I-Ocular Hypertension

I-Ocular hypertension yisimo sezokwelapha lapho ukucindezela emehlweni akho kungaphezu kokuvamile. Lokhu kukhuphuka komfutho we-ocular kungaholela ezinkingeni ezinkulu zamehlo uma kuyekwa kungabhekwa. Ukuqonda i-hypertension ye-ocular kubalulekile ekugcineni impilo enhle yamehlo kanye nokuvimbela ukulahleka kombono okungase kube khona.
Le bhulogi izochaza izimbangela nezimpawu zokucindezela kwamehlo aphezulu. Sizobheka izizathu ezibangela ingcindezi ephezulu emehlweni akho, ukuthi uzibona kanjani izimpawu, nokuthi yini ongayenza ngakho. 

Iyini I-Ocular Hypertension?

Kwenzeka lapho ingcindezi ngaphakathi kweso iphakeme kunokuvamile. Amehlo ahlala ekhiqiza uketshezi olucacile olubizwa ngokuthi i-aqueous humor olugeleza phambi kwamehlo bese luphuma. I-IOP iyanda uma ihlaya elinamanzi lingakhiphi iso lapho kufanele. Le ngcindezi ye-intraocular (IOP) ikalwa ngamamilimitha e-mercury (mmHg). Ngokujwayelekile, umfutho wamehlo ojwayelekile usukela ku-10 kuye ku-21 mmHg. Kubhekwa njenge-hypertension ye-ocular lapho umfutho wegazi ungaphezu kuka-21 mmHg ehlo elilodwa noma womabili lapho kuhlolwa kabili noma ngaphezulu.

Izimpawu ze-Ocular Hypertension

Ngokungafani nezinye izimo zamehlo ezingabangela ukungakhululeki noma ukushintsha kokubona, ukucindezela okuphezulu emehlweni akho ngokuvamile akuholeli kunoma yiziphi izimpawu ezisheshayo noma ezisobala. Lokhu kuthulile kwe-ocular hypertension kusho ukuthi abantu abaningi abazi ukuthi banalesi simo kuze kube yilapho sitholakala ngesikhathi sokuhlolwa kwamehlo okujwayelekile.

Ezimweni ezingavamile, abantu abanomfutho wegazi ophakeme we-ocular bangase babhekane nokungaphatheki kahle kwamehlo lapho bethinta noma benyakaza amehlo noma izinhlungu zekhanda. Kodwa-ke, lezi zimpawu aziqondile ku-hypertension yamehlo futhi zingabangelwa ezinye izici ezihlukahlukene. Kubalulekile ukuqaphela lokho umbono ongenalutho, evame ukuhlotshaniswa nezinkinga zamehlo, ngokuvamile akulona uphawu lwe-ocular hypertension kuphela.

Izinkinga ze-Ocular Hypertension

Imbangela eyinhloko yokucindezela okukhulu emehlweni akho ukungalingani ekukhiqizeni nasekukhipheni amanzi amahlaya, uketshezi olucacile ngaphakathi kweso. Lapho imigudu yokukhipha amanzi (etholakala engeli yegumbi elingaphambili phakathi kwe-iris ne-cornea) ingasebenzi kahle, uketshezi luyakha, lukhulise ukucindezela kwe-intraocular.

Izinto ezimbalwa ezinomthelela kulokhu kungalingani yilezi:

• I-drainage angle ingase ivalwe, noma i-drain ingase ingaphumi kahle.  
• Isimo lapho izinhlayiya ze-pigment zintanta eduze kweso (Pigment dispersion syndrome) zivimbela i-trabecular meshwork's drainage angle.
• Isimo lapho ama-protein flakes angavimba khona i-drainage angle (pseudoexfoliation syndrome).
• I-Uveitis noma ukuvuvukala kwengxenye ephakathi yeso 
• Ukulimala kwamehlo noma izimo ezithile zamehlo nakho kungabangela umfutho wegazi ophakeme wamehlo.
• Isimila seso
• Large i-cataracts lokho kuvimbe i-drainage passage

Izinto Eziyingozi Ze-Ocular Hypertension

Izici eziyingozi zokuthuthukisa i-ocular hypertension yilezi:

• Abantu abangaphezu kweminyaka engama-40 basengozini enkulu. 
• Umlando womndeni kanye nezici zofuzo zinomthelela omkhulu kungcindezi ye-intraocular. 
• Ubuhlanga bungenye into, ngocwaningo olubonisa ukuthi abantu base-Afrika baseMelika kanye ne-Hispanics bangase babe sengozini enkulu.
• Izimo zezokwelapha ezifana nesifo sikashukela, umfutho wegazi ophakeme, kanye nokungaboni kahle eduze (myopia) nakho kungandisa amathuba okuba nomfutho wegazi ophakeme wamehlo. 
• Ukwengeza, ukuba ne-cornea emaphakathi encane noma ukopha ekhanda le-optic nerve kungase kuthinte ukufundwa kwengcindezi futhi kwandise ingozi.
• Ukusetshenziswa isikhathi eside kwemithi ye-steroid kanye nomlando wokulimala kwamehlo noma ukuhlinzwa nakho kungabangela umfutho wegazi ophakeme wamehlo. 

Izinkinga

Umfutho wegazi ophakeme we-ocular, obonakala ngomfutho ophakeme wamehlo, ungaholela ezinkingeni ezinkulu uma ungelashwa. Lezi izi:

• I-glaucoma 
• Ukulahlekelwa kokubona okungenakuhlehliswa ngokuhamba kwesikhathi
• Ukuvalwa kwe-retinal vein

Ukuxilongwa kwe-Ocular Hypertension

Ukuxilongwa kwe-hypertension ye-ocular kuhilela uchungechunge lokuhlola ukukala ingcindezi ye-intraocular (IOP) nokuhlola impilo yamehlo. 
Ngesikhathi sokuhlolwa kwamehlo, udokotela uzokwenza uphenyo oluningana. Lezi izi:

• I-Tonometry: Lokhu kuhlolwa kukala i-IOP. Uma ukuhlolwa kokuqala kubonisa ukucindezela okukhulu, udokotela angase asebenzise i-tonometry enembe kakhudlwana, i-applanation tonometry, ukuze aqinisekise ukufundwa. Lokhu kuhlola kubhekwa njengokunembe kakhulu kokulinganisa umfutho wamehlo.
• I-Optical coherence tomography (OCT): Lokhu kuhlolwa kokuxilonga okungavamisile kuhlola i-optic nerve ngomonakalo noma noma yikuphi ukungahambi kahle kwesakhiwo. Lokhu kungadinga ukunwetshwa kwabafundi. Izithombe ze-optic disc (indawo engaphambili ye-optic nerve) zivame ukuthathwa ukuze zisetshenziswe esikhathini esizayo futhi ziqhathaniswe.
• Ukuhlolwa Kwenkundla Okubukwayo: Okwaziwa nangokuthi i-perimetry, ukuhlolwa kwenkambu ebonakalayo kusiza ukuhlola umbono we-peripheral. Lokhu kuhlola kusiza ukuthola noma yiziphi izimpawu zokulahlekelwa umbono ezingase zibonise ukukhula kwe-glaucoma. 
• I-Gonioscopy: Lokhu kuhlolwa kokuxilonga kuhlola i-angle yokukhipha amanzi yeso.
• I-Pachymetry: Lesi sivivinyo esibucayi sikala ukujiya kwe-corneal kusetshenziswa i-ultrasound probe, esiza ukucacisa ukunemba kokufundwa kwe-IOP, njengoba ukujiya kwe-corneal kungathinta ukukalwa kwengcindezi.

Ukwelashwa Kwe-Ocular Hypertension

• Amaconsi Eso: Indlela yokwelapha ejwayeleke kakhulu ibandakanya ukusetshenziswa kwamaconsi esweni abhalwe udokotela. Le mithi isebenza ngokunciphisa ukukhiqizwa koketshezi esweni noma ukwandisa ukugeleza kwayo, ngaleyo ndlela yehlise ingcindezi ye-intraocular. Amanye amaconsi iso yilawa:
  • I-Prostaglandin Analogues:  Lezi zivame ukusetshenziswa kanye ngosuku futhi zibe nomthelela omkhulu ekwehliseni umfutho wamehlo. 
  • I-Beta-blockers: Zingasetshenziswa kanye noma kabili ngosuku ukunciphisa ukukhiqizwa koketshezi emehlweni.
  • Ama-Alpha-adrenergic Agonists noma Ama-Carbonic Anhydrase Inhibitors: Le mithi ingasetshenziswa izikhathi ezimbili kuya kwezintathu ngosuku futhi isebenze ngokunciphisa ukuphuma koketshezi noma ukwandisa uketshezi oluphuma esweni.
• Ukuhlinzwa: Uma amaconsi eso ewodwa akwehlisi ngokwanele ukucindezela emehlweni akho, udokotela wakho angase ancome ukwelashwa nge-laser noma ukuhlinzwa. Lezi zinqubo zithuthukisa ukuphuma koketshezi esweni, kuqhubeke nokunciphisa umfutho we-intraocular. Kodwa-ke, lezi zinketho zivame ukucatshangelwa lapho imithi ingazange iphumelele ekulawuleni isimo.

Uzoyibona Nini Udokotela

Kunconywa ukuthi uhlolwe amehlo njalo uma usengozini enkulu yokuba ne-glaucoma. Ukuxilongwa kusenesikhathi nokwelashwa kwe-ocular hypertension kungasiza ekuvimbeleni isimo ukuthi singathuthukeli sibe yi-glaucoma, okungenye yezimbangela ezinkulu zokulahlekelwa ukubona unomphela uma ingelashwa.

Funa usizo lwezokwelapha ngokushesha uma uhlangabezana: 

• Ama-halos azungeze izibani
• Umbono ophundlekile
• Ubuhlungu bamehlo
• Noma yiziphi izimpawu ezintsha noma eziya ziba zimbi ezihlobene neso

Prevention

Nakuba kungenzeki ngaso sonke isikhathi ukuvimbela umfutho wegazi ophakeme wamehlo, kunezinyathelo ongazithatha ukuze unciphise ubungozi bakho futhi ugcine impilo yamehlo enhle, njenge: 

• Izivivinyo Zamehlo Ezivamile: Kunconywa ukuthi uhlolwe amehlo okungenani njalo ngemva kweminyaka emibili noma ngaphezulu njalo uma usengozini enkulu yokuba ne-glaucoma.
• Ukugcina Indlela Yokuphila Enempilo: Lokhu kuhlanganisa ukungabhemi, njengoba ukubhema kulimaza impilo yakho yonke, kuhlanganise namehlo akho. 
• Ukuvikela Amehlo Akho Ekulimaleni Okungaba Khona: Gqoka izibuko zelanga ngaphandle futhi usebenzise izembatho zamehlo ezivikelayo phakathi nemisebenzi ephakamisa ubungozi bakho bokulimala kweso (thintana nezemidlalo noma usebenze ngezinto eziyingozi).
• Ukudla Okunempilo: Faka imifino enamahlamvu aluhlaza okumnyama, ukudla okunothe ngamavithamini C no-E, nenhlanzi ephezulu Ama-acids ama-omega-3 ekudleni kwenu. 
• Ukuzivocavoca Okuvamile: Kungasiza futhi ukugcina impilo yonke futhi kunciphise ukucindezelwa kwamehlo.
• Umlando Womndeni: Qaphela umlando womndeni wakho wezifo zamehlo, njengoba ezinye izimo, njenge-glaucoma, zingaba nezakhi zofuzo. 

Isiphetho

Ukunakekela amehlo akho kubandakanya okungaphezu nje kokubhekana nomfutho wegazi ophakeme wamehlo. Kuhlanganisa ukwamukela indlela yokuphila enempilo, ukuvikela amehlo akho ekulimaleni, nokuqaphela izici eziyingozi. Khumbula, nakuba i-hypertension yamehlo ingaholeli njalo ku-glaucoma, kuyisici esiyingozi esidinga ukuqapha ngokucophelela. Ngokusebenzisana eduze ne-ophthalmologist yakho nokulandela iseluleko sabo, ungasiza ekuqinisekiseni impilo yesikhathi eside yamehlo akho.

Imibuzo Evame Ukubuzwa

1. Ingabe i-hypertension yamehlo yehlukile kune-glaucoma?

I-hypertension ye-ocular ihluke ngempela kune-glaucoma. I-Ocular hypertension imane isho umfutho okhuphukile wamanzi ngaphakathi kwamehlo, nakuba amehlo enempilo ngenye indlela. Ku-glaucoma, kuvame ukuba nomfutho ophakeme we-intraocular eduze kwe-optic nerve eyonakele kanye nokulahleka kwenkundla yokubuka. Abantu abane-hypertension yamehlo basengozini enkulu yokuba ne-glaucoma, kodwa ukuba nomfutho wegazi ophakeme wamehlo akusho ukuthi umbono wakho usengozini ngokuzenzekelayo.

2. Ngingawunciphisa kanjani umfutho wamehlo?

Ukunciphisa ukucindezela kwamehlo, izinyathelo ezimbalwa zingathathwa. Ukuzivocavoca njalo kungabangela ukwehla kwengcindezi ye-intraocular, futhi lo mphumela ungathatha izinyanga ezimbalwa. Ukugcina isisindo somzimba esifanele kubaluleke kakhulu, njengoba kokubili i-BMI ephansi nephezulu ihlotshaniswe nengozi eyengeziwe yesimo se-glaucoma. Ukulala ikhanda liphakanyiswe ngama-degree angu-20 kungase kunciphise ukucindezeleka kwamehlo ngobusuku bonke. Ukwengeza, ukulawula ukucindezeleka ngokusebenzisa imikhuba efana nokuzindla kungasiza ekunciphiseni ukucindezeleka kwamehlo.

3. Yikuphi ukudla okuphakamisa umfutho wamehlo?

Nakuba kungekho bufakazi obuqondile bokudla okuthile okuphakamisa ukucindezela kwamehlo, imikhuba ethile yokudla ingase ibe nomthelela womfutho wegazi ophakeme wamehlo. I-caffeine ingabangela ukukhuphuka kokucindezela kwamehlo okuhlala okungenani imizuzu engu-90, ngakho-ke kuyalulekwa ukulinganisela ekusetshenzisweni kwe-caffeine. Ukudla okuphezulu kwamafutha agcwele kanye nama-trans kufanele kukhawulwe noma kugwenywe njengoba kungaholela ekuzuzeni isisindo kanye nokwanda kwe-BMI, okungase kuthinte ukucindezela kwamehlo ngokungaqondile. Ukudla usawoti okweqile nakho kungaba nomthelela ngokungaqondile ukucindezela kwamehlo ukuphakamisa umfutho wegazi.

4. Ingabe ukuntula ubuthongo noma ukungalali kahle kungabangela umfutho wamehlo?

Ucwaningo lubonisa ukuthi izinkinga zokulala zingaba nomthelela ekuqhubekeleni phambili kwe-glaucoma. Ucwaningo lubonisa ukuthi ukungalali kahle—okuhlanganisa ubude besikhathi sokulala, ukuphazamiseka kokulala, ukuphazamiseka kokulala nokozela emini—kungaba isici esiyingozi noma umphumela we-glaucoma. Kukhona futhi ukuxhumana phakathi kwe-glaucoma kanye nokozela obala emini. I-apnea engalashiwe yokuvimbela ukulala (OSA) ingase iphakamise ithuba lokuthuthukisa i-glaucoma. 

UDkt. Sanghamitra Dash

MBBS, MS (I-Ophthalmology)
CARE Hospitals, Bhubaneswar

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529