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Funda kabanzi lapha

Umbono ophansi

By UBill W, MD

Umthombo wesithombe: faculty.washington.edu/chudler/armd.html

Ini? Ukubona okuphansi, ngezinye izikhathi okwaziwa ngokuthi ukukhubazeka kokubona, into engizinikele ngayo ukuze ngibhale iposi lebhulogi ngayo. Njengodokotela wokunakekela oyinhloko, ngiyavuma izithakazelo zami zazivame ukuhambisana nesigaba sempilo engangikuso.

Manje njengoba ngingena esigabeni “esiphezulu” sempilo, nikuqagele; izimo noma izifo ezithinta iminyaka yami ngiyazinaka.

Inyanga Yokuqwashisa Ngombono Ophansi/Inyanga Yokuqwashisa Ngokuwohloka Kwe-macular ehlobene nobudala i igcinwa minyaka yonke ngoFebhuwari. Yinyanga yokuqwashisa eqondiswe ekusabalaliseni ulwazi olwengeziwe mayelana ne-Age-related macular degeneration (AMD) kanye nezifo ezithinta amehlo ezingaholela ekulimaleni kokubona.

Ziyini izinombolo?

Isilinganiso esihle kakhulu ukuthi kunabantu abayizigidi eziyi-196 emhlabeni jikelele abane-AMD. Kubonakala sengathi labo abaneminyaka engaphezu kuka-50 yibona abasengozini enkulu. Eqinisweni, i-AMD iyimbangela engu-No. 1 yokulahlekelwa ukubona kulabo abaneminyaka engaphezu kwengama-50. Kukhona “izinhlobo” ezimbili ze-AMD, kodwa sizofika kulokho ngokushesha. Amaphesenti ayishumi nantathu abantu abangaphezu kweminyaka engama-85 banalesi simo. Kuvame kakhulu kubantu bokhokho base-Europe abamhlophe futhi abesifazane bathinteka kakhulu kunabesilisa. Yimbangela ehamba phambili yokukhubazeka kokubona kanye nokulahlekelwa ukubona emazweni athuthukile.

Ziyini izimpawu?

Okuvame kakhulu yilezi:

  • Izinto zibukeka zilufifi phakathi kokuthile.
  • Kuya ngokuya kuba nzima ukufunda noma ukwenza eminye imisebenzi emihle ekukhanyeni okuphansi.
  • Uvame ukubona imigqa eqondile njenge-wavy.
  • Kungase kube nezindawo ezingenalutho endaweni yakho yokubuka emaphakathi.
  • Izimpawu ziyehluka kuye ngokuthi hlobo luni lwe-AMD onalo:
  • Abantu abane I-AMD eyomile (85-90%)balahlekelwa ukubona kancane kancane. Bangase babone inkinga yeso elilodwa noma womabili lapho befunda noma beshayela. Noma bangase babone ukuthi manje sebedinga izibani ezikhanyayo noma ingilazi yokukhulisa izinto ukuze babone kahle njengakuqala. Abantu abane-AMD eyomile kwesinye isikhathi babuye babone izindawo ezibonakala zilufifi.
  • Abantu abane i-AMD emanzi (10-15%)kungaba nezinguquko kungazelelwe embonweni. Lapho beqala ukuqaphela izimpawu, bangase babe nezinkinga esweni elilodwa kuphela. (Kamuva, womabili amehlo avamise ukuba nezinkinga.) Uma abantu abane-AMD emanzi bebheka imigqa eqondile, imigqa ibukeka igobile noma i-wavy.
  • Lesi simo sihlotshaniswa nokuwa noma ukulimala njalo.

Uma ukhathazekile futhi ucabanga ukuthi ungase ube ne-AMD

  • Ukuhlola kwakho kokuqala kuzobandakanya imibuzo emayelana nezinto ezibonakala zinemimo ehlanekezelwe, ukubona okunciphile, ukukhanya okubenyezelayo noma okuntantayo embonweni, indawo eyimpumputhe, nobunzima bokujwayela ubumnyama. Uzobuzwa ngezinkinga zamehlo ezedlule; umlando womndeni wezifo zamehlo; umlando wezidakamizwa, okuhlanganisa ukusetshenziswa kwe-aspirin kanye ne-antioxidant; kanye nomlando wezenhlalo, kuhlanganise nomlando wokubhema.
  • Kufanele uhlolwe amehlo nge-ophthalmologist.
  • Uma une-AMD yangaphambi kwesikhathi, kungenzeka welulekwe ukuthi uzihlole ngokwakho umbono wakho ngegridi ye-Amsler (bona ngezansi ukuze uthole izibonelo ezijwayelekile nezingajwayelekile).
  • Uma ubhema...YEKA! Ukubhema kuyisici esinamandla esingaguquleka kalula. Umfutho wegazi ophakeme kanye nama-lipid aphezulu nawo ahlotshaniswa ne-AMD. Nokho, abukho ubufakazi bokuthi ukusetshenziswa kwama-“statins” (imithi yokwehlisa i-cholesterol) kunomthelela.
  • Ezinye izici okufanele zicatshangelwe zihlanganisa ukwanda kokudla okunothe nge-omega-3. Lokhu kufaka phakathi amantongomane, izinhlanzi ezinjenge-tuna, i-salmon, i-mackerel, noma ezinye.
  • Ukusetshenziswa okungaguquki kokuvikela iso ezimweni zokukhanya okuphezulu. (Gcina izibuko zakho zelanga ziseduze!)
  • Inani elikhulayo lobufakazi liphakamisa ukuthi abantu abane-AMD nabo basengozini yezifo zesistimu ezifana nohlangothi. Udokotela wakho oyinhloko uzofuna ukuqapha isimo sakho sezempilo esiphelele.

Ukwelashwa

Akukho ukwelashwa okutholakalayo kwe-AMD eyomile, noma engeyona i-neovascular. Iziguli ezine-AMD eyomile kufanele zinikezwe ukwesekwa; welulekwa mayelana nokuguqulwa kwendlela yokuphila, ukuyeka ukubhema, kanye ne-antioxidant supplementation; futhi iqashwe njalo.

Ucwaningo Lwezifo Zamehlo Ezihlobene Nobudala (AREDS) lwathola ukuthi umthamo omkhulu wevithamini oral antioxidant (okungukuthi, amavithamini C no-E, i-beta carotene) kanye nokufakwa kwe-zinc kwehlisa ukuqhubeka kwe-AMD emaphakathi noma ethuthukisiwe cishe ngama-25%. Ngakho-ke, ubufakazi busekela ukusetshenziswa kwe-antioxidant vitamin kanye nezithako zamaminerali ezisekela ukusebenza kwe-ocular, njengalezo ezifundwe ku-AREDS, ukubambezela ukulahleka kombono ezigulini ezine-AMD.

I-Vitamin E, i-beta carotene, i-vitamin C, kanye nezithako zamavithamini amaningi akuboniswanga ukuvimbela noma ukubambezela ukuthuthukiswa kwe-AMD.

Iziguli ezine-AMD emanzi, noma ezine-neovascular, kufanele zidluliselwe kudokotela wamehlo ukuze ziphathwe. Ukwelashwa komugqa wokuqala yisidakamizwa esilwa ne-VEGF. Lona umuthi ovimbela ukukhula emithanjeni yegazi. Lesi sidakamizwa silawulwa ngomjovo ngqo esweni njalo ngenyanga noma njalo ezinyangeni ezintathu. Le mithi ikhetha ukucekela phansi imithambo yegazi ekhula ngendlela engavamile ngemuva kweso. Lokhu kungaholela ekuboneni okuthuthukisiwe kweziguli ezine-AMD ye-neovascular. Kunabantu abaqala ngokuwohloka kwe-macular ezomile bese beba nohlobo olumanzi.

Ekugcineni

Ukuvuselelwa kombono (evame ukubizwa ukulungiswa kombono) igama elisetshenziswa elisho ukuvuselelwa ukuze kuthuthukiswe ukubona lapho kukhona ukungaboni kahle. Ngamanye amazwi, kuyinqubo yokubuyisela ikhono lokusebenza kanye nokwenza ngcono izinga lempilo nokuzimela kumuntu olahlekelwe umsebenzi wokubona ngenxa yokugula noma ukulimala. Okugxilwe kakhulu kulokho kukhubazeka okungakwazi ukuzuza ngezibuko zamehlo, i-contact lens, imithi, noma ukuhlinzwa. Kugxilwe ekusizeni abantu benze imisebenzi yansuku zonke. I-Vision rehab itholakale iwusizo kakhulu ekusizeni abantu balondoloze ukuzimela kwabo.

 

Resources

macular.org

uptodate.com/contents/age-related-macular-degeneration-the-basics?search=age related macular degeneration&source=search_result&selectedTitle=1~72&usage_type=default&display_rank=1

en.wikipedia.org/wiki/Vision_rehabilitation

aafp.org/pubs/fpe/editions/519-adult-eye-conditions/diabetic-retinopathy-and-age-related-macular-degeneration.html

Cheung CMG, Wong TY. Ingabe ukuwohloka kwe-macular okuhlobene neminyaka kuwukubonakaliswa kwesifo sesistimu? Amathemba amasha okungenelela kusenesikhathi nokwelashwa. J Intern Med. 2014;276(2):140-153

amslergrid.org/AmslerGrid.pdf