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หัวข้อกระทู้ : ต้อหิน (Glaucoma) คืออะไร?  
โดย : Dr. Somchai
    toppic : ต้อหิน (Glaucoma) คืออะไร?
โพสเมื่อวันที่ :
พฤหัสบดี ที่ 25 เดือน พฤษภาคม พ.ศ.2560 เวลา 16:30:51   
โพสโดยคุณ
: Dr. Somchai
ไอพี : 171.96.191.XXX จำนวนผู้เข้าชม : 2277

 

ต้อหิน (Glaucoma) คืออะไร?

ต้อหิน glaucoma
สุขภาพ

ต้อหิน (Glaucoma) เป็นโรคของดวงตาชนิดหนึ่งที่เกิดจากความเสื่อมของเส้นประสาทตา หรือเส้นประสาทตาถูกทำลาย โดยเป็นเส้นประสาทที่เชื่อมระหว่างตากับสมอง ปัจจัยหลักมาจากความดันในลูกตาสูง ซึ่งเกิดจากการระบายน้ำออกของลูกตามีการอุดตันและเสื่อมสภาพ ทำให้ระบายน้ำออกจากลูกตาได้ไม่ดีพอ ส่งผลให้ความดันภายในลูกตาเพิ่มขึ้นอย่างช้า ๆ จนทำลายประสาทตาในที่สุด

 

ต้อหิน

 

ต้อหินสามารถเกิดขึ้นได้กับคนทุกเพศทุกวัย และมีอุบัติการณ์เพิ่มขึ้นตามอายุ แต่จะเกิดขึ้นบ่อยในผู้สูงอายุ โดยเฉพาะในผู้ที่มีอายุตั้งแต่ 40 ปีขึ้นไป ผู้ที่มีประวัติของคนในครอบครัวเป็นต้อหิน หรือผู้ที่ป่วยเป็นโรคเบาหวาน เป็นต้น นอกจากนั้น องค์กรอนามัยโลก (WHO) ยังระบุว่า ต้อหินเป็นสาเหตุสำคัญของการสูญเสียการมองเห็นของคนทั่วโลกเป็นอันดับ 2 รองจากต้อกระจก พบผู้ป่วยโรคต้อหินทั่วโลกถึง 70 ล้านคน โดยเกือบ 10% ของผู้ป่วยหรือประมาณ 6.7 ล้านคน ต้องตาบอด หรือสูญเสียการมองเห็นอย่างสิ้นเชิง ในประเทศไทย ข้อมูลจากสถิติสาธารณสุข ปี 2555 พบผู้ป่วยโรคต้อหินทั่วประเทศ จำนวน 17,687 ราย

 

ถึงแม้ว่าต้อหินจะเป็นโรคที่ไม่สามารถรักษาให้หายขาดได้ แต่ก็สามารถป้องกันและควบคุมการสูญเสียของการมองเห็นได้

 

อาการของต้อหิน

 

โดยทั่วไป ต้อหินจะไม่มีอาการ หรือสัญญาณปรากฏเด่นชัดในตอนแรก และจะเกิดอาการแตกต่างกันไปขึ้นอยู่กับชนิดของต้อหิน ดังนี้

 

ต้อหินมุมเปิด (Open-angle Glaucoma)

 

เป็นต้อหินชนิดที่พบได้บ่อยที่สุด เกิดจากการไหลเวียนของน้ำในลูกตาลดลง ไม่ทราบกลไกที่แน่นอน สันนิษฐานว่าเกิดจากความเสื่อมของช่องระบายน้ำออกจากลูกตา ส่งผลให้น้ำในลูกตาไม่สามารถไหลเวียนออกได้อย่างปกติ ทำให้เกิดความดันในลูกตาสูงจนส่งผลให้ประสาทตาถูกทำลาย

ส่วนมากจะไม่มีอาการแสดงในระยะแรก แต่ถ้าไม่ได้รับการรักษาในระยะเริ่มต้นจะส่งผลให้สูญเสียการมองเห็นอย่างช้า ๆ ตามัวลงเล็กน้อยคล้ายมีหมอกมาบังทางด้านข้าง ซึ่งนำไปสู่การตาบอดในที่สุด ผู้ป่วยมักไม่รู้ตัว ยกเว้นคนที่มีการสังเกตค่อนข้างดี

ต้อหินมุมปิด (Angle-closure Glaucoma)

เป็นต้อหินที่พบได้น้อยกว่าต้อหินมุมเปิด อาการจะเกิดขึ้นได้อย่างรวดเร็ว เพราะโครงสร้างในการระบายน้ำออกจากลูกตามีการอุดตันอย่างทันทีทันใด ซึ่งที่มุมตาจะมีเนื้อเยื่อลักษณะคล้ายตะแกรงที่เรียกว่า trabecular meshwork เป็นทางผ่านของน้ำในลูกตา เมื่อเกิดการอุดตันขึ้น จึงทำให้เกิดความดันในลูกตาสูงตามมาจนส่งผลให้ประสาทตาถูกทำลาย

อาการที่จะเกิดขึ้นได้ คือ ปวดศีรษะ ตาแดง ตามัว เห็นแสงรุ้งรอบดวงไฟ และคลื่นไส้ อาเจียน

ในกรณีที่เกิดขึ้นเฉียบพลันจะมีอาการปวดตา หรือปวดศีรษะข้างเดียวกับตา

ต้อหินตั้งแต่กำเนิด หรือกรรมพันธ์ุ (Congenital Glaucoma)

เกิดในทารก หรือเด็ก อาการมักรุนแรงและควบคุมโรคได้ยาก หากไม่ได้รับการรักษาตั้งแต่ระยะแรกอาจพัฒนาไปจนทำให้ตาบอดได้ การตรวจหาโรคอาจทำได้ยากแต่สามารถสังเกตพฤติกรรมของเด็กและสังเกตทางกายภาพได้ เช่น

มีดวงตาที่ใหญ่กว่าคนปกติ

ไม่ชอบแสงสว่างจ้า

ไม่สามารถควบคุมการกระพริบตาได้

มีตาแดง ตาแฉะ หรือตาขุ่นมัว

ขยี้ตาบ่อย ๆ

ต้อหินชนิดแทรกซ้อน (Secondary Glaucoma)

อาจเกิดมาจากภาวะแทรกซ้อนจากความผิดปกติทางตา หรือเกิดจากโรคตาอื่น ๆ เช่น ได้รับบาดเจ็บ หรือเกิดอุบัติเหตุที่ตา มีเนื้องอก หรือใช้สเตียรอยด์เป็นเวลานาน ทำให้พัฒนามาเป็นต้อหิน

สาเหตุของต้อหิน

ในตาของเรานั้นจะมีน้ำหล่อเลี้ยงที่เรียกว่า aqueous humor ซึ่งถูกผลิตขึ้นโดยเนื้อเยื้อที่เรียกว่า ciliary body โดยน้ำหล่อเลี้ยงที่ถูกสร้างขึ้นมาจะไหลเวียนสู่ช่องหน้าลูกตา (anterior chamber) ทำหน้าที่หล่อเลี้ยงเลนส์ กระจกตา และหลังจากนั้นจะถูกดูดซึมผ่านออกจากลูกตาไปทางมุมตา (angle) โดยมุมตาจะมีโครงสร้างลักษณะคล้ายตะแกรง ที่เรียกว่า trabecular meshwork ซึ่งจะอยู่บริเวณขอบของม่านตา เมื่อน้ำหล่อเลี้ยงตาที่ผลิตขึ้น และการระบายออกของน้ำในตามีความสมดุล ก็จะทำให้ความดันตาอยู่ในระดับปกติ

 




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ความคิดเห็นที่ 4 พุธ ที่ 1 เดือน สิงหาคม พ.ศ.2561 เวลา 15:16:34 ไอพี : 69.167.29.15XX
โดย : liuchunkai
 
 

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ความคิดเห็นที่ 5 พุธ ที่ 22 เดือน สิงหาคม พ.ศ.2561 เวลา 09:32:53 ไอพี : 69.167.6.55XX
โดย : liuchunkai
 
 

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ความคิดเห็นที่ 6 พุธ ที่ 5 เดือน กันยายน พ.ศ.2561 เวลา 10:18:13 ไอพี : 207.148.7.144XX
โดย : jainbin1022


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ความคิดเห็นที่ 7 เสาร์ ที่ 15 เดือน กันยายน พ.ศ.2561 เวลา 10:26:57 ไอพี : 69.167.28.116XX
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ความคิดเห็นที่ 8 พฤหัสบดี ที่ 1 เดือน พฤศจิกายน พ.ศ.2561 เวลา 15:51:25 ไอพี : 199.48.242.215XX
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