Ingabe amehlo akho ahlala ebuhlungu? Ake sifunde ngokuguguleka kwe-Corneal okuphindaphindiwe!

Ingabe nawe uzizwa ubuhlungu obungabekezeleleki uma uvula amehlo akho ekuseni? Ingabe kuzwakala sengathi kukhona okuthile ngaphakathi kweso lakho, njengokungathi kukhona okukuhlabayo? Kunzima ukubheka ukukhanya, futhi izinyembezi ziyageleza nje? Lokhu kungaba umonakalo ongqimbeni oluphezulu lweso lakho, okungukuthi, i-cornea, okuyisimo lapho ingxenye ephezulu ye-cornea ihlutshulwa khona. Lokhu sikubiza ngokuthi i-Recurrent Corneal Erosion (RCE) . Nakuba leli gama liyinkimbinkimbi kancane, lesi yisimo esivamile. Ungakhathazeki, ake sixoxe ngalokhu ngokuningiliziwe, kalula kakhulu.

Kuyini ngempela ukuguguleka kwe-Corneal Recurrent (RCE)?

Kalula nje, ulwelwesi olubonakalayo olungaphambili kweso lakho, njengefasitela lemoto, yilokho esikubiza ngokuthi i-cornea . Yilokhu okuvikela izingxenye ezizwelayo ngaphakathi kweso ezweni langaphandle. Kufana nengilazi yokuphepha ebekwe phezu kwamehlo ethu. Le cornea inezendlalelo ezinhlanu, noma izendlalelo. Endabeni ye-Recurrent Corneal Erosion (RCE), izendlalelo ezimbili eziphezulu ziyathinteka.

Lezo zitezi ezimbili yilezi:

• I-Epithelium: Lolu ungqimba olungaphandle kakhulu lwe-cornea. Luneziphetho eziningi zemizwa, okwenza lube nomuzwa ophindwe kangamakhulu ezinkulungwane kunesikhumba sethu. Ngisho nechashaza elincane lothuli lingazwakala kithi.
• I-membrane kaBowman: Lolu ngqimba lwenziwe kakhulu ngeprotheni ebizwa ngokuthi i-collagen . Cabanga ngalo njengejeli elihlala futhi libambe ndawonye, ​​futhi yileyo ndlela elisebenza ngayo. I-membrane kaBowman ibamba ungqimba lwe-epithelial olungenhla kanye nongqimba olungezansi ndawonye, ​​okuzisiza ukuthi zihlale ndawonye.

Manje, uma une-RCE, i-epithelium uqobo kanye ne-membrane kaBowman akuxhunyiwe kahle. Lokho kuxhumana kuyabuthaka. Khona-ke ungqimba oluphezulu, i-epithelium uqobo, lungaqhekeka kalula, njenge-peel. Uma lokho kwenzeka, ungqimba olusengozini kakhulu ngaphansi luyaphuma. Lokhu kuyinto ebuhlungu kakhulu ngoba i-epithelium igcwele iziphetho zemizwa.

Sivame kangakanani lesi simo se-RCE?

I-RCE iyisimo esivame kakhulu, kodwa kunzima ukusho ukuthi bangaki abantu abasitholayo. Ucwaningo olwenziwe eLondon, eNgilandi, luthole ukuthi lesi simo sithinta cishe u-1% wabantu kulelo dolobha minyaka yonke. Kodwa-ke, lelo nani lingase libe ngaphansi kwenani langempela. Lokhu kungenxa yokuthi ngisho nokuklwebheka okuncane kungase kungadingi ukunakekelwa kwezokwelapha. Ama-cornea ethu aklanyelwe ukuzipholisa ngokushesha okukhulu. Ngakho-ke, ukuklwebheka okuncane kungaphola ngemizuzu noma amahora.

Ziyini izimpawu ze-RCE?

Uma une-RCE, izimpawu zakho zivame ukuvela lapho uqala ukuvula amehlo akho ekuseni . Isibonelo, ebusuku, ukuxhumana phakathi kwejwabu lakho nengqimba engenhla ye-cornea yakho kungaba buthaka. Uma uvula amehlo akho ekuseni, indawo ebuthaka ingabangela ukuthi ungqimba olungaphezulu lwe-cornea yakho lusuke ejwabu. Uma lokhu kwenzeka, ungase ube nezimpawu ezifana nalezi:

• Ubuhlungu obukhulu:Ubuhlungu bungase buzwakale sengathi kukhona okubhajwe ngaphakathi kweso, njengokungathi kuhlatshwa ngommese.
• Ukubomvu kwamehlo.
• Ukwesaba ukukhanya: Ngisho nokukhanya okuncane kungaba nzima ukukuthwala.
• Ukudabuka okukhulu emehlweni (i-Epiphora).
• Kuzwakala sengathi kukhona uthuli noma into enamathele ngaphakathi kweso, kodwa kungenzeka ungaboni lutho ngaphakathi kweso.

Kungani lesi simo se-RCE senzeka?

Lokhu kufana nokufaka upende omusha odongeni oluye lwaqhekeka ngaphandle kokuluhlanza kahle. Ngoba ungqimba lopende olungaphansi aluhlanzekile, futhi ngenxa yeziphambeko ezikulo, upende omusha ngeke unamathele kahle. Ngisho noma uthinta nje, ungqimba olusha lungaphuma, akunjalo? Kunjalo. Uma kukhona ubuthakathaka noma umonakalo ezingqimbeni ezingaphansi ze-cornea, ungqimba oluphezulu ngeke lunamathele kahle.

Ezimweni eziningi , imbangela eyinhloko ye-RCE ukulimala kweso kwangaphambilini . Kungaba ukuncinza noma ukulimala okuvela entweni efana nozipho lwakho, ekhoneni lephepha, noma iqabunga lomuthi, igatsha elincane. Cabanga ukuthi usebenza engadini bese igatsha elincane lishaya iso lakho. Ngisho noma kungabonakali njengento enkulu ngaleso sikhathi, ngemva kwezinsuku ezimbalwa, noma ngisho neminyaka, ungase uvuke unobuhlungu obukhulu lapho uvula amehlo akho ekuseni. Lokhu kulimala akudingeki kube okwakamuva. Abanye abantu bangathola i-RCE ngenxa yokulimala kweso okwenzeke eminyakeni edlule. I-RCE ebangelwa ukulimala okunjalo ivame ukuthinta iso elilodwa kuphela.

I-RCE ingabangelwa futhi yizifo ezithile ze-cornea kanye nezimo ezingamahlalakhona ezithinta amehlo. Nakuba lokhu kuvame ukuthinta iso elilodwa kuphela, abanye abantu bangase babe nezimpawu kuwo womabili amehlo.

Izibonelo zalokhu yilezi:

• I-Epithelial Basement Membrane Dystrophy (EBMD): Ebizwa nangokuthi i-map-dot-fingerprint dystrophy, lokhu kuwubuthakathaka ezingqimbeni ezingezansi ze-cornea.
• I-Dry eye syndrome: Lesi simo senzeka lapho ukukhiqizwa kwezinyembezi emehlweni kuncipha.
• Isifo sikashukela sohlobo lwesibili.
• Ukuvuvukala nokuvuvukala kwamehlo (i-Blepharitis).
• I-ocular rosacea: Lena inkinga yamehlo eyenzeka ngesimo sesikhumba.

Yiziphi izinkinga ezingaba khona ze-RCE?

Izinkinga ezibangelwa yi-RCE ngokuvamile aziyona ingozi empilweni, kodwa zingaba zimbi kakhulu futhi zibe zimbi kakhulu.

Kunjalo:

• Ingozi ephezulu yokuthi i-RCE iphinde ivele esikhathini esizayo: Uma i-RCE isivele ikhona, amathuba okuthi i-cornea yonakale futhi aphezulu.
• Umswakama we-cornea: Uma i-cornea yonakaliswa ngokuphindaphindiwe yi-RCE, ukucaca kwayo kungancipha. Lokhu kunciphisa inani lokukhanya okungena esweni, okwenza kube nzima ngawe ukubona.
• Ingozi eyengeziwe yokutheleleka:I-cornea yakho iyisithiyo esivikelayo. Uma yonakele, izendlalelo ezingaphansi zichayeka kumagciwane. Lokhu kungaholela kalula ekuthelelekeni kwamehlo . Lokhu kungaba kubi ngezinye izikhathi.

Ungasibona kanjani isimo se-RCE?

I-RCE ivame ukuba lula ukuyixilonga. Udokotela wamehlo noma udokotela wamehlo angakusola lokhu ngokukubuza ngezimpawu zakho, umlando wakho wezokwelapha, kanye nanoma yikuphi ukulimala kwamehlo kwangaphambilini.

Bese kwenziwa ezinye izivivinyo ukuqinisekisa lokhu. Ngaphambi kokwenza lezo zivivinyo, ungase unikezwe umuthi wokunciphisa izinhlungu.

Ukuhlolwa okungenziwa yile:

• Ukuhlolwa kwesibani esinqunyiwe: Kulokhu kuhlolwa, udokotela wakho uhlola iso lakho nge-microscope ekhethekile (isibani esinqunyiwe). Phakathi nalokhu kuhlolwa, kufakwa udayi oluhlaza okwesibhakabhaka obizwa ngokuthi i-fluorescein esweni lakho (kungaba njengamaconsi eso noma ngomucu okhethekile). Lokhu kukuvumela ukuthi ubone noma yimiphi imihuzuko ku-cornea.
• Ukuhlolwa kokunamathela: Lokhu kuhilela ukuthinta ngobumnene ubuso be-cornea ngesiponji sokuhlinzwa. Uma une-RCE, ungqimba oluphezulu lwe-cornea luzohamba nesiponji, lunganamatheli kahle. Lokhu kuyasiza lapho ezinye izivivinyo zingabonisi ngokucacile ukuklwebheka.

Iphathwa kanjani i-RCE?

Odokotela belapha i-RCE ngendlela yesinyathelo ngesinyathelo. Ngokuvamile baqala ngokwelashwa okulula bese bedlulela ekwelashweni okuyinkimbinkimbi kakhulu uma kungasizi. Kodwa-ke, uma i-RCE inzima, bangase baye ngqo ekwelashweni okuyinkimbinkimbi kakhulu.

Ukuphathwa kwezokwelapha

Umgomo oyinhloko ukudala indawo ekhululekile ukuze iso lakho lizipholele lodwa. Izindlela eziningi zokwelapha zizenzela zona. Udokotela wakho uzokunikeza imiyalelo eqondile yokuthi yini okufanele uyenze.

Eminye imithi ingathatha izinsuku noma amasonto. Kuye ngokuthi i-RCE inzima kangakanani, eminye ingathatha izinyanga.

Ukuphathwa kwezokwelapha kungafaka okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ukuphathwa kobuhlungu: I-RCE iyisimo esibuhlungu. Izibulala-zinhlungu ezifana nemithi elwa nokuvuvukala engeyona eye-steroidal (ama-NSAID) zingasiza ekunciphiseni ubuhlungu. Futhi, amafutha akhethekile nama -contact lens abhandeji angasiza ekunciphiseni ubuhlungu.
• Ukugcotshwa kwamehlo: Izinyembezi zokwenziwa, amaconsi kasawoti, amajeli, noma amafutha okugcoba anganikezwa emehlweni. Odokotela batusa ukuzifaka ebusuku ngaphambi kokulala. Lokhu kwenzelwa ukuvimbela ukuqala noma ukuba kubi kwe-RCE uma uvula amehlo akho ekuseni.
• Usawoti we-Hypertonic:Lolu ketshezi lwandisa ukumuncwa koketshezi ebusweni beso. Lokhu kusiza i-epithelium ukuthi inamathele kangcono ezingqimbeni ezingaphansi. Odokotela batusa ukusebenzisa lokhu emini, kanye namafutha owasebenzisa ebusuku.
• Amaconsi noma amafutha alwa namagciwane: Lawa anikezwa ukusiza ekwelapheni noma yikuphi ukutheleleka kwamehlo okubangela i-RCE, noma ukuvimbela ukutheleleka ukuthi kungenzeki kuze kube yilapho iso liphola.
• Amalensi okuxhumana aqashwe ngebhandeji noma ngebhandeji: Zombili lezi zinikeza ungqimba olwengeziwe lwesivikelo kuze kube yilapho iso liphola. Ilensi yebhandeji iyibhandeji elibekwa esweni, njengelensi yokuxhumana. Lisiza iso ukuba lizipholise.
• I-Cycloplegia: Imisipha elawula amehlo akho ishintsha ukuma kwamehlo akho kancane. Yilokhu okukuvumela ukuthi ubone izinto ezikude ezahlukene ngokucacile. I-Cycloplegia ikhubaza okwesikhashana imisipha esesweni elithintekile. Lokhu kuvumela iso ukuthi lihlale lisesimweni esifanayo, okwenza kube lula ukululama.
• Amaconsi e-serum: Lawa maconsi akhethekile aqukethe amaprotheni omzimba kanye nezinye izithako ezisiza iso ukuba liphilise. Angaba yi-autologous , okusho ukuthi enziwe ngegazi lakho, noma angenziwa ngegazi elinikelwe.
• Imithi ethile: Le kungaba imithi evimba amaprotheni aphazamisa ukuphulukiswa kwe-cornea, njenge -corticosteroids noma i-doxycycline , noma imithi equkethe izinto zokukhula ezikhuthaza ukuphulukiswa.

Ukwelashwa ngokuhlinzwa

Ukwelashwa ngokuhlinzwa kuhilela ukususa izingxenye ze-epithelium ezonakele bese uyivumela ukuthi ikhule ngendlela efanayo, engenazibazi. Lokhu kuhlinzwa kuvame ukwenziwa ngaphansi kwe-anesthesia yangaphandle, ngakho-ke akukho buhlungu.

Ngisho nangemva kwalokhu kwelashwa, udokotela wakho angase akunikeze imithi njengoba kushiwo ngenhla. I-epithelium ivame ukukhula kabusha zingakapheli izinsuku ezimbalwa. Kodwa-ke, kungathatha amasonto noma izinyanga zokwelashwa okuqhubekayo ukuze i-epithelium inamathele kahle ezingqimbeni ezingaphansi.

Ukwelashwa ngokuhlinzwa kungafaka okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ukususwa kwezicubu ze-epithelial ezonakele: Lokhu kuhilela ukususa izicubu ze-epithelial ezonakele ngamathuluzi akhethekile.
• Ukupholisha i-diamond burr: Udokotela usebenzisa ithuluzi elikhethekile ukukhuhla izicubu ze-epithelial endaweni ethintekile ye-cornea, okuvumela yonke indawo ukuthi ikhule ngokulinganayo.
• Ukubhoboza kwe-stromal: Udokotela usebenzisa inalithi encane kakhulu noma i-laser ukwenza imigodi emincane ku-stroma , ungqimba lweso olungaphansi kwe-membrane kaBowman. Uma le migodi ibekwe ezindaweni ezifanele, iso liyaziphulukisa kuleyo migodi. Lokhu kuqinisa isibopho phakathi kwezingqimba eziphezulu.
• Ukubekwa kwe-amniotic membrane: Lokhu kusebenza njengelensi yebhandeji, kodwa kusebenzisa izicubu ezithathwe ku-placenta. I-placenta isuswa ngokuhlinzwa bese ifakwa enkambisweni eqinile yokubulala inzalo. Udokotela uyibeka ngqo endaweni ethintekile yeso. Izicubu ze-placenta zivikela iso futhi zisize izendlalelo zangaphandle ze-cornea zikhule futhi.

Izinkinga/imiphumela emibi yokwelashwa

Izinkinga nemiphumela emibi yokwelashwa iyahlukahluka kakhulu kuye ngokwelashwa okutholayo. Udokotela wakho angakutshela kangcono ukuthi yimiphi imiphumela emibi ongayithola nokuthi yini ongayenza ukuze uyinciphise noma uyivimbele.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Isikhathi sokululama ngemva kokwelashwa sincike ezintweni eziningana. Ungqimba lwe-epithelial lwe-cornea yakho lungakhula futhi luphiliswe ngokushesha. Kodwa-ke, kungathatha amasonto noma izinyanga ukuthi ungqimba olungaphansi luphole ngokuphelele futhi luhlangane kahle. Udokotela wakho angakutshela ukuthi kuzothatha isikhathi esingakanani ukuthi ululame nokuthi ungalindela nini ukubona ushintsho ezimpawini zakho, embonweni, noma endleleni amehlo akho azizwa ngayo.

Yini okufanele ngiyilindele uma ngine-RCE?

Uma une-RCE, uphawu oluyinhloko ubuhlungu . Ezinye izimpawu zivamile, azikhululekile, futhi ziphazamisa imisebenzi yansuku zonke. Kodwa imihuzuko emincane ivame ukuphola ngokushesha. Iningi labantu lifuna usizo lwezokwelapha lapho imihuzuko yabo iphakathi kuya kwenzima.

Inkinga enkulu ozobhekana nayo ukuthi lokhu kungaphinde kuvele . Uma lokhu kwenzeka, kunethuba elikhulu lezinkinga ezithinta umbono wakho.

Ngakho-ke, kungcono ukubona uchwepheshe wamehlo uma ubona izimpawu ze-RCE, ikakhulukazi uma uqala ukuvula amehlo akho ekuseni . Ukwelashwa okusheshayo kunganciphisa umonakalo obangelwa yi-RCE futhi kunciphise ingozi yokuthi iphinde ivele esikhathini esizayo.

I-RCE ingahlala isikhathi esingakanani?

I-cornea yakho inekhono elimangalisayo lokuzelapha. Umonakalo omncane ungaphola emahoreni ambalwa, kanti umonakalo omkhulu ungathatha izinsuku ezimbalwa.

Kodwa khumbula, i-RCE yenzeka kuphela uma amehlo akho engapholi kahle. Uma lokho kwenzeka, kuzodingeka uqhubeke nokusebenzisa imithi yakho yamehlo noma ezinye izindlela zokwelapha njengoba kuyalelwe udokotela wakho amasonto noma izinyanga. Kungase kubonakale kungumsebenzi okhathazayo futhi okhathazayo, kodwa kuyindlela engcono kakhulu yokuqinisekisa ukuthi amehlo akho aphulukiswa kahle futhi avimbele i-RCE ukuthi yenzeke esikhathini esizayo.

Iyini inhloso yesimo se-RCE?

I-RCE ibuhlungu, ayikhululeki, futhi ngezinye izikhathi iyingozi, kodwa ayisongeli impilo. Ngezinye izikhathi iyabuya, kodwa ukuphinda kwenzeke kungelashwa. Ngenhlanhla, izinkinga ezithinta umbono wakho isikhathi eside noma unomphela azivamile.

Ingabe i-RCE ingavinjelwa noma ingozi incishiswe?

Ama-RCE angenzeka ngokungalindelekile. Awanakuvinjelwa ngokuphelele, kodwa kunezinto ongazenza ukuze unciphise amathuba okuba enzeke.

Yini engenziwa ukuvimbela i-RCE?Into ebaluleke kakhulu ukuvimbela ukulimala kwamehlo. Gqoka izibuko zamehlo, izihlangu zobuso, noma izibuko zokuphepha noma nini lapho amehlo akho esengozini yokulimala. Lokhu kubaluleke kakhulu uma usebenza ngamathuluzi noma endaweni lapho kunengozi yokuthola izinto emehlweni akho.

Ukufaka izinyembezi zokwenziwa, ama-gel, noma amafutha emehlweni akho ngaphambi kokulala kungaba usizo kakhulu, ikakhulukazi uma uvuka unamehlo abuhlungu ekuseni. Ukugcina ubuso be-cornea kanye ne-eyelid bumanzi kusiza ukuvimbela ukunamathela okubangela ukudabuka.

Ngizinakekela kanjani?

Uma ucabanga ukuthi une-RCE, kungcono ukufuna ukwelashwa kusenesikhathi . Lokhu kuzokusiza ukuphatha izimpawu zakho futhi kunciphise ingozi yezinkinga zesikhathi esizayo.

Uma une-RCE, udokotela wakho uzokuqondisa ukuthi ungayiphatha kanjani. Kubaluleke kakhulu ukulandela imiyalelo yabo ngqo. Uma ulandela imiyalelo ngqo futhi uthatha imithi noma ukwelashwa njengoba kuyalelwe, cishe uzolulama ngaphandle kwezinkinga.

Kufanele ngimbone nini udokotela wami noma ngifune iseluleko sezokwelapha?

Uma une-RCE, kufanele uye ekuvakasheni okulandelayo njengoba kunconywe udokotela wakho. Lokhu kuzomvumela ukuthi aqaphe indlela i-cornea yakho ephola ngayo futhi alungise ukwelashwa kwakho uma kudingeka. Uma ubona noma yiziphi izinguquko ezimpawu zakho, ekuboneni kwakho, noma ekusebenzeni kahle kokwelashwa kwakho, kufanele ukhulume naye noma umvakashele.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

I-RCE ngokuvamile ayiyona into ephuthumayo, kodwa ingaba buhlungu futhi iphazamise kakhulu imisebenzi yansuku zonke. Uma unezimpawu ze-RCE, kuwumqondo omuhle ukushayela ucingo ehhovisi likadokotela womndeni wakho ukuze uthole isiqondiso. Ungaya nasemtholampilo wokunakekelwa okuphuthumayo.

Nakuba i-RCE ingavamile ukuba yisimo esiphuthumayo, ifana nokulimala kwamehlo okukhulu njengokusikeka kwe-cornea , okuwukusikeka nokudabuka kwe-cornea.

Uma ungabaza, funa ukwelashwa okuphuthumayo ngaphandle kokulibala. Ukwenza kanjalo kungenza umehluko omkhulu ekwelashweni, ekululameni, nasekulondolozeni umbono wakho.

Uma unezinye zezimpawu ezilandelayo kanye nobuhlungu bamehlo, kufanele ufune iseluleko sezokwelapha:

• Ukulimala esweni lakho, njengokusikeka, ukuphuka, ukuqhekeka, noma inxeba lokubhoboza.
• Ukulahlekelwa umbono ngokuzumayo (noma ngabe kungokwesikhashana noma kuthinta ingxenye yombono kuphela).
• Amehlo akho ayasha noma abomvu ngendlela ongeke uyichaze.
• Isicanucanu nokuhlanza.
• Ikhanda elibuhlungu .
• Imfiva.
• Umuzwa ofana nokuthile unamathele esweni lakho (kungakhathaliseki ukuthi ubona noma cha noma cha noma yini engabangela lowo muzwa).

Ekugcineni kancane...

Uma amehlo ethu esebenza kahle, asicabangi nokuthi siwasebenzisa kangakanani, akunjalo? Kodwa uma amehlo ethu ebuhlungu, futhi singazi ukuthi kungani, kungaba yinto eyesabekayo kakhulu. I-RCE iyisimo esibi nesibuhlungu, kodwa kunezindlela ezinhle zokwelapha lesi simo.

Uma unezimpawu ze-RCE, ikakhulukazi uma zisanda kuvela, khuluma nodokotela noma udokotela wamehlo. Uma usheshe uthole ukuxilongwa bese uqala ukwelashwa, amathuba akho okululama ngokushesha nokuvimbela lesi simo ukuthi singaphinde sivele esikhathini esizayo.

Ukulimala kwamehlo , Ukulimala kwe-cornea, Ubuhlungu bamehlo, Ukubomvu kwamehlo, Ukuguguleka kwe-cornea okuphindaphindiwe, i-cornea, Ubuhlungu bamehlo