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Nā maka luhi a i ʻole asthenopia

e like me kā ophthalmologists i kapa i kēia ʻano, hōʻike ia iā ia iho ma ke ʻano o nā hōʻailona kumuhana o ka luhi ʻike. I kēia hihia, hiki i ka mea maʻi ke hoʻopiʻi e pili ana i:

  • hoʻemi i ka ʻike maka (ka manaʻo o kahi "pale" a i ʻole "fog" i mua o nā maka);
  • ke ʻano o ka ʻike ʻole ʻia a i ʻole ka intermittency o nā mea i nīnau ʻia;
  • ka manaʻo o ka "sand" i nā maka;
  • ʻulaʻula o nā maka;
  • photophobia a i ʻole ka maʻi hoʻololi ʻeleʻele;
  • paʻakikī a hiki ʻole paha ke nānā wikiwiki i ka hoʻololi ʻana i kou maka mai kahi mamao kokoke i kahi mea ma kahi mamao a me ka hope;
  • nā maʻiʻeha;

ʻO ke kumu diagnostic criterion no ka asthenopia ʻo ia ka piʻi ʻana o nā hoʻopiʻi i hōʻike ʻia ma luna nei i ka wā o ke koʻikoʻi ʻike maka (hana ma ke kamepiula, hana me nā palapala, heluhelu a i ʻole ka hana ʻana). I kēia hihia, hiki i nā hōʻailona kūpono āpau ke emi a nalowale loa i ka wā hoʻomaha.

Asthenopia

Pilikia nā mākua a me nā keiki. Eia kekahi, pili pinepine kēia maʻi i nā keiki o ke kula waena a me ke kula kiʻekiʻe, a me nā haumāna. ʻO ia hoʻi, kēlā mau ʻāpana o ka heluna kanaka e hana ana i kekahi hana e pili ana i ke koʻikoʻi ʻike no ka manawa lōʻihi.

A no laila ʻo nā kumu nui a me nā kumu pilikia no ka ulu ʻana o ka asthenopia:

  • heluhelu a i ʻole kekahi hana ʻike maka ma ke kukui haʻahaʻa;
  • hana ma ke kamepiula a i ʻole ke nānā ʻana i ke TV no ka manawa lōʻihi;
  • ka lōʻihi o ke kaʻa ʻana, ʻoi aku i ka pō a me ka pō;
  • ka hana e pili ana i ke ko'iko'i mau, no ka la'ana, hana me na kiko'ī li'ili'i.
  • ka hoʻoponopono kūpono ʻole o ka ametropia (myopia, ʻike maka a i ʻole astigmatism);
  • nā maʻi maʻamau, i nā maʻi endocrine;
  • ʻona ʻona;

Nā ʻano o ka asthenopia:

  • Astenopia muscular. Hoʻopili ʻia me ka nāwaliwali o ka convergence ʻo ia hoʻi ka nānā ʻana o nā maka ʻelua i ka mea paʻa. He paʻakikī kēia inā nāwaliwali nā ʻiʻo o ka maka.)
  • Asthenopia hoʻokipa. ʻO ka noho ʻana ke kaʻina hana physiological o ka hoʻololi ʻana i ka mana refractive o ka maka i ka wā e ʻike ʻia ai nā mea i loaʻa ma nā mamao like ʻole. ʻO nā mea hoʻokipa o ka maka e pili ana: nā ʻiʻo ʻiʻo maʻemaʻe o ka ʻiʻo ciliary, nā fibers o ka ligament zonular, choroid a me nā lens. Hiki i nā pilikia i ka hana ʻana o kēia mau hale ke kōkua i ka emi ʻana o ka mālama ʻana o ka noho ʻana a hoʻoulu i kekahi mau hoʻopiʻi asthenopic.
  • Hoʻopili ʻia ka asthenopia me kahi maʻi hui pū ʻana o ka hoʻohuli ʻana a me ka noho ʻana.
  • Hiki ke hoʻopili ʻia ka asthenopia neʻe me ke koʻikoʻi a i ʻole nā ​​maʻi noʻonoʻo like ʻole. 
  • Loaʻa ka hōʻailona asthenopia me nā maʻi like ʻole o ka maka a me nā ʻāpana kokoke a nalo i ka wā e ola ai ka maʻi kumu (1).

Loaʻa pinepine ʻia ka asthenopia muscular me ka myopia ʻaʻole i hoʻoponopono ʻia, ka ʻike maka, ka presbyopia (ka ʻike maka pili makahiki) a i ʻole ka astigmatism.

Hiki ke loaʻa nā hoʻopiʻi Asthenopic me nā makaaniani i koho hewa ʻole ʻia a i ʻole nā ​​leka pili. A i ʻole ua holomua ka myopia a i ʻole presbyopia, a hoʻomau ka mea maʻi i ka hoʻohana ʻana i nā aniani kahiko i kūpono ʻole iā ia ma ke ʻano o ka diopter.

Hiki i ka asthenopia muscular ke kū mai i ke kua o nā maʻi maʻamau e pili ana i nā ʻiʻo o ka rectus ocular, no ka laʻana, nā maʻi endocrine (thyrotoxicosis), myasthenia gravis a i ʻole myositis.

Me ka myopia, hana ʻia ka hana ma kahi mamao me ka hoʻonui ʻia o ka noho ʻana, i hana ʻia me ke kōkua o nā ʻiʻo rectus kūloko. Me ka strabismus, loaʻa ka asthenopia ma muli o ka luhi ma muli o ka makemake e lanakila i ka deviation o nā maka.

Nā kumu asthenopia hoʻokipa - ka spasm o ka noho ʻana, ka hoʻoponopono kūpono ʻole o ka ʻike maka a me ka astigmatism, ocular a me ka maʻi maʻamau e alakaʻi i ka nāwaliwali o ka ʻiʻo ciliary, no ka laʻana, nā maʻi inflammatory a me nā degenerative o ka maka. I ka hana ʻana ma kahi kokoke, koi ʻia ka haʻalulu noho ʻana, i hana ʻia me ke kōkua o nā ʻiʻo ciliary.

ʻO ka hōʻailona o ka asthenopia:

  • Ka hoʻoholo ʻana o ka ʻike maka me ka hoʻoponopono ʻole
  • Skiascopy no nā haumāna haiki a ākea (pinepine i nā keiki).
  • Refractometry me kahi haumāna haiki a ākea.
  • Ka hoʻoholoʻana i ka angle strabismus me ka hoʻohanaʻana i keʻano Hirschberg a me ka synoptophore;
  • Ka hoʻoholoʻana i keʻano o ka hihiʻo e hoʻohana ana i ka ho'āʻoʻehā;
  • Ke ana ʻana i ka waiho ʻana - waiho ʻia kahi pale opaque i mua o kekahi maka a noi ʻia kekahi e heluhelu i ka kikokikona ma kahi mamao o 33 cm. A laila kau ʻia nā lens maikaʻi ʻole me ka hoʻonui ʻana i ka ikaika i mua ona a ʻae ʻia e "maʻa" no kekahi manawa. ʻO ka lens ikaika loa, kahi e hiki ai ke heluhelu ʻia ka kikokikona, ua manaʻo ʻia he wahi hoʻomaha. I ka makahiki 20-30 ua like ia me 10 diopters, ma hope o 40 mau makahiki e emi ana.
  • Hoʻoholo ʻia ka mālama ʻana i ka fusion me ka hoʻohana ʻana i kahi synoptophore. I kēia hihia, ua hui pū ʻia nā ʻāpana ʻelua o ke kiʻi, a laila hoʻomaka lākou e hoʻokaʻawale i nā ʻāpana o nā kaha kiʻi a hoʻoholo i ka manaʻo i ka wā e hoʻomaka ai ka maka e ʻike i ke kiʻi he 2 mau mea like ʻole. ʻO ka maʻamau, ʻo nā mālama maikaʻi (convergent) he 15-25 degere, a he 3-5 degere ka mālama ʻole (divergent). Me ka asthenopia ua hoʻemi ʻia lākou. Hiki ke hoʻoholo ʻia me ka hoʻohana ʻana i nā lens prismatic.

Ka mālama ʻana i ka asthenopia.

ʻO ka mālama ʻana i ka asthenopia, ma ke ʻano he kānāwai, he lōʻihi ia a hilinaʻi nui ʻia i ka makemake o ka mea maʻi a me ke ʻano no ka hoʻōla. ʻO ke ala nui i koho pono ʻia ka hoʻoponopono ʻana o ka ametropia me nā aniani a i ʻole nā ​​​​lens contact. Pono ka mālama ʻana i ke kumu o ka asthenopia, me ka extraocular pathology. No ka hoʻomaha ʻana i ka spasm o ka noho ʻana a hoʻomaha i ka ʻiʻo ciliary, hoʻokomo ʻia nā mydriatics pōkole, 1 hāʻule i kēlā me kēia lā a i kēlā me kēia lā i ka pō no hoʻokahi mahina.

Hoʻohana ʻia nā ʻano hana lapaʻau no ka hoʻomaʻamaʻa ʻana i nā mālama o ka noho maikaʻi a me ka convergence. Loaʻa kēia ma ka hoʻohana ʻana i nā lens o nā ikaika like ʻole, prisms a me nā simulators kūikawā (2).

ʻO nā lako kamepiula a me nā ʻano kamepiula no ka mālama ʻana i ka amblyopia:

  • Kōkua ʻo Synoptophore i ka hoʻomaʻamaʻa ʻana a me ka hoʻomohala ʻana i nā waihona fusional (ka hiki ke hoʻohui i nā kiʻi ʻike mai nā maka ʻelua i hoʻokahi kiʻi).
  • Hoʻomaha ka laser stimulation i ka ʻiʻo ciliary. 
  • Hoʻopili ka mea hoʻomaʻamaʻa accomodo i ka noho ʻana i ka wā e nānā kokoke a mamao, a hiki ke hoʻohana ʻia ma ka home. 
  • Nā polokalamu kamepiula like ʻole. E hoʻomaha i ka luhi o ka maka a pale i ka ulu ʻana o ka maʻi kamepiula - EyeDefender, Safe eyes, RELAX. Inā he myopia, hypermetropia a strabismus paha, a laila EYE, Strabismus, Blade, Flower, Crosses, Contour, etc. (3).

Hāʻawi ka mālama ʻana i nā lako lako i nā hopena maikaʻi loa i nā keiki.

Ka pale ʻana i ka ulu ʻana o ka asthenopia:

  • Hoʻoponopono pololei a me ka manawa kūpono o nā hewa refractive (myopia, farsightedness, astigmatism).
  • Hoʻokō i ka hana a me ka hoʻomaha hoʻomaha e pili ana i nā maka. Ma hope o kēlā me kēia hola o ka pilikia o ka maka, pono ʻoe e hoʻomaha. I kēia manawa, hiki iā ʻoe ke hana i nā hoʻomaʻamaʻa maka.
  • ʻO nā kukui kūloko a me ka nui o ka wahi hana.
  • ʻO ka hoʻohanaʻana i nā aniani perforated kūikawā e hoʻomaha i ke kaumaha o ka nohoʻana.
  • ʻO ka lawe ʻana i nā huaora a i ʻole nā ​​meaʻai meaʻai no nā maka a me ka meaʻai kūpono, kaulike ma ke ʻano laulā.
  • Nā haʻuki a me nā hana hoʻoikaika kino.

ʻO ka wānana no ka asthenopia me ka mālama ʻana i ka manawa a me ka hoʻokō ʻana i nā lula pale āpau.

 

1. "Nā hana binocular i ametropia" Shapovalov SL, Milyavsky TI, Ignatieva SA, Kornyushina TA St. Petersburg 2014

2. "Hoʻomaʻamaʻa paʻakikī o nā maʻi accommodative i ka myopia loaʻa" Zharov VV, Egorov AV, Konkova LV, Moscow 2008.

3. "Hoʻomaʻamaʻa hana o ka strabismus concomitant" Goncharova SA, Panteleev GV, Moscow 2004.

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