Kano Kano Maroke

Ko te mate kanohi maroke he āhuatanga noa e puta ana ina kore e taea e ō roimata te whakarato i te whakakakahu pai mō ō kanohi. Ka taea te koretake me te kore pumau o ngā roimata mō ngā take maha. Hei tauira, ka puta pea ngā kanohi maroke ki te kore koe e whakaputa i ngā roimata nui, ki te whakaputa rānei koe i ngā roimata kino. Ko tenei kore pumau o ngā roimata ka ārai ki te mumura me te pakaru o te mata o te kanohi.

Ka ahua kore ngāwari ngā kanohi maroke. Ki te whai koe i ngā kanohi maroke, ka taea e ō kanohi te wero, te tahuna rānei. Ka pā pea ngā kanohi maroke ki a koe i etahi wā, pēnei i te rerenga waka, i roto i te ruma whakahaumaru hau, i te eke paihikara rānei, i muri i te titiro ki te mata rorohiko mō etahi haora.

Ka taea e ngā maimoatanga mō ngā kanohi maroke te whakapai ake i tō ngāwari. Ka uru pea ēnei maimoatanga ki ngā huringa oranga me ngā matū kanohi. Ka hiahia pea koe ki te tango i ēnei mahi mutunga kore hei whakahaere i ngā tohu o ngā kanohi maroke.

Ngā tohu me ngā pūāhua, e pā ana te nuinga ki ngā kanohi e rua, ka uru pea ki roto:

• Te āhua e ngiha ana, e tahuna ana, e ngākau kinotia ana rātou kanohi
• Te wai māngō i roto i ngā kanohi, i te taha o ngā kanohi rānei
• Te ngawari ki te mārama
• Te whero o te kanohi
• Te āhua kei te mea kei roto i ō kanohi
• Te raruraru ki te kakahu i ngā karāhe kōtakitaki
• Te raruraru ki te taraiwa i te pō
• Ngā kanohi wai, ko te whakautu tēnā o te tinana ki te mamae o ngā kanohi maroke
• Te tirohanga mōrearea, te ngenge rānei o te kanohi

Tena tirohia tō kaiwhakarato hauora mena kua roa ngā tohu me ngā pūāhua o ngā kanohi maroke, tae atu ki ngā kanohi whero, ngāngā, wātea, kāhore rānei e pai. Ka taea e tō kaiwhakarato te tango i ngā mahi hei whakatau i te aha te mea e raru ana i ō kanohi, te tuku atu rānei i a koe ki te tohunga.

Ko ngā kanohi maroke ka puta mai i ngā take maha e whakaroa ana i te kirikiri wai ihu hauora. E toru ngā paparanga o tō kirikiri wai ihu: ngā hinu ngako, te wai wai me te kōkopu. Ko te whakakotahitanga o ēnei mea te nuinga o te wā ka pupuri i te mata o ō kanohi kia ngohengohe, maeneene, me te mā. Ko ngā raruraru ki tetahi o ēnei paparanga ka taea te whakaeke i ngā kanohi maroke.

He maha ngā take mō te kore mahi o te kirikiri wai ihu, tae atu ki ngā huringa homoni, te mate ā-whakaheke, ngā ngongo kamo i te pupu, te mate kanohi mate pāwera rānei. Ki ētahi tāngata, ko te take o ngā kanohi maroke ko te heke o te whakaputanga wai ihu, te nui haere rānei o te kohu wai ihu.

Ngā take ka piki ake ai te tūpono o te maroke o ngā kanohi:

• Ko te pakeke atu i te 50. Ka iti haere te tukunga o ngā roimata i te wā e koroheke haere ana. He maha ake ngā kanohi maroke i roto i te hunga neke atu i te 50.
• Ko te wahine. He maha ake te kore o ngā roimata i roto i ngā wāhine, ina koa ki te pā ana ki ngā huringa homoni nā te hapu, te whakamahinga rongoā whakahaputanga, te wā rāpoi rānei.
• Te kai kai iti te wītamini A, kei roto i te ate, kāreti, me te broccoli rānei, te iti rānei o ngā ngako momona omega-3, kei roto i te ika, ngā nati walnut, me ngā hinu huawhenua.
• Te kakahu i ngā karāhe miro, te hītori rānei o te pokanga whakatika.

Ko ngā mate pea ka pā ki te hunga e maroke ana o rātou kanohi:

• Ngā mate kanohi. Ka tiaki te roimata i te mata o ō kanohi kei pā te mate. Ki te kore te roimata, ka nui ake pea te tūpono o te mate kanohi.
• Te pakaru o te mata o ō kanohi. Ki te kore e rongoā, ka āhei pea te maroke o te kanohi kia puta ai te mumura o te kanohi, te pakaru o te mata o te cornea, ngā uaua o te cornea, me te ngaro o te tirohanga.
• Te heke o te kounga o te ora. Ka āhei pea te maroke o te kanohi kia uaua ai te mahi i ngā mahi o ia rā, pēnei i te pānui.

Mēnā ka pāngia koe e te maroke o ngā kanohi, kia aro nui ki ngā āhuatanga ka tino pēnei ai ō tohu. Na, kimihia ngā huarahi hei karo i aua āhuatanga kia ārai ai i ngā tohu o te maroke o ō kanohi. Hei tauira:

• Kaua e tukua te hau kia pupuhi ki ō kanohi. Kaua e whakamahi i ngā whakamātao makawe, i ngā whakamahana waka, i ngā whakamatao hau, i ngā pūhau rānei e anga ana ki ō kanohi.
• Tāpiri atu te makuku ki te hau. I te takurua, ka taea e te whakamakuku te tāpiri i te makuku ki te hau maroke o roto.
• Whakaarohia te kakahu i ngā karāhe miro katoa, i ētahi atu kakahu tiaki kanohi rānei. Ka taea te tāpiri i ngā pare haumaru ki ngā pito o runga me ngā taha o ngā karāhe kia ārai ai i te hau me te hau maroke. Pātaihia ngā pare kei hea koe e hoko ai i ō karāhe.
• Tangohia ngā wā okioki kanohi i ngā mahi roa. Ki te pānui koe, ki te mahi ranei i tētahi atu mahi e hiahia ana ki te aro nui o te tirohanga, tangohia ngā wā okioki kanohi. Kati te pupuhi i ō kanohi mō ngā meneti torutoru. Ranei, pupuhitia kia maha ngā wa mō ngā hēkona torutoru hei āwhina i te hora o ō roimata ki ō kanohi.
• Kia mōhio ki tō taiao. Ka tino maroke te hau i ngā teitei teitei, i ngā wāhi kēra, i roto i ngā waka rererangi hoki. I te whakapau i te wā i roto i tētahi taiao penei, ka awhina pea te pupuhi i ō kanohi i te maha o ngā wa mō ngā meneti torutoru i te wā kotahi hei whakaiti i te maroke o ō roimata.
• Whakatūria tō mata rorohiko i raro iho i te taumata o te kanohi. Ki te kei runga ake i te taumata o te kanohi tō mata rorohiko, ka whakatūwhera ake ō kanohi ki te matakitaki i te mata. Whakatūria tō mata rorohiko i raro iho i te taumata o te kanohi kia kaua ai e whakatūwhera nui ō kanohi. Ka āwhina pea tenei ki te whakaheke i te maroke o ō roimata i waenganui i ngā pupuhi kanohi.
• Whakamutu i te kai paipa me te karo i te paowa. Ki te kai paipa koe, pātai atu ki tō kaiwhakarato hauora mō te awhina ki te whakatakoto i tētahi rautaki mutu kai paipa ka tino mahi mōu. Ki te kore koe e kai paipa, kia mamao atu i te hunga e kai paipa ana. Ka kaha ake te kino o ngā tohu o te maroke o ngā kanohi i te paowa.
• Whakamahia ngā roimata whakakapi i ia wā. Ki te pāngia koe e te maroke o ngā kanohi, whakamahia ngā matū kanohi ahakoa kei te pai ō kanohi kia mau tonu te hinuhinu.

Ko ētahi o ngā whakamātautau me ngā tukanga ka taea te whakamahi hei whakatau i te take o ō kanohi maroke ko:

He whakamātautau hei ine i te nui o ō roimata. Ka ine pea tō tohunga tiaki kanohi i te nui o ō roimata mā te whakamahi i te whakamātautau roimata a Schirmer. I roto i tēnei whakamātautau, ka whakanohoia ngā paparanga pepa horoi i raro i ō taupoki kanohi raro. I muri i ngā rima meneti, ka ine tō tohunga tiaki kanohi te nui o te paparanga i ngāpakutia e ō roimata.

He atu whiringa mō te ine i te nui o ngā roimata ko te whakamātautau aho whero phenol. I roto i tēnei whakamātautau, ka whakanohoia he aho kī i te tae whakaū-pH (ka huri te tae o te tae e ngā roimata) ki runga i te taupoki kanohi raro, ka whakamakukuhia ki ngā roimata mō ngā 15 hēkona, katahi ka ine mō te nui o ngā roimata.

• He tirohanga kanohi whānui. He tirohanga kanohi kei roto he hītori katoa o tō hauora whānui me tō hauora kanohi ka taea te āwhina i tō tohunga tiaki kanohi ki te whakatau i te take o ō kanohi maroke.

• He whakamātautau hei ine i te nui o ō roimata. Ka ine pea tō tohunga tiaki kanohi i te nui o ō roimata mā te whakamahi i te whakamātautau roimata a Schirmer. I roto i tēnei whakamātautau, ka whakanohoia ngā paparanga pepa horoi i raro i ō taupoki kanohi raro. I muri i ngā rima meneti, ka ine tō tohunga tiaki kanohi te nui o te paparanga i ngāpakutia e ō roimata.

  He atu whiringa mō te ine i te nui o ngā roimata ko te whakamātautau aho whero phenol. I roto i tēnei whakamātautau, ka whakanohoia he aho kī i te tae whakaū-pH (ka huri te tae o te tae e ngā roimata) ki runga i te taupoki kanohi raro, ka whakamakukuhia ki ngā roimata mō ngā 15 hēkona, katahi ka ine mō te nui o ngā roimata.

• He whakamātautau hei whakatau i te kounga o ō roimata. He atu whakamātautau e whakamahi ana i ngā tae motuhake i roto i ngā matū kanohi hei whakatau i te āhua o te mata o ō kanohi. Ka titiro tō tohunga tiaki kanohi ki ngā tauira peita i runga i ngā cornea me te ine i te roa o te wā i mua i te maroke o ō roimata.

• He whakamātautau osmolarity roimata. Ko tēnei momo whakamātautau e ine ana i te hanganga o ngā pūngāwerewere me te wai i roto i ō roimata. Ki te mate kanohi maroke, ka iti ake te wai i roto i ō kanohi.

• Ngā tauira roimata hei rapu i ngā tohu o te mate kanohi maroke, tae atu ki te matrix metalloproteinase-9 teitei, te lactoferrin iti rānei.

Mō te nuinga o te hunga e pangia ana e ngā tohu maroke o te kanohi i etahi wā, he iti noa te whakamahinga o ngā tūtohu kanohi kore-whakahaunga, e kiia ana hoki ko ngā roimata mahi. Ki te mau tonu āu tohu, ā, he nui ake te kino, he maha atu ngā whiringa kei a koe. Ko te mea e mahi ai koe e whakawhirinaki ana ki te take o te maroke o ō kanohi.

Ka arotahi etahi maimoatanga ki te whakahoki mai, ki te whakahaere rānei i te āhuatanga, i te take rānei e pā ana ki te maroke o ō kanohi. Ka taea e ētahi atu maimoatanga te whakapai ake i te kounga o ō roimata, te aukati rānei i te tere o te maroke o ō roimata mai i ō kanohi.

Ko tētahi huarahi ki te whakaora i te maroke o te kanohi ko te ārai i ngā waha ki ngā ngongo roimata me ngā pūtu silicone iti (pūtu punctal). Ka kati ēnei pūtu i te waha iti (punctum) kei te kokonga o roto o ō kamo matau me ō kamo maui. Ka tiaki te kati i ō roimata ake me ngā roimata mahi kua tāpirihia pea e koe.

I ētahi wā, ka taea te whakakore i ngā tohu me ngā tohu o te maroke o te kanohi mā te whakaora i te take hauora kei raro. Hei tauira, ki te mea he rongoā te take o te maroke o ō kanohi, ka taea e tō tohunga tiaki kanohi te tūtohutia tētahi rongoā rerekē e kore e pā te pānga o te taha.

Ki te pēhea koe he āhuatanga o te kamo, pēnei i te tahuri o waho o ō kamo (ectropion), ka taea e tō tohunga tiaki kanohi te tuku atu ki tētahi taote kanohi e mōhio ana ki te pokanga kiri o ngā kamo (taote oculoplastic).

Ko ngā rongoā whakahaunga e whakamahia ana hei whakaora i te maroke o te kanohi ko:

Ko ētahi atu tukanga ka taea te whakamahi hei whakaora i te maroke o te kanohi ko:

Te kati i ō ngongo roimata hei whakaiti i te ngaro o te roimata. Ka taea e tō tohunga tiaki kanohi te whakaaro ki tēnei maimoatanga kia kore ai e tere rawa te wehe atu o ō roimata i tō kanohi. Ka taea te mahi i tēnei mā te kati i ngā wahi o ō ngongo roimata, e mahi ana hei whakaheke i ngā roimata.

Ka taea te ārai i ngā ngongo roimata me ngā pūtu silicone iti (pūtu punctal). Ka taea te tango i ēnei. Ka taea rānei te ārai i ngā ngongo roimata me te tukanga e whakamahi ana i te wera. Ko tēnei te otinga pumau ake e kiia nei ko te thermal cautery.

Te whakamahi i ngā karāhe whakapā motuhake. Pātai atu ki tō tohunga tiaki kanohi mō ngā karāhe whakapā hou i hangaia hei āwhina i te hunga e maroke ana o rātou kanohi.

Ka taea e ētahi atu tangata e maroke rawa ana o rātou kanohi te whiriwhiri i ngā karāhe whakapā motuhake e tiaki ana i te mata o ngā kanohi me te hopu i te makuku. E kiia ana ēnei ko ngā karāhe scleral, ko ngā karāhe tāpare rānei.

• Ngā rongoā hei whakaiti i te mumura o te kamo. Ka taea e te mumura i te taha o ō kamo te aukati i ngā ngongo hinu mai i te tukunga o te hinu ki ō roimata. Ka taea e tō tohunga tiaki kanohi te tūtohutia ngā rongoā hei whakaiti i te mumura. Ko ngā rongoā mō te maroke o te kanohi e inuhia ana i te nuinga o te wā, ahakoa ko ētahi e whakamahia ana hei tūtohu kanohi, hei hinu rānei.

• Ngā tūtohu kanohi hei whakahaere i te mumura o te cornea. Ka taea te whakahaere i te mumura i te mata o ō kanohi (cornea) me ngā tūtohu kanohi whakahaunga e whakauru ana i te rongoā whakakore-mate cyclosporine (Restasis) te corticosteroids rānei. Kāore i te pai ngā corticosteroids mō te whakamahinga roa nā te mea pea he pānga o te taha.

• Ngā whakauru kanohi e mahi ana pēnei i ngā roimata mahi. Ki te pēhea koe he tohu maroke o te kanohi o te reo waenga ki te nui, ā, kāore ngā roimata mahi e āwhina, ka taea te whiringa atu he whakauru kanohi iti e rite ana ki te pūngāwerewere parauri. Kotahi te rā, ka waiho e koe te whakauru hydroxypropyl cellulose (Lacrisert) i waenganui i tō kamo raro me tō poroporo kanohi. Ka rewa haere te whakauru, ka tukuna he mea e whakamahia ana i roto i ngā tūtohu kanohi hei whakamakuku i tō kanohi.

• Ngā rongoā whakaohooho-roimata. Ka āwhina ngā rongoā e kiia nei ko ngā cholinergics (pilocarpine, cevimeline) ki te whakapiki i te whakaputa roimata. Kei te wātea ēnei rongoā hei pire, hei keke, hei tūtohu kanohi rānei. Ko ngā pānga pea o te taha ko te werawera.

• Ngā tūtohu kanohi i hangaia mai i ō toto ake. E kiia ana ēnei ko ngā tūtohu serum toto autologous. Ka taea pea te whiringa ki te pēhea koe he tohu maroke o te kanohi nui e kore e whakautu ki tētahi atu maimoatanga. Hei hanga i ēnei tūtohu kanohi, ka tukatukahia tētahi tauira o ō toto hei tango i ngā pūtau whero, ka whakaranuhia ki te otinga tote.

• He whakainu ihu hei whakapiki i te whakaputa roimata. I whakaaetia e te Food and Drug Administration (FDA) i te wā tata nei te varenicline (Tyrvaya) hei whakaora i te maroke o te kanohi. Ka tukuna tēnei rongoā mā te whakainu ihu. Me whakainu te varenicline kotahi ki ia rua o ngā ihu, rua i te rā.

• Te kati i ō ngongo roimata hei whakaiti i te ngaro o te roimata. Ka taea e tō tohunga tiaki kanohi te whakaaro ki tēnei maimoatanga kia kore ai e tere rawa te wehe atu o ō roimata i tō kanohi. Ka taea te mahi i tēnei mā te kati i ngā wahi o ō ngongo roimata, e mahi ana hei whakaheke i ngā roimata.

  Ka taea te ārai i ngā ngongo roimata me ngā pūtu silicone iti (pūtu punctal). Ka taea te tango i ēnei. Ka taea rānei te ārai i ngā ngongo roimata me te tukanga e whakamahi ana i te wera. Ko tēnei te otinga pumau ake e kiia nei ko te thermal cautery.

• Te whakamahi i ngā karāhe whakapā motuhake. Pātai atu ki tō tohunga tiaki kanohi mō ngā karāhe whakapā hou i hangaia hei āwhina i te hunga e maroke ana o rātou kanohi.

  Ka taea e ētahi atu tangata e maroke rawa ana o rātou kanohi te whiriwhiri i ngā karāhe whakapā motuhake e tiaki ana i te mata o ngā kanohi me te hopu i te makuku. E kiia ana ēnei ko ngā karāhe scleral, ko ngā karāhe tāpare rānei.

• Te wewete i ngā ngongo hinu. Ka taea e ngā kāpeka mahana, e ngā pūeru kanohi rānei e whakamahia ana i ia rā te whakakore i ngā ngongo hinu kua ārai. Ko te taputapu thermal pulsation tētahi atu huarahi hei wewete i ngā ngongo hinu, engari kāore i te mārama mena ka whakawhiwhia tēnei tikanga i tetahi painga ki ngā kāpeka mahana.

Ka taea pea e koe te whakahaere i ō kanohi maroke mā te horoi i ngā kamo mā te maha me te whakamahi i ngā tūtohu kanohi kore-whakahaunga rānei i ētahi atu hua hei awhina i te whakakōkō i ō kanohi. Ki te roa te wā o tō mate (mate pūmau), whakamahia ngā tūtohu kanohi ahakoa kei te pai ō kanohi kia mau tonu te whakakōkō.

He maha ngā hua kore-whakahaunga mō ngā kanohi maroke kei te wātea, tae atu ki ngā tūtohu kanohi, e kiia ana hoki ko ngā roimata mahi, ngā keu me ngā hinu. Kōrero atu ki tō tohunga tiaki kanohi mō te mea pea ka pai rawa mōu.

Ka taea pea ko ngā roimata mahi anake te mea e hiahia ana koe ki te whakahaere i ngā tohu kanohi maroke ngawari. He maha ngā tāngata e hiahia ana ki te whakatakoto i ngā tūtohu i te maha o ngā wā i te rā, ā, ko ētahi ka whakamahi noa i te kotahi i te rā.

Whakaarohia ēnei take i te wā e whiriwhiri ana i tētahi hua kore-whakahaunga:

Tūtohu whakamarumaru vs. tūtohu kore-whakamarumaru. Ka tāpirihia ngā whakamarumaru ki ētahi tūtohu kanohi hei whakaroa i te roa o te ora. Ka taea e koe te whakamahi i ngā tūtohu kanohi me ngā whakamarumaru tae atu ki te whā o ngā wā i te rā. Engari, ko te whakamahi i ngā tūtohu whakamarumaru i te maha atu ka taea te pāngia o ngā kanohi.

Ka tae mai ngā tūtohu kanohi kore-whakamarumaru i roto i ngā kete kei roto i ngā ipu whakamahinga kotahi maha. I muri i to whakamahinga i te ipu, ka maka atu e koe. Ki te whakawhirinaki koe ki ngā tūtohu kanohi neke atu i te whā o ngā wā i te rā, he haumaru ngā tūtohu kore-whakamarumaru.

Mō ngā tāngata e pangia ana e te blepharitis me ētahi atu āhuatanga e pā ana ki te mumura o ngā kamo e aukati ana i te rere o te hinu ki te kanohi, ka āwhina pea te horoi i ngā kamo i te maha me te ngawari. Hei horoi i ō kamo:

• Tūtohu whakamarumaru vs. tūtohu kore-whakamarumaru. Ka tāpirihia ngā whakamarumaru ki ētahi tūtohu kanohi hei whakaroa i te roa o te ora. Ka taea e koe te whakamahi i ngā tūtohu kanohi me ngā whakamarumaru tae atu ki te whā o ngā wā i te rā. Engari, ko te whakamahi i ngā tūtohu whakamarumaru i te maha atu ka taea te pāngia o ngā kanohi.

  Ka tae mai ngā tūtohu kanohi kore-whakamarumaru i roto i ngā kete kei roto i ngā ipu whakamahinga kotahi maha. I muri i to whakamahinga i te ipu, ka maka atu e koe. Ki te whakawhirinaki koe ki ngā tūtohu kanohi neke atu i te whā o ngā wā i te rā, he haumaru ngā tūtohu kore-whakamarumaru.

• Tūtohu vs. hinu. Ka hipoki ngā hinu kanohi whakakōkō i ō kanohi, ka homai he whakaora roa atu i ngā kanohi maroke. Engari he mātotoru ake ēnei hua i ngā tūtohu kanohi, ā, ka taea te pupuhi o tō tirohanga. Mō tēnei take, he pai rawa te whakamahi i ngā hinu i mua tonu i te moe. Ka taea te whakamahi i ngā tūtohu kanohi i tetahi wā, ā, e kore e whakaroa i tō tirohanga.

• Ngā tūtohu e whakaiti ana i te whero. He pai kia karohia ēnei hei otinga mō ō kanohi maroke, i te mea ka taea e te whakamahinga roa te pāngia.

• Whakamahia he tauera mahana ki ō kanohi. Whakamakukuhia he kākahu ma me te wai mahana. Pupuritia te kākahu ki runga i ō kanohi mō te rima meneti. Whakamakukuhia anō te kākahu me te wai mahana ina makariri. Whakamātauria ngāwari te kākahu ki runga i ō kamo—tae atu ki te raro o ngā makawe—hei wewete i tetahi paru.

• Whakamahia he hopi ngawari ki ō kamo. Whakamahia te hopi pēpi rānei i tētahi atu hopi ngawari. Whakatakotoria te horoi ki runga i ō matihao ma, ā, whakamātauria ngāwari ō kanohi kati tata ki te raro o ō makawe. Horoi katoa.