Retinal Detachment
Incamake
Ikimenetso cy'umwijima mu jisho ni uko ikibazo cyihutirwa aho uruhu rworoshye rw'inyuma y'ijisho, twita retina, rutandukana n'aho rwari rusanzwe. Uturutu tw'ijisho dutandukana n'urwego rw'imijyana y'amaraso ituma ijisho ribona umwuka n'ibiribwa. Ibimenyetso byo gutandukana kwa retina bikunze kuba harimo kumva ibintu by'umweru n'ibintu bito by'umukara mu maso yawe.
Ikimenetso cy'umwijima mu jisho kibaho iyo uruhu rworoshye rw'inyuma y'ijisho rutandukanye n'aho rwari rusanzwe. Uru ruhu rwitwa retina. Ikimenetso cy'umwijima mu jisho ni ikibazo cyihutirwa.
Ikimenetso cy'umwijima mu jisho gitandukanya uturutu tw'ijisho n'urwego rw'imijyana y'amaraso ituma ijisho ribona umwuka n'ibiribwa. Igihe kirekire ikimenetso cy'umwijima mu jisho kiguma kidakurikiranwe, ibyago byo kubura burundu ubushobozi bwo kubona mu jisho ryangiritse birushaho kwiyongera.
Ibimenyetso byo gutandukana kwa retina bishobora kuba birimo ibi bikurikira: kugabanuka k'ububone, kugaragara kw'ibintu by'umukara bito by'umukara n'urumuri mu maso yawe, no kubura ubushobozi bwo kubona ku ruhande. Guhamagara muganga w'amaso, twita ophthalmologist, vuba bishobora kugufasha gukiza ubushobozi bwawe bwo kubona.
Ibimenyetso
Kuvura kwa retina ntabwo kubabaza. Akenshi, ibimenyetso biba biriho mbere yuko kuvura kwa retina bibaho cyangwa mbere yuko kibije. Ushobora kubona ibimenyetso nka: Igiturumbuka cy'ibice bito cyangwa imirongo y'izunguzungu isa n'iyagenda mu gice cy'amaso yawe. Ibi bita floaters. Umucyo uca mu jisho rimwe cyangwa mu yombi. Ibi bita photopsias. Kubura neza kw'ubwenge. Iboneza riba ku ruhande, ryitwa kandi iboneza rya kure, riba ribi. Igicucu nk'igitambaro ku gice cy'amaso yawe. Egera umuganga byihuse niba ufite ibimenyetso byo kuvura kwa retina. Iyi ndwara ni ubutabazi bushobora gutera igihombo kirambye cy'ubwenge.
Igihe cyo kubona umuganga
Jya kwa muganga byihuse niba ufite ibimenyetso byo gutandukira kwa retina. Iyi ndwara ni ubutabazi bwihuse bushobora gutera igihombo cy'ububasha bw'amaso igihe kirekire. Jason Howland: Ufite ibibazo by'amaso? Mbese ubona utudomo tw'umukara cyangwa icyatsi, amasuka cyangwa imigozi ihindagurika iyo uhindura amaso? Bishobora kuba ari ibintu byo mu maso. Bwana Howland: Ibintu byo mu maso birakunda cyane uko ugenda ukura kandi niba ufite amaso maremare. Ikibazo gikomeye – bishobora gutera ibikomere bya retina. Dr. Khan: Iyo ikomere ribaye muri retina, amazi ashobora kwinjira munsi y'icyo gikomere maze agakura retina nk'urupapuro ku rukuta kandi ibyo ni ukutandukira kwa retina. Bwana Howland: Kandi bishobora gutera ubuhumyi, niyo mpamvu ari ingenzi cyane gukora isuzuma ry'amaso rimaze iminsi mike umaze kubona ibintu bishya cyangwa impinduka mu maso. Ibyinshi mu bintu byo mu maso ntibisaba kuvurwa, ariko umuganga w'amaso ashobora kugusaba gukora isuzuma ry'amaso buri gihe kugira ngo ubu burwayi budakomeza gukura.
Impamvu
Hari ubwoko butatu nyamukuru bwo kwangirika kw'umunyuramyenda, kandi impamvu zibitera zitandukanye:
- Rhegmatogenous (reg-mu-TOJ-uh-nus). Ubu bwoko bwo kwangirika kw'umunyuramyenda ni bwo bugaragara cyane. Kwanguka kw'umunyuramyenda kwa rhegmatogenous biterwa n'umwobo cyangwa umwenda mu munyuramyenda uretse amazi akanyuramo agateranira munsi y'umunyuramyenda. Aya mazi arushaho kwiyongera agatuma umunyuramyenda utandukana n'imiterere iri munsi yawo. Ibice umunyuramyenda utandukaniyeho bibura amaraso bigahagarara gukora. Ibi bituma ubona nabi.
Impamvu isanzwe itera kwangirika kw'umunyuramyenda kwa rhegmatogenous ni ubusaza. Uko ugenda ukura, ibintu bisa n'igikoma birimo umwenge wawe, bizwi nka vitreous (VIT-ree-us), bishobora guhinduka imiterere, bikagabanuka cyangwa bikaba amazi menshi. Ubusanzwe, vitreous itandukana n'umunyuramyenda nta kibazo. Iki ni ikibazo gisanzwe cyitwa posterior vitreous detachment (PVD).
Uko vitreous itandukana cyangwa ikura ku munyuramyenda, ishobora gukurura umunyuramyenda kugeza ubwo itera umwenda. Akenshi ntibibaho. Ariko niba PVD itera umwenda kandi uwo mwenda utabyazwe, vitreous ishobora kunyura muri uwo mwenda ikajya mu kibanza kiri inyuma y'umunyuramyenda. Ibi bituma umunyuramyenda wangirika.
- Tractional. Ubu bwoko bwo kwangirika bushobora kubaho iyo umubiri w'ibikomere ukura ku munyuramyenda. Uwo mubiri w'ibikomere utuma umunyuramyenda utandukana n'inyuma y'ijisho. Kwanguka kw'umunyuramyenda kwa tractional bisanzwe biboneka mu bantu barwaye diyabete idakurikiranwa neza.
- Exudative. Muri ubu bwoko bwo kwangirika, amazi ateranira munsi y'umunyuramyenda, ariko nta mwobo cyangwa umwenda mu munyuramyenda. Kwanguka kw'umunyuramyenda kwa exudative bishobora guterwa no gusaza kw'umunyuramyenda wa macular, indwara zandura, ibibyimba cyangwa ibibazo by'uburibwe.
Rhegmatogenous (reg-mu-TOJ-uh-nus). Ubu bwoko bwo kwangirika kw'umunyuramyenda ni bwo bugaragara cyane. Kwanguka kw'umunyuramyenda kwa rhegmatogenous biterwa n'umwobo cyangwa umwenda mu munyuramyenda uretse amazi akanyuramo agateranira munsi y'umunyuramyenda. Aya mazi arushaho kwiyongera agatuma umunyuramyenda utandukana n'imiterere iri munsi yawo. Ibice umunyuramyenda utandukaniyeho bibura amaraso bigahagarara gukora. Ibi bituma ubona nabi.
Impamvu isanzwe itera kwangirika kw'umunyuramyenda kwa rhegmatogenous ni ubusaza. Uko ugenda ukura, ibintu bisa n'igikoma birimo umwenge wawe, bizwi nka vitreous (VIT-ree-us), bishobora guhinduka imiterere, bikagabanuka cyangwa bikaba amazi menshi. Ubusanzwe, vitreous itandukana n'umunyuramyenda nta kibazo. Iki ni ikibazo gisanzwe cyitwa posterior vitreous detachment (PVD).
Uko vitreous itandukana cyangwa ikura ku munyuramyenda, ishobora gukurura umunyuramyenda kugeza ubwo itera umwenda. Akenshi ntibibaho. Ariko niba PVD itera umwenda kandi uwo mwenda utabyazwe, vitreous ishobora kunyura muri uwo mwenda ikajya mu kibanza kiri inyuma y'umunyuramyenda. Ibi bituma umunyuramyenda wangirika.
Ingaruka zishobora guteza
Ibintu bikurikira bizamura ibyago byo gutandukana kwa retina:
- Urukoko — gutandukana kwa retina birakunda cyane mu bantu bafite imyaka iri hagati ya 40 na 70.
- Gutandukana kwa retina mbere mu jisho rimwe.
- Amateka y'umuryango yo gutandukana kwa retina.
- Kubura kureba cyane, bizwi kandi nka myopie.
- Imirimo yo kubaga amaso mbere, nko gukuraho cataracte.
- Imvune ikomeye y'ijisho mbere.
- Amateka y'izindi ndwara cyangwa uburwayi bw'amaso, harimo retinoschisis, uveitis cyangwa kugabanuka kw'uruhande rw'inyuma rwa retina bizwi nka lattice degeneration.
Kupima
Kumenya icyo ufite bimwe mu byo umuganga wawe akora kugira ngo amenye niba ikibazo cy’umwijima utandukanye n’inyuma y’ijisho ari cyo gituma ugira ibimenyetso.Itsinda ry’abaganga bawe rishobora gukoresha ibizamini n’ibikoresho bikurikira kugira ngo bamenye icyo ufite:
- Isuzuma ry’umwijima. Umuhanga mu buvuzi bw’amaso ashobora gukoresha igikoresho gifite umucyo mwinshi n’ibirahure bidasanzwe kugira ngo asuzume inyuma y’ijisho ryawe, harimo n’umwijima.Ubu bwoko bw’igikoresho butanga ishusho ihamye y’ijisho ryawe ryose.Bituma umuganga wawe abona ibyuho, iminkanyari cyangwa gutandukana kw’umwijima.
- Amashusho akoresheje ubuvuzi bw’amajwi. Umuhanga mu buvuzi bw’amaso ashobora gukoresha iki kizamini niba amaraso yavuye mu jisho ryawe.Amaraso atuma bigorana kubona umwijima.
Umuhanga wawe mu buvuzi ashobora gusuzuma amaso yombi nubwo waba ufite ibimenyetso mu jisho rimwe gusa.Niba iminkanyari y’umwijima itabonetse muri ubu busuzumwa, umuganga wawe ashobora kukusaba kugaruka nyuma y’ibyumweru bike.Gusubira kwawe bigamije kwemeza ko ijisho ryawe ritagize iminkanyari y’umwijima yadindiye kubera gutandukana kw’umwijima.Kandi, niba ufite ibimenyetso bishya, ni ngombwa ko usubira kwa muganga wawe ako kanya.
Uburyo bwo kuvura
Ubuganga ni bwo buryo hafi ya hose bukoreshwa mu gusana umwenge, umwobo cyangwa gutandukana kwa retina. Hari uburyo butandukanye buhari. Baza umuganga wawe w'amaso ku byago n'inyungu z'uburyo bwo kuvura ufite. Hamwe mushobora guhitamo uburyo bwo kuvura cyangwa igikorwa cyo kuvura gikubereye. \n\nIyo retina ifite umwenge cyangwa umwobo ariko itaracikanye, umuganga wawe w'amaso ashobora kugutegurira imwe muri iyi miti. Iyi miti ishobora gufasha gukumira gutandukana kwa retina no kubungabunga ubwenge. \n\n- Ubuganga bwa lazeri, bwitwa kandi photocoagulation ya lazeri cyangwa retinopexy. Umuganga aratuma urumuri rwa lazeri mu jisho rimenyereye umunwa. Lazeri ikora ibikomere hafi y'umwenge wa retina kugira ngo ikore inkovu isanzwe "ikora" retina ku mubiri uri munsi. \n- Gukonjesha, bwitwa kandi cryopexy. Mbere y'uko kuvura gutangira, uhabwa imiti yo kubabara ijisho. Hanyuma umuganga ashyira igikoresho gikonjesha ku ruhu rwo hanze rw'ijisho hejuru y'umwenge. Gukonjesha bituma habaho inkovu ifasha gukomera retina ku rukuta rw'ijisho. \n\nUbu buryo bwo kuvura bubiri bushobora gukorwa mu biro by'umuganga w'amaso. Akenshi, ushobora gutaha nyuma. Uzabwirwa kudakora ibikorwa bishobora guhungabanya amaso — nko kwiruka — ibyumweru bibiri cyangwa bikabakaba. \n\nNiba retina yawe yacitse, uzakenera kubagwa kugira ngo uyisane. Ni byiza kubagwa mu minsi mike ubonye ko retina yawe yacitse. Ubwoko bw'ubuganga umuganga wawe asaba biterwa n'ibintu nko gukomera gutandukana kwa retina n'uburemere bwayo. \n\n- Kwinjiza umwuka cyangwa gaze mu jisho. Ubu buganga bwitwa pneumatic retinopexy (RET-ih-no-pek-see). Umuganga winjiza ikibindi cy'umwuka cyangwa gaze mu gice cy'hagati cy'ijisho, bita kandi vitreous cavity. Iyo gishyizwe neza, ikibindi gitsinda agace ka retina kariho umwobo cyangwa ibyobo ku rukuta rw'ijisho. Ibi bihagarika umuyoboro w'amazi mu mwanya uri inyuma ya retina. Umuganga kandi akoresha cryopexy cyangwa laser photocoagulation mu gihe cyo kuvura kugira ngo akore inkovu hafi y'umwenge wa retinal. \n\nAmazi yakusanyirijwe munsi ya retina yisukura ubwayo, hanyuma retina ishobora gukomera ku rukuta rw'ijisho. Ushobora gukenera gufata umutwe wawe mu buryo runaka kugeza ku cyumweru kugira ngo ukomeze ikibindi mu mwanya ukwiye. Ikibindi kigenda ubwayo mu gihe. \n- Gukanda uruhu rw'ijisho. Ubu buganga bwitwa scleral (SKLAIR-ul) buckling. Burimo umuganga utose igice cya silicone ku gice cyera cy'ijisho, bita sclera, hejuru y'agace kagizweho ingaruka. Ubu buganga bukomera urukuta rw'ijisho kandi bugabanya imbaraga zimwe na zimwe ziterwa na vitreous ikubita retina. Silicone ishyirwa mu buryo budabuza kubona, kandi isanzwe isigara aho iteka. Mu gihe cyo kubagwa, cryoretinopexy cyangwa laser photocoagulation bishobora gukorwa kugira ngo bifashe gufunga amwenge muri retina. Niba amazi yakusanyirijwe munsi ya retina, umuganga ashobora kuyakuramo. \n- Gukuramo no gusimbuza amazi mu jisho. Ubu buganga buzwi nka vitrectomy (vih-TREK-tuh-me). Umuganga akuraho vitreous hamwe n'imiterere iyo ari yo yose ikubita retina. Hanyuma umwuka, gaze cyangwa silicone oil binjizwa mu mwanya wa vitreous kugira ngo bifashe gutandukanya retina. Mu gihe cyo kubagwa, amwenge muri retina ashobora gufungwa na cryoretinopexy cyangwa laser photocoagulation. Hashobora kuba hari amazi munsi ya retina akenera gukurwamo. \n\nUmwuka cyangwa gaze binjizwa mu mwanya wa vitreous bisukura mu gihe. Ububiko bwa vitreous buzura amazi. Niba hakoreshejwe silicone oil, ishobora gukurwaho hakoreshejwe ubuganga nyuma y'amezi. \n\nVitrectomy ishobora guhuzwa na scleral buckling. \n\nKwinjiza umwuka cyangwa gaze mu jisho. Ubu buganga bwitwa pneumatic retinopexy (RET-ih-no-pek-see). Umuganga winjiza ikibindi cy'umwuka cyangwa gaze mu gice cy'hagati cy'ijisho, bita kandi vitreous cavity. Iyo gishyizwe neza, ikibindi gitsinda agace ka retina kariho umwobo cyangwa ibyobo ku rukuta rw'ijisho. Ibi bihagarika umuyoboro w'amazi mu mwanya uri inyuma ya retina. Umuganga kandi akoresha cryopexy cyangwa laser photocoagulation mu gihe cyo kuvura kugira ngo akore inkovu hafi y'umwenge wa retinal. \n\nAmazi yakusanyirijwe munsi ya retina yisukura ubwayo, hanyuma retina ishobora gukomera ku rukuta rw'ijisho. Ushobora gukenera gufata umutwe wawe mu buryo runaka kugeza ku cyumweru kugira ngo ukomeze ikibindi mu mwanya ukwiye. Ikibindi kigenda ubwayo mu gihe. \n\nGukuramo no gusimbuza amazi mu jisho. Ubu buganga buzwi nka vitrectomy (vih-TREK-tuh-me). Umuganga akuraho vitreous hamwe n'imiterere iyo ari yo yose ikubita retina. Hanyuma umwuka, gaze cyangwa silicone oil binjizwa mu mwanya wa vitreous kugira ngo bifashe gutandukanya retina. Mu gihe cyo kubagwa, amwenge muri retina ashobora gufungwa na cryoretinopexy cyangwa laser photocoagulation. Hashobora kuba hari amazi munsi ya retina akenera gukurwamo. \n\nUmwuka cyangwa gaze binjizwa mu mwanya wa vitreous bisukura mu gihe. Ububiko bwa vitreous buzura amazi. Niba hakoreshejwe silicone oil, ishobora gukurwaho hakoreshejwe ubuganga nyuma y'amezi. \n\nVitrectomy ishobora guhuzwa na scleral buckling. \n\nNyuma y'ubuganga, ubwenge bwawe bushobora kumara amezi kugira ngo bube bwiza. Ushobora gukenera ubuganga bwa kabiri kugira ngo kuvura kugire icyo kugeraho. Bamwe ntibagaruka ubwenge bwabo bwose bwari butakaye. \n\nGutandukana kwa retina bishobora gutuma utakaza ubwenge. Bitewe n'umubare w'ubwenge utakaza, ubuzima bwawe bushobora guhinduka cyane. \n\nUshobora kubona ibi bitekerezo ari ingirakamaro uko wigira ubuzima ufite ubumuga bw'ubwenge: \n\n- Fata ijisho. Ijisho ryawe rishobora guhinduka nyuma yo gusana gutandukana kwa retina, cyane cyane niba gutandukana kuvurwa na scleral buckle. Fata ijisho rishya rimwe ijisho ryawe rimaze gukira kugira ngo ubone ubwenge bwawe. Saba amasaro y'umutekano kugira ngo urinde amaso yawe. \n- Komeza inzu yawe. Fata umucyo ukwiye mu rugo rwawe kugira ngo usome n'ibindi bikorwa. \n- Kora inzu yawe itekanye. Kuraho ibitambaro byo hejuru cyangwa komeza ibitambaro ku butaka ukoresheje kaseti kugira ngo wirinde kugwa no kugwa. Himura imigozi y'amashanyarazi uva mu duce utemberamo cyane. Kandi shyira kaseti y'amabara ku nkengero z'inkingi. Tekereza gushyira amatara azimya iyo asanze hari umuntu. \n- Sabe ubufasha niba ubikeneye. Bwira inshuti zawe n'abantu bo mu muryango wawe ku mpinduka z'ubwenge bwawe kugira ngo bagufashe.
Umuhakana: Kanama ni urubuga rw'amakuru y'ubuzima kandi ibisubizo byayo ntibigize inama z'ubuvuzi. Jya ubona umuganga ufite uruhushya rwo gukorera hafi yawe mbere yo gukora impinduka izo ari zo zose.