Keratoconus
Uhlolojikelele
Ekheratoconus, i-cornea yakho iyaphuka futhi kancane kancane iphuma ngaphandle ibe yingxande. Lokhu kungabangela ukubona okuphazamisekile, okungacaci.
I-Keratoconus (ker-uh-toe-KOH-nus) yisimo sokulimala kwamehlo lapho i-cornea yakho — ingxenye engaphambili yamehlo akho ecacile, enesimo sengxande — iphuka futhi kancane kancane iphuma ngaphandle ibe yingxande.
ICornea enesimo sengxande ibangela ukubona okungacaci futhi ingabangela ukuzwela ekukhanyeni nasekubonakaleni. I-Keratoconus ngokuvamile ithonya womabili amehlo. Noma kunjalo, ingathinta iliso elilodwa ngaphezu kolunye. Ngokuvamile iqala ukuthonya abantu phakathi kweminyaka yabo yobusha nokuphelelwa yiminyaka engama-30. Isimo singathuthuka kancane iminyaka engu-10 noma ngaphezulu.
Ezigabeni zokuqala ze-keratoconus, ungase ukwazi ukulungisa izinkinga zokubona ngamagalasi noma ama-contact lenses abuthakathaka. Kamuva, kungase kudingeke uqondaniswe nama-contact lenses aqinile, agcwele igesi noma ezinye izinhlobo zama-lenses, njenge-scleral lenses. Uma isimo sakho sibe sibi, ungase udinga ukuhlinzwa kwe-cornea.
Inkqubo ebizwa ngokuthi i-corneal collagen cross-linking ingasiza ekuthambiseni noma ekuyekiseni i-keratoconus ukuthi iqhubeke, mhlawumbe ivimbele isidingo sokuhlinzwa kwe-cornea esikhathini esizayo. Lolu phiko lungase lunikezwe ngaphezu kwezinketho zokulungisa ukubona ezingenhla.
Izimpawu
Amasimptomu e-keratoconus angashintsha njengoba isifo siqhubeka. Ahlanganisa: Ukubona okuphazamisekileyo noma okuphambukileyo. Ukuncipha kokubekezela ekukhanyeni okukhulu nasekugqamile, okungabangela izinkinga ekuqhumeni ebusuku. Isidingo sokuhlala ushintsha ama-prescription amehlo. Ukubiwa okungazelelwe noma ukufiphaza kokubona. Bona udokotela wakho wamehlo uma ukubona kwakho kuya kubi ngokushesha, okungenzeka kubangelwe ukugoba okungajwayelekile kweliso, okubizwa ngokuthi yi-astigmatism. Udokotela wakho wamehlo angase futhi abuke izimpawu ze-keratoconus ngesikhathi sokuhlolwa kwamehlo okujwayelekile.
Isikhathi sokubona udokotela
Bona udokotela wakho weziso uma umbono wakho ubuhlungu kakhulu, okungenzeka ukuthi kubangelwa ukugoba okungajwayelekile kweliso, okuthiwa yi-astigmatism. Udokotela wakho weziso angase futhi afune izimpawu ze-keratoconus ngesikhathi sokuhlolwa kwamehlo okujwayelekile.
Izimbangela
Akekho owaziyo ukuthi yini ebangela i-keratoconus, nakuba kubonakala sengathi izinto ezihlobene nezofuzo nezemvelo zihilelekile. Cishe umuntu omunye kwabayishumi abane-keratoconus unomzali onaleli gciwane.
Izici eziyingozi
Lezi zinto zingandisa amathuba akho okukhula i-keratoconus:
- Ukuba nomlando womndeni we-keratoconus.
- Ukuqhekeza amehlo ngamandla.
- Ukuba nezimo ezithile, ezifana ne-retinitis pigmentosa, i-Down syndrome, i-Ehlers-Danlos syndrome, i-Marfan syndrome, i-hay fever ne-asthma.
Izingqinamba
Kwezinye izimo, i-cornea yakho ingase ifufe ngokushesha futhi ibe yimbangela yokwehla kokuqonda okungazelelwe kanye nokulimala kwe-cornea. Lokhu kubangelwa yisimo lapho ukugqoka kwangaphakathi kwe-cornea yakho, okuthiwa yi-Descemet's membrane, kuwohloka. Lokhu kubangela ukuba amanzi angene kwi-cornea, isimo esaziwa ngokuthi yi-hydrops. Ukufufuza kuvame ukuya phansi ngokwalo, kodwa isigaxa singase senzeke esithinta ukubona kwakho.
I-keratoconus ephambili nayo ingase ibe yimbangela yokuba i-cornea yakho ilimale, ikakhulukazi lapho ikoni ibonakala khona kakhulu. I-cornea elilimalile iholela ezinkingeni zokubona ezibi kakhulu futhi ingadinga ukuhlinzwa kwe-cornea.
Ukuxilongwa
Ukuthola i-keratoconus, udokotela wakho weziso uzobuyekeza umlando wakho wezokwelapha nowomndeni bese enza uvivinyo lwamehlo. Kungenzeka futhi kwenziwe ezinye izivivinyo ukuze kutholakale okwengeziwe ngesimo se-cornea yakho. Izivivinyo zokuthola i-keratoconus zihlanganisa:
- Ukuqondisa amehlo. Lo mvivinyo usebenzisa imishini ekhethekile elinganisa amehlo akho. Ungase ucelwe ukubuka ngedivayisi enezinhlanzi zezinso ezahlukene, ebizwa nge-phoropter. Le divayisi ikusiza ukwahlulela ukuthi iyiphi inhlanganisela ekunika umbono oqondile. Abanye odokotela bangase basebenzise ithuluzi lesandla elibizwa nge-retinoscope ukuhlola amehlo.
- Ukuhlolwa kwe-slit-lamp. Lo mvivinyo uhilela ukuqondisa isibani esiqondile esembovane phezu komphetho weliso nokusebenzisa i-microscope enamandla aphansi ukubuka iliso. Udokotela weziso uhlola ukuma kwe-cornea yakho futhi abukele ezinye izinkinga ezingase zibe khona emehlweni.
- I-Keratometry. Lo mvivinyo uhilela ukugxila isiyingi sokukhanya e-cornea futhi ulinganise ukubonakala. Lokhu kunquma ukuma oluyisisekelo lwe-cornea.
- Ukuqamba kwe-cornea ngekhompyutha. Izivivinyo zezithombe ezikhethekile, njenge-corneal tomography ne-corneal topography, zirekhoda izithombe ukudala imephu yesimo se-cornea. I-Corneal tomography ingalinganisa nobubanzi be-cornea. Lolu hlobo lokuhlola ngokuvamile lungathola izimpawu zokuqala ze-keratoconus ngaphambi kokuthi isifo sibonakale ngokuhlolwa kwe-slit-lamp.
Ukwelashwa
Ukwelapha i-keratoconus kuncike ezingeni lobunzima besimo sakho nokuthi isimo siqhubeka ngokushesha kangakanani. Ngokuvamile, kunezindlela ezimbili zokwelapha i-keratoconus: ukuthambisa ukuqhubeka kwesifo nokuthuthukisa ukubona.Uma i-keratoconus iqhubeka, ukuhlanganiswa kwe-collagen ye-cornea kungase kubonakale ukuyithambisa noma ukuyivimba ukuba ingabi sibi kakhulu. Lolu lwelo lwembophezelo luhloselwe ukuqina isikhungo se-cornea. Kunganciphisa ukukhula kwe-cornea futhi kusize ukufeza ukubona kangcono ngezigqoko noma ama-lenses wokuxhumana. Lolu lwelo lwembophezelo lunamandla okukuvimbela ekutheni udinga ukutshalwa kwe-cornea esikhathini esizayo.Ukuthuthukisa ukubona kuncike ezingeni lobunzima be-keratoconus. I-keratoconus ephansi kuya kwephakathi ingaphathwa ngezigqoko noma ama-lenses wokuxhumana. Lokhu cishe kuyoba ukwelashwa kwesikhathi eside, ikakhulukazi uma i-cornea iqinile ngokuhamba kwesikhathi noma kusuka ekuhlanganiseni.Kwabanye abantu abane-keratoconus, i-cornea iba ne-scarring ngesifo esithuthukile. Kwabanye, ukugqoka ama-lenses wokuxhumana kuba nzima. Kulaba bantu, ukucutshungulwa kwe-cornea kungase kudingeke. – Izigqoko noma ama-lenses wokuxhumana abuthakathaka. Izigqoko noma ama-lenses wokuxhumana abuthakathaka angalungisa ukubona okungacace noma okuphambukile ekuqaleni kwe-keratoconus. Kodwa abantu bavame ukudinga ukushintsha iresiphi yabo yezigqoko noma ama-contacts njengoba ukuma kwe-corneas yabo kuguquka.– Ama-lenses wokuxhumana aqinile. Ama-lenses wokuxhumana aqinile ngokuvamile isinyathelo esilandelayo ekwelapheni i-keratoconus ethuthukile. Ama-lenses aqinile afaka uhlobo oluqinile, oluvumela igesi. Ama-lenses aqinile angase azizwe engakhululekile ekuqaleni, kodwa abantu abaningi bayazivumelanisa nokugqoka futhi anganikeza ukubona okuhle kakhulu. Lolu hlobo lwe-lens lungenziwa ukuze lufaneleke kwi-corneas yakho.– Ama-lenses e-Piggyback. Uma ama-lenses aqinile engakhululekile, udokotela wakho wamehlo angase akukhuthaze "ukubeka" i-lens yokuxhumana eqinile phezulu kwe-soft.– Ama-lenses e-Hybrid. La ma-lenses wokuxhumana anaphakathi oluqinile ngesigcawu esithambile ngaphandle ukuze kube lula. Abantu abangakwazi ukubekezelela ama-lenses wokuxhumana aqinile bangase bakhethe ama-lenses e-hybrid.– Ama-lenses e-Scleral. La ma-lenses asebenziseka kahle ekuguqukeni okungajwayelekile kwesimo se-cornea yakho e-keratoconus ethuthukile. Esikhundleni sokuphumula e-cornea njengoba ama-lenses wokuxhumana avamile enza, ama-lenses e-scleral ahlala engxenyeni emhlophe yamehlo, ebizwa nge-sclera, futhi ahlanganisa i-cornea ngaphandle kokuyithinta.Uma usebenzisa ama-lenses wokuxhumana aqinile noma e-scleral, qiniseka ukuthi uwabekwe udokotela wamehlo onolwazi ekwelapheni i-keratoconus. Uzodinga futhi ukuhlolwa okuvamile ukuze ubone ukuthi ama-lenses asafaneleka kahle yini. I-lens engalungile ingalimaza i-cornea yakho.Ama-lenses wokuxhumana e-Scleral abumba ingxenye emhlophe yamehlo futhi ahlanganisa i-cornea. Isigaba sokuvikela se-saline sihlala phakathi kwamehlo ne-lens yokuxhumana. La ma-lenses yindlela engcono kune-opereysheni kwabantu abaningi abane-keratoconus.– Ukuhlanganiswa kwe-cornea. Kule nqubo, i-cornea igcwaliswa ngama-eye drops e-riboflavin futhi iphelelwa ukukhanya kwe-ultraviolet. Lokhu kubangela ukuhlanganiswa kwe-cornea, okuqinisa i-cornea ukuvimbela ukuguquka kwesimo. Ukuhlanganiswa kwe-cornea kungasiza ukunciphisa ingozi yokulahleka kokubona okuqhubekayo ngokuqinisa i-cornea ekuqaleni kwesifo.Ungase udinga ukucutshungulwa uma une-cornea scarring, ukuncipha okukhulu kwe-cornea yakho, ukubona okubi ngama-lenses amandla kakhulu noma ukungakwazi ukugqoka noma yiluphi uhlobo lwama-lenses wokuxhumana. Kuye ngendawo yekoni ephumelelayo nobunzima besimo sakho, izinketho zokucutshungulwa zifaka:– Izingxenye ze-ring ze-cornea ze-Intrastromal (ICRS). Nge-keratoconus ephansi kuya kwephakathi, udokotela wakho wamehlo angase akukhuthaze ukufaka ama-rings amancane angokwenziwa e-cornea yakho. Lolu lwelo lwembophezelo lungasiza ekuqinisweni kwe-cornea, okungasiza ekuthuthukiseni ukubona nokwenza ama-lenses wokuxhumana afanele kangcono. Ngezinye izikhathi, le nqubo yenziwa ndawonye nokuhlanganiswa kwe-cornea.– Ukutshalwa kwe-cornea. Uma une-cornea scarring noma ukuncipha okukhulu, cishe uzodinga ukutshalwa kwe-cornea. Kuye ngesimo sakho, udokotela wakho wamehlo angase akukhuthaze ukushintsha konke noma ingxenye ye-cornea yakho nge-tissue yomnikelo enempilo. Ukuhlinzwa kwe-cornea kwaziwa ngokuthi yi-keratoplasty.Ukutshalwa kwe-cornea kwe-keratoconus ngokuvamile kuphumelela kakhulu. Izingozi ezingase zenzeke zifaka ukulahlekelwa kwe-graft, ukubona okubi, ukutheleleka ne-astigmatism. I-astigmatism ngokuvamile ilawulwa ngokugqoka ama-lenses wokuxhumana aqinile futhi, okuvamile kuhlala kulula ngemuva kokutshalwa kwe-cornea.