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Ukuba nombono ocacileyo, obukhali kubalulekile ukusinceda sibone umbono ocacileyo wehlabathi. Ukusuka ekubukeleni izinto ezikufuphi nezikude ukuze siqiniseke ukuba asiphoswa yinyathelo kwaye siwile, amehlo ethu ahlala eshukumisela ukunika ubuchopho ulwazi olutsha malunga nokusingqongileyo. Kodwa, xa umbono wakho esiba mpofu kwaye ungacacanga kwaye ungaziboni izinto ngokucacileyo, unokuba nombono ophuthileyo. Kule nqaku, siza kuthetha ngezizathu, iimpawu, ukuxilongwa kunye nokunyangwa kwamehlo.
Yintoni Umbono Ongacacanga?
Umbono ongacacanga ubhekisa ekunciphiseni kokubukhali kombono, owenza ukuba kube nzima ukubona iinkcukacha ezintle. Ingxaki nakweyiphi na indawo yamehlo, njenge-cornea, i-retina okanye i-optic nerve, inokukhokelela kumbono ophazamisayo. Umbono ongacacanga unokuvela ngenxa yezifo ezithile zamehlo okanye inokuba luphawu lweemeko ezininzi zonyango ezinje ngeswekile okanye ukubetha [1] , [Mbini] . Amayeza afana ne-chloroquine, ichiza elisetyenziselwa ukunyanga isifo seengcongconi lineziphumo ebezingalindelekanga ezifana nokufiphala okwexeshana kombono [3] .
Kuxhomekeka kwisizathu, umbono ophuthileyo unokubakho ngeliso elinye okanye kuwo omabini amehlo.
Yintoni Ebangela Ukungaboni kakuhle?
Zininzi izinto ezinokubangela ukungaboni kakuhle, ezi zinto zilandelayo:
• I-Astigmatism -Ngokwe-American Optometric Association, i-astigmatism yimeko eqhelekileyo yamehlo ebangela umbono ophuthileyo. Kwenzeka ngenxa ye-cornea engacacanga okanye iilensi ngaphakathi kwiso, ethintela ukukhanya ekugxileni ngokufanelekileyo kwi-retina (indawo ekhanyayo ekukhanyeni ngasemva kweliso), ekhokelela kumbono ophazamisayo okanye ogqwethekileyo [4] .
I-Astigmatism ihlala ivela kwezinye iimeko zamehlo ezinje nge-myopia (ukubona kufutshane) kunye ne-hyperopia (ukubona kude). Kwaye indibaniselwano yezi meko zamehlo ibizwa ngokuba ziimpazamo ezingaqondakaliyo kuba zichaphazela indlela amehlo agobe ngayo okanye ukubonakalisa ukukhanya.
• IMyopia (kufutshane nokubona) -Yimeko eqhelekileyo yamehlo apho unokubona ngokucacileyo izinto ezikufutshane, kodwa kude izinto zikhangeleka zimfiliba. Abantu abane-myopia banobunzima ekuboneni izinto ngokucacileyo ngelixa bebukele umabonwakude okanye beqhuba ngokufuthi bebangela umbono ophuthileyo [5] .
• I-Presbyopia -Ukukhubazeka kombono okunxulumene nobudala okwenza ukuba kube nzima ukugxila kwizinto ezikufuphi, kubangele umbono ocacileyo.
• Hyperopia (ukubona kude) -Yenye imeko yamehlo aqhelekileyo, apho unokubona izinto ezikude ngokucacileyo, kodwa izinto ezikufutshane zikhangeleka zimfiliba.
• Cataract -Yindawo enamafu egubungela ilensi ecacileyo yamehlo. Ngokwesiqhelo, ilensi (ebekwe ngasemva kwe-iris) ijonge ukukhanya kwi-retina, ehambisa umfanekiso ngokusebenzisa imithambo-luvo yengqondo iye kwingqondo. Kodwa, ukuba iilensi zigutyungelwe yikati, iphazamisa ukukhanya okufikelela kwi-retina ngasemva kweliso, kukhokelela kukungaboni kakuhle okanye ukungaboni kakuhle [6] .
• Ukudodobala okuhambelana nobudala be-macular Esi sifo sichaphazela i-macula, ebekwe kufutshane neziko le-retina ejongene nombono obukhali ophakathi. Xa ukonakala okuhambelana nobudala be-macular kuya phambili, umbono ophakathi uyawohloka ubangela ukufiphala kunye nelahleko yombono [7] . Ukomelela okuhambelana nobudala be-macular kuxa ukulahleka kombono kuqhubeka kancinci kwaye imeko emanzi enxulumene nobudala be-macular yindlela ekhawulezileyo kunye nethonya lokulahleka kombono.
• Iglaucoma -Iqela lezimo zamehlo ezonakalisa imithambo-luvo ye-optic. Uphononongo lwenziwe kwizigulana ezingama-99 zafunyaniswa zineentlobo ezahlukeneyo kunye namanqanaba eglaucoma. Bazalise iphepha lemibuzo elibonise ukuba zonke izigulana, kubandakanya nezigulana ezinesifo esikhawulezileyo okanye esikumgangatho ophakathi ezinamava zidinga ukukhanya ngakumbi kunye nombono ongacacanga, oxelwe njengezona mpawu zixhaphakileyo [8] .
• Iritis -Iritis, ekwabizwa ngokuba yi-acute anterior uveitis, kukudumba kwe-iris (inqaku elinombala wamehlo) kwaye ichaphazela nomphambili weliso phakathi kwe-cornea kunye ne-iris (igumbi langaphakathi). Isifo esinganyangekiyo kunye nesokubonakala emva kwexesha kubangela iimpawu ezinje ngombono ophazamisekileyo [9] .
• I-Retinal detachment -Yenzeka xa i-retina yakho ikhala kude nelihlo lakho kwaye kuncitshisiwe ekunikezelweni kwegazi. Ngokophando olupapashwe kwiJenali yeLiso lezeMpilo yoLuntu, iimpawu eziqhelekileyo zokubanjwa kwethina kukubona okungacacanga okanye ngequbuliso, ukuphulukana nentlungu ngaphandle kwamehlo kwiliso elichaphazelekayo. Ezinye izigulana ezinamathambo e-retinal ekhethekileyo ziya kufumana ilahleko kumhlaba (ukulahleka kombono kwelinye icandelo lendawo ebonakalayo) [10] .
• Ukuvaleka kwe-vein vein - Sisifo sesibini esiqhelekileyo semithambo yegazi esibangela ukulahleka kombono kwizigulana ezindala. Zimbini iintlobo ze-retinal vein occlusion: isebe le-retinal vein occlusion (i-BRVO) kunye ne-central retinal vein occlusion (CRVO). Izigulana ezine-retinal vein occlusion zihlala zihlala zinombono ongacacanga kwiliso elinye elenzeka ngesiquphe, elingenabuhlungu [Shumi elinanye] .
• IHyphema -Ibonakaliswa kukuqokelelwa kwedama elikhulu legazi kwigumbi elingaphandle elenzeka emva kokugcina ukwenzakala kwiliso. Izigulana zifumana ukwehla ngesiquphe okanye ukulahleka kombono. Ukulahleka kombono kuxhomekeke kwinqanaba lezigulana ze-hyphema microhyphema ezinokuba nombono oqhelekileyo okanye umbono ophuthileyo (ukudityaniswa kwegazi kunokuthintela ukukhanya ukuba kungafiki kwi-retina ebangela umbono omfiliba ngamanye amaxesha) kwaye abaguli abane-hyphema epheleleyo banokuphantse babe nelahleko yombono [12] .
• Isifo seswekile -Abantu abanesifo seswekile banokufumana utshintsho kumbono wabo. Izifundo zibonise ukuba abaguli abanesifo seswekile bahlala benempawu zokungaboni kakuhle ngexesha le-hyperglycemia (amanqanaba eswekile egazi), enokuba sisiphumo sokutshintsha okwethutyana ngenxa yenguqu kwelensi okanye kwiretina [13] .
• Ukubetha -Emva kokubetha, iingxaki zombono zixhaphakile kwaye iimpawu zibandakanya ukungaboni kakuhle phakathi kwabanye. Isifundo senziwe kwizigulana ezingama-915 ezineminyaka engama-69 ubudala. Kuzo izigulana ezingama-479 zazinokulahleka kwentsimi ebonakalayo, izigulana ezingama-51 azinazo iimpawu ezibonakalayo, isiqingatha sezigulana ezinesifo sasinokulahleka kokubonakalayo kuphela kwaye esinye isiqingatha sinamava umbono ophuthileyo, ubunzima ekufundeni, kwidiploma, kunye nobunzima bokuqonda [14] .
• Ithumba lobuchopho Kukukhula kweeseli ezingaqhelekanga kwingqondo. Umbono ongacacanga luphawu oluqhelekileyo lwethumba lobuchopho.
• Isifo sokugubhuka - Sisifo esihlasela inkqubo ye-nervous system echaphazela imithambo-luvo ye-optic, ingqondo kunye nomqolo. Phantse ikota enye yezigulana ezine-multiple sclerosis ezifunyenwe zine-unilateral okanye i-INO yamazwe amabini (ukungahambi kakuhle kwamehlo) zihlala zinombono ongacacanga kunye nezinye iimpawu [Shumi elinantlanu] .
• IMyasthenia gravis - Sisifo esinganyangekiyo se-neuromuscular esibangela ubuthathaka bemisipha ebusweni nasemehlweni. I-Ocular myasthenia gravis ichaphazela izihlunu zamehlo kunye neenkophe, zibangela iimpawu eziqhelekileyo ezinje ngombono wokungaboni kakuhle kunye nokujongeka kweenkophe.
• Ukujonga kwakhona isifo seswekile -Ingxaki yeswekile echaphazela amehlo. I-retinopathy yeswekile ivela xa kukho umonakalo kwimithambo yegazi kwiretina. Iimpawu kukungaboni kakuhle, ukungaboni kakuhle ebusuku kunye nokuphazamiseka kombono phakathi kwabanye.
• Migraine -Imigraine sisifo esixhaphakileyo sentloko esibangela ukuba iintlungu ezibukhali ezinokuza kuqala okanye zihambisane neempawu ezibonakalayo ezahlukeneyo. Iingxaki zombono ezibangelwa yimigraine zinokuvela ekungacacini okanye umbono wenkungu, ukulahleka kombono kwelinye okanye omabini amehlo kunye nokuzingisa kwemifanekiso [16] .
• Lingonakali -Ukuhlanjululwa kwe-Corneal kwenzeka xa izinto ezincinci zingena kwiliso lakho kwaye zinokubangela umonakalo kumphezulu we-cornea. I-cornea inemisonto emininzi yemithambo-luvo, ethe-ethe kukuthintela nokwenzakala, ke xa into yelinye ilizwe enjengokhozo lwesanti okanye isinambuzane esincinci ingena elisweni lakho, iqala ukunkcenkceshela kwaye ibuhlungu. Ngenxa yoko, uya kuqala ukufumana umbono ongacacanga kunye novakalelo ekukhanyeni [17] .
• Ukudibana komzimba - Isigulo esihlangeneyo (conjunctivitis) siziindidi ezintathu: ukuqaqamba, amaxesha athile kunye nokuhlala ixesha elide. Izifo ezosulelayo okanye i-GPC (i-papillary conjunctivitis enkulu), i-hay fever conjunctivitis yonyaka okanye uhlobo lwe-vernal kunye neefom ezingapheliyo. Iimpawu ze-conjunctivitis yexesha eliqhelekileyo zihlala zingaboni kakuhle, iintlungu, njlnjl. [18] .
• Uxinzelelo lwamehlo kwidijithali (umbono wekhompyuter syndrome) -Ngokuka-American Optometric Association, uxinzelelo lwamehlo kwidijithali lubangela iingxaki ezininzi ezinxulumene neliso kunye nemibono kwaye ixhaphake kakhulu kubantu abasebenzisa iselfowuni, ikhompyuter kunye nethebhulethi ixesha elide. Olunye lweempawu eziqhelekileyo zamehlo edijithali kukubona okungacacanga.
• I-keratitis yebacteria Sisifo se-cornea esibangelwa ziintsholongwane ezinjenge S. aureus, coagulase-negative staphylococci, S. pneumoniae kunye ne pseudomonas aeruginosa. I-Pseudomonas aeruginosa lolona hlobo luqhelekileyo lweebhaktiriya ezichaphazela abaphethe iilensi zonxibelelwano. Izigulana ezine-bacterial keratitis zihlala zineempawu ezinje ngombono ophuthileyo, ifotophobiya kunye nentlungu [19] .
• Amayeza -Amayeza athile anokuba neziphumo ezibi kwiliso kwaye abangele umbono o-blurry. Ukusetyenziswa gwenxa kweziyobisi kwi-erectile kubonisiwe ukuba kwenza umbono ongacacanga kunye nokwanda kokuziva ukukhanya [Amashumi amabini] . Amachiza-non-steroidal anti-inflammatory njenge-indomethacin xa isetyenziswe ixesha elide inokubangela umbono ophuthileyo [amashumi amabini ananye] . Kwaye i-chloroquine, ichiza elichasene ne-malaria linokubangela ukungaboni kakuhle.
Iimpawu zoMbono oMfiliba
Kuxhomekeka kwisizathu, umbono ophuthileyo unokuhamba okanye ungahambi nezinye iimpawu, ezi zibandakanya:
• Ubuntununtunu bokukhanya
• Intlungu yamehlo
• Iindawo zokudada okanye amabala phambi kwamehlo akho
• Ukudinwa kwamehlo nokudinwa
• Ububomvu
• Umbono ombaxa
• Ukuma nokuba buhlungu kwamehlo
• Ukukhutshwa kwamehlo
• Iimpawu zomothuko emehlweni
• Intloko ebuhlungu kunye nesicaphucaphu
• Ukurhawuzelela
• Umfundi omhlophe
Xa ufuna ukubona ugqirha
Kuya kufuneka ukhawuleze ufune unyango ukuba unombono ongacacanga kwaye unazo naziphi na ezi mpawu kulandela umbono ongacacanga, njengentloko ebukhali, ubunzima ekuthetheni, ingxaki ekuboneni, ukugoba kobuso, ukungabikho kolungelelwaniso kunye nobuthathaka ebusweni, emlenzeni okanye izihlunu zengalo.
Ukuchongwa kombono ongacacanga
Ugqirha uyakuchonga unobangela wombono omfiliba ngokubuza imibuzo enje 'Uqale nini ukuba nombono omfiliba?', 'Zeziphi ezinye iimpawu onazo ngombono omfiliba?' kunye neminye imibuzo efana nokubuza malunga nembali yakho yezonyango kunye nembali yosapho yeemeko zamehlo. Oku kuyakumnceda ugqirha ukuba aqonde eyona nto isigulana siyivayo kuba uninzi lwezigulana lunokuchaza umbono omfiliba njengokulahleka kwinyathelo okanye ukungakwazi ukubona ngokucacileyo okanye ukufunda incwadi.
Ugqirha unokuqhubeka nokuvavanya uvavanyo lwe-acuity, uvavanyo lwamehlo olujonga ukuba ungazibona njani iinkcukacha zeleta okanye isimboli kumgama othile. Ngokufanelekileyo, uvavanyo lwe-acuity lwenziwa ngokusetyenziswa kwetshathi ejwayelekile eprintiweyo yeSnellen kunye nesigulana esime iinyawo ezingama-20 (iimitha ezintandathu) kude okanye usebenzisa itshathi yamehlo ebanjwe malunga neesentimitha ezingama-35. Iliso ngalinye liyavavanywa ngelixa elinye iliso ligutyungelwe yinto eqinileyo. Ukuba isigulana sinxibe iimbonakalo zemigangatho kufuneka sinxibe ngexesha lovavanyo. Kwizigulana ezingaphezulu kweminyaka engama-40 enxibe izinto ezibonakalayo, itshathi yamehlo kufuneka isetyenziswe kwii-intshi ezili-14.
Emva koko, isigulana sicelwa ukuba sifunde oonobumba abancinci nabakhulu kwitshathi yamehlo. Ukuba isiguli asikwazi kufunda bonke oonobumba nkqu nakumgama okufutshane, umvavanyi ubuza isigulana ukuba senze ukubala ngomnwe ukubona ukuba isigulana singazibala ngokuchanekileyo. Ukuba ukubala ngomnwe akunakwenzeka, umvavanyi uvavanya ukuba ingaba isigulana siyazibona na iziphakamiso zesandla. Ukuba oku akusebenzi, ukukhanya kukhanyisiwe emehlweni ukubona ukuba isigulana siyakubona na ukukhanya.
Ukuba isiguli asinazo iiglasi, isiphawuli sibanjwa kufutshane nelihlo, eyindlela efanelekileyo yokufumanisa iimpazamo zokuphikisa.
Kwizigulana ezincinci, ezinomceli mngeni okanye ezingafundanga, itshathi yeSnellen isetyenziswa ngemifanekiso okanye ezinye iisimboli kuyo [22] .
Olunye uvavanyo lwamehlo olufana nokuhlolwa kwesibane kunye ne-ophthalmoscopy lwenziwe.
Uviwo lwesibane esisikiweyo lwenziwa ngokusebenzisa imicroscope enokukhanya okuqaqambileyo. Ugqirha wamehlo uza kuqala abahlaziye abafundi bakho ngamachaphaza athambileyo. Kwaye emva koko ugqirha uya kujonga ngakumbi kwizakhiwo ezahlukeneyo ngaphambili nangaphakathi kwamehlo akho. Kuya kunceda ekufumaniseni oyena nobangela wombono ophuthileyo.
Ophthalmoscopy lolunye uvavanyo lwamehlo olwenziwa ngokusebenzisa i-ophthalmoscope ukujonga ngasemva kwamehlo akho. Ngayo ugqirha ujonga iretina, imithambo-luvo kunye nemithambo yegazi. Olu vavanyo lwamehlo lunceda ugqirha ukukhangela izifo kunye nezinye iingxaki zamehlo.
Unyango lombono ongacacanga
Kuxhomekeke kwisizathu sokungaboni kakuhle, unyango lwenziwe. Sibhale phantsi ezimbalwa:
• I-Astigmatism Uvavanyo olubanzi lwamehlo lunokunceda ukufumanisa i-astigmatism kwaye lunokunyangwa ngoncedo lweglasi yamehlo, iilensi zonxibelelwano, i-orthokeratology kunye notyando lwe-laser.
• Ukudodobala okuhambelana nobudala be-macular -Uvavanyo olugqityiweyo lweliso kunye nolunye uvavanyo lokuqonda kuya kunceda ekufumaniseni ukonakala okuhambelana nobudala be-macular. Unyango lokwehla kobudala obomileyo obunxulumene nobudala kubandakanya unyango lokondla kunye nezongezo kunye nokwehla okumanzi okunxulumene nobudala be-macular kubandakanya i-anti-VEGF (vascular endothelial growth factor).
• Iglaucoma -Uvavanyo lwamehlo olunzulu lwenziwa ukufumanisa i-glaucoma. Unyango lwamehlo lusetyenziselwa unyango lwe-glaucoma.
• Ukubetha - Kuxhomekeka kuhlobo lwesifo, unyango lwenziwe.
• Migraine -Amayeza kunye neendlela ezithile zasekhaya zinokuzisa isiqabu kwintloko ebuhlungu ye-migraine.
• Cataract -Uvavanyo olupheleleyo lwamehlo lwenziwa ukufumanisa isifo samehlo. Kwaye iliso lisuswe ngophawu lwamehlo.
• Seswekile -Kuxhomekeke kuhlobo lwesifo seswekile unyango lwenziwe kwaye oku kubandakanya ukutya okusempilweni, ukujonga iswekile yegazi, ukuzivocavoca umzimba, i-insulin kunye namayeza omlomo.
• Lingonakali - Amaconsi wamehlo okanye ioyile inokunceda ukunyanga ukubola kwe-corneal.
Uthintelo loMbono oMfiliba
• Yiya kuhlolwa rhoqo ngamehlo
• Nxiba izibuko zelanga ukukhusela amehlo akho kwimitha ye-UV.
• Yitya ukutya okunotye ivithamin C, ivithamin E, beta-carotene, zinc, lutein, zeaxanthin kunye ne-omega 3 fatty acids njengoko ezi zondlo zinciphisa umngcipheko wezifo zamehlo ezinxulumene nobudala. [2. 3] .
• Sebenzisa izikhuselo zamehlo xa usenza umsebenzi oyingozi.
• Kuphephe ukuchitha iiyure ezininzi kwiikhompyutha, iipilisi okanye iiselfowuni.
• Yeka ukutshaya [24]
• Lawula amanqanaba eswekile yegazi lakho.
Ii-FAQ eziqhelekileyo
Q. Yintoni enokubangela ukungaboni kakuhle?
UKUYA . Ukufunyanwa kwe-Retinal, ukubetha, ukonakala kwe-macular kunye nokulimala kwamehlo zezona zinto zibangela imbono engalindelekanga.
Q. Ngaba umbono opholileyo ngequbuliso ungxamisekileyo?
UKUYA. Funa unyango ngokukhawuleza, ukuba ufumana ilahleko ngequbuliso kwimbono ebukhali.
Q. Ngaba umbono ongacacanga angahamba?
UKUYA. Umbono omdaka okwexeshana ungahamba ngoncedo lweglasi yamehlo, nangona kunjalo, ukuba luphawu lwemeko engaphantsi qhagamshelana nogqirha wakho.
Q. Ngaba umbono omfiliba luphawu lokwehla emzimbeni?
UKUYA. Ukuphelelwa ngamanzi emzimbeni kubangela uxinzelelo lwamehlo olunokubangela iimpawu ezinje ngombono wokungaboni kakuhle.
Q. Ngaba ukungalali kungabangela umbono ophuthileyo?
UKUYA. Ukungalali ngokwaneleyo kunokubangela amehlo owomileyo kwaye oku kunokubangela ukukhanya kobuntununtunu, iintlungu okanye ukungaboni kakuhle.
Q. Ngaba iifowuni zinokubangela ukungaboni kakuhle?
UKUYA. Ewe, iifowuni kunye nezinye izixhobo ze-elektroniki zinokubangela ukungaboni kakuhle.
Q. Kutheni umbono wam ngequbuliso usibekele kwiliso elinye?
UKUYA. Umbono onamafu uhlala uluphawu lwamehlo, imeko yamehlo ebangela indawo enamafu kwilensi yamehlo.
Umbuzo: Ngaba ixesha elininzi kakhulu lesikrini linokwenza amehlo angaboni kakuhle?
UKUYA. Ewe, ixesha elininzi lesikrini linokwenza amehlo akho afiphale.
Q. Ndingawamisa njani amehlo am angabi mfiliba?
UKUYA. Qinisekisa ukuba awukhathazi amehlo akho kakhulu, ufumana ukulala okuninzi, usele amanzi amaninzi kwaye utye ukutya okuya kunceda ukugcina amehlo akho esempilweni.
USneha KrishnanAmayeza ngokubanziMBBS Yazi ngakumbi
