I-Corneal Ulcer

Isilonda se-cornea singasongela ukubona uma singelashwa. Lesi simo esibucayi samehlo sithinta i-cornea-indawo engaphambili ecacile iso-futhi idinga ukunakekelwa ngokushesha ukuze kuvinjwe ukulahlekelwa ukubona unomphela. Ukubonwa kusenesikhathi kwezimpawu zezilonda ze-cornea kanye nokwelashwa ngokushesha kuthuthukisa kakhulu amathuba okululama ngokuphelele. Izinketho zesimanje zokwelapha izilonda ze-cornea zenze kwaba nokwenzeka ukonga ukubona ezimweni eziningi lapho iziguli zifuna usizo ngokushesha.

Yini I-Corneal Ulcer (Keratitis)?

I-cornea ulcer, eyaziwa ngokuthi i-keratitis, izilonda ezivulekile ezivela ku-cornea—ungqimba lwezicubu ezicacile, ezimise okwedome ngaphambili kweso. Lesi simo senzeka lapho kulahleka izicubu ze-cornea, ngokuvamile ezihambisana nokuvuvukala. Odokotela babheka izilonda ze-cornea njengesimo esiphuthumayo samehlo ngenxa yamandla azo okubangela ukulimala kombono unomphela uma zingelashwa.

Izimpawu Ze-Corneal Ulcer

Okulandelayo yizimpawu ezivame kakhulu zezilonda ze-cornea:

• Ububomvu noma ukubonakala kwegazi esweni elithintekile
• Ukudabuka kakhulu noma iso elimanzi (epiphora)
• Ubuhlungu beso obusukela ekungaphatheki kahle kancane kuye ebuhlungwini obukhulu
• Ukuzwa komzimba wangaphandle, okufana nokuba nothuli noma i-elash esweni
• Ukuzwela ukukhanya (photophobia)
• Ukubona okufiphele noma okunciphile
• Amajwabu amehlo avuvukele

Izici Zobungozi kanye nezimbangela Ama-Corneal Ulcers

Ukuthuthukiswa kwezilonda zamakhowe kubangelwa yizimbangela ezihlukahlukene, kanti izifo ziyimbangela eyinhloko. Lezi zifo zivame ukwenzeka lapho ungqimba lwangaphandle oluvikelayo lwe-cornea luba sengozini, okuvumela izinto eziphilayo eziyingozi ukuthi zingene ezicubu zamehlo.

Izimbangela ezithathelwanayo zihlanganisa:

• Ukutheleleka Kwamagciwane: Ukugqokwa kwamalensi okuxhumana kwandisa kakhulu ingcuphe yokuba nezilonda zamakhone, ikakhulukazi ngamalensi athambile agqokwa isikhathi eside. Ingozi iba ngokuphindwe kashumi uma lawa ma-lens egqokwa ngobusuku bonke.
• Ukutheleleka Ngegciwane: Ibangelwa igciwane le-herpes simplex noma i-varicella virus
• Ukutheleleka kwefungal: Ngokuvamile okubangelwa impahla yezitshalo engena esweni
• Ukutheleleka kweParasitic: Ikakhulukazi e-Acanthamoeba, etholakala emanzini ahlanzekile nasenhlabathini

Izimbangela ezingatheleleki yilezi: 

• Ukushiswa kwe-Chemical
• Izimo ezizenzakalelayo
• Ukusabela okunobuthi
• Izinkinga ze-Neurotrophic

Ezinye izici eziningi zingakhuphula amathuba okuba nezilonda ze-corneal, okuhlanganisa: 

• Amehlo amile
• Ukuphazamiseka kwejwabu leso okuvimbela ukuvaleka okufanele
• Ukukhubazeka kukaBell
• Ukulimala kwe-Corneal
• Izimo ezimbi kakhulu ze-allergic 
• Thayipha i-2 sikashukela noma labo abasebenzisa i-steroid eye drops 
• Umlando wokuhlinzwa kwamehlo noma izifo ze-cornea

Izinkinga zeCorneal Ulcer

Izinkinga eziningana zingavela uma isilonda se-cornea sihlala singelashwa noma sithola ukwelashwa okwanele:

• I-Corneal Scarring: Amamaki ahlala njalo ku-cornea angathinta ukucaca kombono
• Izinguquko Zombono: Ukuthuthukiswa kwe-astigmatism engavamile ethinta ukubona
• Izinkinga Zesakhiwo: Ingozi ye-cornea perforation (izimbobo ku-cornea)
• Izimo zesibili: Ukuthuthukiswa kwezimo zamehlo ezinzima ezihlanganisa:
  • I-glaucoma (umfutho wamehlo owengeziwe)
  • I-cataracts (i-clouding of the eye lens)
  • I-Endophthalmitis (ukutheleleka kwamehlo kwangaphakathi okukhulu)

Sifo

Inqubo yokuxilonga ihlanganisa ukuhlola okuphelele kusetshenziswa ithuluzi elikhethekile elibizwa ngokuthi i-slit-lamp biomicroscope, evumela ukubonwa okunemininingwane kwendawo ye-cornea.

Uchwepheshe wamehlo ngokuvamile wenza izivivinyo ezimbalwa ezibalulekile zokuxilonga:

• I-Fluorescein Staining: Udayi okhethekile ugqamisa izindawo ezilimele ze-cornea
• I-Corneal Culture: Amasampula esilonda asiza ukukhomba izifo ezithile
• I-Confocal Microscopy: Inikeza izithombe ezinemininingwane yamaseli e-cornea
• Izithombe ezinencazelo ephezulu: Ibhala ukubukeka nokuqhubeka kwesilonda
• Uphenyo Lwelabhorethri: Kungase kudingeke uma izimo ezingaphansi ezifana rheumatoid arthritis, lupus, noma okunye ukuphazamiseka kwe-autoimmune kusolwa. 
• I-Corneal Topography kanye ne-Anterior Segment OCT: Lokhu kuhlola kunikeza ulwazi oluningiliziwe mayelana nokujula nobukhulu besilonda.

Ukwelashwa

Izinketho zokwelapha izilonda ze-cornea zincike kumsuka wembangela ehlonziwe ngesikhathi sokuxilongwa. Izindlela zokwelapha eziyinhloko zihlanganisa:

• Imithi:
  • Amaconsi e-eye e-antibiotic athinta izifo ezibangelwa amagciwane
  • Imithi elwa namagciwane yezifo ezibangelwa amagciwane
  • Ukwelashwa kwe-antifungal yezilonda ze-fungal
  • Imithi ekhethekile yezifo ezithathelwanayo
• Ukwelashwa kwe-Anti-inflammatory:
  • I-Corticosteroid iso amaconsi ukunciphisa ukuvuvukala
  • Kusetshenziswe ngokucophelela ngaphansi kokuqondisa kwezokwelapha
  • Ngokuvamile kuhlanganiswe nokwelashwa kwe-antimicrobial
• Ukuhlinzwa: Ezimweni ezimbi kakhulu ezingaphenduli emithini, ukungenelela kokuhlinzwa kungase kudingeke. Ukufakelwa kwe-cornea kuhilela ukususa nokufaka esikhundleni se-cornea eyonakele ngezicubu zomnikeli ezinempilo. Odokotela ngokuvamile batusa le nqubo ezimeni lapho imithi iyodwa ifakazela ukuthi ayanele.

Uzoyibona Nini Udokotela

Ukwelashwa ngokushesha kuyadingeka uma iziguli ziba:

• Ubuhlungu obukhulu beso, ikakhulukazi kulandela ukuhlukumezeka
• Ukubona ngokuzumayo kuyashintsha noma ukungaboni kahle
• Ukuzwela ukukhanya okunamandla okuthinta imisebenzi yansuku zonke
• Ukukhishwa kwamehlo okubalulekile
• Izimpawu eziba zimbi naphezu kokwelashwa okuqhubekayo
• Ingcindezi esweni ehambisana nesicanucanu
• Izinkinga zokubona ngomkhuhlane noma amakhaza
• Ukungakwazi ukuhambisa amehlo ngokujwayelekile
• Ukuqhunyiswa kwenhlamvu yeso

Prevention

Ukuvimbela izilonda ze-cornea kuhilela ukusebenzisa izinqubo zokunakekelwa kwamehlo ezifanele kanye nokugcina inhlanzeko enhle. 

Izinyathelo ezibalulekile zokuvimbela zihlanganisa:

• Ukugcina inhlanzeko yezandla efanele ngaphambi kokuthinta amehlo
• Ukusebenzisa ama-eyewear okuvikela ngesikhathi semisebenzi enobungozi obukhulu
• Ukulandela ukudla okulinganiselayo okucebile ngamavithamini
• Ukuhlala ugcwele amanzi ngokwanele usuku lonke
• Thatha amakhefu avamile ngesikhathi sesikrini usebenzisa umthetho wama-20-20-20
• Ukugwema ukuchayeka emanzini ngenkathi ugqoke amalensi
• Ukushintsha amakesi amalensi okuxhumana njalo ezinyangeni ezi-1-3
• Ukugqoka izibuko zelanga ezinokuvikelwa kwe-UV400 noma okungu-100% kwe-UV uma ungaphandle

Isiphetho

Izilonda ze-Corneal zihlala ziyisimo esibucayi samehlo esidinga ukunakekelwa ngokushesha nokwelashwa okufanele. Intuthuko yezokwelapha yenze ukwelashwa okuphumelelayo kwaba nokwenzeka, ikakhulukazi lapho iziguli zifuna ukunakekelwa kusenesikhathi. Ukuhlanganisa imithi efanele, ukuqapha ngokucophelela, nokunakekelwa kwamehlo okufanele kuholela emiphumeleni emihle yesiguli.

Imibuzo Evame Ukubuzwa

1. Yiziphi izimpawu zokuqala zezilonda ze-cornea?

Izimpawu zokuqala zesilonda se-cornea ngokuvamile zihlanganisa ububomvu neso elimanzi. Iziguli zivame ukuzwa umuzwa womzimba wangaphandle, njengokungathi kukhona okunamathele emehlweni azo. Ukuzwela ukukhanya nokungakhululeki okuncane kungase kwenzeke ngaphambi kokuba kuvele izimpawu ezinzima kakhulu.

2. Ingabe i-cornea isilonda siyelapheka?

Izilonda eziningi ze-cornea ziyelapheka ngokwelashwa okufanele. Inqubo yokuphulukisa ngokuvamile ithatha amasonto amabili kuya kwamathathu ngemithi efanele. Kodwa-ke, impumelelo incike ekungeneleleni kusenesikhathi kanye nokulandela ngokucophelela uhlelo lokwelapha olunqunyiwe.

3. Iyiphi indlela esheshayo yokwelapha isilonda samehlo?

Indlela ephumelela kakhulu yokuphulukisa ihilela ukunakwa ngokushesha kanye nokunamathela ngokuqinile ekwelashweni okunqunyiwe. Iziguli kufanele:

• Khipha contact lens ngokushesha
• Sebenzisa ama-antibiotic anqunyiwe noma imishanguzo ye-antifungal njengoba kuyalelwe
• Gwema ukuhlikihla noma ukuthinta iso elithintekile
• Yiya kuwo wonke ama-aphoyintimenti okulandelela

4. Yiziphi izigaba ezine ze- cornea ulcer?

Izilonda ze-Corneal ziqhubeka ngezigaba ezine ezihlukene:

• Ukukhubazeka kwe-Epithelial: Ukulimala kokuqala koqweqwe lwangaphandle lwe-cornea
• Ukungena kwe-Stromal: Ukutheleleka kusakazekela ezingqimbeni ezijulile
• I-Descemetocele: Isilonda sifinyelela ungqimba lwangaphakathi lwe-cornea
• I-Corneal perforation: Ukungena okuphelele nge-cornea

5. Yikuphi ukudla okulungele izilonda ze-cornea?

Ukudla okunomsoco kusekela ukuphulukiswa kwe-cornea. Ukudla okunosizo kuhlanganisa:

• Amaqanda (ocebile ku-vitamin A kanye ne-zinc)
• Inhlanzi (equkethe i-omega-3 fatty acids)
• Izithelo ezisawolintshi (eziphezulu ngovithamini C)
• Imifino enamaqabunga njenge-kale (equkethe i-lutein ne-zeaxanthin)
• Ama-alimondi (umthombo we-vitamin E)

CARE Medical Team