E ai ki tētahi pūrongo rangahau a te World Health Organization, i eke te tokomaha o ngā tūroro myopia i Haina ki te 600 miriona i te tau 2018, ā, ko te reiti myopia i waenga i ngā taiohi te tuatahi o te ao. Kua riro a Haina hei whenua myopia nui rawa atu o te ao. E ai ki ngā raraunga tatauranga o te tau 2021, ko te reiti myopia te haurua o te taupori o te whenua. Nā te nui o te hunga myopia, he mea tino nui te whakatairanga pūtaiao i ngā mātauranga ngaio e pā ana ki te myopia.
Te tikanga o te myopia
Kāore anō kia mārama te pūtake tuturu o te myopia. Ki te kī māmā noa, kāore mātou e mōhio he aha i puta ai te myopia.
Ngā āhuatanga e pā ana ki te myopia
E ai ki ngā rangahau hauora me ngā rangahau tirohanga, he maha ngā āhuatanga pēnei i te ira me te taiao e pāngia ai te putanga mai o te myopia, ā, tērā pea e pā ana ki ēnei āhuatanga e whai ake nei.
1. He āhua ira tō te myopia. I te mea kei te hohonu haere ngā rangahau mō ngā āhuatanga ira o te myopia, inā koa he hītori whānau tō te myopia pathological, kua whakaūtia i tēnei wā ko te myopia pathological he mate ira kotahi, ā, ko te mea tino noa ko te tukunga iho autosomal recessive. I tēnei wā, he maha ngā āhuatanga tuku iho o te myopia māmā, ā, he nui te pānga o ngā āhuatanga kua riro mai.
2. Mō ngā āhuatanga taiao, ko ngā āhuatanga pēnei i te pānui tata roa, te korenga o te māramatanga, te roa rawa o te wā pānui, te tuhituhi kore mārama, te iti rawa rānei o te tuhituhi, te tū noho kino, te kore kai pai, te whakaiti i ngā mahi o waho, me te pikinga o te taumata mātauranga, tera pea e pā ana ki te whanaketanga o te myopia. He mea e pā ana ki te putanga mai o te mate.
Ngā rerekētanga whakarōpūtanga o te myopia
He maha ngā whakarōpūtanga o te myopia, nā te mea ko te pūtake o te tīmatanga, te pūtake o ngā rerekētanga tirohanga, te nui o te myopia, te roa o te myopia, te pumau, me te whai wāhi o te whakatikatika ka taea katoa te whakamahi hei paearu whakarōpū.
1. E ai ki te nui o te myopia:
Te iti o te matapōkere:iti iho i te 300 nekehanga (≤-3.00 D).
Te matapōkere iti:300 nekehanga ki te 600 nekehanga (-3.00 D~-6.00 D).
Te matapōkere:neke atu i te 600 nekehanga (>-6.00 D) (e kiia ana hoki ko te myopia pathological)
2. E ai ki te hanganga whakaata (pūtake tika):
(1) Te matapōkere o te tirohanga,Ko te myopia tēnei e hua mai ana i te pikinga ake o te kaha whakaata o te karu kanohi nā ngā wāhanga whakaata rerekē o te karu kanohi, nā te huinga rerekē rānei o ngā wāhanga i te mea he noa te roa tuaka o te kanohi. Ka taea e tēnei momo myopia te noho rangitahi, te noho pumau rānei.
Ka taea te wehewehe i te myopia whanoke ki te myopia piko me te myopia taupū whanoke. Ko te tuatahi ka puta mai i te piko rawa o te cornea, te arotahi rānei, pērā i ngā tūroro he keratoconus, he arotahi porowhita, he arotahi iti rānei; ko te tuarua ka puta mai i te nui rawa o te taupū whanoke o te wai me te arotahi, pērā i te katarata tuatahi, ngā tūroro mumura o te iris-ciliary body.
(2) Te matapōkere tuaka:Kua wehea anō hoki ki te myopia axial kore-kirihou me te myopia axial kirihou. Ko te myopia axial kore-kirihou ko te mana whakaata o te kanohi he noa, engari ko te roa o te tuaka o mua me muri o te karu kanohi ka nui ake i te awhe noa. Ko ia pikinga 1mm i te tuaka o te karu kanohi he rite ki te pikinga o te 300 nekehanga o te myopia. I te nuinga o te wā, ko te diopter o te axial myopia he iti iho i te 600 nekehanga o te myopia. I muri i te pikinga o te diopter o te axial myopia wāhanga ki te 600 nekehanga, ka piki tonu te roa axial o te kanohi. Ka taea e te diopter myopia te eke ki te neke atu i te 1000 nekehanga, ā, i ētahi wā ka eke ki te 2000 nekehanga. Ka kiia tēnei momo myopia ko te myopia teitei haere whakamua, ko te myopia kua whakarerekētia rānei.
He maha ngā huringa mate o ngā kanohi pērā i te myopia teitei, ā, kāore e taea te whakatika i te tirohanga kia pai. He hītori whānau tō tēnei momo myopia, ā, he hononga ira. Kei te mau tonu te tumanako mō te whakahaere me te whakaora i te tamarikitanga, engari kāore i te pakeke.
Ko te myopia axial kirihou e kiia ana ko te myopia pono kirihou. Ko ngā take, pēnei i te kore o ngā huaora me ngā matū iti i te wā tipu me te whanaketanga, ka taea te whakaputa i te myopia, tae atu ki te myopia i puta mai i te ophthalmia, i ngā mate tinana rānei. Ka wehea anō hoki ki te pseudomyopia rangitahi kirihou, te myopia waenga kirihou me te myopia axial kirihou.
(a) Te mate pōuri kirihou rangitahi:He poto ake te wā e puta ai tēnei momo myopia i te pseudomyopia rangitahi kirihou. Ka taea e tēnei momo myopia, pērā i te pseudomyopia rangitahi accommodative, te hoki ki te tirohanga noa i roto i te wā poto. Me rerekē ngā tikanga whakaora mō ngā momo myopia rerekē. Ngā āhuatanga o te pseudomyopia rangitahi kirihou: ina whakatikatikaina ngā āhuatanga, ka pai ake te tirohanga; ina puta mai ngā āhuatanga hou, ka hohonu haere te myopia. I te nuinga o te wā, he awhe kirihou mai i te 25 ki te 300 nekehanga.
(b) Te matapōkere kirihou waenga:Kāore te koi o te tirohanga e pai ake i muri i te whakatikatika i ngā āhuatanga, ā, kāore he myopia tūturu kirihou e toro atu ana i te tuaka tirohanga.
(c) Te matapo o te tuaka kirihou:Ina whanake te pseudomyopia kirihou i roto i te momo myopia axial ki te myopia pono kirihou, ka uaua ake te whakahoki mai i te tirohanga. Ka whakamahia te ratonga whakangungu whakaora myopia 1+1, ā, he puhoi te tere o te whakaora. He roa hoki te wā e hiahiatia ana.
(3) Te matapōkere pūhui:e noho tahi ana ngā momo tuatahi e rua o te myopia
3. Te whakarōpūtanga e ai ki te whanaketanga o te mate me ngā huringa mate
(1) Te matapōkere māmā:E mōhiotia ana ko te "juvenile myopia", he momo "myopia" noa. Kāore anō kia mārama ngā āhuatanga ira. Ko te nuinga o te wā e pā ana ki te kaha o te tirohanga i te wā o te taiohitanga me te whanaketanga. I te pakeketanga me te whanaketanga tinana, i tētahi tau, ka pumau tonu. Ko te nui o te "myopia" he iti, he taurite rānei, he puhoi te whanaketanga o te "myopia", ā, he pai te tirohanga kua whakatikatikaina.
(3) Te matapōkere mate pāwera:E mōhiotia ana ko te myopia ahu whakamua, he maha ngā āhuatanga ira. Ka hohonu haere te myopia, ka tere haere te whanaketanga i te wā o te taiohinga, ā, kei te whanake tonu te karu ahakoa kua eke ki te 20 tau te pakeke. Ka tino ngoikore te mahi tirohanga, ka kitea mā te tawhiti iti iho i te tikanga me te tirohanga tata, me te tirohanga rerekē me te aro ki te rerekētanga o te tirohanga. Ka haere tahi me ngā raruraru pēnei i te pirau o te retina i te pou o muri o te kanohi, ngā ira myopic arc, te toto macular, me te posterior scleral staphyloma, ka hohonu haere te mate, ka whanake; he ngoikore te pānga whakatikatika tirohanga i ngā wāhanga whakamutunga.
4. Te whakarōpūtanga i runga i te mea he kaha whakatikatika kei roto.
(1) Te mate pōuri:E mōhiotia ana ko te myopia accommodative, ka puta mai i te mahi tata roa, te pikinga o te kawenga tirohanga, te kore e taea te whakangā, te taumahatanga accommodative, te spasm accommodative rānei. Ka taea e te myopia te ngaro mā te rongoā hei whakanui i ngā karu. Heoi, e whakaponohia whānuitia ana ko tēnei momo myopia te wāhanga tuatahi o te putanga mai me te whanaketanga o te myopia.
(2) Te tirohanga whānui tūturu:I muri i te whakamahinga o ngā rongoā cycloplegic me ētahi atu rongoā, kāore te nui o te myopia e heke iho, e iti iho rānei i te 0.50D te nui o te myopia.
(3) Te tirohanga whānui:e pā ana ki te diopter o te myopia kua heke i muri i te whakamahinga o ngā rongoā cycloplegic me ētahi atu maimoatanga, engari kāore anō kia whakahokia mai te āhua emmetropic.
Ko te myopia pono, teka rānei, ka tautuhia i runga i te whakatikatikanga o te tirohanga. Ka taea e ngā kanohi te whakatere i a rātou anō mai i ngā mea tawhiti ki ngā mea tata, ā, ko tēnei kaha whakatere e whakawhirinaki ana ki te mahi whakatikatika a ngā kanohi. Ko te mahi whakatikatika rerekē o ngā kanohi ka wehea anō ki: te pseudomyopia rangitahi urutau me te myopia pono urutau.
Ko te myopia rangitahi accommodative, ka pai ake te tirohanga i muri i te mydriasis, ā, ka pai ake te tirohanga i muri i te okiokinga o ngā kanohi mō tētahi wā. I roto i te myopia waenga accommodative, kāore e taea e te koi o te tirohanga i muri i te whakawhānui ake te tae ki te 5.0, he noa te tuaka o te kanohi, ā, kāore te taha o te karu e toro haere ana i te āhua tinana. Mā te whakanui ake i te tohu myopia tika ka taea ai te whakatutuki i te koi o te tirohanga ki te 5.0.
Te myopia tūturu e āhei ana te whakaora. E pā ana tēnei ki te korenga o te pseudomyopia e āhei te whakaora i roto i te wā. Ka roa te noho o tēnei āhuatanga, ā, ka whakaroahia te tuaka o te kanohi kia urutau ai ki tēnei taiao tirohanga tata.
I muri i te whakaroa o te roa tuaka o te kanohi, ka wātea ngā uaua ciliary o te kanohi, ā, ka hoki te kōpiko o te karu ki te āhua noa. Kua oti i te myopia tētahi tukanga whanaketanga hou. Ka whakaroahia ia roa tuaka o te kanohi mā te 1mm. Ka hohonu ake te myopia mā te 300 nekehanga. Ka puta te myopia tūturu e āhei ana te noho tahi. He rerekē tēnei momo myopia tūturu i te myopia tūturu tuaka. Ka taea hoki e tēnei momo myopia tūturu te whakaora i te tirohanga.
Tāpiritanga ki te whakarōpūtanga myopia
Me mōhio tātou i konei ehara te pseudomyopia i te "myopia" hauora nā te mea ka taea e tēnei "myopia" te noho i roto i te tangata, i roto i tētahi āhua tirohanga, i tētahi wā, ā, ka ngenge ngā kanohi. Ko te myopia e ngaro ana i muri i te whakawhanuitanga o ngā kamo ko te pseudomyopia, ā, ko te myopia e mau tonu ana ko te myopia tūturu.
Ka whakarōpūtia te myopia axial i runga i te take o ngā āhuatanga rerekē o ngā ara whakaata i roto i te kanohi.
Mena he emmetropic te kanohi, ka hurihia te mārama e ngā momo ara whakaata i roto i te kanohi ki te retina. Mō te hunga emmetropic, he ōrite te kaha whakaata katoa o ngā momo ara whakaata i roto i te kanohi me te tawhiti (tuaka kanohi) mai i te cornea i mua o te kanohi ki te retina i muri.
Mena he nui rawa te mana whakaata katoa, he roa rawa rānei te tawhiti, ka taka te mārama ki mua i te retina ina titiro tawhiti atu, koia tēnei te myopia. Ko te myopia i puta mai i te mana whakaata nui ko te myopia whakaata (nā ngā rerekētanga o te kornea, ngā rerekētanga o te karu, te katarata, te mate huka, me ētahi atu), me te myopia axial i puta mai i te roanga o te roa axial o te karu i tua atu i te āhua emmetropic (te momo myopia e pā ana ki te nuinga o te tangata).
He rerekē ngā wā ka pāngia te nuinga o te tangata e te myopia. Ko ētahi ka whānau mai me te myopia, ko ētahi ka myopia i te taiohinga, ā, ko ētahi ka myopia i te pakeketanga. E ai ki te wā o te myopia, ka taea te wehewehe ki te myopia whānau (ka whānau mai te myopia), te myopia tīmatanga wawe (kei raro i te 14 tau te pakeke), te myopia tīmatanga mutunga (16 ki te 18 tau te pakeke), me te myopia tīmatanga mutunga (i muri i te pakeketanga).
Kei reira anō hoki te pātai mēnā ka rerekē te diopter i muri i te whanaketanga o te myopia. Mēnā kāore te diopter e rerekē mō ngā tau e rua neke atu, kua pumau. Mēnā ka noho roa te diopter i roto i ngā tau e rua, kua piki haere te āhua.
Whakarāpopototanga o te whakarōpūtanga o te myopia
I roto i ngā mara o te rongoā kanohi me te tirotiro kanohi, he maha atu ngā whakarōpūtanga o te myopia, kāore mātou e whakauru atu i ēnei nā te mea he tohungatanga mōkito noa iho. He maha ngā whakarōpūtanga o te myopia, kāore e taupatupatu. E whakaata noa ana i te uaua me te koretake o te tikanga o te putanga mai me te whanaketanga o te myopia. Me whakaahua me te wehewehe i ngā momo kāwai o te myopia mai i ngā āhuatanga rerekē.
Ko te raruraru o te matapōkere o ia tangata o tātou e mate pōkere ana me noho hei peka o te kāwai matapōkere e rite ana. Kāore e kore he koretake te kōrero mō te ārai me te whakahaere i te matapōkere ahakoa te whakarōpūtanga o te matapōkere.
Wā tuku: Whiringa-ā-rangi 24-2023