Tshintu tshia ku babende mu dîsu, dinyanguka dia tshiadi, ne diambuluisha dia kumpala dia muena mudimu wa tshiamu tshia mitaku¶

Tshitupa tshia mêsu tshia muntu tshidi tshimueneka patoke ntshitupa tshidi ne mijilu ya bungi pa mutu pa mubidi, tshidi tshifila kudi nsongo ya mijilu mitue ku 7 000 ku milimetre kare kupitshila ku tshitupa tshia mêsu tshia mijilu ya trigeminal (mijilu ya mu mutu V1). Bu mudi bunene bua mijilu ebu bupite bua dikoba dia muntu misangu 300 too ne ku 600, nansha tshitupa tshikese tshia mabue a lupepele, dikosa dia ku tshianza tshia pa mutu, anyi sekonde mikese ya dikala dia tshiamu tshia ultraviolet tshidi katshiyi tshikuba bidi mua kupatula kanyinganyinga kakole ka mubidi wa bende, disama dia mêsu didi kadiyi disua, ne disama dia tshiadi didi mua kupatuka kutshibula.

Mu tshikondo tshimue tshimue, midimu ya lubilu lua bungi bu mudi kukuma tshiamu ku tshiamu, kuenza mudimu ne tshiamu tshia rotary angle grinder, anyi kuenza mudimu ne tshiamu tshia string trimmer kudi mua kuela tshintu tshikese tshia tshiamu tshijima mu tshitupa tshia dîsu anyi tshia sclera munda mua dîsu ne dibungama dikese dia ku ntuadijilu. Kumanya mua kutangila tshitupa tshia mêsu tshidi tshiunzuluke anyi tshintu tshikuabu tshidi munda mua mêsu kumpala kua kulenga bipese bia mêsu, mushindu wa kupatula bipese bia kuulu bia mêsu bua kupatula tshintu tshisokome tshidi tshikuate mu tshitupa tshia muinshi mua mêsu, ne bua tshinyi bantu badi bavuala biamu bia kutangila nabi mêsu ne matonsi a ku nzubu adi ne njiwu mikole ya dipanga dia mêsu dia kashidi kudi ne mushinga wa bungi bua kulama dimona.

Enza nunku mpindieu¶

1. Ambila muntu bua kulekela kuela dîsu diakamue ne kumuteka muaba udi kayi ne butoke bua bungi. Kuela dîsu didi ne tshitupa tshia dikala, tshia tshiamu, tshia mvinyo anyi tshia silice kudi kutshibula tshitupa atshi muinshi menemene mu tshitupa tshia dîsu tshidi katshiyi ne bukole bu mudi dibeji dia nsenga, ne kufina pa tshitupa tshia dîsu tshidi tshitapa kudi mua kupatula mâyi a munda mua mputa ne pambelu pa mputa.
2. Tangila dîsu muinshi mua butoke bua "Open Globe" anyi bimanyinu bikunze bia lubilu lukole KUMPALA kua wewe kuteta bua kusukula anyi kukoka pa bipese bia mêsu. Bikala disama dienzeke paudi ukuma tshiamu pa tshiamu, utshibula, utshibula, anyi pabuipi ne tshintu tshidi tshituta, NANSHA wewe mumone **tshintu tshidi tshimueneka bu binsonji anyi mashi, mu dîsu didi dibuela mu dîsu (hyphema), tshintu tshifiike tshia gelatine tshidi tshipatuka pa mutu, anyi tshintu tshidi tshilamakaja mu tshimuenekelu tshia mêsu tshidi tshitoke, KUENA KUENZA dîsu ne KUTEKI bipese bia mêsu.
3. Bikila nimero ya lukasa lukasa ya muaba uudi musombele anyi ndaku diakamue ku tshibambalu tshia njiwu tshidi ne luondapu lua mêsu bua disama dionso didibu bela meji ne: didi dibuela munda, dikuma dia tshiamu tshia lubilu lukole, anyi dijimija dia mêsu. Ela 911 mu États-Unis ne mu Canada, 112 mu Union européenne mujima, 999 mu Royaume-Uni, 000 mu Australie, anyi tangila mukanda wa malu a njiwu nomba ya tshimpitshimpi. Lama dîsu didi ditapa anyi ditshibuka diakamue ne tshintu tshikole tshia bukubi (bu mudi tshiamu tshia Fox eye shield anyi kuinshi kua dikopo dia dibeji dilamakaja ku mpala ne ku mufuba wa ditama) kuyi uteka tshintu nansha tshimue tshia gaze pa disu.
4. Umbusha tshiamu tshia kutangila natshi mêsu diakamue ANU pikala disama dikale dia lupuishi lua lubilu lukese, dikoseka, anyi dia UV ne tshiamu tshia kutangila natshi tshidi tshipatuka bipepele. Kulekedi tshiamu tshia kutangila natshi mêsu mu dîsu didi dinyanguke anyi didi ne tshiji to, bualu bactérie Pseudomonas aeruginosa idi mikuate muinshi mua tshiamu tshia mêsu idi mua kusunguluka mu disu dia munda mu mêba 24. Shi tshiamu tshia kutangila natshi tshidi tshilamakaja, bindila too ne paudi usukula dîsu ne mâyi a mukele adi kaayi ne disama bua dikale dienda dienda.
5. Umbusha lupuishi lua lubilu lukese, mishiku ya mêsu, nsenga, anyi lupuishi lua mitshi mu dîsu ku diambuluisha dia mâyi a mukele anyi mâyi a mu pompi adi kaayi ne luya lukole. Teka mutu wa muntu ku luseke ne dîsu didi ditapa ditangile kuinshi bua mâyi apatuke mu ditumba dia munda (pabuipi ne tshibumba tshia muulu) pambelu pa ntempelo, bipangisha ku disukula mu dîsu didi kadiyi ditapike.
6. Lama mêsu onso abidi makanga ne kuikisha bua kumona ni udi ne disama dia tshiadi anyi tshiamu tshia ultraviolet (photokeratitis), ne KUTEKA NANSHA MU MUTU bua kuela mafuta adi ashala mu dîsu kumbelu to. Bualu bua mêsu abidi adi enda pamue (dimona dia pa tshibidilu), kuikisha ne mêsu onso abidi makanga bitekete bitekete mu nzubu wa mîdima kudi kuimanyika disama dia dîsu dia kuulu bua kukosa tshilema tshia disu. Kuena ne bua kuela bintu bia ku mêsu bikole ne kuena ne bua kuenza mudimu ne manga a anesthesie (proparacaine anyi tetracaine) kumbelu to.

Mutshi wa mapangadika a tshimpitshimpi bua bintu bia pambelu bia mêsu ne mputa ya pa mutu¶

flowchart TD
    Start["Acute Eye Pain, Foreign Body Sensation, or Flash Burn"]
    StopRub["Instruct Patient: DO NOT RUB OR PRESS ON THE EYE"]
    HighVel{"High-Velocity Mechanism OR Open Globe Signs?<br/>(Hammering metal, grinding, teardrop pupil, hyphema, embedded corneal shard)"}
    ShieldGlobe["OPEN GLOBE / INTRAOCULAR FOREIGN BODY PROTOCOL<br/>1. DO NOT flush, DO NOT evert lid, DO NOT apply pressure<br/>2. Tape a rigid paper cup or Fox eye shield over bony orbit<br/>3. Keep patient seated at 30 to 45 degrees (nothing by mouth)<br/>4. Transport immediately to Emergency Ophthalmology + Orbital CT"]
    UVCheck{"History of Unshielded UV Exposure 6 to 12 Hours Ago?<br/>(Arc welding, snow/glacier reflection, tanning bed, germicidal UVC lamp)"}
    UVCare["ULTRAVIOLET PHOTOKERATITIS (WELDER'S FLASH / SNOW BLINDNESS)<br/>1. Move to dark room and remove contact lenses immediately<br/>2. Apply cool damp cloth over gently closed eyelids<br/>3. Instill preservative-free artificial tears or lubricating ointment<br/>4. Seek medical evaluation for cycloplegic drops and oral analgesia"]
    LooseFB["Low-Velocity Loose Foreign Body or Surface Scratch<br/>(Windblown dust, sand, eyelash, sawdust, fingernail, tree branch)"]
    Irrigate["Gentle Ocular Irrigation Protocol<br/>1. Tilt head so injured eye is lowest (flush inner-to-outer corner)<br/>2. Irrigate with sterile normal saline or lukewarm tap water<br/>3. Remove contact lens once lubricated"]
    CheckClear{"Did Irrigation Remove the Particle?"}
    EvertLid["Inspect & Evert Upper Eyelid (Subtarsal Sulcus)<br/>1. Ask patient to look down while gently pulling upper lashes forward/up<br/>2. Sweep visible loose speck off inner lid with wet cotton swab<br/>3. NEVER touch or scrape a speck stuck on the clear cornea"]
    PostAbrasion["Corneal Abrasion & Rust Ring Screening<br/>1. Do NOT apply a tight pressure eye patch<br/>2. Urgent clinic visit for fluorescein staining & rust ring removal<br/>3. Mandatory antipseudomonal antibiotic drops if contact lens wearer"]

    Start --> StopRub
    StopRub --> HighVel
    HighVel -->|Yes: High-Velocity or Globe Rupture| ShieldGlobe
    HighVel -->|No: Low-Velocity Surface Issue| UVCheck
    UVCheck -->|Yes: Bilateral Delayed Pain & Photophobia| UVCare
    UVCheck -->|No: Unilateral Grit or Scratch| LooseFB
    LooseFB --> Irrigate
    Irrigate --> CheckClear
    CheckClear -->|No: Still Feels Under Upper Lid| EvertLid
    CheckClear -->|Yes: Particle Flushed Out| PostAbrasion
    EvertLid --> PostAbrasion

Kufuanyikija bintu bia pambelu bia mu mêsu, bipupu bia mu mêsu, ne bipupu bia ultraviolet¶

Bualu bua tshintu tshikuabu tshidi tshikuate, disama dia tshiadi didi dishala, tshilonda tshia kumpala tshia tshiadi, ne dibutuka dia tshiamu tshia ultraviolet bionso ebi bidi ne tshimanyinu tshia disama dia mubidi wa bende, ditshibuka (epiphora), ne diumvua dia butoke (photophobia), bidi bishilangane bilondeshile tshikondo tshia dimanyisha, dikala dia ku luseke, tshimuenekelu tshia mubidi ne buludiki bua luondapu lua bukubi.

Tshitupa 1: Dikonkonona dia tshintu tshiunzulula anyi tshintu tshikuabu tshidi munda mua mêsu¶

Kumpala kua wewe kuela mayi mu dîsu didi ditapa anyi kukoka tshilamba tshia dîsu, udi ne bua kupitshisha tusunsa 15 bua kumbusha disama dia globe didi dibuela (globe mubulula) anyi tshintu tshikuabu tshia munda mua dîsu tshidi tshienda lubilu lua bungi (IOFB). Kuenza mudimu wa dipanda dia dîsu anyi kufina ne tshilamba pa tshitupa tshia dîsu tshidi tshipanduluke kudi kufina tshitupa tshia dîsu tshidi ne gelatinous vitreous humor ne uveal tissue kupitshila ku tshitupa tshia dîsu tshidi tshipanduluke, bienza bua dîsu dijimine kashidi.

Bimanyinu 7 bikunze bia Open Globe anyi Intraocular Foreign Body¶

KUENA mâyi, KUENA umbusha tshintu tshidi tshipatuka, ne KUENA kutenga bipese bia mêsu pikala tshimue tshia ku bintu bidi bilonda ebi tshikaleku:

1. Mushindu wa lubilu lua bungi: Muntu uvua ukuma tshiamu pa tshiamu, wenza mudimu ne tshiamu tshia mashika, wenza mudimu ne tshiamu tshia lubilu lua bungi, nkata ya nshinga, tshiamu tshia kuela natshi mabue, anyi tshiamu tshia kukosa natshi bisonsa, anyi uvua mupete tshipupu anyi bingoma.
2. A peaked, teardrop-shaped, or irregular pupil: Padi cornea anyi limbus (muelelu udi cornea mutoke usambakena ne sclera mutoke) mutobola, aqueous humor udi upatuka ne iris wa dikala udi ujika tshina tshidi munda, ukoka pupil mujokoloke mu **tshitupa tshia binsonji tshidi tshileja buludiludi muaba udibu.
3. Tshintu tshifiike tshidi tshimueneka anyi tshipupu pa disu anyi pa tshiadi: Iris anyi choroidal tissue udi mupatuke udi umueneka bu ntete mikese ya tumuma tua mvinyo mifiike anyi mifiike idi misombe pa mutu pa dîsu. Kuena ne bua kuela meji ne: bualu ebu budi anu tshitupa tshia bukoya to, ne kuena mua kuteta bua kubusukula to.
4. Hyphema (mashi adi asangisha munda mua nzubu wa kumpala wa dîsu): Mashi adi amueneka a tshitoke tshitoke anyi a tshitoke tshifiike adi amueneka kumpala kua iris wa dikala adi aleja disama dikole dia munda mua dîsu.
5. A "bullous" 360-degree bloody conjunctiva: Padi tshitoka tshia dîsu tshiuwule tente ne mashi a muinshi mua disu adi afika mu tshitupa tshionso tshia dîsu, tshidi misangu ya bungi tshisokoka dinyanguka dia scleral muinshi muatshi.
6. Dikuluka anyi dipanga dia bulongame dia nzubu wa kumpala: Kutangila dîsu didi ditapa ku luseke ne kudifuanyikija ne dîsu didi kadiyi ditapa kudi kuleja ne: muaba udi pankatshi pa dîsu didi ditoke ne dîsu dia mubidi udi ne dikala didi anu diakane (dîsu didi dilenga dîsu) anyi didi muinshi menemene.
7. Tshitupa tshidi tshimueneka tshidi tshibuikila pa tshilamba tshia mêsu tshidi tshitoke: Bikala tshitupa tshia tshiamu, tshia dikala anyi tshia mutshi tshilamakaja buludiludi mu tshitupa tshia mêsu tshidi tshitoke pa mutu pa iris anyi pupille, kuteketshi bua kutshisukula anyi kutshisukula to.

Mushindu kayi wa kukuba Open Globe udibu bela meji ne udi mu budimi¶

Shi tshimue tshia ku bimanyinu 7 bidi kulu ebi tshidiku: * Enza tshilamba tshia ku mesu tshikole: Enza mudimu ne tshiamu tshia aluminium tshia Fox eye shield anyi ukose tshitupa tshia kuinshi tshia santimetre 4 (1,5 inches) ku dikopo dia kunua dia dibeji anyi dia foam. * Lama tshilamba ku mifuba ya mpala idi minyunguluke: Teka tshilamba tshia ngabu anyi tshia dikopo dia dibeji bua tshikale pa tshilamba tshia mpala tshia mifuba (tshilamba tshia pa mutu pa mpala) tshia kuulu ne pa tshiadi tshia ku tshiadi (tshiamu tshia zygomatic) tshidi kuinshi, tshienza tshijengu tshijima pa mutu pa dîsu kuyi ulenga bipese bia mêsu anyi bipese bia mêsu. Utshikuate ne bipese bia tshilamba bidi bienda mu diagonale kumbukila ku mpala too ne ku ditama. * KUTEKI tshilamba tshia gaze muinshi mua tshilamba tshia kujingila: Kuela gaze muinshi mua tshilamba tshia kujingila mêsu kudi kukudimuna tshilamba tshia kujingila tshidi tshifina panshi pa tshitupa tshia dîsu tshidi tshipanduluke. * Lama mubedi musombe pa 30-to-45-degree, mupole, ne NPO (kakuyi tshintu ku mukana): Kupangisha bua kuela nsukadi, kukokola, anyi kuinama, bualu Valsalva straining udi ubandisha tension wa munda mua mêsu. Lama mubedi kayi udia biakudia padibi bikengela kuenza anesthesie wa tshimpitshimpi bua kulongolola globe wa dipanda.

Tshitupa 2: Diumusha dia tshintu tshikuabu tshidi katshiyi ne njiwu¶

Paudi ujadika ne: disama edi ndifumine ku tshintu tshidi tshienda lubilu lukese (bu mudi lupuishi lua lupepele, nsenga, nsenga, tshilamba tshia ku mêsu anyi tshipupu) ne kakuyi bimanyinu bia dibuela dia globe, udi mua kusukula pa mutu pa mêsu bimpe.

Njila A: Dilengeja dia mesu ku diambuluisha dia bukole budi bukokela bintu panshi¶

1. Teka mubedi ne dîsu didi ditapa ditangile panshi: Lekela muntu au asombe anyi alale panshi ne uteke mutu wende ku luseke bua dîsu didi ditapa dikale panshi kupita dîsu didi kadiyi ditapa. Teka tshilamba tshia kuowela ku ntempelo yabu anyi kuata tshibombi tshia mfyo muinshi mua ditama diabu.
2. Kuata bipese bia mêsu bitekete bitekete ku mifuba ya orbite: Ku diambuluisha dia tshianza tshiebe tshinene ne munu webe wa tshianza tshia balume, kuata bitekete bitekete bipese bia ku mêsu bia kuulu kuulu ku mifuba ya mpala ne kuinshi kua kuinshi ku mufuba wa ditama. Kufinyi nansha kakese minu yebe ku tshitupa tshia dîsu tshitekete.
3. Ela mâyi a mukele (0.9% chloride de sodium), tshintu tshia kusukula natshi mêsu tshia mu tshisalu, anyi mâyi a mu pompi adi kaayi ne kapia: Kuata mulondo anyi dikopo mu bule bua santimetre 2 too ne ku 5 (1 anyi 2 inches) pa mutu pa **ditumba dia munda dia dîsu (dia munkatshi) pabuipi ne tshibumba tshia mâyi, kulekela mâyi apita bimpa pa mutu pa dîsu ne kupatuka mu ditumba dia pambelu (lateral canthus).
4. Ela mubedi atangile dîsu diende mu nseke yonso padibu bamuowa mâyi: Lomba muntu bua kutangila mulu, panshi, ku dia bakaji ne ku dia balume padi mâyi enda apita bua mâyi afike too ne mu mifuba ya ku mutu ne ya kuinshi ya mêsu (fornices).

Mushindu B: Kukonkonona tshilamba tshia kuinshi ne kupatula tshilamba tshia kuulu¶

Bikala disukula kadiyi disukula tshitupa atshi ne muntu utshidi anu umvua tshintu tshikole muinshi mua tshilamba tshia kuulu dîba dionso didiye utapa mêsu, tshitupa atshi tshidi pabuipi ne kuikala mu subtarsal sulcus, tshitupa tshidi katshiyi tshitamba bunene tshidi mu bule bua milimetre 2 (0,08 inches) munda mua tshitupa tshia munda tshia tshilamba tshia kuulu tshia goudron.

1. Tangila tshibombi tshia kuinshi kua mêsu (inferior fornix) kumpala: Lomba mubedi bua atangile mulu mutangile ku plafond paudi ukoka bitekete bitekete dikoba dia kuinshi kua mêsu panshi ku tshiadi. Wewe mumone tshintu tshidi tshilala pa tshilamba tshia munda tshia rose (palpebral conjunctiva), tshilenga bitekete bitekete ne nsongo ya tshilamba tshia butoyi tshikezuke tshitokesha ne saline wa sterile bua tshilamate ku tshilamba tshia butoyi tshitoke ne tshipatuke.
2. Evert (flip) tshilamba tshia kuulu ku diambuluisha dia mushindu wa cotton-swab fulcrum:
3. Tshitupa 1: Imana kumpala kua mubedi udi musombe ne umuambile bua tangila panshi misangu yonso ku makasa ende eku ulama mutu wende mulongolola. Kutangila panshi kudi kupepeja muscle wa levator palpebrae superioris, udi ukengela bua kukudimuna dilongo dia tshiadi dikole.
4. Tshitupa 2: Kuata nsuki ya kuulu bitekete bitekete pankatshi pa tshianza tshinene ne munu wa tshianza tshimue ne ukoke tshibuikidiji tshia kuulu kakese kumpala (kule ne tshitupa tshia dîsu) ne panshi.
5. Tshitupa 3: Ne tshianza tshieba tshikuabu, teka mutshi anyi tshiamu tshia plastike tshia tshiamu tshia tshiamu tshia coton tshidi tshitangile ku dikoba dia pambelu dia tshilamba tshia kuulu ku tshitupa tshia kuulu (pabuipi ne 1 centimètre / 0.4 inches pa mutu pa mulongo wa nsuki, ku muelelu wa tshilamba tshikole tshia tshilamba tshia ku mêsu).
6. Tshitupa 4: Fina bitekete bitekete panshi pa tshiamu tshia mudimu bu tshiamu tshia kukanga natshi paudi ukoka nsuki ya mêsu kuulu ne panyima pa tshiamu. Tshilamba tshia ku makasa tshikole netshikale tshibuikila bimpe munda ne pambelu, tshileja tshitupa tshia muinshi mua tshiadi tshia rose.
7. Tshitupa 5: Kuata mishiku bitekete bitekete ku mpala ne tshianza tshiebe tshinene padi mubedi utungunuka ne kutangila panshi. Wewe mumone tshitupa tshia mabue, lupuishi, anyi tshilamba tshia ku mêsu tshisombe pa tshilamba tshia munda tshidi tshikudimune, utshikose bitekete bitekete ne tshilamba tshia butoke tshidibu balengeje ne mâyi a mukele.
8. Tshitupa 6: Bua kupingaja tshilamba tshia mêsu muaba watshi wa pa tshibidilu, udi mua kulekela anu nsuki ya mêsu ne kulomba mubedi bua tangila mulu mutangile ku plafond ne kuela mêsu musangu umue. Tshibuikidiji netshipingane bimpe pa muaba watshi.

Bipupu bia mu mêsu, bipese bia tshiamu tshia mitaku, ne njiwu ya tshiamu tshia kutangila natshi mêsu¶

Nansha padibu bamane kupatula tshintu tshikuabu tshidi katshiyi tshienda bimpe, anyi padibu bamane kutshibula buludiludi ku dikasa dia muana, ku ditamba dia mutshi, ku muelelu wa dibeji anyi ku broshe wa dilengeja dia mubidi, mubedi utu anu udiumvua bu ne: tshintu tshidi tshitshidi tshilamakaja mu dîsu. Diumvua dia mubidi wa bende didi dienzeka bualu tshitupa tshia kuulu tshia mêsu tshidi tshipita ku nsongo ya mijilu idi kayiyi milengeja ya disama dia mêsu ku dipetu dionso.

Mushindu kayi udi mputa ya mu mêsu ikola ne bua tshinyi bipese bia mputa bidi bikengela munganga¶

Tshitupa tshia pa mutu tshia tshitupa tshia mêsu (tshitupa tshia tshitupa tshia mêsu tshidi tshienza bu tshitupa tshia mêsu) tshidi tshipingana ne lukasa lua dikema: selile ya epiteliale mimpe idi minyunguluke tshitupa tshidi tshikosa idi inyanguka, ipita pa tshilamba tshia muinshi mua buloba tshidi katshiyi ne tshintu bu mudi amoeba, ne yenza mitose bua kujula kabidi bitupa bikese bia bungi mu mêba **24 bua kushiya mputa, kuyi ufila mputa Tshitupa tshia Bowman ne stroma wa mêsu uvua muinshi muatshi kabivua bibuele to.

Ino, bintu bibidi bya pa bula bya mubidi wa ku babende bikandika kuondapibwa biyampe kadi bilomba bukwashi bwa muñanga wa meso difuku dimo:

1. Bintu bia tshiamu tshia mitaku bia mu mêsu ne bipese bia tshiamu tshia mitaku: Padi tshintu tshikese tshia tshiamu tshia mitaku anyi tshia tshiamu tshia mitaku tshia mu tshiamu tshia kulongolola natshi mashinyi, tshia tshiamu tshia frein anyi tshia tshiamu tshia mitaku tshibuela mu tshiadi, biamu bia electrolyte bidi bibanga kuenza oxidation mu tshiamu tshia mitaku mu mêba 2 to ne ku 6, bienza tshijengu tshia tshiamu tshia mitaku tshia orange ** tshidi ne nzembu wa tshiamu tshia mitaku udi ubuela mu tshitupa tshia mêsu tshidi tshinyunguluke ne mu stroma wa kumpala. Nansha mudi tshitupa tshia tshiamu tshia munkatshi tshipueka, tshipese tshia tshiamu tshia toxique tshidi tshienza mudimu bu tshintu tshikuabu tshidi tshipangisha dikanga dia epiteliale, tshidi tshijula dibuela dia globules blancs sterils (iridocyclitis), ne tshishiya tshilonda tshia kashidi tshidi katshiyi tshimueneka pa mulongi pa kumbusha padi munganga mua kuenza bua dîsu dikale ditekete muinshi mua mikroskope wa slit-lamp ne kupatula bitekete bitekete tshitupa tshia mubidi tshidi tshinyanguke ku diambuluisha dia tshiamu tshia oxygène tshiamu tshia mêsu tshia lubilu lukese Alger brush.
2. Disama dia mubidi ne dia bikunyibua (njiwu ya Keratitis wa bikunyibua): Milonda idi ifumina ku matamba a mitshi, ku nsongo ya pine, ku meba a rose, ku tshisuku tshia mu budimi, anyi ku mitshi ya madimi idi ifila bikunyibua bia filamentous (Fusarium ne Aspergillus) anyi Acanthamoeba mu tshilema tshia ku mêsu. Disama dia mesu didi difumina ku bikunyibua kadiena ne tshia kupeta matonsi a steroïde nansha kakese ne didi dilomba dilonda dia munganga wa mêsu.

Bua tshinyi katuena tuela kabidi bipese bia mêsu bia bukole bua bungi pa mputa ya mu mêsu¶

Munkatshi mua makumi a bidimu, tulasa tua diambuluisha dia kumpala ne tshibambalu tshia malu a mpukapuka bavua balamakaja tshilamba tshia gaze (tshiamu tshia pression) pa dîsu divua dinyanguke bua kupangisha tshilamba tshia dîsu bua kuendakana. Malongesha a matuku etu aa a ophthalmology (kusangisha ne Cochrane systematic reviews) mmaleje ne: dilengeja dia pa tshibidilu dia mputa ya mu mêsu kadiena kabidi dimpe to, ne didi mua kuikala ne njiwu:

• Kulengeja kakuena kukolesha lubilu lua diondapangana dia tshitupa tshia mubidi anyi kukepesha kanyinganyinga mu bilonda bikese anyi bia munkatshi (< 10 millimètres carrés).
• Tshitupa tshia kapia, tshifiike, tshikanga tshidi tshibandisha luya lua pa mutu pa mêsu ne tshipangisha dishintakaja dia binsonji bia oxygène, tshienza tshintu tshidi tshikolesha divulangana dia lukasa dia bactérie.
• Kulengeja muntu udi muvuale tshiamu tshia kutangila natshi mêsu anyi tshintu tshidi tshienza bua nsongo ya mubidi ki nkuimpe to, bualu kudi kuvudija bikole njiwu ya disama dia Pseudomonas anyi dia ulcère cornéenne fungique.
• Kuela tshilamba tshia ku mêsu kudi kumbusha diakamue dimona dia muinshi mua mêsu (stereopsis), kuvudija njiwu ya dikuluka, dikuluka, anyi dibunda dia mashinyi.

Pamutu pa kuela tshilamba tshikole, enza bua mubedi ajikije bimpe mu nzubu udi kayi ne butoke bua bungi ne mêsu onso abidi makanga bitekete bitekete, uvuale manyanu a dîba mafiike padiye wenda, ne wenze mudimu ne mafuta a antibiotique a ophthalmique (bu mudi mafuta a erythromycine bua bantu badi kabayi bavuala mafuta a mêsu) adi enza mudimu bu tshintu tshinene tshidi pankatshi pa mafuta a mêsu ne mafuta a mêsu tshitupa tshia mêsu tshinyanguke.

Tshilumbu tshia tshimpitshimpi: Pseudomonas aeruginosa¶

Shi muntu udi uvuala biamu bia kutangila nabi mêsu bitekete anyi bikole udi ne disama dia mu mêsu, disama dia tshintu tshikuabu anyi disama dia dîsu dikunze:

• Umbusha tshiamu tshia kutangila natshi mêsu diakamue ne utshiteke mu tshibombi tshiatshi tshia kulamina bintu (lua ne tshiamu tshia kutangila natshi mêsu ne tshibombi kudi munganga wa mêsu pikalabi bikengela kuenza culture microbiologique).
• Matoyi a antipseudomonal adi akengedibua: Kuvuala tshiamu tshia kutangila natshi mêsu kudi kushintulula binsonji ne kukuata Pseudomonas aeruginosa, tshipupu tshia Gram-negative tshidi tshipatula elastase ne enzyme ya alkaline protease idi mua kulengeja ne kutshibula tshitupa tshia mubidi wa muntu mu mêba 244. Mafuta a mesu a erythromycin kaena akuata Pseudomonas to; Bantu badi ne tshiamu tshia kutangila natshi mêsu badi ne disama dia tshiadi badi ne bua kupeta manga a antipseudomonal fluoroquinolone eye drops (bu mudi moxifloxacin, ciprofloxacin, anyi ofloxacin) anyi tobramycin kudi munganga, kabena ne bua kuikala ne tshilamba tshia mêsu to, ne badi ne bua kubakonkonona kabidi mu mêba 24.
• Kubanga kabidi kuvuala biamu bia kutangila nabi mêsu too ne padi munganga ujadika ne: tshitupa tshia mubidi tshidi tshiondopibua bimpe ne mubedi mmushale kayi ne bimanyinu bia disama edi munkatshi mua matuku a bungi.

Tshipepele tshia tshiamu tshia mudimu ne bufofo bua neje (Ultraviolet Photokeratitis)¶

Ultraviolet photokeratite (udibu babikila misangu ya bungi ne: welder's flash, arc eye, anyi snow blindness) i disama dia radiation dia tshimpitshimpi dia mu tshitupa tshia pa mutu tshia cornée ne dia conjonctiva didi difumina ku dikala dia ultraviolet wa bule bukese, nangananga ** 58B to nanometers)** ne UVC (100 to 280 nanometers).

Miaba ya bungi idi ifila disama dia UV photokeratite¶

• Kuenza mudimu ne tshiamu tshia mudimu (MIG, TIG, stick, ne plasma cutting): Kutangila tshiamu tshia mudimu tshidi katshiyi tshikuba ku bule bua metre 2 too ne ku 5 (6 too ne ku 16 feet) bua bungi buonso bua 5 too ne ku 30 sekonde kakuyi difiika anyi mundidimbi 10-to-14 udi ufila nzembu ya UVC/UB mikumbane bua kuosha tshiamu tshia nzembu. Bantu badi benza mudimu pabuipi apu kabayi ne makalashi a bukubi a polycarbonate adi apangisha UV batu misangu ya bungi bosha kudi lumuenu lua ku luseke.
• Dimona dia neje (miaba mitumbuke ne miaba ya ku nsongo): Neje mupiamupia udi uleja too ne ku 80 too ne ku 85 pa lukama ya nzembu ya UV muulu ufumina panshi, eku 1000 metre yonso (3280 feet) wa dibandila dia bule udi uvudija bukole bua UV pabuipi ne 10 too ne ku 12 pa lukama.
• Matanda a munda mua nzubu, miendu ya mercury-vapor anyi metal-halide, ne ampule ya UVC idi ishipa tuishi: Miendu ya UVC idi kayiyi mikuba idi ifila disama dikole dia photokeratite mu minite mikese.

Bua tshinyi mutoyi wa tshiamu tshia soudure udi ujula muntu udibu bashipe munkatshi mua butuku¶

Lumu lua ultraviolet ludi luenza mudimu mu mushindu wa photo-chimique pamutu pa kuenza mudimu wa luya. Bu mudi UVB ne UVC photons miangatshibue kudi tuselile tua pambelu tua tshitupa tshia mêsu, bidi bifikisha ku DNA thymine dimers ne apoptose wa selile. Mu tshikondo tshia mudimu wa disuika anyi luendu lua pa ski, muntu udi udiumvua mushindame bimpe. Mu tshikondo tshia 6-to-12-heure tshia tshisokomenu, selile ya pa mutu idi minyanguke idi ifua ne ipueka mu binunu ne binunu bia tutotshi tua pa mutu mu tshitupa tshia mêsu (keratite wa pa mutu), ileja ndekelu ya mijilu ya muinshi mua epiteliale. Nunku, mubedi utu ujuka pankatshi pa midi ne pa dîba 4:00 wa dinda ne kanyinganyinga kakole kakole, umvua bu ne: mêsu ende onso abidi mmawule tente ne nsenga ya kapia, kayi mua kukangula bipese bia mêsu bivua biuwule mu butoke (photophobia ne blepharospasm), ne binsonji bia bungi bia mâyi.

Diambuluisha dia kumpala dia ku kakese ku kakese ne dilama dia luondapu bua flash wa muena soudure¶

1. Ela muntu mu kazubu ka mîdima diakamue ne ikala ne mêsu onso abidi makanga bitekete bitekete: Kukepesha miendu yonso ne kuikisha ne mêsu onso abidi makanga kudi kuimanyika disama dia pupille ne kudi kupangisha bipese bia mêsu bua kulenga bilema bia mu tshitupa tshia mêsu.
2. Umbusha biamu bia kutangila nabi mêsu diakamue: Sukula ne mâyi a mukele anyi binsonji bia kuenza nabi mudimu bua biamu bia kutangila nabi bipatuke bipepele kabiyi bipatula tshitupa tshikuabu tshia mubidi.
3. Ela tshintu tshia mashika, tshia mashika pa bipese bia mêsu bikanga: Ela tshilamba tshikezuke tshitokesha mu mayi mashika pa mêsu onso abidi makanga munkatshi mua minite 15 to ne 20 musangu umua. Kutekayi neje buludiludi pa bipese bia mêsu nansha kakese.
4. Ela binsonji bia tshianana bidi kabiyi ne tshintu tshidi tshilama anyi mafuta a mêsu misangu ne misangu: Dienza mudimu musangu umue Mafuta a mêsu adi kaayi ne tshintu tshidi tshilama bintu anyi mafuta a butuku adi kaayi ne tshintu tshidi tshilama bintu adibu bateka kunyima kua mêba 1 anyi 2 adi alengeja nsongo ya mijilu idi mipatuke. Kuenza mudimu ne manga a vasoconstrictor anyi manga a kumbelu adi kaayi a sterile (bu mudi: bitupa bia bimuma bia blé, mabele a mamu, anyi mifuba ya tshiayi).
5. Keba luondapu bua kujikija kanyinganyinga ka mukana, mafuta a antibiotique, ne disulakana dia cycloplegie: Munganga nealengeje mêsu ne dikala dia fluorescein bua kumbusha nsese ya tshiamu idi munda, ne pa tshibidilu udi ufunda manga a NSAID anyi acetaminophen/paracetamol, mafuta a antibiotique adi alengeja, ne imue misangu udi utua cycloplegie mu tshitupa tshîpi. Bimanyinu bitu bijika mu mêba 24 too ne ku 72 kakuyi dijimija dia mêsu dia kashidi.

Malu a diambuluisha dia kumpala adi akuba dimona diebe kunyima kua disama dia dîsu, kadi kaena apingana pa muaba wa dikonkonona dia malu a luondapu anyi dilongesha dia ku bianza to. Ela meji bua kulonga tulasa tua diambuluisha dia kumpala mu tshisumbu tshia Croix-Rouge anyi tshia Rouge-Rouge, St John Ambulance, anyi mufidi wa malu a bukubi ku mudimu, ne uvuale misangu yonso makalashi a bukubi a polycarbonate a ANSI Z87.1 / EN 166 paudi wenza mudimu ne biamu anyi ne butoke bua UV.

Nkonko itubu bela misangu ya bungi¶

Miaba mifumina¶

• Tshilongelu tshia bena Amerike tshia malu a mêsu (AAO, États-Unis): Mushindu muimpe wa kuenza mudimu ne buludiki bua luondapu pa bidi bitangila dinyanguka dia mêsu, bintu bia pambelu bia mêsu, mputa ya mu mêsu, ne disama dia keratite dia bactérie.
• Tshilongelu tshia baminganga ba mêsu (Royaume-Uni): Mibelu ya dilama dia mêsu: Dinyanguka dia mêsu, tshintu tshikuabu, disama dia keratite dia mikrobe, ne disama dia photokeratite (disu dia arc).
• National Health Service (NHS, United Kingdom) & Moorfields Eye Hospital NHS Foundation Trust: Eye Injuries, Foreign Bodies, and Welder's Flash Emergency Patient Guidance.
• Cochrane Database of Systematic Reviews (International): Patching for Corneal Abrasion (Turner & Rabiu) and Interventions for Corneal Rust Rings.
• Tshibambalu tshia ditunga tshia bukubi ne makanda a mubidi (NIOSH / CDC, États-Unis): Dikuba dia mêsu bua diandamuna dia lukasa ne dikuba dia nsese ya dîba (Welding Arc) ya mu midimu.
• Bulongolodi bua malu a bukola bua mubidi pa buloba bujima (OMS, International): Mukanda wa kumpala wa dilama dia mêsu: Dikonkonona ne dilama dia lukasa dia disama dia mêsu.

Malu adi apetangana¶

• Ditapa dia mêsu ne diosha dia mêsu ne manga
• Kuosha bikole ne disukula dia bintu bia tshimpitshimpi
• Chili ne capsaicine bidi biosha mu mêsu
• Mputa ya ku mutu ne bimanyinu bia disama dia tshiadi
• Impalement ne embedded foreign object stabilization
• Nomba ya tshimpitshimpi ne dituma dia matunga makuabu