwakho ukuba kuyimfuneko. Ukuba ubona naluphi na utshintsho kwiimpawu zakho, umbono wakho, okanye ukusebenza kakuhle konyango lwakho, kufuneka uthethe nabo okanye ubatyelele.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

I-RCE ayisoloko iyinto engxamisekileyo, kodwa inokuba buhlungu kwaye iphazamise kakhulu imisebenzi yemihla ngemihla. Ukuba uneempawu ze-RCE, kulungile ukufowunela iofisi kagqirha wosapho lwakho ukuze ufumane isikhokelo. Ungaya nakwikliniki yokhathalelo olungxamisekileyo.

Nangona i-RCE ingaqhelekanga ukuba yingxamiseko, ifana nokwenzakala kwamehlo okunzulu okufana nokukrazuka kwe-cornea , okubangelwa kukusika nokukrazuka kwe-cornea.

Ukuba unamathandabuzo, funa unyango olungxamisekileyo ngaphandle kokulibazisa. Ukwenza njalo kunokwenza umahluko omkhulu kunyango, ekuchacheni, nasekugcineni umbono wakho.

Ukuba unezinye zezi mpawu zilandelayo kunye nentlungu yamehlo, kufuneka ufune ingcebiso kagqirha:

• Ukwenzakala kweliso lakho, njengokusikwa, ukukrweleka, ukuqhekeka, okanye inxeba elihlatyiweyo.
• Ukulahlekelwa ngumbono ngequbuliso (nokuba yinto yexeshana okanye ichaphazela inxalenye yombono kuphela).
• Amehlo akho ayatsha okanye abomvu ngendlela ongenakukwazi ukuyichaza.
• Isicaphucaphu nokuhlanza.
• Intloko ebuhlungu .
• Ifiva.
• Ukuziva ngathi kukho into ebambeke elisweni lakho (nokuba ubona nantoni na enokubangela loo mvakalelo okanye awuyiboni).

Ekugqibeleni kancinci...

Xa amehlo ethu esebenza kakuhle, asicingi nokuba siwasebenzisa kangakanani, akunjalo? Kodwa xa amehlo ethu ebuhlungu, kwaye singazi ukuba kutheni, kunokuba yinto eyoyikisayo. I-RCE yimeko enzima nebuhlungu, kodwa kukho unyango olufanelekileyo lwayo.

Ukuba uneempawu ze-RCE, ingakumbi ukuba zintsha, thetha nogqirha okanye ugqirha wamehlo. Okukhona ufumanisa ukuba unesifo ngokukhawuleza kwaye uqala unyango, kokukhona amathuba akho okuchacha ngokukhawuleza nokuthintela ukuba esi sifo singaphindi sivele kwixesha elizayo.

Ukulimala kwamehlo , Ukulimala kwe-cornea, Intlungu yamehlo, Ububomvu bamehlo, Ukukhukuliseka kwe-cornea okuphindaphindiweyo, i-cornea, Intlungu yamehlo