Ua nānā anei ʻoe i kou mau maka i loko o ke aniani? Hiki iā ʻoe ke ʻike i ka pōʻai ʻeleʻele ma waenakonu o ka ʻāpana kala o ka maka (kapa mākou iā ia he iris). ʻO ia ka mea a mākou e kapa ai he haumāna. Hoʻololi kona nui i kēlā me kēia manawa. Akā i kekahi manawa, inā liʻiliʻi kēia haumāna ʻaʻohe mea i ka nui o ka loli o ke kukui, hiki ke lilo i hōʻailona o kahi pilikia olakino. ʻO ia ka mea a mākou e kapa nei i ka lāʻau lapaʻau ʻo Miosis .
I ka ʻōlelo maʻalahi, he aha ka Miosis?
ʻO ka miosis ka wā e liʻiliʻi ai ka haumāna o ka maka ma mua o ka maʻamau, e like me ka nananana. Hoʻomalu ʻia ka nui o ka haumāna e nā ʻiʻo ma ka ʻāpana kala o ko kākou maka, ʻo ia hoʻi ka iris.
E like me kou ʻūmiʻi ʻana i kou hele ʻana i ka lā mālamalama, e liʻiliʻi ana hoʻi kā mākou mau haumāna i ka mālamalama mālamalama. Eia kekahi, ma nā wahi pouli, e nui aʻe ana nā haumāna (dilate) e ʻike maikaʻi aku ai. He hana maʻamau kēia. Eia naʻe , i loko o kekahi kanaka me ka miosis, e liʻiliʻi mau ana nā haumāna me ka nānā ʻole i ka nui o ka loli o ke kukui . Kapa kekahi poʻe iā lākou he 'pinpoint pupils' no ka mea ua like lākou me ka piko o ke nila.
Hiki i kēia ʻano ke hiki i hoʻokahi maka wale nō (unilateral) a i ʻole ma nā maka ʻelua (bilateral).
ʻOkoʻa ma waena o Miosis a me Mydriasis
He mau kūlana ʻē kēia ʻelua. ʻO Miosis ka wā e haiki ai ka iris. ʻO Mydriasis ka wā e nui loa ai ka iris (dilated).
He aha nā kumu nui o ka miosis?
Aia kekahi mau kumu e liʻiliʻi ai ka lihilihi o ka maka. He mea maʻamau kekahi, aʻo kekahi hiki ke ʻoi aku ka koʻikoʻi.
| Kumu | Hopena |
|---|---|
| ʻO kekahi mau lāʻau lapaʻau (e.g., opioids) | Hoʻopilikia pinepine ia i nā maka ʻelua . |
| ʻO ka maʻi Horner | Hoʻokahi wale nō ʻaoʻao o ka maka i hoʻopilikia ʻia. |
| Ka lāʻau make | Hoʻopilikia pinepine ia i nā maka ʻelua . |
| Ka mumū o ka maka (Uveitis/Iritis) | Hoʻopilikia pinepine ia i hoʻokahi maka , akā i kekahi manawa hiki ke hoʻopilikia i nā maka ʻelua. |
| ʻO ka hahau ʻana o Pontine | Ua pilikia nā maka ʻelua . |
| Nā ʻeha poʻo hui | Hoʻokahi wale nō ʻaoʻao e pili ana. |
1. Kekahi mau lāʻau lapaʻau
ʻO kekahi mau lāʻau lapaʻau, ʻoiai nā opioids, i hoʻohana ʻia no ka ʻeha nui, hiki ke hoʻemi i ka iris ma nā maka ʻelua. Hiki i kekahi mau kulu maka i hoʻohana ʻia no ka glaucoma, e like me ka pilocarpine, ke hana i kēia.
2. ʻO ka maʻi Horner
He kūlana kēia i hoʻokumu ʻia e ka hoʻopilikia ʻana i nā aʻalolo sympathetic e holo ana mai ko kākou lolo a i nā maka a me ke alo. Ma kēia kūlana, hiki ke ʻike ʻia nā hōʻailona e like me nā lihilihi maka e kūlou ana a me nā lihilihi maka e kūlou ana ma kekahi ʻaoʻao wale nō o ka maka.
3. Ka lāʻau make
Hiki ke hana ʻia kēia kūlana e ka ʻai ʻana i kekahi mau pesticides, ʻoiai nā organophosphates . Hiki ke hana ʻia e ka overdose o nā lāʻau ʻē aʻe, e like me benzodiazepines.
Inā he kānalua iki paha no ia mea, pono e lawe koke ʻia ka mea maʻi i ka Emergency Treatment Unit (ETU) kokoke loa i ka haukapila. He mea nui loa hoʻi e kelepona i ke Kikowaena ʻIke Poisons Lahui ma ka Halemai Lahui ʻo Colombo no ka ʻōlelo aʻoaʻo hou aku.
4. Nā mumū o ka maka
ʻO ka mumū i loko o ka maka, ka mea e hoʻoulu ai i ka ʻulaʻula a me ka ʻeha, hiki ke hana i ka hana pono ʻole o ka iris. ʻO Uveitis a me iritis ʻelua mau ʻano like.
5. ʻEha o ka lolo a i ʻole ka maka
Hiki nō hoʻi kēia ke hana ke paʻi kekahi mea i ka maka a hōʻeha, a i ʻole ma muli o kahi hahau (Pontine stroke) e hana ʻia ana ma kekahi mau ʻāpana o ka lolo, ʻoiai ka lolo.
6. Nā kumu ʻē aʻe
Eia kekahi, hiki ke ʻike ʻia ka miosis i nā kūlana e like me nā haumāna Argyll Robertson, kahi e kū nei i nā pae hope o ka syphilis i mālama ʻole ʻia, a me nā ʻeha poʻo cluster.
E aʻo pū kākou e pili ana i ka Miosis e kū mai ana i ka wā o ke ʻoki ʻana i ka cataract.
I ka wā o ke ʻoki ʻana i ka cataract, pono e hoʻonui ʻia ka iris i mea e maʻalahi ai ke ʻoki ʻana. Eia nō naʻe, i kekahi manawa hiki i ka iris ke ʻūlū koke i ka wā o ke ʻoki ʻana. Ua kapa ʻia kēia he intraoperative miosis. ʻO kekahi mau lāʻau lapaʻau, e like me nā alpha-1 antagonists no ke koko kiʻekiʻe a i ʻole ka hoʻonui ʻana o ka prostate, aia i ka pilikia nui. No laila, he mea nui e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei ma mua o ka hana ʻana i kekahi ʻoki ʻana.
He aha nā lāʻau lapaʻau no kēia?
He hōʻailona ka miosis, ʻaʻole he maʻi, no laila ke kuhikuhi ʻia nei ka lāʻau lapaʻau i ke kūlana kumu i hoʻokumu ai.
- Inā ma muli o ka lāʻau lapaʻau: Na kāu kauka e hoʻoholo inā e hoʻōki a hoʻololi paha i ka lāʻau lapaʻau.
- Inā he maʻi maka: e hāʻawi ʻia ʻoe i nā lāʻau anti-inflammatory a i ʻole nā lāʻau anti-infectious.
- ʻO ka maʻi Horner: Pono paha ke ʻoki ʻana inā hana ʻia e kahi mea e like me ka puʻupuʻu.
- I ka hanana o ka hahau ʻana: Pono e hāʻawi ʻia ka lāʻau lapaʻau ulia pōpilikia ma ka haukapila.
Hiki ke pale ʻia ka miosis?
Hiki iā mākou ke pale aku i ka miosis i hoʻokumu ʻia e kekahi mau kumu.
- Ke noho mamao aku nei mai nā lāʻau lapaʻau: Ke pale loa nei i ka hoʻohana ʻana i nā lāʻau lapaʻau, ʻoi aku hoʻi nā opioids.
- Ke komo ʻana i nā lako pale: He mea nui loa ia e komo i ka pale maka kūpono, e like me nā goggles, i ka wā e pāʻani ana i nā haʻuki a i ʻole e hana ana i nā hana weliweli.
- Ke hoʻomaopopo pololei ʻana i kāu kauka: E hoʻomaopopo mau i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
E hoʻomanaʻo, ʻo kēia ʻano loli i ke kala o kou mau maka, ʻoiai inā hiki koke mai ia a i ʻole e hele pū ʻia me nā hōʻailona ʻē aʻe (e like me ka mae ʻana ma kekahi ʻaoʻao o ka maka, ka ʻeha poʻo nui, nā maka ʻulaʻula), hiki ke lilo i hōʻailona o kahi maʻi koʻikoʻi. No laila, mai hoʻowahāwahā iā ia.
Leka Lawe-Home
- He haumāna liʻiliʻi ʻo Miosis, kahi mea e pane pono ʻole ai i ka mālamalama.
- ʻAʻole kēia he maʻi, akā he hōʻailona o kekahi maʻi ʻē aʻe.
- Hiki i nā kumu ke ʻano maʻalahi a hiki i nā kūlana koʻikoʻi e like me nā lāʻau lapaʻau, ka lāʻau make, nā maʻi neurological, nā hahau ʻana, a me nā maʻi maka.
- Inā ʻike ʻoe i kēia ʻano loli i kou iris, ʻoiai inā hele mai me nā hōʻailona ʻē aʻe, e ʻike koke i ke kauka.
- E hoʻomaopopo mau i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei.
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