Ingabe amehlo akho abukeka sengathi ayavuvukala? (Proptosis) Ake sixoxe ngalokhu!

Wake wazizwa sengathi amehlo akho makhulu noma avele ngaphandle? Mhlawumbe umngane noma ilungu lomndeni likutshelile ngalokhu. Empeleni lesi yisimo esingabonakala kwabanye abantu. Sisibiza ngokuthi (Proptosis) noma (Exophthalmos) ngokwezokwelapha. Akukho okufanele ukwesabe, uma ukwazi lokhu, ungakulawula njenganoma yini enye.

Kuyini i-proptosis?

Kalula nje, i-proptosis yilapho elinye noma womabili amehlo akho ephuma endaweni yawo evamile. Cabanga ukuthi amehlo akho, noma iso elilodwa, libonakala libheke phambili kancane kunokujwayelekile. Lokhu kungenza ukubukeka kwakho kubukeke kuhlukile kancane. Ngezinye izikhathi, kungabonakala sengathi othile ukubhekile ngamehlo akhe evulekile ngokumangala, futhi kungahlala kunjalo.

Manje njengoba iso liphambi kwakho, kungaba nzima kancane ukucwayiza. Uyazi, siyacwayiza ukuze sigcine amehlo ethu emanzi futhi evikelekile. I-membrane evikelayo ephezu kwamehlo ethu , ebizwa ngokuthi i-cornea , ithola umswakama ewudingayo uma sicwayiza. Uma singakwazi ukucwayiza kahle, leyo cornea iyoma futhi kunethuba elikhulu lokuthi izolimala.

Kwabanye abantu, lokhu kungabangela ukubona okufiphele, noma ukubona okuphindwe kabili – sikubiza ngokuthi i-diplopia – nezinye izinto ezinjalo. Lesi simo sivame ukubizwa ngokuthi “ukukhulisa amehlo” noma “ukuvuvuka kwamehlo.”

Ziyini izimpawu zalokhu?

Manje ake sibone ukuthi yiziphi ezinye izimpawu ongase uzizwe futhi uzibone lapho la mehlo ephuma.

Uma amehlo akho ekhukhumala, amhlophe amehlo akho abonakala kakhulu kunokujwayelekile. Amabhola akho amehlo nawo aphuma ezimbotsheni zawo. Ungase uqaphele ukuthi amajwabu akho angaphezulu awabonakali kangako, okwenza kubonakale sengathi amehlo akho avulekile kakhulu.

Ngaphezu kwalesi sibonakaliso esiyinhloko, kungase kube nezinye izimpawu eziningana:

• Uma uhambisa amehlo akho, uzizwa sengathi anamathele ngaphakathi, njengezinhlayiya zesihlabathi .
• Amehlo omile, ukubomvu, noma ukudabuka njalo. Siphinde sikubize lokhu ngokuthi (i-Epiphora) .
• Ukuvuvukala nokubomvu kwamehlo.
• Ukuzwa sengathi imisipha iqinile uma uzama ukuhambisa iso, futhi ngezinye izikhathi ungakwazi nhlobo ukuhambisa iso.
• Ukuzwela ukukhanya kusho ukuthi kunzima ukubheka ukukhanya, nokukhanya kwelanga.
• Ikhanda elibuhlungu.
• Ukuba nomkhuhlane.

Yiziphi izimpawu ezidinga usizo lwezokwelapha ngokushesha?

Uma unezinye zalezi zimpawu, kufanele nakanjani ubone udokotela ngokushesha. Khumbula ukuthi lezi yizinto ezivamile, akunjalo?

• Umuzwa ohlabayo ngaphakathi kwamehlo.
• Kungazelelwe, kuzwakala sengathi amehlo akho azophuma.
• Ukuba nobuhlungu obukhulu noma ukubomvu emehlweni.
• Lezi zimpawu zivela esweni elilodwa kuphela.
• Ukulahlekelwa ukubona noma ukuncipha kancane kancane kokubona kwakho.
• Umbono ofiphele noma ukubona izinto ezimbili ngesikhathi esisodwa (umbono ophindwe kabili).
• Ukubheka into ethile ngokusobala kusho ukuba nobunzima bokugxila.

Kungani amehlo ami ephuma kanje? Ziyini izizathu?

Manje ake sibone ukuthi kungani amehlo ephuma kanje, nokuthi yini engabangela lokhu.

Esikhathini esiningi, imbangela enkulu yalokhu inkinga ngesistimu yakho yokuzivikela komzimba. Kalula nje, amasosha avikela imizimba yethu ezifweni ahlasela ngephutha amanye amangqamuzana ethu. Kulesi simo, leso simiso sokuzivikela komzimba sihlasela amangqamuzana endlala yakho yegilo kanye nezicubu ezingemuva kwamehlo akho.

Lokhu kuvuvukala kwamehlo kubantu abanezinkinga ze-thyroid kubizwa ngokuthi i-Thyroid Eye Disease (TED) . Eqinisweni, lesi simo sivame ukubonakala kubantu abanezifo ezihlobene ne-thyroid.

Kungase kube nezinye izizathu eziningana:

• Isifo sikaGraves: Lokhu kuhlobene futhi ne -hyperthyroidism, isimo lapho indlala yegilo isebenza ngokweqile. Lokhu kubangelwa nayisifo esifanayo sokuzivikela komzimba esishiwo ngenhla.
• I-Hyperthyroidism: Lesi simo singase senzeke ngisho nangaphandle kwesifo sikaGraves, lapho indlala yegilo isebenza ngokweqile.
• Ukutheleleka kwe-eye socket: Uma kwenzeka ukutheleleka kwebhaktheriya noma igciwane ngaphakathi kwe-eye socket, ukuvuvukala kungasunduza iso phambili.
• Ukulimala: Uma kukhona ukopha ngemuva kweso, ikakhulukazi ngenxa yokulimala kweso noma ekhanda, lelo gazi lingahlangana futhi likhiphe iso.
• Izimila: Uma kuvela isimila (esingesihle noma esibi) ngaphakathi noma eduze kweso, singabangela nokuthi iso livuvuke phambili. Isibonelo, izimila ezihilela imizwa, njenge- neuroblastoma , noma ezinye izimila ezithambile . Kodwa-ke, lezi zinhlobo zezimbangela zomdlavuza azivamile.

Yiziphi izinkinga ezingaba khona? Ingabe ikhona imiphumela yesikhathi eside?

Lokhu kungase kuzwakale kusabisa kancane kuwe, kodwa iqiniso liwukuthi, kubantu abaningi, lesi simo asibangeli izinkinga ezinkulu noma imiphumela yesikhathi eside. Akukududuzi lokho?

Kodwa-ke, akuvamile kakhulu ukuthi kube nezinkinga ezithile. Isibonelo, ukubona kabili noma ukulahlekelwa umbono ngokuphelele kungase kwenzeke unomphela. Futhi, njengoba ngishilo ngaphambili, uma ungakwazi ukucwayiza futhi amaconsi amehlo agcobayo engasizi, iso lakho lingase libeIngqimba engenhla, i-cornea, nayo ingalimala. Lokhu kubizwa ngokuthi i-corneal ulceration. Yingakho kubalulekile ukufuna ukwelashwa ngokushesha uma unezimpawu.

Ukuthola kanjani lokhu? Odokotela bakuqinisekisa kanjani lokhu?

Kulungile, uma unezimpawu ezinjengalezi, udokotela angakuthola kanjani ukuthi lokhu kuyi-Proptosis ngempela noma okunye?

Okokuqala, udokotela uzokubuza umbuzo oningiliziwe mayelana nezimpawu zakho. Bazokubuza ngokuningiliziwe ukuthi usunesikhathi esingakanani unalezi zimpawu, ukuthi zaqala kanjani, yiziphi ezinye izinkinga onazo, noma yiziphi izifo oke waba nazo ngaphambilini, nokuthi ngabe kukhona yini emndenini wakho oke waba nezimo ezifanayo.

Ngemva kwalokho, nakanjani uzohlolwa amehlo. Lokhu kungafaka phakathi izinto ezifana nalezi:

• Ithuluzi elikhethekile (isibani esiqhekekile) lisetshenziselwa ukukhulisa nokuhlola izakhiwo ezisebusweni nangaphakathi kweso lakho ngokuningiliziwe. Lokhu kungabona izinto ezifana namanxeba nokoma kwe-cornea.
• Zihlola indlela amehlo akho nezinkophe zakho ezihamba ngayo, nokuthi ungawakhomba yini womabili amehlo ohlangothini olufanayo.
• Babheka amehlo ngokucophelela ukuze babone ukuthi abomvu yini, ukuthi kukhona ubuhlungu, ukuthi kukhona ukuvuvukala, nokuthi kukhona yini ukudabuka.

Yiziphi ezinye izivivinyo okuzodingeka zenziwe?

Ngemva kokuhlolwa kokuqala, udokotela angenza nokuhlolwa okwengeziwe ukuze athole imbangela, njengokuthi:

• I-Exophthalmometry: Lokhu kungase kuzwakale kungajwayelekile, kodwa kusebenzisa ithuluzi elikhethekile (i-exophthalmometer) ukukala ukuthi inhlamvu yeso lakho iphume ibanga elingakanani kusuka engosini yeso ngamamilimitha. Lokhu kungasiza ekunqumeni ubucayi besimo.
• Ukuhlolwa kwegazi: Lokhu kuzohlola amazinga ama-hormone (TSH, T3, T4) ukuze kuhlolwe ukusebenza kwe-thyroid gland. Ngoba (Isifo Samehlo Se-thyroid) siyimbangela eyinhloko.
• Izifundo zokuthatha izithombe: Ukuze kube sobala, kwenziwa i -MRI (Magnetic Resonance Imaging) noma i -CT scan (Computed Tomography scan) ukuze kubonakale ngokucacile ukuthi kukhona yini ukuvuvukala, iqhubu, uphawu lokutheleleka, noma ukopha emisipheni, ezinzwa, nasezicutshini ezinamafutha ngemuva kweso.
• Ezinye izivivinyo zelebhu: Ngezinye izikhathi kungathathwa isampula yokukhishwa kwamehlo noma izicubu (ukukhuliswa) ukuqinisekisa ukuthi kukhona yini ukutheleleka.

Yiziphi izindlela zokwelapha?

Kulungile, manje ake sibheke izindlela zokwelapha lokhu. Ukwelashwa okutholayo kuzoncika embangweni wamehlo akho avuvukile kanye nobunzima besimo.

• Izinyembezi zokwenziwa: Lezi zingasetshenziswa izikhathi eziningana ngosuku njengamaconsi noma ijeli ukunciphisa ukoma kwamehlo nokuvikela i-cornea . Lezi zingathengwa ekhemisi.
• Ama-antibiotic:Uma kutholakala ukuthi ukuphuma kwamehlo akho kubangelwa ukutheleleka ngamagciwane, uzonikezwa ama-antibiotic afanele (ngomlomo noma nge-IV).
• Ukwelashwa kwezimo ezingaphansi: Isibonelo, uma indlala yegilo isebenza ngokweqile (i-hyperthyroidism), kunikezwa imithi yokulwa negilo ukuze iyilawule. Isifo se-Graves siphathwa ngendlela efanayo.
• Imithi yokwelapha nge-intravenous (IV): Ngezinkinga ezinkulu zokuvuvukala nokubona okubangelwa yisifo samehlo se-thyroid (TED), ama-corticosteroids (isb., i-methylprednisolone) anganikezwa nge-intravenous (IV pulse therapy) ukuze kuncishiswe ukuvuvukala ngokushesha. Umuthi omusha obizwa ngokuthi i-Teprotumumab (Tepezza®) nawo utholakale usebenza kahle kakhulu ku-TED.

Ingabe kukhona ezinye izindlela zokwelapha ngaphandle kokuhlinzwa?

Yebo, ngezinye izikhathi ezinye izindlela zokwelapha zingenziwa ngaphandle kokuhlinzwa, njengokuthi:

• Ukwelashwa kokubona okukabili: Lokhu kufaka phakathi amalensi akhethekile, njengama -prism, anamathiselwe ezibukweni zakho. Lokhu kusebenza ngokuqondisa ukukhanya okungena esweni ngendlela ehlukile, kulungisa umbono wakho. Ukuzivocavoca kwamehlo nakho kungaphakanyiswa.
• Imithi yokucindezela amasosha omzimba: Le mithi (isib. i-Mycophenolate, i-Rituximab) ingasiza ekunciphiseni umonakalo owenziwa yisimiso sokuzivikela emehlweni, ikakhulukazi ezimweni ezifana ne-(TED).
• Ama-Corticosteroids: Ama-steroid anganikezwa njengamaphilisi omlomo, imijovo, noma ngemithambo ukuze kuncishiswe ukuvuvukala noma kubuyiselwe umbono. Kodwa-ke, lokhu kungaba nemiphumela emibi uma kusetshenziswa isikhathi eside, ngakho-ke kufanele kuthathwe kuphela ngaphansi kokuqashwa ngudokotela.

Ingabe ngizodinga ukuhlinzwa?

Akuwona wonke umuntu odinga ukuhlinzwa. Kodwa kunezimo ezithile lapho ukuhlinzwa kuyadingeka khona. Isibonelo:

• Ukuhlinzwa kokunciphisa ukucindezeleka kwe-Orbital: Lokhu kuhlinzwa kwenziwa ukuze kudalwe isikhala esengeziwe emjikelezweni ongemuva kweso . Lokhu kuvumela iso ukuthi libuyele ngaphakathi. Lokhu kwenziwa uma kukhona usongo ekuboneni, noma uma iso seliphumele kude ngokwanele ukulimaza i-cornea.
• Ukuhlinzwa kwe-Strabismus: Ukuhlinzwa kwemisipha yamehlo kungenziwa ukuze amehlo womabili abhekise ohlangothini olufanayo.
• Ukuhlinzwa kwejwabu: Uma amehlo engakwazi ukuvala kahle, kwenziwa ukuhlinzwa ukushintsha indawo yamehlo ukuze kuvikelwe i -cornea .
• Ukususwa kwesimila: Uma kukhona isimila, kuzodingeka sisuswe ngokuhlinzwa.

Kuzokwenzekani ngokulandelayo? Kuzothatha isikhathi esingakanani ukululama?

Uma uthola imbangela yalezi zimpawu futhi uzelapha ngokushesha, imiphumela iba ngcono kakhulu. Uma uthola ukwelashwa okufanele, ungavimbela nezinkinga.

"Ingabe ukuzwa kwami ​​​​kuzophinde kubuyele esimweni esijwayelekile?" cishe ubuza. Yebo,Ezimweni eziningi, iso lingabuyela esimweni salo esijwayelekile. Kodwa-ke, ngisho nangemva kokwelashwa okuphumelelayo, kungathatha isikhathi esithile ukuthi iso libuyele esimweni salo sokuqala. Ngezinye izikhathi kungathatha izinyanga, ngezinye izikhathi ngisho neminyaka. Kuya ngembangela, ubukhali besimo, kanye nempendulo yokwelashwa.

Singakuvimbela kanjani ukuthi isimo singabi sibi kakhulu?

Kulungile, njengoba usunalesi simo (i-Proptosis), kunezinto ezibalulekile ongazenza ukuze usivimbele ukuthi singabi sibi kakhulu:

• Lawula amazinga akho e-thyroid: Uma unesifo se-thyroid, ikakhulukazi isifo sikaGraves, landela imiyalelo kadokotela wakho ngqo. Thatha imithi yakho yansuku zonke ngesikhathi, futhi uthole ukuhlolwa kwegazi njalo ukuze ugcine amazinga akho e-thyroid engaphakathi kwesilinganiso esijwayelekile.
• Yeka ukubhema ngokuphelele: Uma ubhema, lena yinto engcono kakhulu ongayenza. Ukubhema akugcini nje ngokwenza lesi simo (i-Thyroid Eye Disease) sibe sibi kakhulu, kodwa futhi kunciphisa kakhulu impumelelo yokwelashwa. Ukuyeka ukubhema kuzothuthukisa kakhulu indlela umzimba wakho osabela ngayo ekwelashweni. Ngakho-ke, yenza leso sinqumo namuhla.

Uphila kanjani nalesi simo? Uhlala kanjani uqinile engqondweni?

Amehlo akho angashintsha ukubukeka kwakho. Lokhu kungaba nomthelela omkhulu ekuzethembeni kwakho nasekuzethembeni kwakho. Ungase uzizwe ukhathazekile kakhulu futhi ukhathazekile ngalokhu. Ungase ucabange, "Abantu bazocabangani?" noma "Ubuso bami bushintshile." Uma lokhu kuthinta umbono wakho, ezinye izinto empilweni yakho yansuku zonke kanye nobudlelwano bezenhlalo zingashintsha ngokungalindelekile. Lezi zinguquko zingabangela ukuthi uzizwe ukhungathekile, ukhathazekile, noma ucindezelekile. Kuvamile, futhi awuwedwa obhekene nalezi zinto.

Khumbula, awuwedwa kulolu hambo. Ukucela usizo akusikho ubuthakathaka, kungamandla.

Izinto ezinjengalezi zizokusiza ukubhekana nalezi zinselele:

• Funa usizo kuchwepheshe wezempilo yengqondo : Kubalulekile ukukhuluma nomuntu onjengodokotela wezifo zengqondo noma umeluleki. Bangakusiza ukuthola izindlela zokubhekana, ukubhekana, nokuphatha imicabango nemizwa yakho emibi ngokusebenzisa izindlela zokwelapha ezifana ne -Cognitive Behavior Therapy (CBT) .
• Thola usizo kusonhlalakahle: Uma ungakwazi ukushayela ngenxa yezinkinga zokubona noma unezinye izinkinga ezingokoqobo, bangakusiza ukuthola amaqembu okusekela endaweni yakini noma izinsiza eziku-inthanethi. La maqembu agcwele abantu abaye badlula kokuhlangenwe nakho okufanayo nawe, ngakho ukukhuluma nabo kungaba usizo olukhulu.

Ekugcineni, kufanele uthi...

I-proptosis ingaba yinto ecasulayo futhi eyesabekayo ngempela ukuba nayo. Siyaqonda lokho. Kodwa ungakuvumeli ukuthi konakalise impilo yakho. Uma usheshe ubonane nodokotela, kuzoba lula ngaye ukuthola imbangela. Ngemuva kwalokho ungaqala ukwelashwa okudingekayo, uvimbele isimo ukuthi singabi sibi kakhulu, futhi uvimbele izinkinga ezingaba khona.

Kubalulekile futhi ukunakekela impilo yakho yengqondo. Njengempilo yakho engokomzimba, udinga ukunakekela impilo yakho yengqondo. Ukufuna usizo kumeluleki wezempilo yengqondo kungakusiza ukuthi ulawule imizwa yakho futhi ubhekane nale nselele ngamandla. Isisebenzi sezenhlalakahle singakudlulisela ezindaweni lapho ungathola khona ukwesekwa okudingayo.

Ngakho-ke, ungakhathazeki ngalutho futhi ungesabi ukufuna usizo. Ngikufisela ukululama okusheshayo!

i- proptosis, i-exophthalmos, amehlo avuvukile, isifo samehlo e-thyroid, isifo se-Graves, i-hyperthyroidism, izinkinga zamehlo