Ke manaʻo nei anei kou mau maka i kēia ʻano? E kamaʻilio kākou e pili ana i ka Uveitis!

Ua ʻike anei ʻoe i nā maka ʻulaʻula, ʻeha, a me ka pohihihi iki? A i ʻole ua manaʻo paha ʻoe e lana ana nā mea i mua o kou mau maka? He mau hōʻailona kēia a mākou e nānā ʻole ai i kekahi manawa, akā hiki iā lākou ke lilo i mau hōʻailona o kekahi maʻi mumū ʻē aʻe i loko o ka maka. ʻO ia ke ʻano a mākou e kamaʻilio ai i kēia lā, i kapa ʻia ʻo uveitis. Hiki i kēia ke lilo i mea koʻikoʻi loa, no laila he mea nui e makaʻala iā ia.

He aha ka Uveitis? E hoʻomaopopo maʻalahi kākou!

I ka ʻōlelo maʻalahi, ʻo ka uveitis kahi mumū, a i ʻole ka pehu ʻana, o ka uvea, ka papa waena o ka maka. E noʻonoʻo iā ia e like me ke kāmela. He ʻāpana koʻikoʻi loa ka uvea o ke kāmela. I kekahi manawa, hiki ke idiopathic kēia mumū, ʻo ia hoʻi, hiki ke hana ʻia e kekahi mau kūlana i ʻike ʻia. Hiki i kēia kūlana ke hoʻopilikia i hoʻokahi wahi o ka maka , a i ʻole hiki ke hoʻopilikia i kekahi mau wahi. ʻOkoʻa nā hōʻailona ma muli o kahi i hoʻopilikia ʻia. Hiki iā ʻoe ke ʻike i ka ʻeha maka, ka ʻulaʻula, a i ʻole ka mumū. A i ʻole e hoʻopilikia ʻia kou ʻike. Hiki iā ia ke hoʻopilikia i hoʻokahi maka wale nō, a i ʻole nā ​​​​maka ʻelua i ka manawa hoʻokahi. I kēia manawa, e nānā, ʻaʻohe wahi nui no ka pehu ʻana i loko o ko mākou mau maka. No laila, ʻoiai kahi liʻiliʻi o ka pehu hiki ke hoʻololi i ke ʻano o loko o ka maka. Ua ʻike anei ʻoe he mea nui loa ke ʻano o loko o ka maka no kā mākou ʻike? No laila, ʻoiai kahi loli liʻiliʻi ma muli o kēia pehu hiki ke loaʻa ka hopena nui i ka ʻike.

I kekahi mau hihia koʻikoʻi, hiki i ka uveitis ke alakaʻi i ka nalowale mau o ka ʻike a i ʻole ka makapō. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.

Pehea ka maʻamau o ka Uveitis?

He ʻano maʻamau kēia. Ma ka honua holoʻokoʻa, ma kahi o 4 miliona mau hihia hou, a i ʻole ma kahi o 4 miliona mau kānaka, i ʻike ʻia me kēia maʻi i kēlā me kēia makahiki. ʻOiai ma kahi ʻāina e like me ʻAmelika Hui Pū ʻIa, ma waena o 80,000 a me 168,000 mau hihia i hōʻike ʻia i kēlā me kēia makahiki. ʻO kēia ka mea maʻamau i waena o nā pākeke. Hoʻonui ka pilikia o ka loaʻa ʻana o kēia ʻano me ka makahiki. He emi iki ka maʻamau i waena o nā keiki ʻōpio, me nā keiki e helu ana ma waena o 2% a me 20% o nā maʻi āpau.

He aha nā hōʻailona o ka uveitis?

ʻO nā hōʻailona o ka uveitis e pili maoli ana i ka ʻāpana o ka maka i hoʻopilikia ʻia e ka mumū. Hoʻokaʻawale nā ​​​​loea loea iā ia i ʻekolu mau ʻāpana nui: anterior, intermediate, a posterior. I kekahi manawa ua hoʻopilikia ʻia nā ʻāpana ʻekolu, a ua kapa ʻia kēia he panuveitis.

Nā Hōʻailona o ka Uveitis mua

ʻO kēia mau mea ʻekolu , ʻo ka uveitis mua ka mea maʻamau.Hoʻopilikia kēia i ka iris a me ke kino ciliary o ka maka. I ka manawa pinepine, hiki iā ʻoe a i ʻole nā ​​​​mea ʻē aʻe ke ʻike i nā hōʻailona. ʻO kēia mau hōʻailona:

• ʻEha maka: Hiki ke koʻikoʻi.
• ʻUlaʻula a wela paha o nā maka: Hiki i nā maka ke ʻulaʻula, maneʻo, a wela.
• ʻIke pōwehiwehi: He kūlana i hiki ʻole ai iā ʻoe ke ʻike maopopo.
• ʻIke i ka mālamalama (photophobia): Paʻakikī ke nānā aku i ka mālamalama, me he mea lā e polū ana nā maka.
• Ka pehu ʻana o ka membrane keʻokeʻo o ka maka (swollen conjunctiva).
• Nā loli i ke ʻano o ke apo ʻeleʻele: ʻO ke apo ʻeleʻele, ka mea poepoe pinepine, hiki ke lilo i ʻano ʻē.
• He hōʻiliʻili wai keʻokeʻo ma ke alo o ka maka (hypopyon) a i ʻole he apo keʻokeʻo a puni ka maka ʻeleʻele.

Nā ʻano o ka Uveitis Waena a me ka Uveitis Hope

I nā hihia o ka uveitis waena a me hope, ʻaʻole maʻalahi ka ʻike ʻana i nā hōʻailona iā ʻoe a i ʻole nā ​​​​mea ʻē aʻe. Akā, hoʻopilikia nui nā hōʻailona i kāu mea e ʻike ai a me ke ʻano o kou ʻike ʻana. Hiki i nā hōʻailona o kēia mau kūlana ke komo pū me:

• Hoʻonui ʻia ke ʻano o nā mea liʻiliʻi e lana ana i mua o nā maka ( nā mea lana a i ʻole myodesopsias), a i ʻole e ʻoi aku ko lākou ʻike ʻia ma mua o ka wā ma mua.
• Nā kīnā o ke kahua ʻike: ʻIke ʻole ʻia kekahi mau wahi o ka maka ke nānā ʻia mai ka maka i hoʻopilikia ʻia.
• Ka ʻike ʻana i emi iho .

He aha nā kumu o ka Uveitis?

Nui nā kumu hiki ke loaʻa i ka uveitis. ʻO ka mea kupanaha, ma 50% a 70% o nā hihia, ʻaʻole hiki i kahi kauka maka ke loaʻa i ke kumu. ʻO ia hoʻi, he kūlana "idiopathic" ia. Eia naʻe, ʻo nā kumu nui e hiki ke loaʻa:

• Nā maʻi
• Nā maʻi e hoʻopilikia i ke kino holoʻokoʻa (nā kumu ʻōnaehana)
• Nā ʻeha maka
• Kekahi mau lāʻau lapaʻau

1. Nā maʻi

ʻO ka maʻi ka wā e komo ai kekahi mea, e like me ka germ, i loko o ke kino a hōʻino. ʻO ka Uveitis i hoʻokumu ʻia e kahi maʻi e hoʻopilikia pinepine i hoʻokahi maka wale nō. Hiki ke hana ʻia e nā ʻano germs like ʻole:

• Nā maʻi: Nā maʻi e like me ka Herpes Simplex Virus (HSV), Varicella-Zoster Virus (VZV), ka mea e hoʻoulu ai i ka moa a me ka herpes zoster, a me Cytomegalovirus (CMV). Hiki ke hana ʻia e nā maʻi hiki ke pale ʻia me ka lāʻau lapaʻau e like me ka rubella.
• Bacteria:ʻO nā bacteria e hoʻoulu ai i nā maʻi e like me ka syphilis a me ka maʻi puʻupuʻu.
• Nā Fungi: Nā ʻōpala e like me Candida (ka mea e hoʻoulu ai i ka candidiasis) a me Aspergillus (ka mea e hoʻoulu ai i ka aspergillosis).
• Nā Parasites: Hiki ke laha kēia mau mea iā ʻoe mai nā holoholona, ​​ʻoi aku hoʻi nā pōpoki (toxoplasmosis, kahi i laha ʻia ma o nā ʻōpala pōpoki i loaʻa i ka maʻi) a me nā ʻīlio (toxocariasis). Hiki iā ʻoe ke loaʻa i kēia maʻi mai ka ʻai ʻana i ka puaʻa i moʻa ʻole ʻia (cysticercosis a i ʻole toxoplasmosis).

2. Nā kumu e hoʻopilikia ai i ke kino holoʻokoʻa (Nā kumu ʻōnaehana)

I kekahi manawa, ʻaʻole i hoʻokumu ʻia ka uveitis e kahi mea e hoʻopilikia wale i nā maka. Hiki ke lilo i hopena ʻaoʻao o ka lāʻau lapaʻau a i ʻole he hōʻailona o kahi maʻi e hoʻopilikia i ke kino holoʻokoʻa. I kēia hihia , hoʻopilikia pinepine ʻia nā maka ʻelua. Eia kekahi mau kūlana autoimmune a me ka mumū e pili ana me ka uveitis:

• ʻO ka maʻi ʻōpū mumū ( IBD )
• ʻO ka Sarcoidosis
• ʻO ka maʻi ʻo Behçet
• ʻO ka Lupus (Systemic Lupus Erythematosus - SLE)
• Tubulo-interstitial nephritis (TINU)

Hiki i nā kānaka me kahi hoʻololi DNA kikoʻī i kapa ʻia ʻo `HLA-B27` ke loaʻa i nā maʻi hono mumū e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka uveitis. ʻO nā hiʻohiʻona penei:

• ʻO ka ʻāʻī ʻōpiopio idiopathic
• ʻO ka Spondylitis Ankylosing
• ʻO ka ʻeha puʻupuʻu (Psoriatic Arthritis)
• ʻO ka Spondyloarthritis Axial
• ʻO ka ʻāʻī ʻōpū o loko
• ʻO ka ʻāʻī ʻeha (Arthritis Reactive)

3. Nā ʻeha

Hiki i kahi ʻeha maka ke hōʻino i nā ʻiʻo a me/a i ʻole nā ​​​​​​kīʻaha koko i loko o ka uvea. Ke loaʻa kahi ʻeha, hoʻohana kā mākou ʻōnaehana pale i kahi kaʻina hana i kapa ʻia ʻo ka mumū e ho'ōla iā ia. No kēia kumu , hiki ke loaʻa ka uveitis ma hope o ke ʻoki maka. ʻOiai nā loli liʻiliʻi i ke ʻano o loko o ka maka, e like me nā loli i hoʻokumu ʻia e ka mumū, hiki ke hana i nā hōʻailona o ka uveitis. ʻO ke koʻikoʻi o nā hōʻailona e pili ana i nā mea e like me ka wahi a me ke koʻikoʻi o ka ʻeha.

4. Nā lāʻau lapaʻau

Hiki ke piʻi aʻe ka pilikia o ka hoʻomohala ʻana i ka uveitis i ka wā e hoʻohana ai i kekahi mau lāʻau lapaʻau. ʻO kekahi mau laʻana:

• ʻO ke Cidofovir
• ʻO Rifabutin
• Nā Bisphosphonates
• Nā kulu maka Brimonidine
• Nā mea pale Tyrosine Kinase

He maʻi lele anei kēia?

ʻAʻole laha ka Uveitis mai ke kanaka a i ke kanaka. Eia nō naʻe, hiki ke laha kekahi mau maʻi (e like me nā virus, bacteria) ke kumu. Eia kekahi, hiki ke hana ʻia e nā maʻi i hiki ke laha mai nā holoholona a i nā kānaka (e like me ka toxoplasmosis), no laila pono ʻoe e makaʻala i kēlā.

He aha nā pilikia e hiki ke loaʻa mai ka Uveitis?

ʻO ka pilikia nui a weliweli loa o ka uveitis ka nalowale o ka ʻike a me ka makapō. Hoʻololi kēia ʻano i loko o ka maka, a ʻo kēlā mau loli ke kumu o nā pilikia. ʻO kekahi o kēia mau loli:

• Nā Cataracts
• ʻEdema Macular Cystoid
• Ka retina i hoʻokaʻawale ʻia a i ʻole ka hōʻino ʻana i ka retina
• ʻO Glaucoma (hōʻino ʻia ke aʻalolo optic ma muli o ka hoʻonui ʻia o ke kaomi maka)
• Kaomi intraocular kiʻekiʻe
• ʻŌpū Macular - membrane epiretinal
• ʻO ka pehu ʻana a me ka hōʻino ʻana o ke aʻalolo optic
• Synechiae (hana ʻia kēia i ka wā e pili ai ka iris o ka maka i ka lens a i ʻole ka cornea)

Pehea e ʻike ʻia ai ka Uveitis?

Hiki i ke kauka maka ke ʻike i ka uveitis. E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​me kou mōʻaukala olakino a me nā maʻi a i ʻole nā ​​​​ʻeha i hala koke nei. Eia kekahi, hiki iā ia ke nānā i kou mau maka a hana i nā hoʻokolohua kūikawā e ʻimi i nā hōʻailona o ka uveitis. Hoʻomaka pinepine nā hoʻokolohua no ka uveitis me kahi hoʻokolokolo maka. ʻO kēia mau mea he hoʻāʻo ʻike maka a me kahi hoʻokolokolo kukui slit . Hiki i kāu kauka ke kauoha i kahi hoʻāʻo tonometry e ana i ke kaomi maka a me kahi scan optical coherence tomography (OCT) e ʻimi i nā loli ma ke kua o kou maka. Hiki ke kauoha ʻia nā hoʻokolohua ʻē aʻe, ma muli o kāu mau hōʻailona a me nā kumu i manaʻo ʻia. Eia kekahi laʻana:

• Nā hoʻāʻo koko: Hiki i kēia ke ʻike i nā loli i ke koko e hōʻike ana i ka maʻi, nā hōʻailona o ka ʻōnaehana pale, a i ʻole nā ​​​​​​kūlana olakino ʻē aʻe.
• Nā scan kiʻi: Hiki i nā mea e like me ka X-ray umauma a i ʻole ka scan MRI (Magnetic Resonance Imaging) o ka lolo ke kōkua i ka ʻimi ʻana i nā pilikia ma kahi ʻē. Hoʻohana kekahi mau scan kiʻi i kahi dye kūikawā, e like me ka fluorescein, e hōʻike i nā kīʻaha koko i loko o ka maka. Hiki i nā loli i ke ʻano dye ke hāʻawi i nā kauka i nā hōʻailona koʻikoʻi e pili ana i ke kumu o ka uveitis.

No ka mea, ʻokoʻa paha nā hoʻokolohua ma muli o kāu mau hōʻailona a me ke kūlana, ʻo kāu loea maka ke kanaka maikaʻi loa e wehewehe iā lākou iā ʻoe. Hiki iā ia ke haʻi hou aku iā ʻoe e pili ana i kēia mau hoʻokolohua a me ke kumu e ʻōlelo ʻia ai lākou.

Pehea e mālama ʻia ai ka uveitis?

No ka mea, he nui nā kumu o ka uveitis, hiki ke ʻokoʻa loa nā lāʻau lapaʻau. ʻAʻohe lāʻau lapaʻau kūikawā no ka uveitis. Eia nō naʻe, hiki ke mālama ʻia kekahi o nā kūlana e hoʻoulu ai. Inā pēlā, hiki i ka mālama ʻana i ke kumu ke kōkua i ka hoʻomaʻemaʻe ʻana i ka uveitis. Inā ʻaʻole hiki ke loaʻa ke kumu, hiki i kāu kauka maka ke hoʻohana i nā lāʻau lapaʻau maʻamau. Hiki i nā lāʻau lapaʻau ke komo pū me nā lāʻau lapaʻau, ke ʻoki kino, a me nā ʻano hana ʻē aʻe e kōkua ai i ka hōʻemi ʻana i kāu mau hōʻailona a pale i nā pilikia e hiki mai ana. ʻO nā lāʻau lapaʻau e pili ana i nā hōʻailona e kālele pinepine ana i:

• Kaohi ʻeha: No ka mea hiki i ka uveitis ke ʻeha, he mea maʻamau nā lāʻau lapaʻau e hōʻemi i ka ʻeha. Hiki i kēia ke komo pū me nā lāʻau lapaʻau (cycloplegics) e hoʻopale i nā ʻiʻo o ka iris (ʻoi aku ka haumāna).
• Hoʻēmi i ka mumū: ʻO nā lāʻau lapaʻau e like me nā steroids a me nā lāʻau anti-inflammatory nonsteroidal (NSAIDs) hiki ke kōkua i ka hoʻēmi ʻana i ka ʻeha a me ka mumū i hoʻokumu ʻia e ka uveitis.
• Nā lāʻau lapaʻau kūikawā: No ka laʻana, ʻaʻole kōkua nā lāʻau antiviral e mālama ai i nā virus i nā maʻi bacteria, fungal, a i ʻole parasitic.

Ma muli o ka nui o nā koho lapaʻau, ʻo kāu ophthalmologist ke kanaka maikaʻi loa e kamaʻilio pū me e pili ana i kāu mau koho.

Hiki ke pale ʻia ka uveitis?

ʻO ka mea pōʻino, ʻaʻole hiki ke pale loa ʻia ka uveitis. ʻO ka hapa nui o nā mea e hoʻoulu ai he mea i manaʻo ʻole ʻia a hana paha ma nā ʻano i maopopo ʻole i nā loea. Eia nō naʻe, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o nā kūlana a i ʻole nā ​​hanana e hiki ai ke alakaʻi i ka uveitis. ʻO nā mea nui hiki iā ʻoe ke hana:

• E hana i nā hoʻokolohua maka maʻamau e ʻike mua i nā pilikia maka (ʻo ia hoʻi ma ka liʻiliʻi ʻelua i ka makahiki, a ʻoi aku paha pinepine inā loaʻa iā ʻoe kahi maʻi e pono ai nā hoʻokolohua pinepine).
• E komo i ka pale maka e pale ai a hōʻemi paha i ke koʻikoʻi o nā ʻeha maka.
• Inā loaʻa iā ʻoe nā maʻi (inā hiki), e mālama iā lākou ma mua o ko lākou ʻino ʻana a laha paha.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ʻo Uveitis?

Inā loaʻa iā ʻoe ka uveitis, e hilinaʻi kou ʻike i kekahi mau kumu. ʻO kekahi o nā mea nui loa:

• Pehea ka lōʻihi e loaʻa ai kahi hōʻoia a me ka lāʻau lapaʻau.
• ʻO ka ʻāpana kikoʻī o ka maka i hoʻopilikia ʻia.
• ʻO ke kumu kumu (inā hiki i kāu kauka ke loaʻa).
• ʻO kou olakino holoʻokoʻa a me nā maʻi ʻē aʻe āu e loaʻa ai.

Ma muli o ka hiki i kēia mau mea ke loaʻa ka hopena nui, hiki i kāu loea maka ke haʻi maikaʻi iā ʻoe i ka mea e manaʻo ai. Hiki iā ia ke hoʻopilikino i ka ʻike i kou kūlana kikoʻī a me nā kikoʻī o ka hihia. Hiki iā ia ke aʻo aku iā ʻoe i nā mea hiki iā ʻoe ke hana e kōkua iā ʻoe iho.

He aha ka manaʻolana no ka uveitis?

ʻO ka Uveitis kahi kumu maʻamau o ka nalowale o ka ʻike a me ka makapō kānāwai. Ma ʻAmelika Hui Pū ʻIa, a hiki i ka 10% o ka poʻe i makapō kānāwai ma muli o ka uveitis a i ʻole pili i ka uveitis. ʻO ka lohi o ka ʻike ʻana a me ka mālama ʻana hiki ke alakaʻi i nā hopena maikaʻi ʻole. ʻO ia ke kumu he mea nui e pale ʻole i nā hōʻailona o ka uveitis a i ʻole "e hoʻomanawanui wale." Inā ua ʻike ʻia a mālama ʻia ʻoe i ka wā mua, ʻaʻole paha ʻoe e loaʻa i nā pilikia ʻike lōʻihi. Inā hana ʻoe, ʻoi aku ka nui o kou hoʻōla piha ʻana a pale i nā pilikia ʻike mau loa.

Pehea wau e mālama ai iaʻu iho?

Inā loaʻa iā ʻoe ka uveitis, e alakaʻi kāu loea maka iā ʻoe ma o ka lāʻau lapaʻau a haʻi iā ʻoe i nā mea e pono ai ʻoe e hana ma ke ʻano he ʻāpana o kāu lāʻau lapaʻau. He mea nui loa ia e hahai i nā ʻōlelo a kāu loea maka, no ka mea hiki i kēia ke hōʻemi i ka pilikia o ka nalowale mau o ka ʻike.

Āhea wau e ʻike ai i kaʻu kauka?

E hoʻonohonoho kāu kauka maka i nā kipa hahai nou, a he mea nui e mālama iā lākou. ʻAe kēia mau manawa i kāu kauka e nānā i kāu mau hōʻailona a me ka holomua o kāu lāʻau. E haʻi pū kāu kauka iā ʻoe i nā hōʻailona a i ʻole nā ​​​​hōʻailona āu e ʻike ai i ke kauka a i ʻole e ʻimi i ke kōkua lapaʻau pilikia inā loaʻa iā ʻoe kekahi. Eia kekahi mau hōʻailona e pono ai ʻoe e ʻike i ke kauka a i ʻole e ʻimi i ke kōkua lapaʻau pilikia:

• Inā piʻi ka ʻeha.
• Inā e ʻino aʻe kou ʻike a i ʻole e nalowale koke kou ʻike (loa a hapa paha).
• Inā ʻike ʻoe i nā kukui o ke kukui i mua o kou mau maka.
• Inā hoʻomaka koke ʻoe e ʻike i nā mea lana, a inā e ʻoi aku ka ʻino o nā mea lana e kū nei a i ʻole e ʻike nui ʻia.
• Inā loaʻa iā ʻoe ka photophobia, ʻo ia hoʻi ka ʻeha o kou mau maka a ʻoluʻolu ʻole paha i ka mālamalama ʻālohilohi.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau penei:

• "He aha ke ʻano o ka Uveitis i loaʻa iaʻu?"
• "Ua ʻike anei ʻoe i ke kumu o kēia? No laila he aha ia?"
• "He aha nā koho lapaʻau aʻu e loaʻa ai? He aha kāu e ʻōlelo mai nei?"
• "Aia kekahi mau pilikia a i ʻole nā ​​hopena ʻaoʻao o ka lāʻau lapaʻau?"
• "Hiki anei kēia ke hoʻi mai ma hope o ka lāʻau lapaʻau?"
• "He aha kaʻu e hana ai e pale i koʻu ʻike, pale i ka nalowale o ka ʻike, a i ʻole e pale i kēia mai ka hana hou ʻana?"
• "Pono anei au e makaʻala i nā hōʻailona o nā pilikia? Inā pēlā, he aha kēlā mau hōʻailona?"

He mea maʻamau ke makaʻu i ka lohe ʻana i kahi maʻi e like me ka uveitis, a me ka lohe ʻana e nalowale paha kou ʻike. Akā, he nui nā mea hiki iā ʻoe ke hana e hoʻomaikaʻi i kou kūlana. Hiki i ka ʻike mua ʻana a me ka mālama ʻana ke pale i nā pilikia koʻikoʻi e like me ka nalowale mau o ka ʻike. No laila, inā loaʻa iā ʻoe nā hōʻailona o ka uveitis, mai hoʻowahāwahā iā lākou. Ma hope o ka hōʻoia ʻana, ʻo ka hahai ʻana i nā ʻōlelo a kāu kauka maka ke ala maikaʻi loa e loaʻa ai nā hopena maikaʻi loa. Inā he mea āu e maopopo ʻole ai, e nīnau i kāu kauka. ʻO ka hana pū ʻana ke ala maikaʻi loa e kōkua iā ʻoe a pale i nā pilikia e hiki mai ana.

He aha nā mea nui a kākou e hoʻomanaʻo ai mai kēia moʻolelo mai?

ʻAe, e hōʻuluʻulu kākou i kekahi o nā mea a mākou i kamaʻilio ai e pono ai ʻoe e hoʻomanaʻo:

• ʻO ka Uveitis kahi mumū o ka papa waena o ka maka (ka uvea). Hiki iā ia ke hoʻopilikia nui i kou ʻike.
• Inā loaʻa iā ʻoe nā hōʻailona e like me nā maka ʻulaʻula, ka ʻeha o ka maka, ka ʻike pohihihi, ka ʻike ʻana i ka mālamalama, a i ʻole ka ʻike ʻana i nā mea e lana ana i mua o kou mau maka , mai hoʻowahāwahā iā lākou. E ʻike koke i ke kauka maka.
• Nui nā kumu no kēia; nā maʻi ʻaʻai, nā maʻi ʻē aʻe i loko o ke kino, nā ʻeha, kekahi mau lāʻau lapaʻau, a pēlā aku. I kekahi manawa, ʻaʻole hiki ke loaʻa ke kumu.
• ʻO ka mea nui loa, ʻo ia ka ʻike mua ʻana i ka maʻi a hoʻomaka i ka lāʻau kūpono. Hiki i kēia ke kōkua nui i ka pale ʻana i nā pilikia weliweli e like me ka nalowale mau o ka ʻike maka.
• E hahai pono i nā ʻōlelo aʻoaʻo a kāu kauka maka a me ka lāʻau lapaʻau. E hoʻohana pono i kāu lāʻau lapaʻau, a mai hōʻole i nā manawa i koho ʻia e kāu kauka.
• ʻOiai ʻaʻole hiki ke pale loa ʻia, ʻo ka hoʻokolokolo maka mau ʻana, ke kau ʻana i ka pale maka (ʻoi aku hoʻi i nā hana weliweli), a me ka mālama koke ʻana i nā maʻi i loko o ke kino hiki ke kōkua i ka hōʻemi ʻana i ka pilikia o kēia ʻano i kekahi ʻano.

E hoʻomanaʻo, he mea makamae loa kou mau maka, no laila ʻo kou kuleana ke mālama iā lākou.