Được viết: Thứ bảy, 10-06-2017

Bệnh tăng nhãn áp, hay còn gọi là Glocom, là tình trạng tổn thương dây thần kinh thị giác do áp lực tăng cao bất thường trong mắt. Áp lực này gây ra bởi sự ứ đọng thủy dịch khi  đường thoát của nó bị chặn lại. Bệnh tiến triển nhiều năm khiến thị lực suy giảm không hồi phục, thậm chí dẫn tới mù lòa. Tuy nhiên, chúng ta có thể ngăn chặn tiến trình này nếu được phát hiện và điều trị sớm.

Phân loại bệnh tăng nhãn áp / Glocom

Bệnh tăng nhãn áp bao gồm 2 loại:

Tăng nhãn áp góc mở

Đây là dạng tăng nhãn áp phổ biến nhất. Góc thoát thủy dịch được hình thành bởi giác mạc và mống mắt vẫn còn mở, nhưng hệ thống lưới lọc đã bị chặn một phần. Do đó, nước mắt thoát ra chậm làm tăng áp lực trong mắt, dẫn đến tổn thương dây thần kinh thị giác. Tình trạng bệnh này diễn tiến rất chậm và rất khó để phát hiện.

Tăng nhãn áp góc đóng

Xảy ra khi góc thoát nước mắt bị thu hẹp hoặc chặn lại hoàn toàn. Do đó, nước mắt không thể lưu thông ra ngoài, dẫn tới áp suất trong mắt tăng lên. Tăng nhãn áp góc đóng có thể xuất hiện đột ngột (tình trạng cấp tính) hoặc từ từ (tình trạng mạn tính). Tăng nhãn áp góc đóng cấp tính là tình trạng cấp cứu khẩn cấp, có thể nhanh chóng dẫn đến mù lòa.

Tăng nhãn áp khiến áp lực tăng cao trong mắt

Tăng nhãn áp khiến áp lực tăng cao trong mắt

Nguyên nhân gây bệnh tăng nhãn áp / Glocom

Tất cả các nguyên nhân gây tích tụ thủy dịch ở vùng trước của mắt (tiền phòng) đều gây nên tình trạng tăng nhãn áp: Thủy dịch tiết ra quá mức hoặc kênh thoát thủy dịch bị chặn lại.

- Do lắng đọng các hạt sắc tố từ mống mắt vào trong kênh thoát nước mắt

- Do bệnh khác: Người bị bệnh tiểu đường, cao huyết áp có nguy cơ mắc tăng nhãn áp cao hơn.

- Do thuốc: Khi sử dụng thuốc kháng histamine, corticoid có thể gặp phải tác dụng không mong muốn là tăng nhãn áp, tuy nhiên rất hiếm gặp.

- Do một số nguyên nhân khác: dây thần kinh thị giác nhạy cảm, hoặc do xơ vữa động mạch làm giảm lượng máu đến nuôi dây thần kinh thị giác.

Một số yếu tố nguy cơ khác có thể gây ra tăng nhãn áp (Glocom) bao gồm gen, tuổi, do bẩm sinh.

Triệu chứng bệnh tăng nhãn áp / Glocom

Triệu chứng tăng nhãn áp có thể khác nhau tùy thuộc vào dạng bệnh như sau:

Tăng nhãn áp góc mở: Người bệnh thấy mất dần tầm nhìn ngoại vi, cảm giác như nhìn mọi vật qua đường hầm tối.

Tăng nhãn áp góc đóng: Người bệnh thấy tầm nhìn đột nhiên bị giảm, mắt đỏ và đau nghiêm trọng, đau đầu, đau bụng hoặc buồn nôn, nôn; đặc biệt có hiện tượng nhìn thấy cầu vồng xung quanh ánh sáng đèn pin.

Trường hợp tăng nhãn áp góc đóng cấp tính, các triệu chứng diễn ra đột ngột và nặng, còn với tăng nhãn áp mạn tính thì người bệnh không phát hiện ra bất thường cho đến khi có các triệu chứng đột ngột xảy ra.

Tăng nhãn áp bẩm sinh: Trường hợp này rất hiếm gặp và khó theo dõi. Khi trẻ được 3 – 4 tuổi, có thể xuất hiện các triệu chứng mắt đỏ và giãn rộng, nhạy cảm với ánh sáng, chảy nước mắt liên tục, mắt giật,…

Tăng nhãn áp thứ cấp: Đây là tình trạng tăng nhãn áp do bệnh khác gây nên (ví dụ: chấn thương, viêm màng bồ đào). Các dấu hiệu tăng nhãn áp thường bị che lấp bởi các triệu chứng của bệnh ban đầu; tuy nhiên người bệnh có thể thấy các triệu chứng đặc trưng như nhìn mờ, nhìn thấy quầng cầu vồng,…

Tpcn Minh Nhãn Khang giúp hỗ trợ điều trị các bệnh lý về mắt: giảm mờ nhòe, nhức mỏi mắt và tăng cường thị lực. Liên hệ 0971.003.903 (trong giờ hành chính) để được tư vấn.

Biến chứng bệnh tăng nhãn áp /Glocom

Trong quá trình tiến triển bệnh, người bệnh bị suy giảm thị lực không hồi phục. Nếu không điều trị kịp thời có thể gây ra mù lòa. Ngay cả khi được điều trị, khoảng 15% người bệnh vẫn bị mù ít nhất một mắt trong vòng 20 năm.

Chẩn đoán bệnh tăng nhãn áp bằng cách nào?

Bên cạnh việc theo dõi các triệu chứng lâm sàng của người bệnh, bác sĩ sẽ thực hiện các xét nghiệm chẩn đoán chính xác bệnh như: Đo áp lực nội nhãn, thử nghiệm tổn thương thần kinh thị giác, kiểm tra vùng mất thị lực, đo độ dày giác mạc, kiểm tra góc thoát nước,… Từ các xét nghiệm, bác sĩ sẽ chẩn đoán chính xác loại bệnh, giai đoạn bệnh để có hướng điều trị phù hợp.

Điều trị tăng nhãn áp / Glocom

Những tổn thương gây ra bởi tăng nhãn áp là không thể phục hồi. Tuy nhiên, việc điều trị và kiểm tra thường xuyên có thể giúp làm chậm hoặc ngăn ngừa tình trạng mất thị lực, đặc biệt khi được điều trị sớm.

Mục tiêu của điều trị tăng nhãn áp là làm giảm áp lực trong mắt. Tùy vào tình trạng cụ thể, có thể điều trị nội khoa, can thiệp bằng laser, phẫu thuật.

Điều trị nội khoa bằng thuốc

Với trường hợp tăng nhãn áp nhẹ và vừa, thường bắt đầu điều trị bằng thuốc nhỏ mắt, bao gồm prostaglandins, thuốc chẹn beta, các chất chủ vận alpha adrenergic, các chất ức chế anhydrase carbon (hiếm dùng), cholinergic. Nhỏ mắt đúng cách có tác dụng rất lớn trong điều trị tăng nhãn áp. Tuy nhiên các thuốc này có thể gây ra một số các tác dụng phụ như: đỏ và nhói mắt, thay đổi màu lông mi hoặc da mí mắt, mờ mắt, khó thở, nhịp tim chậm, mệt mỏi, ảnh hưởng huyết áp, tiểu nhiều, ngứa da.

Khi nhỏ mắt không đưa được áp lực mắt trở về bình thường, bác sĩ có thể kê thuốc uống, thường là một chất ức chế anhydrase carbonic. Thuốc này có thể gây ra một số các tác dụng phụ như tiểu nhiều, ngứa ngón tay ngón chân, trầm cảm, buồn nôn, dạ dày và sỏi thận.

Điều trị ngoại khoa

Các phẫu thuật như laser, phẫu thuật lọc, đặt ống điện khí có thể khơi thông kênh thoát nước mắt, để giảm áp lực trong mắt. Tuy nhiên, phẫu thuật có thể gây ra các biến chứng gồm đau, đỏ, nhiễm trùng, viêm, chảy máu, áp lực mắt cao hoặc thấp bất thường và mất thị lực. Một số loại phẫu thuật có thể làm tăng tiến triển đục thủy tinh thể nếu bạn đang mắc kèm bệnh lý này.

Điều chỉnh lối sống

Kê cao đầu bằng gối mềm để làm giảm áp lực cho mắt bị tăng nhãn áp khi nằm

Kê cao đầu bằng gối mềm để làm giảm áp lực cho mắt bị tăng nhãn áp khi nằm

Bạn có thể kiếm soát bệnh nhãn áp tốt hơn bằng lối sống lành mạnh theo hướng dẫn sau:

- Tập thể dục thường xuyên: có thể giúp giảm áp lực trong mắt.

- Ăn uống lành mạnh: tăng cường rau xanh, cá tươi; hạn chế ăn uống các thực phẩm, đồ uống chứa nhiều cafein, hạn chế uống quá nhiều nước.

- Gối đầu bằng gối mềm, nhô cao khoảng 20 độ để làm giảm áp lực đáy mắt trong khi ngủ.

- Sử dụng thuốc đều đặn theo đơn của bác sỹ.

- Mang kính bảo vệ mắt khi lao động, tập thể thao,...

- Thăm khám thường xuyên: Các bác sĩ tại Mỹ khuyến cáo nên thăm khám ít nhất 1 năm 1 lần với người từ 40 tuổi và không có nguy cơ, 2 lần 1 năm với người có nguy cơ cao bị tăng nhãn áp hoặc trên 65 tuổi.

Bạn cần biết lịch sử bệnh tăng nhãn áp của gia đình mình vì những người trong gia đình có bệnh tăng nhãn áp sẽ có nguy cơ mắc bệnh cao hơn người bình thường. Bên cạnh đó, cần duy trì lối sống lành mạnh và thăm khám thường xuyên, điều trị kịp thời để bảo vệ đôi mắt luôn sáng khỏe.

Ds. Lương Lan

Nguồn tham khảo

http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042

http://www.aao.org/eye-health/diseases/what-is-glaucoma

Bình luận  

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