Ke waimaka mau nei ʻoe i kou mau maka? E aʻo kākou e pili ana i ka Blocked Tear Duct / Nasolacrimal Duct Obstruction!

Ke kahe mau nei anei nā maka o kāu keiki liʻiliʻi? A i ʻole he maka waimaka mau kou? I kekahi manawa makemake paha ʻoe e hamo i kou mau maka. He mea hoʻonāukiuki iki kēia. ʻO ke kumu o kēia paha he ʻano paʻa i loko o kāu ʻōnaehana duct waimaka, ʻo ia hoʻi, ke ala e hele ai nā waimaka. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia `(Nasolacrimal Duct Obstruction)`. I kēia lā, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī, me ka maʻalahi loa.

He aha nā ala waimaka i ālai ʻia?

I ka ʻōlelo maʻalahi, ʻo ka paʻa ʻana o ka waimaka ke ālai ʻia nā waimaka e kekahi mea, e pale ana iā lākou mai ka kahe pono ʻana mai ko kākou mau maka. Hiki i kēia paʻa ke hoʻolohi i ke kahe ʻana o nā waimaka a hoʻōki loa paha iā lākou. ʻO kēia ke kumu o ka hōʻiliʻili ʻana o nā waimaka i loko o ka ʻōnaehana waimaka a hoʻi hou i luna i loko o ka maka.

Ua ʻike anei ʻoe he mea nui nā waimaka no ko kākou mau maka e hana pono ai? Mālama nā waimaka i ka ʻili o ka maka i pulu a kōkua i ka cornea e omo i ka oxygen. ʻO kekahi mea ʻē aʻe, aia pū kekahi mau mea pale maʻi i loko o nā waimaka. Mālama kēia mau mea i nā maka mai nā maʻi, a kōkua paha iā lākou e ho'ōla wikiwiki inā loaʻa iā lākou ka maʻi.

E noʻonoʻo e like me kahi ʻauwai e hoʻokahe ana i ka wai mai luna o ka hale. Hōʻiliʻili nā ʻauwai i ka wai a hoʻouna i lalo i ka paipu. Akā, inā paʻa kēia paipu i kekahi wahi, hōʻiliʻili ka wai a hoʻomaka e paila mai loko mai o nā ʻauwai, ʻeā? Pēlā nō kēia me kēia.

He hōʻiliʻili o nā lua liʻiliʻi a me nā ʻano hana e like me ka paipu ko kākou ʻōnaehana waimaka. Ke kahe nei nā waimaka mai ka maka mai penei:

1. Puncta: ʻElua mau lua liʻiliʻi o kēlā me kēia maka ma nā lihilihi o luna a me lalo. ʻO kekahi o kēia mau mea ua kapa ʻia he punctum. Ua like ia me ka lua hoʻokahe i loko o kahi poho holoi a i ʻole ka ʻauʻau. Ke kahe nei nā waimaka ma o kēia mau lua i loko o nā ʻōmole i kapa ʻia he canaliculi.

2. Kanalikuli: Hoʻokahe nā waimaka mai kēlā me kēia punctum i loko o kahi ʻōmole liʻiliʻi i kapa ʻia he canaliculus (plural: canaliculi). Hoʻohui kēia mau ʻōmole ʻelua e hana i kahi ʻōmole nui aʻe, kahi e pili ai i ka ʻōmole nasolacrimal.

3. Nā ʻauwai nasolacrimal: ʻO kēia nā ʻāpana hope loa e like me ka paipu e hele ai nā waimaka. Pono kēlā me kēia ʻauwai waimaka e loaʻa kahi kiwikā liʻiliʻi ma ka ʻaoʻao lalo.

4. Kiwikā o Hasner: He puka liʻiliʻi kēia kiwikā e hiki ai i nā waimaka ke kahe i loko o ke ala ihu. Wehe pinepine ia ma mua o ko kākou hānau ʻia ʻana. Eia nō naʻe, i kekahi mau pēpē, ʻaʻole paha e wehe. Inā ʻaʻole e wehe, ua kapa ʻia ʻo ia ʻo ka Membrane o Hasner.

Pehea ka maʻamau o ke ālai ʻia ʻana o nā ala waimaka?

He mea maʻamau loa nā ala waimaka i paʻa i nā keiki ʻuʻuku loa . Hoʻopilikia lākou ma waena o 6% a me 20% o nā pēpē hānau hou. Eia naʻe, ʻaʻole lākou i maʻamau i nā pākeke.

He aha nā hōʻailona o ke ālai ʻia ʻana o nā ala waimaka?

Inā loaʻa iā ʻoe a i ʻole kāu keiki kahi ala waimaka i ālai ʻia, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• ʻEpipora: He manaʻo o nā waimaka e kahe mau ana mai nā maka mai .
• ʻO nā mea e like me nā waimaka e pipili ana ma nā lihilihi maka a i ʻole nā ​​lihilihi maka, e paʻakikī ai ke wehe i kou mau maka i ke kakahiaka .
• Ka makemake mau e hamo i ka maka a i ʻole kahi a puni ke kahawai i paʻa.
• ʻUlaʻula a me ka pehu ʻana o nā maka ma muli o ka hamo pinepine ʻana.
• Manaʻo wau ua pōwehiwehi iki kou ʻike .

Hiki i kēia ālai ʻana ke maʻalahi i ka loaʻa ʻana o ka maʻi i nā ala waimaka. Inā loaʻa kēlā maʻi, nā hōʻailona e like me:

• Ka pehu ʻana a ʻulaʻula paha o ke kahawai waimaka a i ʻole nā ​​​​ʻiʻo e hoʻopuni ana.
• Ke loaʻa nei ke kuni .
• Uē pinepine a me ka hoʻomaha ʻole (ʻoi aku hoʻi i nā pēpē).
• ʻEha maka a i ʻole ke ʻano o ke kaomi ma ka ʻāpana sinus .
• ʻUlaʻula a mumū paha o ka maka, me ke keʻokeʻo o ka maka (sclera).

No ke aha i ālai ʻia ai kēia mau ʻauwai waimaka?

Aia kekahi mau kumu kūpono o ke ālai ʻia ʻana o nā ala waimaka. He hānau ʻia kekahi, ʻo ia hoʻi, aia lākou i ka wā hānau. Hoʻomohala ʻia kekahi ma hope o ke ola.

Ka ālai ʻana o ke ala waimaka hānau

I ka manawa pinepine, hānau ʻia kahi keiki liʻiliʻi me kahi ala waimaka i ālai ʻia no ka mea ua pani ʻia ka "Valve of Hasner" i ʻōlelo ʻia ma mua e kahi membrane i haki ʻole ʻia ʻo "Membrane of Hasner". A laila, hōʻiliʻili ka wai waimaka i loko o ke ala waimaka. I ka hala ʻana o ka manawa, hiki i kēia mau waimaka i hōʻiliʻili ʻia ke hoʻoulu i ka pehu ʻana o ke ala. Hiki iā ia ke hana i nā maʻi i loko o ke ala waimaka a i ʻole nā ​​​​​​ʻāpana ʻē aʻe o ka ʻōnaehana waimaka.

Nā kumu ʻē aʻe o nā ala waimaka i ālai ʻia

ʻOi aku ka nui o ka hiki ʻana mai o nā ala waimaka i pani ʻia ma muli o nā kūlana olakino ʻē aʻe, a i ʻole i kekahi mau hihia. Loaʻa pinepine kēia mau mea ma nā ʻāpana o luna o ka ʻōnaehana ala waimaka. E nānā kākou i kekahi mau laʻana:

• Nā maʻi: ʻO nā maʻi lōʻihi i loko a puni paha o kou mau maka hiki ke hana i nā ʻiʻo ʻeha. I kekahi manawa, hiki i kēlā ʻiʻo ʻeha ke hoʻohaiki a ālai i nā kīʻaha koko.
• Nā ʻeha: ʻO nā ʻeha i kou maka, nā maka, a i ʻole ka ihu hiki ke hoʻoulu i ka pehu ʻana a me nā loli o nā ʻiʻo a puni nā ala waimaka. ʻO kēlā me kēia pehu ʻana, nā loli o nā ʻiʻo, a i ʻole ka paʻa ʻana e pili ana i kekahi ʻāpana o kēia ʻōnaehana hiki ke alakaʻi i kahi paʻa.
• Dacryostenosis: I kekahi manawa hiki ke haiki kou mau ala waimaka i ka wā hānau, a i ʻole hiki iā lākou ke lilo i haiki ma hope o ke ola. Hiki i kēia mau mea ʻelua ke hana i kahi paʻa.
• Ka ʻelemakule ʻana: I kou wā ʻelemakule, hiki i nā ʻauwai waimaka a me nā wahi a puni lākou ke loli a lahilahi.
• Nā puʻupuʻu a i ʻole nā ​​​​​​ulu: ʻO kēia mau mea e komo pū ana me nā puʻupuʻu maikaʻi ʻole a me nā puʻupuʻu maʻi kanesa (ʻoiai he mea kākaʻikahi loa kēia). Hiki i kahi ʻano puʻupuʻu i kapa ʻia he mucocele ke ālai i nā ala waimaka. He mau ʻeke liʻiliʻi kēia, piha i ka mucus e hana ʻia ana i loko o nā sinus ethmoid, nā lua sinus ma nā ʻaoʻao ʻelua o ka ihu.
• Nā Dacryolith: Hiki i kēia ke hana ʻia ke hōʻiliʻili a mānoanoa ka wai waimaka. Inā nui lākou, hiki iā lākou ke ālai i kahi ala waimaka.

He aha nā kumu pilikia no ke ālai ʻia ʻana o nā ʻauwai waimaka?

ʻOi aku ka nui o ka loaʻa ʻana o kahi ala waimaka i nā pēpē. ʻO ka hapa nui, loaʻa nā ala no ka mea ʻaʻole wehe ka membrane ma ka ʻaoʻao haʻahaʻa o ke ala nasolacrimal a hana i kahi valve i kapa ʻia ʻo Valve of Hasner.

ʻOi aku ka nui o ka poʻe mākua e hoʻomohala i kahi ala waimaka i ālai ʻia inā loaʻa iā lākou ka mōʻaukala o:

• Nā maʻi mumū o nā maka no ka wā lōʻihi, no ka laʻana ʻo `(Uveitis)` .
• Glaucoma .
• Inā ua hana ʻia ʻoe i ke ʻoki maka a i ʻole sinus .
• Inā ua loaʻa iā ʻoe ka lāʻau lapaʻau ma mua , no ka laʻana, radiation therapy a i ʻole chemotherapy.

He aha nā pilikia o nā ala waimaka i ālai ʻia?

ʻO kahi ala waimaka i paʻa ʻia kahi wahi maikaʻi loa no ka ulu ʻana o ka bacteria. No laila, ʻo nā maʻi bacteria a i ʻole nā ​​abscesses ka pilikia nui . Hiki i kēia mau maʻi ke hoʻopilikia i kou sinuses, nā maka, a me nā ʻiʻo a puni. No laila he mea nui ka mālama ʻana i ka maʻi e pale aku ai i ka laha ʻana.

Pehea ʻoe e ʻike ai i kahi ala waimaka i ālai ʻia?

Hiki i kekahi kauka maka a i ʻole kekahi mea mālama ola kino ʻē aʻe ke ʻike i kēia maʻi ma muli o kāu mau hōʻailona a ma ka nānā ʻana a me ka hoʻopā ʻana a puni ka maka a me ke kahawai waimaka. E nīnau pū lākou iā ʻoe e pili ana i kāu mau hōʻailona. Inā manaʻo lākou ua paʻa ke kahawai waimaka o kāu pēpē, e nānā paha lākou a hana i kekahi mau hoʻokolohua e ʻike ai inā he paʻa.

ʻO kahi hoʻāʻo maʻalahi ka "hoʻāʻo nalowale o ka dye." Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi kulu o kahi dye kūikawā i kapa ʻia ʻo fluorescein i loko o kou maka. ʻĀlohilohi ka Fluorescein i ka uliuli. No laila hiki i ke kauka ke hoʻokomo i kahi kulu o kēia i loko o kahi wai saline a hoʻokomo i kēlā wai saline i loko o kou maka. Ma hope o ʻelima mau minuke, hiki iā lākou ke paʻa i kahi kukui ʻeleʻele e ʻike inā aia nō ka dye. Inā pēlā, hōʻike ia he paʻa piha a hapa paha kou ala waimaka.

Hiki ke hana ʻia nā hoʻokolohua ʻē aʻe, ʻoiai inā manaʻo kāu kauka ua hiki ke kumu ʻia kāu mau ala waimaka i paʻa ʻia e kekahi kūlana a pilikia paha. ʻO nā hoʻokolohua a lākou e ʻōlelo ai e pili ana i kāu mau hōʻailona, ​​​​nā kūlana, a me nā mea a lākou e manaʻo ai.

ʻOiai he nui nā kumu e hoʻopilikia nei i kēia, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me lākou e pili ana i kāu mau koho hoʻāʻo. Hiki iā lākou ke hāʻawi iā ʻoe i ka ʻike e pili ana a koʻikoʻi i kou kūlana kikoʻī.

Pehea ʻoe e mālama ai i kahi ala waimaka i ālai ʻia? Aia kekahi lāʻau lapaʻau no kēia?

He maʻi hiki ke mālama ʻia nā ala waimaka i paʻa.Eia nō naʻe, ʻokoʻa nā koho lapaʻau ma muli o ka makahiki o ka mea maʻi a me nā kumu ʻē aʻe. Hiki i kēia kūlana ke hoʻomaikaʻi i kekahi manawa me ka ʻole o ka lāʻau lapaʻau, ʻoiai hoʻi i nā pēpē. Eia nō naʻe, ʻoi aku ka maikaʻi o ka hoʻāʻo ʻana e mālama iā ia e pale aku i nā pilikia e like me ka maʻi.

Hiki ke hāʻawi ʻia kekahi mau lāʻau lapaʻau, e like me nā antibiotics, i nā kānaka o nā makahiki āpau. Hāʻawi pinepine ʻia kēia mau mea inā he maʻi e pili ana i kahi ala waimaka i ālai ʻia. Hiki iā lākou ke hele mai ma ke ʻano o nā poni a i ʻole nā ​​kulu maka. Hiki i nā lāʻau lapaʻau ʻē aʻe ke kōkua. Hiki i kāu kauka maka ke haʻi iā ʻoe i nā mea hou aʻe e pili ana i kēia mau koho.

ʻO ke ʻano lapaʻau nui no nā ala waimaka i ālai ʻia i nā pēpē a me nā keiki liʻiliʻi he ʻano lomilomi kūikawā hiki ke hana ʻia ma ka home . Inā loaʻa i kāu keiki a i ʻole ke keiki āu e mālama nei kēia maʻi, e hōʻike pololei kā lākou kauka lapaʻau iā ʻoe pehea e hana ai. ʻO ka maʻamau, ua lawa kēia ʻano lomilomi e pohā ai ka membrane a lilo i valve. E noʻonoʻo i ka nui o ka hana a kahi lomilomi liʻiliʻi!

Inā ʻaʻole e hoʻomaikaʻi ka paʻa ʻana o kahi pēpē me ka lomilomi ma ko lākou lā hānau mua, pono paha lākou i kahi lāʻau ʻokoʻa. Eia kekahi, ʻaʻole kōkua nui ka lomilomi i nā pākeke , no laila pono pinepine nā lāʻau ʻē aʻe.

Pono paha kekahi o kēia mau lāʻau lapaʻau i ka hoʻomaha a i ʻole ka anesthesia. Hiki i kāu (a i ʻole kāu keiki) ophthalmologist a i ʻole ka mea mālama ola kino ke wehewehe i ke kumu e ʻōlelo nei lākou i ka anesthesia.

Dilation, probing a me ka irrigation

He ala maʻalahi kēia ʻano hana ʻekolu-ʻanuʻu e mālama ai i kahi ala waimaka i ālai ʻia. Hiki iā ia ke kōkua i nā pēpē i pane ʻole i ka lomilomi, a ʻo ia pinepine ka lāʻau mua no nā keiki makua a me nā pākeke.

Eia nā ʻanuʻu o kēia ʻano hana:

1. Dilation: Ma kēia hana mua, hoʻonui (hoʻonui) kahi kauka maka i ka puncta i hoʻopilikia ʻia a me nā ʻano hana ʻē aʻe o ka ʻōnaehana waimaka. Hana kēia i kahi no ka mea e hana ʻia ma ka hana aʻe.

2. Nānā ʻana: Ma kēia ʻanuʻu, hoʻohana ke kauka maka i kahi mea hana kūikawā e nānā (probe) i ka ʻāpana i paʻa ʻia o ke ala waimaka. E kōkua kēia iā lākou e ʻike i ke kumu o ka paʻa ʻana a, inā hiki, e wehe iā ia.

3. Hoʻoinu wai: ʻO kēia hana hope loa e pili ana i ka holoi ʻana i ke kahawai waimaka me ka wai saline e hōʻoia i ka maʻemaʻe a kahe maikaʻi ke kahe.

Hoʻonui ʻia ka baluna

Ke lawa ʻole ka hoʻonui maʻalahi ʻana, ka nānā ʻana, a me ka hoʻoinu ʻana i ka wai, pono paha kahi kaʻina hana hoʻonui holomua. I kēlā hihia, e hoʻohana ke kauka maka o kāu keiki i kahi mea me kahi pōpō liʻiliʻi i hoʻopili ʻia. E hoʻopiha mālie lākou i ka pōpō ma kahi i haiki ʻia. Hiki i kēia paʻi ʻana i loko ke hoʻonui pinepine i ka ʻōmole a hoʻoponopono i ka pilikia.

Ke hoʻokomo ʻana i ka stenting a i ʻole ka intubation

I kekahi mau hihia, ʻaʻole hiki i ka hoʻonui ʻana o ka balloon wale nō ke hoʻonui mau i kahi ala waimaka i haiki. I ia mau hihia, ʻo ka hoʻokomo ʻana i kahi paipu a i ʻole stent paha ke koho maikaʻi loa. Hāʻawi kēia mau mea hana i kahi ʻōnaehana ikaika a hakahaka e hiki ai ke mālama i ka ala a hiki ke kahe nā waimaka.

Nā kaʻina hana ʻoki kino

I kekahi mau hihia, ʻo ke ʻoki kino ke koho maikaʻi loa, ʻo ia hoʻi ke hoʻoponopono ʻana i kahi ala waimaka i paʻa a i ʻole e kāpae iā ia a hana i kahi ala ʻē aʻe no ka wai waimaka e hoʻokahe. ʻElua ʻano nui o ke ʻoki kino:

• Dacryocystorhinostomy (DCR): Ma kēia kaʻina hana, hana ke kauka lapaʻau i kahi ala bypass no ke kahe ʻana o ka waimaka. Hoʻopau loa kēia ala hou i ka mea i ālai ʻia.
• Conjunctivacryocystorhinostomy (CDCR): Hoʻoponopono hou kēia ʻoki ʻana i kāu ʻōnaehana waimaka holoʻokoʻa.

ʻOkoʻa loa nā pono, nā hemahema, a me nā pilikia e hiki mai ana o kēia mau ʻoki kino. Hiki i ke ʻano o ka paʻa ʻana iā ʻoe, kona wahi, a me nā kumu ʻē aʻe ke hoʻopilikia i kēia. ʻO kāu kauka ʻoki kino a kauka maka paha ke kumu maikaʻi loa o ka ʻike e pili ana i ka mea e manaʻo ai.

Hiki ke pale ʻia nā ala waimaka i ālai ʻia?

Hiki mai nā ala waimaka i ālai ʻia no nā kumu i manaʻo ʻole ʻia, ma waho o kou mana, a i ʻole ʻike ʻole ʻia e ʻoe. ʻO ia hoʻi , ʻaʻohe ala e pale aku ai iā lākou .

Eia nō naʻe, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i ka manawa kūpono o kahi pilikia e hiki ai ke alakaʻi i kahi ālai ʻana. Kūkulu nui ʻia kēia mau mea a puni ka pale ʻana i ka maʻi. ʻO kēia mau hana palekana:

• Mai hamo pinepine i kou mau maka a hoʻopā aku iā lākou me ke kumu ʻole.
• Mai kaʻana like i nā huahana maka, e like me nā kulu maka a i ʻole nā ​​​​mea hoʻonani, me nā poʻe ʻē aʻe.
• E hahai i nā ʻōlelo a kāu kauka maka i ka wā e hoʻomaʻemaʻe ai i nā aniani hoʻopili.
• E hoʻololi i nā mea hoʻonani e like me ka mascara, eyeliner, a me ka eyeshadow i kēlā me kēia ʻekolu a ʻeono mahina.
• E holoi pinepine i kou mau lima me ka maikaʻi.

He aha kaʻu e manaʻo ai inā he ala waimaka koʻu (a i ʻole kaʻu keiki)?

ʻO ka maʻamau he hopena maikaʻi no nā ala waimaka i ālai ʻiaAia nō ia i ke kumu. ʻAʻole weliweli nā ʻauwai waimaka i paʻa iā lākou iho. Akā hiki i kekahi mau kumu ke lilo. Eia kekahi, hiki i nā paʻa ke hana i nā maʻi weliweli, no laila he mea nui e ʻike i kahi paʻa a loaʻa ka lāʻau lapaʻau.

He hopena maikaʻi loa nā ālai ʻana o ka hānau ʻana. Ma kahi o 70% o nā keiki me kēia mau ālai ʻana e ʻoi aku ka maikaʻi ma ka 6 mahina o ka makahiki, a ma kahi o 90% e ʻoi aku ka maikaʻi ma ko lākou lā hānau mua. ʻOiai hiki ke nalo aku nā ālai ʻana iā lākou iho, hiki i ka lomilomi ke hoʻolalelale i ke kaʻina hana a hōʻemi i ka manawa o ka maʻi a i ʻole nā ​​​​pilikia ʻē aʻe. ʻAʻole pinepine nā ālai ʻana o ka hānau ʻana e hoʻopilikia i nā pilikia ma hope o ke ola.

I nā pākeke, maikaʻi ka hopena maʻamau, ma muli o ke kumu. Nui nā kumu, ʻoi aku hoʻi nā mea e pili ana i ka ʻeha, pane maikaʻi i ka lāʻau lapaʻau, a he nui nā ala e kōkua ai. Hiki i kāu loea maka ke haʻi iā ʻoe i nā lāʻau lapaʻau e kōkua nui ai, nā hopena āu e manaʻo ai, a me nā mea hiki iā ʻoe ke hana e hoʻomaikaʻi i kēlā mau hopena.

Pehea wau e mālama ai iaʻu iho?

Inā loaʻa iā ʻoe (a i ʻole kahi keiki āu e mālama nei) kahi ala waimaka i paʻa, e alakaʻi ke kauka maka iā ʻoe i ke ʻano o ka mālama ʻana a me ka hoʻokele ʻana. ʻAʻole loa ʻoe e hoʻāʻo e nānā a mālama paha i kahi ala waimaka i paʻa iā ʻoe iho . Inā manaʻo ʻoe he mau hōʻailona kou o kahi ala waimaka, pono ʻoe e hoʻonohonoho i kahi manawa me ke kauka maka a ʻike iā lākou i ka hikiwawe loa.

Āhea wau e ʻike ai i kaʻu kauka a ʻimi paha i ke kōkua?

Inā he ala waimaka paʻa kou, e hāʻawi kāu kauka maka iā ʻoe i nā ʻōlelo aʻoaʻo a me ke alakaʻi. Hiki iā ʻoe ke nīnau iā lākou i nā hōʻailona a me nā ʻōuli āu e makaʻala ai, inā paha e kāhea aku ʻoe iā lākou a i ʻole e ʻimi koke i ke kōkua lapaʻau.

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

Hiki paha iā ʻoe ke nīnau i kāu loea maka a i ʻole ka mea mālama ola kino i kēia mau nīnau:

• He aha ke kumu kūpono loa o ke ālai ʻia ʻana o nā ala waimaka?
• He aha ke ʻano o ka lāʻau lapaʻau āu e paipai nei?
• Aia kekahi mau hopena ʻaoʻao o ka lāʻau lapaʻau?
• Pili anei kēia ala waimaka i kahi maʻi ʻē aʻe?
• He aha kaʻu e hana ai e pale aku i kēia ālai ʻana mai ka hoʻi hou ʻana mai?

ʻO ka mea hope loa, leka lawe i ka home:

Hiki i ka ʻauwai waimaka paʻa ke lilo i mea ʻoluʻolu ʻole a ʻeha hoʻi no nā pākeke. A inā he keiki kāu e mālama nei nona kekahi, he mea maʻamau ke hopohopo a makaʻu. ʻO ka mea pōmaikaʻi, he maʻi hiki ke mālama ʻia nā ʻauwai waimaka paʻa. Hoʻōla koke ka hapa nui o nā keiki, ʻoiai me nā ʻano lomilomi maka maʻalahi. ʻO ka hopena no nā pākeke he maikaʻi nō hoʻi, ʻoiai me kekahi mau kumu a me nā mea kōkua.

Inā manaʻo ʻoe he paʻa ka puka waimaka o kāu keiki (a i ʻole ʻoe), e kamaʻilio me ke kauka maka a i ʻole kekahi mea mālama ola kino ʻē aʻe. Hiki i ka ʻike mua a me ka mālama ʻana ke hana i kahi ʻokoʻa nui i ka hoʻomaʻemaʻe ʻana i kēia mau waimaka paʻa a me ka hoʻomaha ʻana i ka hopohopo e hele mai me lākou. Mai hopohopo, aia nā hoʻonā!

ʻO ke ālai ʻana o ka ʻauwai nasolacrimal, nā maka waimaka, nā ʻauwai waimaka o nā pēpē, ke olakino o ka maka, ka ʻōnaehana waimaka, Epiphora