Ukuwohloka Okumomile Kwendawo Ephakathi Yamehlo: Izimpawu, Izimbangela, Nokwelashwa

Ukuwohloka okumomile kwendawo ephakathi yamehlo kuwukonakala kancane kancane kwamangqamuzana azwayo ukukhanya ezingxenyeni eziphakathi kweliso lakho, okuthiwa yi-macula. Lesi simo siwathinta kancane kancane umbono wakho ophakathi ngokuhamba kwesikhathi, okwenza kube nzima ukubona imininingwane emincane njengobuso noma umbhalo. Yilona uhlobo oluvamile lokuwohloka kwendawo ephakathi yamehlo oluhlobene nobudala, oluthinta izigidi zabantu emhlabeni jikelele, futhi nakuba kungase kukhathaze ukufunda ngakho, ukuqonda kukunika amandla okuthatha izinyathelo zokuvikela impilo yamehlo akho.

Iyini imiphumela yokuwohloka okumomile kwendawo ephakathi yamehlo?

Ukuwohloka okumomile kwendawo ephakathi yamehlo kwenzeka lapho ama-deposits amancane aphuzi okuthiwa yi-drusen eqoqana ngaphansi kweliso lakho. I-macula yakho inomthwalo wemfanelo wokubona okuqondile, okuphakathi okuvumela ukufunda, ukuqhuba, nokubona ubuso ngokucacile. Uma la mangqamuzana eqala ukuncipha nokubola, umbono wakho ophakathi awusabiqondi.

Lesi simo sivame ukuthuthuka kancane kancane eminyakeni eminingi. Ngokungafani nokuwohloka okunamafutha kwendawo ephakathi yamehlo, uhlobo oluomile alubandakanyi ukukhula kwezinsimbi zegazi ezingavamile noma ukushintsha kombono ngokuzumayo. Cabanga ngakho njengokukhahlela kancane kancane kunokuba yinkinga ebukhali.

Abantu abaningi abane-macular degeneration banohlobo oluomile, olumele cishe u-85-90% yazo zonke izimo. Nakuba kungathinta ikhwalithi yokuphila kwakho, abantu abaningi baqhubeka begcina ukuzimela kwabo ngokuphathwa okuhle neqhinga lokuguqula.

Ziyini izimpawu zokuwohloka okumomile kwendawo ephakathi yamehlo?

Izimpawu zokuqala zokuwohloka okumomile kwendawo ephakathi yamehlo zivame ukuthuthuka kancane kangangokuba ungase ungaziboni ngokushesha. Ubuchopho bakho buhle kakhulu ekubuyiseleni izinguquko ezincane embonweni, okusho ukuthi izimpawu zingakukhwabanisela ngezinyanga noma iminyaka.

Nazi izimpawu eziyinhloko okufanele uzilinde:

• Ukubona okungacacile noma okungathandeki phakathi, okwenza ukufunda kube nzima
• Ukudinga ukukhanya okukhulu lapho wenza umsebenzi oseduze
• Ubunzima bokuqaphela ubuso kude
• Imigqa eqondile ebonakala iqhubeka noma ihlanekeze
• Amabala amnyama noma engenalutho ekuqaleni kwamehlo akho
• Imibala ebonakala ingakhanyi noma ihlanzekile
• Ubunzima bokujwayela izimo zokukhanya okuncane

Lezi zinguquko zenzeka ngoba i-macula yakho ayisebenzi ukukhanya kahle njengoba yayenza ngaphambili. Izindaba ezinhle ukuthi ukwanda kwe-macular degeneration okomile akunakubangela ubuthakathaka obuphelele ngoba ukubona kwakho okujikelezile kuvame ukuhlala kuphelele.

Imiphi imihlobo yokwanda kwe-macular degeneration okomile?

Ukukhula kwe-macular degeneration okomile kuqhubeka ngezigaba ezintathu ezahlukene, ngayinye inezingqikithi ezahlukene nemiphumela ekuqaleni kwamehlo akho. Ukuqonda lezi zigaba kukusiza ukwazi ukuthi yini okulindeleke nokuthi nini kufanele ufuna ukunakekelwa okwengeziwe.

Isigaba sokuqala sokukhula kwe-macular degeneration okomile sihilela ama-drusen amancane afakwe phansi kwe-retina yakho. Ngokuvamile ngeke uqaphele noma yiziphi izingozi ekuqaleni kwamehlo akho kuleli phuzu, futhi le meko ivame ukutholakala ngesikhathi sokuhlolwa kwamehlo okujwayelekile. Lesi sigaba singaphila iminyaka ngaphandle kokukhula.

Isigaba esiphakathi siletha ama-drusen amakhulu noma ukuguquka kombala e-retina yakho. Ungaqala ukuqaphela ukuguquka okuncane ekuqaleni kwamehlo akho, njengokudinga ukukhanya okuningi ekufundeni noma ukungacaci okuncane ekuqaleni kwamehlo akho. Abanye abantu bathuthukisa indawo ehlulekile encane ekuqaleni kwamehlo abo.

Isigaba esiphambili sihilela ukuphazamiseka okukhulu kwamaselula azinzile okukhanya kanye nokusekela ithishu e-macula yakho. Lesi sigaba sibangela ukulahleka okubonakalayo ekuqaleni kwamehlo akho okuthinta imisebenzi yansuku zonke njengokufunda, ukuqhuba, noma ukuqaphela ubuso. Noma kunjalo, ukubona kwakho okujikelezile kuhlala kungathinteki kakhulu.

Yini ebangela ukukhula kwe-macular degeneration okomile?

Ukuwohloka komkhondo omomile we-macula kuvela lapho amaseli anemibala e-macula yakho ehluma kancane kancane ngokuhamba kwesikhathi. Nakuba singazi kahle ukuthi kungani lokhu kwenzeka kwabanye abantu, hhayi kwabanye, abacwaningi baye bathola izinto eziningi ezihlanganyela kule nqubo.

Izimbangela eziyinhloko nezinto ezifaka isandla zihlanganisa:

• Inqubo yokuguga yemvelo ethonya amaseli e-retina
• Izinto zofuzo ezithathwe ezihlotsheni
• Ukucindezeleka kokuxhaphaza okonakalisa izakhiwo zamaseli
• Ukuhamba okuncane kwegazi kuya e-macula ngokuhamba kwesikhathi
• Ukuqoqwa kwemikhiqizo yokuwohloka kwamaseli
• Ukuvuvukala emathishini e-retina
• Izinto zokuzungezile njengokubekwa ekukhanyeni kwe-UV

Ubudala buhlala buyisici esikhulu kakhulu sokungena engozini, ngezimo eziningi ezivela ngemuva kweminyaka engama-60. Noma kunjalo, ukuba nezici zokungena engozini akusho ukuthi uzophulaphula le meko. Abantu abaningi abanezici eziningi zokungena engozini abazange baphathwe yi-macular degeneration, kanti abanye abanezici ezimbalwa zokungena engozini bayayithola.

Nini kufanele ubona udokotela ngokuwohloka komkhondo omomile we-macula?

Kufanele uhlele ukuhlolwa kwamehlo uma ubona noma yiziphi izinguquko embonweni wakho ophakathi, ngisho noma zibonakala zincane. Ukutholakala kwangaphambi kwesikhathi kukunika ithuba elihle kakhulu lokuthambisa ukuqhubeka nokwenza izinguquko.

Xhumana nodokotela wakho wamehlo ngokushesha uma uhlangabezana nezinguquko eziphuthumayo embonweni, njengokwanda okusheshayo kokuphazamiseka noma amabala amasha abukhali. Nakuba ukuwohloka komkhondo omomile we-macula kuvame ukuqhubeka kancane, ngezinye izikhathi kungaguquka kube yifomu elibi kakhulu, elidinga ukunakekelwa okusheshayo.

Ukuhlolwa kwamehlo okuvamile kuya kubaluleka kakhulu ngemuva kweminyaka engama-50, ngisho noma ungaboni izinkinga zombono. Udokotela wakho wamehlo angathola izinguquko zangaphambi kwesikhathi ngaphambi kokuba kuvele izimpawu futhi akusize uqonde izici zakho zokungena engozini.

Ziyini izici zokungena engozini zokuwohloka komkhondo omomile we-macula?

Izici eziningi zingandisa amathuba akho okuba ne-dry macular degeneration, nakuba ukuba nezici ezingozi akusho ukuthi uzoyithola ngokuqinisekile le meko. Ukuqonda ingozi yakho siqu kuzokusiza wenze izinqumo ezinolwazi mayelana nokuvimbela nokulandelela.

Izici ezingozi ezibaluleke kakhulu zihlanganisa:

• Ubudala obungaphezu kweminyaka engama-60, ingozi ikhula njalo njalo eminyakeni eyishumi
• Umlando womndeni we-macular degeneration
• Ukubhema noma umlando wokusebenzisa utshaba
• Ubuhlanga baseCaucasian
• Ubulili besifazane
• Amehlo anemibala emhlophe
• Isifo senhliziyo
• Ukuphuma kwengcindezi yegazi
• Ukukhuluphala
• Ukubhekana nelanga isikhathi eside ngaphandle kokukhuselwa kwamehlo

Ezinye izinhlobo ze-genetic ezingavamile zingathinta abantu abasebancane, ikakhulu labo abanemiklamo ezuzwe njenge-Stargardt disease. Lezi zinhlobo ze-genetic azivamile kakhulu kodwa zingabangela izimpawu ezifanayo emazingeni asebekhulile.

Nakuba ungakwazi ukushintsha izici ezifana nobudala noma i-genetics, ungakwazi ukubhekana nezingozi ongazishintsha njengokubhema, ukudla, nokuvikela ilanga ukuze unciphise ingozi yakho noma uthambise ukuqhubeka.

Ziyini izinhlanganisela ezingaba khona ze-dry macular degeneration?

Inkinga enkulu ye-dry macular degeneration iwukulahleka kokubona okuphakathi okuqhubekayo okungathinta kakhulu imisebenzi yakho yansuku zonke. Nakuba lokhu kuzwakala kukhulu, ukuqonda ukuthi yini okulindelekile kuzokusiza ukulungiselela nokwenza ngempumelelo.

Izinhlanganisela ezivamile zihlanganisa:

• Ubunzima bokufunda okubhaliwe okuvamile
• Izinselele zokuqhuba, ikakhulu ebusuku
• Izinkinga zokubona ubuso
• Ubunzima ngemisebenzi eminingilizi njengokupheka noma ubuciko
• Ukungena engozini yokwehla ngenxa yokuguquka kokubona
• Ukuhlukaniswa komphakathi ngenxa yemikhawulo ehlobene nokubona

Inkinga engavamile kodwa ebucayi kakhulu yenzeka lapho ukuwohloka komlomo omomile okuqhele kuyaguquka kube ukuwohloka komlomo onamanzi. Lokhu kwenzeka cishe ku-10-15% yezimo futhi kuhilela ukukhula kwezinsimbi zegazi ezingavamile okungabangela ukulahleka kobona ngokushesha.

Ukudideka nokukhathazeka kungaphinda kuvele njengoba abantu belungisa ukuguquka kobona. Noma kunjalo, ngokusekelwa okufanele, amathuluzi okuzihlanganisa, futhi ngezinye izikhathi ukwelulekwa, abantu abaningi baphila impilo yabo ngokuphumelelayo futhi bagcina ubukhulu babo.

Ukuwohloka komlomo omomile kungavikeleka kanjani?

Nakuba ungakwazi ukuvimbela ngokuphelele ukuwohloka komlomo omomile, ikakhulukazi uma unezici eziyingozi zezofu, ungathatha izinyathelo eziningana ezinganciphisa ingozi yakho noma zithambise ukuqhubeka kwayo. Lezi zinqumo zokuphila ziyazuza impilo yakho yonke futhi.

Izindlela zokuvimbela zihlanganisa:

• Ukudla ukudla okunamagqashi aluhlaza kakhulu nemifino enemibala
• Ukuyeka ukubhema nokugwema ukubhema okusecondhand
• Ukugqoka izibuko zokukhanyisa i-UV ngaphandle
• Ukugcina isisindo esinempilo
• Ukuzivocavoca njalo ukuze usekele ukujikeleza kwegazi
• Ukuphatha ukucindezeleka kwegazi ne-kolesterol
• Ukuthatha amavithamini e-AREDS uma kunconywe ngudokotela wakho

Amavithamini e-AREDS (Age-Related Eye Disease Study) anezondlo ezithile ezifana ne-vitamin C, i-vitamin E, i-zinc, ne-lutein ezingasiza ekuthambiseni ukuqhubeka kwabantu abanesifo esiphakathi. Noma kunjalo, lezi zongezelelo azifanele wonke umuntu, ngakho-ke xoxa nodokotela wakho kuqala.

Ukuwohloka komlomo omomile kuhlonzwa kanjani?

Ukuhlonzwa kokwohloka komlomo omomile kuhilela ukuhlolwa okungapheli ubuhlungu okunika udokotela wakho amehlo umbono ophelele wempilo yomlomo wakho. Inqubo ngokuvamile ithatha cishe ihora elilodwa futhi inikeza ulwazi oluyigugu mayelana nesigaba nesiphetho sesimo sakho.

Udokotela wakho weziso uzoqala ngokuhlolwa okuphelele kwamehlo, okuhlanganisa ukuhlolwa kobona kanye nokwandisa abafundi. Bazohlola i-retina yakho usebenzisa imishini ekhethekile ukuze bafune ama-drusen deposits kanye nezinye izinguquko ezibonisa ukubola kwe-macula.

Izivivinyo ezengeziwe zingafaka i-optical coherence tomography (OCT), edala izithombe ezinemininingwane ye-cross-sectional ye-retina yakho, ne-fluorescein angiography ukuhlola ukugeleza kwegazi emithanjeni yakho ye-retina. Ukuhlolwa kwe-Amsler grid kusiza ekutholeni ukuphazamiseka kobona ongase ungazange ukuphawule.

Ukutholakala kwangaphambi kwesikhathi kubalulekile ngoba kuvumela ukuqapha kangcono kanye nokungenelela kwangaphambi kwesikhathi uma isimo siqhubeka. Abantu abaningi bayamangala ukwazi ukuthi banesigaba sokuqala sokubola kwe-macula ngoba izimpawu zingase zingabonakali okwamanje.

Iyini impilo yokwelapha ukubola okomile kwe-macula?

Okwamanje, ayikho impilo yokwelapha ukubola okomile kwe-macula, kepha izindlela eziningi zokwelapha zingasiza ekuthambiseni ukuqhubeka kwayo nasekuphatheni izimpawu ngokuphumelelayo. Indlela ixhomeke esigabeni sakho esithile sesifo nasesimweni sakho somuntu siqu.

Izinketho zokwelapha zihlanganisa:

• Ama-AREDS amavithamini ezigabeni eziphakathi nangeziphambili
• Ukuvuselelwa nokufundiswa kokubona okungaphansi
• Amadivayisi okuqhathanisa nemishini yokuguqula
• Ukukhanya okuthuthukisiwe kokufunda nemisebenzi
• Ukwelashwa kobona ukuze ukhulume ukubona okusele
• Ukuqapha njalo ukuqhubeka kwesifo

Ngokubola okomile kwe-macula okuthuthukile, izindlela zokwelapha ezintsha njenge-geographic atrophy injections ziyafundwa futhi zingatholakala. Lezi zindlela zokwelapha zihlose ukuthambisa ukuqhubeka kokubola kwamaseli e-macula.

Ukuqapha okubaluleke kakhulu kokwelapha ukusebenza nochwepheshe bezokubona abancane abangakusiza ukuba uzilungiselele izinguquko futhi ugcine ukuzimela. Abantu abaningi bayamangala ukuthi bangasebenza kangcono kangakanani ngezinsiza nezinqubo ezifanele.

Indlela yokuphatha ukubola okomile kwe-macula ekhaya?

Ukuphatha i-dry macular degeneration ekhaya kuhilela ukwenza izinguquko eziwusizo ezikusiza ukuba uqhubeke nemisebenzi yakho yansuku zonke ngokuphepha nangokunethezeka. Izinguquko ezincane zingenza umehluko omkhulu ezingeni lokuphila kwakho.

Qala ngokuthuthukisa ukukhanya ekhaya lonke, ikakhulukazi ezindaweni lapho ufunda khona noma wenza umsebenzi ocacile. Izibani ze-LED zinikeza ukukhanya okukhanya, okuqondile ngaphandle kokukhiqiza ubushushu. Cabanga ngokukhanya komsebenzi wemisebenzi ethile njengokufunda noma ukupheka.

Hlela izindawo zakho zokuhlala ukuze unciphise ingozi yokuwa futhi wenze kube lula ukuhamba. Susa ama-throw rugs, qiniseka ukuthi izitebhisi zikhanyisiwe kahle, futhi sebenzisa imibala ehlukile ukuze usize ukwahlukanisa phakathi kwamafutha nezinto.

Amathuluzi okuqeda amandla angakusiza ekufundeni, kusukela kuma-magnifiers amancane okuthwala esandleni kuya kumadivayisi e-elektroniki aqhuba umbhalo kuma-screen. Izincwadi ezinkulu, amadivayisi akhulumayo, kanye nezinhlelo zokusebenza ze-smartphone ezenzelwe usizo lwembikiso zingasiza kakhulu.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ukulungiselela i-aphoyintimenti yakho yamehlo kusiza uqinisekise ukuthi uthola ukunakekelwa okuphelele futhi uthole izimpendulo zemibuzo yakho yonke. Ukulungiselela kancane kwenza ukuvakasha kube nomphumela omkhulu kuwe nodokotela wakho.

Letha uhlu oluphelele lwazo zonke izidakamizwa kanye nezinsiza ozithathayo, kufaka phakathi izinto zokuthengwa ngaphandle kwesikripthi. Ezinye izidakamizwa zingathinta amehlo akho noma zihlangane nezinqubo udokotela wakho angase azincoma.

Bhala noma yiziphi izinguquko zombikiso ozibonile, ngisho noma zibonakala zincane. Faka lapho uqale ukuzibona khona, ukuthi ziyaqina yini, nokuthi zithinta kanjani imisebenzi yakho yansuku zonke. Lolu lwazi lusiza udokotela wakho ukuqonda ukuqhubeka kwesimo sakho.

Cabanga ukuletha ilungu lomndeni noma umngani ukuze akusize ukukhumbula ulwazi olubalulekile futhi ukusiza ngokuthutha uma abafundi bakho bezoqiniswa. Lungiselela uhlu lwemibuzo mayelana nesimo sakho, izinketho zokwelashwa, nokuthi yini okulindelekile kuqhubeke.

Iyini iphuzu eliyinhloko mayelana nokubola komkhondo owomile?

Ukubola komkhondo owomile kuyisimo esilawuleka, nakuba sikulu, akudingeki ukuthi kuvimbele impilo yakho kakhulu. Ukutholakala kwasekuqaleni nokuphathwa okuqaphayo kungasiza ekuvikeleni umbono wakho nasekugcineni ukuzimela kwakho iminyaka eminingi ezayo.

Isinyathelo esibaluleke kakhulu ukulondoloza ukuxhumana neqembu lakho lokunakekela amehlo nokulandelana nokulandelela njalo. Abantu abaningi abane-macular degeneration baqhubeka bephila impilo egcwele, esebenzayo ngokulungisa izindlela zabo zemisebenzi yansuku zonke nokusebenzisa izinsiza ezitholakalayo.

Khumbula ukuthi ukwesekwa kutholakala ngochwepheshe be-low vision, amaqembu wokusekela, kanye neteknoloji yokulungisa. Awuwedwa kule ndlela, futhi ngezinsiza ezifanele nomqondo, ungaphatha ngempumelelo izinselele ezingase zivele.

Imibuzo evame ukubuzwa mayelana nokubola komkhondo owomile

Ingabe ukubola komkhondo owomile kuzongenza ngibe yimpumputhe ngokuphelele?

Ukubola komkhondo owomile akunakwenzeka ukuthi kubangele ubuthakathaka obuphelele. Nakuba kungathinta kakhulu umbono wakho ophakathi, umbono wakho wasezandleni uhlala ukhona, ukuvumela ukuba ugcine ukuhamba nokukwazi ukuzenzela izinto. Abantu abaningi bazilungisa kahle kulezi zinguquko ngokusekelwa nokusetshenziswa kwemishini efanele.

Ukubola komkhondo owomile kuqhubeka kangcono kangakanani?

Ukubola komkhondo owomile kuvame ukuqhubeka kancane eminyakeni eminingi. Izinyathelo zokuqala zingase zihlale zizinzile amashumi eminyaka, kuyilapho izigaba eziphakathi zingase ziqhubekele ezinhlotsheni eziphambili eminyakeni eminingi. Ukulandelela njalo kusiza ekuqapheleni noma yiziphi izinguquko ezingeni lokukhula.

Ingabe ukubola komkhondo owomile kungathinta amehlo womabili?

Yebo, ukubola komkhondo owomile kungathinta amehlo womabili, nakuba kuvame ukuqala kwenye iliso. Uma unayo kwenye iliso, unethuba elikhulu lokuthuthukisa kwenye iliso ngokuhamba kwesikhathi. Noma kunjalo, ukuqhubeka nobukhulu kungase kuhluke kakhulu phakathi kwamehlo.

Ingabe kunokwelashwa okusha okuthuthukiswayo?

Abacwaningi bayafunda ngokujulile izindlela ezintsha zokwelapha ukubola komkhondo omomile, okuhlanganisa ukwelashwa ngamangqamuzana esiqalo, ukwelashwa nge-gene, kanye nezinye izidakamizwa ezinciphisa ukubola komkhondo. Amanye amaphilisi okwelapha ukubola komkhondo okukhulu asevele avunywe yi-FDA, okuyithemba elikhulu kubantu abagulayo.

Kufanele ngiyeke ukuqhuba uma nginokubola komkhondo omomile?

Akusikho ngaso sonke isikhathi. Abantu abaningi abane-dry macular degeneration ekuqaleni noma ephakathi bangayaqhuba ngokuphepha, ikakhulukazi emini. Noma kunjalo, kufanele uhlale uhlola amehlo akho njalo futhi ube eqotho nganoma yiziphi izinselele ozibhekana nazo. Udokotela wakho weziso angakusiza ukuthi ubone ukuthi nini ukuguqula indlela oqhuba ngayo noma ukuyeka ukuqhuba kungaba kufanelekele ukuphepha.