Ingabe ingane yakho encane inalolu hlobo loshintsho emehlweni ayo? Ake sifunde nge-(Congenital Glaucoma)!

Uma sibheka amehlo ezingane zethu ezincane, ngezinye izikhathi sibona into engavamile noma ehlukile, akunjalo? Amehlo ezinye izingane abukeka emakhulu kancane, noma avame ukuba nezinyembezi emehlweni azo, noma abathandi ukubuka ukukhanya. Lokhu ngezinye izikhathi kungaba lula kakhulu futhi kujwayelekile. Kodwa ngesikhathi esifanayo, ngezinye izikhathi kungaba uphawu lwento edinga ukunakwa okuncane. Namuhla sizokhuluma ngesifo samehlo esingase senzeke ezinganeni ezincane kangaka, ikakhulukazi ekuzalweni noma eminyakeni embalwa yokuqala yokuphila, kodwa uma sibonakala kusenesikhathi, singalawulwa kahle futhi umbono wengane ungavikelwa. Lokhu kubizwa ngokuthi i-congenital glaucoma .

Kuyini i-glaucoma yokuzalwa?

Kalula nje, i-glaucoma yokuzalwa yisimo esiba khona ekuzalweni noma ebuntwaneni (kungakapheli iminyaka emi-2-3) ngenxa yezici ezithile zofuzo. Manje ungase ubuze, "Kuyini i-glaucoma?" I-Glaucoma igama elivamile lanoma yisiphi isifo samehlo esonakalisa i-optic nerve, i-nerve eyinhloko engaphakathi kweso esisiza sibone. Lo monakalo ungaholela kancane kancane ekulahlekelweni kokubona.

Izingane ezine-glaucoma yokuzalwa zinengcindezi ephezulu ngaphakathi kwamehlo azo, okubizwa ngokuthi i-ocular hypertension . Amehlo ethu akhiqiza uketshezi olukhethekile olubizwa ngokuthi i-aqueous humor . Lolu ketshezi lubaluleke kakhulu ekugcineni amehlo ephilile. Ngokuvamile, lolu ketshezi lukhiqizwa futhi lukhishwe kahle emehlweni. Kodwa-ke, ezinganeni ezine-glaucoma yokuzalwa, lolu ketshezi aluphumi kahle. Lolu ketshezi lube seluqoqana ngaphakathi kweso, futhi ingcindezi engaphakathi kweso iyanda kancane kancane. Lokhu kucindezela okwandayo kubangela ukuthi i-optic nerve engikhulume ngayo ekuqaleni icindezelwe. Ngokuhamba kwesikhathi, lokhu kungabangela ngisho nezinguquko esimweni samehlo. Ungase uqaphele ukuthi amehlo engane yakho asekhulile, noma i-iris (ingxenye yeso enombala ngempela - i-iris) ingase ibe namafu futhi ishintshe umbala.

Lesi yisifo esingelapheka. Kodwa-ke, uma singelashwa, ukubona kungawohloka kancane kancane futhi kuholele ngisho nasekungabonini. Ngakho-ke, kubaluleke kakhulu ukuqaphela lezi zimpawu bese uqala ukwelashwa ngokushesha okukhulu. Kungaleso sikhathi kuphela lapho umonakalo ungancishiswa khona futhi umbono wengane uvikeleke ngangokunokwenzeka.

Ziyini izimpawu zalesi sifo? Sizibona kanjani?

Ngaphezu kwezimpawu eziyinhloko ezibonakala kulesi sifo, kunezinye izimpawu ezengeziwe.

Kunezimpawu ezintathu eziyinhloko:

Lezi yizici ezintathu odokotela abazinaka kakhulu.

• Ukudabuka kwamehlo njalo (Epiphora): Uma sikhuluma iqiniso, kubonakala sengathi izinyembezi ziyavuza emehlweni ngisho noma ingane ingakhali.
• Ukwesaba ukuthwebula izithombe: Ingane ingase ingafuni ukubuka ukukhanya okukhulu, ivale amehlo noma iphendule ubuso bayo uma iphuma ngaphandle.
• I-Blepharospasm: Kuzwakala sengathi izinkophe zishaya ngokushesha, noma sengathi zizama ukuvala amehlo azo ngokuqinile.

Ezinye izimpawu ongase uzibone:

• I-Buphthalmos: Amehlo engane abonakala emakhulu futhi evuvukele kakhulu kunabanye abantwana. Abanye abazali bathi, "Amehlo engane afana namehlo amakhulu, anjengenkunzi."
• Ukubukeka okuluhlaza okwesibhakabhaka kwebhola leso: Ingxenye emhlophe yeso (i-sclera) ingabonakala ngezicubu ezingaphansi, yenze ibonakale iluhlaza okwesibhakabhaka.
• Ukubonakala okumhlophe noma okunamafu kwe-cornea: Ulwelwesi olucacile phezu kweso elimnyama (i-cornea) luba namafu, lubukeke njengenkungu engilazini.

Ungase futhi uqaphele lezi zinto njengezinguquko embonweni wengane yakho:

• I-Astigmatism: Ingane ingase ingaboni izinto ngokucacile.
• I-Myopia: Isimo lapho izinto eziseduze zingabonakala ngokucacile, kodwa izinto ezikude azibonakali kahle.
• I-Anisometropia: Ngenxa yokuthi umbono kwelinye iso uhlukile kwelinye, ingane ingazama ukusebenzisa iso elibona kangcono kuphela.

Ezinye izinto udokotela wakho angase azithole ngesikhathi sokuhlolwa kwamehlo zifaka:

• I-Corneal Edema: Ingxenye ecacile yeso engaphambili ivuvukele.
• Ukuklwebheka kwe-cornea: I-cornea iyanwebeka ngenxa yokucindezela okukhulu, futhi kungase kwakheke imihuzuko emincane kuyo.
• Ukubola kwe-cornea: Umonakalo wesikhathi eside ungabangela ukubola okungapheli kwe-cornea.

Lezi zimpawu zivame ukubonakala emehlweni womabili, kodwa ngezinye izikhathi zingase zivele esweni elilodwa kuphela.

Kungani lokhu (i-Congenital Glaucoma) kwenzeka? Iyini imbangela?

I-glaucoma yokuzalwa iqala ngesici ekukhuleni kweso lengane. Isici esivame kakhulu yisici ekukhuleni kwezicubu ezikhipha amanzi ngaphakathi kweso, i-trabecular meshwork . Cabanga ngayo njengembobo esinkini. Uma leyo mbobo ingakheki kahle, amanzi ngeke aphume kahle. Lokhu kuyafana nalokhu. Ngenxa yokuthi i-trabecular meshwork ayikhuli kahle, uketshezi olungaphakathi kweso aluphumi kahle. Khona-ke lolo ketshezi luqoqana ngaphakathi kweso, lwandise ingcindezi ngaphakathi kweso. Lokhu kucindezela okwandayo yikona okulimaza i-optic nerve. Futhi, lokhu kucindezela kungabangela i-cornea, ingaphambili leso, ukuba ikhule, yelule, ibe nemicu, futhi ibe nezibazi.

Le nqubo ihamba kancane kancane. Okusho ukuthi, lesi sifo siya siba sibi kancane kancane. Ukuthi siba sibi kangakanani ngokushesha kuncike ohlotsheni lwesici esweni lengane, inani loketshezi oluqongelelekayo, kanye nenani lokucindezela ngaphakathi kweso.

Cabanga, ezinye izingane zibonisa lezi zimpawu ngesikhathi sokuzalwa. Okusho ukuthi, lesi simo besilokhu sikhula ngesikhathi zisesesibelethweni (Ukuthuthukiswa Kwengane). Kwabanye abantwana, izimpawu zingase zivele kamuva, mhlawumbe ezinyangeni ezimbalwa noma unyaka noma emibili. Lokhu kungenxa yokuthi ukukhubazeka kokuzalwa akukubi kangako, futhi kuthatha isikhathi ukuthi izimpawu zivele.

Ingabe kunezinhlobo ezahlukene ze-Congenital Glaucoma?

Yebo, kunezindlela eziningana odokotela abahlukanisa ngazo lesi sifo.

Ukuhlukaniswa ngokweminyaka yokuqala kwezimpawu:

• Uhlobo lwezinsana ezisanda kuzalwa: Izimpawu zivela ekuzalweni noma phakathi nenyanga yokuqala yokuphila.
• Uhlobo lwezingane ezincane: Izimpawu zivela eminyakeni emibili kuya kwemithathu yokuqala yokuphila.

Ukuhlukaniswa ngokwesimo sesici esibangela lesi sifo:

• Uhlobo oluyinhloko: Kulolu hlobo, i-glaucoma yenzeka kuphela ngaphandle kwesinye isiphambeko esibonakalayo ngaphakathi kweso. Abacwaningi bathole izinguquko eziningana zezakhi zofuzo ezingase zibangele lolu hlobo lwe-glaucoma yokuzalwa eyinhloko.
• Uhlobo lwesibili/lokukhula: Kulokhu, i-glaucoma yenzeka njengengxenye yesinye isifo esitholakale ngofuzo, kanye nezinye izinkinga ngaphakathi kweso.

Ezinye izimo zofuzo ezingabangela i-Secondary Congenital Glaucoma:

• I-Aniridia: Ukulahlekelwa okuphelele noma okuyingxenye kwengxenye enombala yeso (iris).
• I-Axenfeld-Rieger syndrome: Isimo esibangela izinkinga ezahlukahlukene ezihlobene namehlo, amazinyo, kanye nenkaba.
• I-Sturge-Weber syndrome: Isimo esingabangela izinkinga ebuchosheni namehlo, kanye nebala elikhulu elibomvu ebusweni (ibala le-port-wine).

Lesi sifo sitholakala kanjani ngokunembile?

Odokotela bamehlo, ikakhulukazi uma bebona izimpawu eziyinhloko okukhulunywe ngazo ngaphambili emehlweni engane encane, basola ukuthi ingane inesifo se-glaucoma esizalwa naso. Ukuqinisekisa lokho kusola, ingane inikezwa i-anesthesia (ngaphansi kwe-anesthesia) bese kwenziwa ukuhlolwa kwamehlo okuphelele. Ungakhathazeki, ingane ngeke izwe ubuhlungu ngenxa ye-anesthesia, futhi kulula ngodokotela ukuhlola amehlo ngokunembile.

Kulolu vivinyo,

• I-Tonometry ilinganisa ingcindezi engaphakathi kweso .
• I-Gonioscopy yenziwa ukuhlola i-engeli yokukhipha amanzi yeso .

Ngaphezu kwalokho, ezinye izivivinyo zingenziwa ezifana nalezi:

• I-Optical Coherence Tomography (OCT): Lokhu kukuvumela ukuthi ubone i-optic nerve ngokuningiliziwe.
• Ukuhlolwa Kwezakhi Zofuzo: Hlola izinguquko zezakhi zofuzo ezingase zibangele lesi sifo.

Iyini indlela yokwelapha lokhu?

Ezinganeni eziningi ezine-glaucoma yokuzalwa, lungisa iphutha elivimbela uketshezi ukuthi lungaphumi esweni.Kudingeka ukuhlinzwa kwamehlo . Ukwelashwa okuyinhloko nokuphumelela kakhulu kwalesi sifo ukuhlinzwa. Futhi, uma ukuhlinzwa kwenziwa ngokushesha, imiphumela iba ngcono. Imithi nayo idlala indima encane. Udokotela angase anikeze imithi okufanele isetshenziswe ngaphambi noma ngemva kokuhlinzwa. Akuvamile kakhulu ukuthi imithi yodwa yanele njengokwelashwa.

Ukuhlinzwa

Umgomo oyinhloko walokhu kuhlinzwa ukunciphisa ukucindezeleka okuphezulu ngaphakathi kweso lengane (Itraocular Pressure). Lokhu kuzonciphisa umonakalo emthanjeni we-optic kanye nezinye izingxenye zeso. Kuzovimbela nomonakalo owengeziwe. Kuye ngokuthi ingane iqala ngokushesha kangakanani ukwelashwa, omunye umonakalo osuvele wenzeke ungase ubuyele emuva. Ungakhathazeki, ingane izoba ngaphansi kwe-anesthesia ngesikhathi sokuhlinzwa kwamehlo, ngakho ngeke izwa lutho.

Kuye ngobudala nesimo sengane, udokotela ohlinzayo uzokhetha enye yalezi zindlela zokuhlinzwa ezilandelayo:

• I-Goniotomy: Lokhu kuhilela ukwenza i-incision encane ku-trabecular meshwork, izicubu ezihlunga uketshezi, ekhoneni lokukhipha amanzi. Odokotela abahlinzayo benza lokhu besebenzisa ithuluzi elibizwa ngokuthi i-gonioscope.
• Ukuhlinzwa Kwe-Trabeculotomy: Ngezinye izikhathi, uma i-engeli lapho uketshezi luphuma khona nge-cornea ingabonakali kahle, odokotela abahlinzayo bazodlula engxenyeni emhlophe yeso (i-sclera) bese benza i-incision kulesi zicubu besebenzisa idivayisi ye-electrocautery ebizwa ngokuthi i-trabeculotome.
• Ukuhlinzwa kwe-Trabeculectomy: Uma ukuhlinzwa okungenhla kungasebenzi, udokotela ohlinzayo uzodlula engxenyeni emhlophe yeso (i-sclera), asuse ingxenye encane ye-meshwork ye-trabecular, bese edala indlela entsha yokukhipha uketshezi.
• Idivayisi Yokukhipha Amanzi E-Glaucoma: Ngezinye izikhathi udokotela ohlinzayo uzofaka idivayisi encane efana ne-tube (i-Tube Shunt) esweni lengane. Le tube ivumela uketshezi oluqoqeka esweni ukuthi luqoqeke kudiski encane ngaphansi kwe-membrane encane (i-conjunctiva) phezu kweso, bese luyikhipha emzimbeni.

Imithi

Ngenxa yokuthi imithi ingaba nemiphumela emibi ezinganeni ezincane, odokotela bayinikeza ngokucophelela okukhulu. Udokotela wakho angakunika imithi yokwehlisa ingcindezi engaphakathi kweso lakho noma ukwandisa ukucaca kwe-cornea yakho ngaphambi kokuhlinzwa. Lokhu kungathuthukisa imiphumela yokuhlinzwa kwakho. Bangase futhi bakunikeze imithi yokuvimbela izinkinga ngesikhathi nangemva kokuhlinzwa.

Imithi elandelayo ingasetshenziswa:

• Ama-Beta-blocker
• I-Diuretics (inciphisa ukunqwabelana koketshezi esweni)
• Ama-Prostaglandin
• Ama-agonist e-Alpha-adrenergic
• Ama-antibiotic (ukuvimbela ukutheleleka)
• Ama-Corticosteroids (ukunciphisa ukuvuvukala)
• I-Mitomycin (ukunciphisa izibazi ngemva kokuhlinzwa)

Sizoba njani isimo ngemva kokwelashwa? (Isibikezelo)

Ukuhlinzwa kwe-glaucoma yokuzalwa kuvame ukuphumelela ekunciphiseni ingcindezi ngaphakathi kweso kanye nokumisa inqubo elimaza umbono wengane. Izingane ezithola ukwelashwa kusenesikhathi, okungukuthi, ngaphambi kokuba kwenzeke umonakalo omkhulu, zingakhula zinokubona okuvamile. Kodwa-ke, ngezinye izikhathi umonakalo ungase ungabuyiselwa ngokuphelele. Futhi, ezinye izingane zingadinga ukwelashwa okwengeziwe, njengezibuko. Into ebaluleke kakhulu ukuqhubeka nokuyisa ingane yakho ukuze iyohlolwa njengoba udokotela wakho encoma.

Ingabe ikhona indlela yokuvimbela lesi sifo?

Eqinisweni, nakuba i-glaucoma yokuzalwa ingangena emindenini, ivame ukwenzeka ngokungahleliwe. Ukuhlolwa kwezakhi zofuzo kungakutshela ukuthi une-mutation yezakhi zofuzo nokuthi kungenzeka kangakanani ukuyidlulisela ezinganeni zakho. Kodwa-ke, asikwazi ukuvimbela izakhi zofuzo zethu ukuthi zingadluliselwa ezinganeni zethu. Kodwa-ke, singakulungela uma kukhona ithuba lokuthi ingane izoqala lesi sifo sezakhi zofuzo. Isibonelo, singaqaphela izimpawu futhi sithathe isinyathelo ngokushesha.

Kuvamile ukuzizwa ukhungathekile uma uthola ukuthi ingane yakho inesifo sokuzalwa esidinga ukwelashwa okuphuthumayo. Ngakolunye uhlangothi, udinga ukwenza izinqumo ezisheshayo mayelana nokwelashwa kwengane yakho, kanti ngakolunye uhlangothi, udinga ukulawula ukwesaba kwakho nokukhathazeka kwakho. Ukuthumela ingane encane ukuba iyohlinzwa nokuyinika imithi kuyinto enzima kakhulu. Kodwa, yiba nokholo eqenjini lakho lezokwelapha. Lesi sikhathi esinzima sizophela maduze, futhi ingane yakho izobe isendleleni eya ekululameni.

Ekugcineni, umyalezo okufanele uwuthathe uye ekhaya:

Uma ubona noma yikuphi ukukhubazeka noma izinguquko emehlweni engane yakho – njengokukhula kwamehlo, ukudabuka njalo, noma ukungathandi ukuphuma ngaphandle – ungakushayi indiva. Kungaba yinto elula, kodwa futhi kungaba uphawu lwesimo esifana ne-glaucoma yokuzalwa.

• Ukutholwa kusenesikhathi kanye nokwelashwa okusheshayo yizinto ezibaluleke kakhulu, ukuze umbono wengane ulondolozwe ngangokunokwenzeka.
• Kukhona ukwelashwa okuphumelelayo kokuhlinzwa kwalesi sifo.
• Qhubeka nokuyisa ingane yakho ekuhlolweni kwezokwelapha njengoba udokotela encoma.
• Uma unemibuzo noma ukungabaza, khuluma nodokotela.

Khumbula, ukunakekelwa kwakho kanye nesinyathelo sakho esisheshayo kungamandla amakhulu ombono wesikhathi esizayo wengane yakho.

I- Glaucoma, I-Congenital Glaucoma, Izifo Zamehlo, Izifo Zamehlo Ezinganeni, Ukucindezeleka Kwamehlo, I-Optic Nerve, I-Optic Nerve