Hoʻopaʻa ʻia a i ʻole ʻia nā Lens Hoʻopili ma lalo o ka lihilihi: No ke aha e hiki ʻole ai ke nalo ma hope o kou maka¶

ʻO ka hamo ʻana i kou maka, ala aʻe mai ka hiamoe ʻana i kāu mau lens hoʻopili, a i ʻole e hoʻāʻo e ʻoki i kahi lens i ka pō wale nō e ʻike ai ua pohu kou ʻike a ua nalowale ka lens ma lalo o kou lihilihi luna e hoʻoulu koke i ka hopohopo. Ke kipa aku nei nā kaukani mea hoʻohana i nā keʻena ulia pōpilikia i kēlā me kēia mahina ua paheʻe kahi lens palupalu a i ʻole ka ʻāpana hydrogel i ʻoki ʻia "ma hope o ko lākou mau maka" i ko lākou lolo, a e hoʻomāhuahua i ka ulia pōpilikia maoli ma ke ʻoki pinepine ʻana a me ka ʻoki ʻana i ko lākou cornea maloʻo me ko lākou mau manamana lima e noʻonoʻo ana ʻo ka ʻiʻo maʻemaʻe ʻo ia ka lens pili.

E hanu hohonu a lawe i kou mau manamana lima mai kou maka i kēia manawa: ʻaʻole hiki ke hele ma hope o kou ʻōpoʻo maka ma ke kino: ʻaʻole hiki ke hele ma hope o kou pōlele maka. cul-de-sac a i ʻole fornix) he 8 a 10 millimeters wale nō (0.3 a 0.4 iniha) ma luna o ka palena luna o kou iris. Inā loaʻa iā ʻoe ka ʻeha o ka maka koʻikoʻi, ka ʻeha ʻana o ka maka, ka nalo koke ʻana o ka ʻike, ka hoʻoheheʻe ʻia ʻana o ka ʻōmaʻomaʻo melemele, a i ʻole ka ʻike kemika, e ʻimi i ka lāʻau lapaʻau wikiwiki a i ʻole e kelepona i kāu helu ulia pōpilikia kūloko (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka European Union, 999 ma United Kingdom; e ʻike i nā mea āpau. helu pilikia). No nā pilikia pili maka a me ka maka, e nānā super glue ma ka lihilihi, lehelehe, a i ʻole ka ʻili, ale ʻia ka niho niho, lei aliʻi inhalation, a haki nā makaaniani, a hoʻopiha hou i ka lāʻau lapaʻau lāʻau lapaʻau.

E hana i kēia i kēia manawa¶

1. E hooki koke i ke kui ana i waenakonu o kou maka a hiki i ka wa e hooiaio ai e kau ana ka lens ma ke ko'o. O ka ma'i optometrist a me ophthalmologists i ma'a mau loa ma hope o ka maka'u "pa'a lens" he iatrogenic corneal epithelial abrasion na ka mea nana i hoolei wale i ka lens ma ke keena lumi hale lole me ka nana ole o kona uhi, a ma lalo o ka uhi o ka lumi kaukau. ke kuʻi ʻana a me ka ʻoki ʻana i ko lākou ʻili ʻili ʻālohilohi me ko lākou mau manamana lima.
2. E holoi pono i kou mau lima me ke kopa maʻemaʻe a me ka wai ʻala ʻole no 20 kekona a maloʻo me ke kāwele lint-free. Mai hoʻopā i kou mau lihilihi a i ʻole ka maka me nā manamana lima holoi ʻole ʻia a i ʻole nā ​​manamana lima i uhi ʻia i ka wai holoi lima, ka aila pepa, a i ʻole ka mea hoʻomaʻemaʻe lima waiʻona, kahi e hoʻomaka koke ai ke keratitis kemika.
3. E hoʻopiha piha i kou maka me nā hāʻule hoʻomaʻemaʻe ʻana o ka lens contact sterile, nā waimaka hana ʻole preservative-free, a i ʻole sterile 0.9% saline solution (ʻaʻole e hoʻopaʻa i ka wai a i ʻole hydrogen peroxide). Hoʻopili paʻa ka lens hydrogel a i ʻole silicone-hydrogel i ka maka a i ʻole ʻāwili i ka hapalua ma lalo o ka lihilihi wale nō ke lilo ʻo ia i dehydrated, e hana ana e like me ke kīʻaha maloʻo. ʻO ka hoʻokahe ʻana i ka ʻili o ka maka me 5 a 10 kulu o ka wai paʻakai sterile a i ʻole ka hoʻomaʻemaʻe hou ʻana i kou maka a pani i kou maka no 2 mau minuke piha e hiki ai i ka polimer matrix maloʻo ke hoʻihoʻi hou i ka wai, e pehu hou i kona curvature maʻamau, a lana kaʻawale iā ia iho.
4. Mai hoʻokomo pololei i kou maka i ka pāpaʻi ʻulaʻula 3% hydrogen peroxide (e like me Clear Care a i ʻole PeroxiClear). E nānā ʻelua i ka lepili o ka ʻōmole: e hoʻohana wale i ka ** sterile saline, multipurpose contact lens rinsing solution, a i ʻole lubricating eye drops ma ka maka.
5. E nana ma ka aoao o kahi e ike ai oe i ka lens a lomilomi malie ma luna o kou lihilihi i paniia a hiki i kou ihu. Ina oe e ike i ke ano o ke kino haole ma lalo o kou po'i luna, e nana pololei i lalo i kou mau kamaa, e pani malie i kou lihilihi luna, a e hoohana i hookahi manamana lima maemae ma waho o kou po'i luna i paniia e hahau malie i ke kihi o ka luakini. Hoʻopau kēia i kahi lens i pelu ʻia i lalo i ke kihi o lalo i hiki ai iā ʻoe ke hāpai maʻalahi.
6. Inā hoʻokuʻu ʻia ka leni kinoea-permeable (RGP / hard) ma ka keʻokeʻo o kou maka, mai paheʻe a ʻoki ʻia paha ma ka ʻili. ʻO ke kauo ʻana i ka lens paʻa i hoʻomoʻa ʻia ma ka maka e ʻoki ai i ka epithelium o ke kino; akā, e kaomi pono i ka lihi o kou lihilihi lalo i ka keʻokeʻo o ka maka (sclera) ma ka ʻaoʻao o ka ʻaoʻao o waho o ka lens paʻakikī e hoʻopololei i ka ʻaoʻao o ka lens i luna, e uhaʻi i ke sila ʻūhā me ka huʻi ea, a paʻi wale.

lāʻau hoʻoholo: ʻO ka protocol wehe palekana ma ke ʻano a me ke kūlana o ka lens contact¶

flowchart TD
    Start["Hoʻopaʻa ʻia ka Lens Hoʻokaʻaʻike, Peʻi ʻia ma lalo o ka lihilihi, a i ʻole ʻia i ka maka"] --> VerifyCheck{"KaʻAnuʻu Hana 1: Aia ka lens i loko o kou maka?"}
    VerifyCheck -->|"ʻAʻole maopopo: ʻO ka ʻike polū + ʻeha ka maka"| VisionTest["Uhi i ka maka 'E aʻe a nānā i ka mamao ʻelua A me ka ʻike heluhelu kokoke - E kali 60 kekona ma mua o ka hoʻopā ʻana i ka maka a nānā i ke poʻomanaʻo / papahele / pālule me ke kukui uila."]
    VerifyCheck -->|"Hoʻopaʻa ʻia i ka maka"| TypeCheck{"He aha ke ʻano o ka leka hoʻopili, a ma hea ʻo ia e noho ai?"}

    TypeCheck -->|"1. Hoʻomoe ʻia nā Lens palupalu ma luna o ka Cornea (Hoʻomaloʻo ʻia ma hope o ka hiamoe ʻana)"| Dehydrated["Mai Kuʻi i ka lens maloʻo: 1. E hoʻoheheʻe i ka maka me ka 8 a 10 kulu o ka paʻakai sterile a i ʻole nā kulu hoʻomaʻemaʻe hou 2. E pani mālie i ka maka a me ka poʻi lomilomi mālie no 2 mau minuke piha."]

    TypeCheck -->|"2. Hoʻopili ʻia nā Lens ʻoluʻolu a neʻe paha ma lalo o ka lihilihi luna"| UpperCul["1. E hoʻokahe i ka maka me ka paʻakai sterile i ʻole e pipili nā ʻaoʻao 2. E nānā pololei i lalo i ka papahele i ka wā e hāpai ana i ke kuʻemaka 3. A i ʻole e hana i ka Cotton-Swab Upper Eyelid Eversion (pale i ka uhi) no ka holoi ʻana i ka lens."]

    TypeCheck -->|"3. ʻAhae / Wehe ʻia ka ʻāpana Lens palupalu i waiho ʻia ma ka maka"| FragmentSearch["1. E kau i ka ʻāpana i hoʻihoʻi ʻia ma ka manamana lima i ka wai paʻakai e ʻike i ke ʻano puzzle e nalowale ana."]

    TypeCheck -->|"4. ʻOkoʻa kinoea-permeable (RGP / Paʻa) a i ʻole Scleral Lens Suctioned"| HardLens["MAI kauo ma ka cornea: 1. E hookahe i ka maka me na kulu wai hou."]

Māhele 1: Hōʻike Anatomical no ke aha e hiki ʻole ai i kahi leka hoʻopili ke hele ma hope o kou maka¶

ʻO ka hoʻomaopopo ʻana i ke anatomy pololei o ke alo o ka maka o ke kanaka e hoʻomaha koke i ka weliweli noʻonoʻo o ka "nalo" lens pili a kōkua iā ʻoe e nānā i ka ʻeke liʻiliʻi a pāpaʻu kahi e peʻe maoli ai ka lens.

1. Ka Conjunctival Cul-de-Sac (The Sealed U-Turn Pocket)¶

Ke huki ʻoe i kou lihilihi haʻahaʻa i lalo a nānā i ke aniani, ʻike ʻoe i ka ʻulaʻula a me ka pulu ma loko o ka lihilihi e ʻoni mālie i luna ma luna o ka ʻili keʻokeʻo o ka maka. ʻO kēlā pepa ʻiʻo i haki ʻole ʻia ka conjunctiva: - Palpebral Conjunctiva: Laina i ke kua (ka ʻili o loko) o kou lihilihi luna a lalo. - Conjunctival Fornix (Cul-de-Sac): Ma kahi hohonu o 8 a 10 millimeters (0.3 a 0.4 iniha) ma luna o ka lihi luna o kou iris (ma lalo o ka po'i o luna) a me 5 a 6 millimeters (0.2 iniha) ma lalo o ka lihi lalo o kou iris, e ho'opili loa ka conjunctival o kou iris (ma lalo o ka po'i luna) a me 5 a 6 millimeters (0.2 iniha) ma lalo o ka lihi lalo o kou iris. 180-degere U-huli. - Bulbar Conjunctiva: E noʻonoʻo i hope mai kēlā huli U e uhi i ka sclera keʻokeʻo o ka ʻōpoe maka a hiki i ka lihi o ke koʻo maʻemaʻe.

   [ SIDE CROSS-SECTION OF THE UPPER EYELID & EYEBALL ]
   ====================================================
            Upper Fornix (Cul-de-Sac) <-- SEALED DEAD-END POCKET (Max 10 mm deep)
                 /===\                    A folded lens stops right here.
                | (C) | <-- Folded Contact Lens
   Upper Eyelid |     |
                |     |=====[ Eyeball / Sclera ]
                |     |     /
                 \___/     |  <-- Clear Cornea

No ka mea, ʻo ka conjunctival fornix he pūnāwai U-turn makapō i hoʻopaʻa paʻa ʻia a puni ka pōʻai 360-degere o kou maka maka, aia ka ** ʻaʻohe puka kino, ʻāwaha, a i ʻole ka tunnel ** e alakaʻi ana ma hope o ka pōʻalo maka. Hiki i ka lens hoʻopili ke pelu i ka hapalua e like me ka pūpū taco a hoʻokomo mālie i loko o ka ʻeke fornix ākea ma luna o kou mau maka maka, kahi hiki ʻole iā ʻoe ke ʻike, akā ʻaʻole hiki ke hoʻi i hope.

Māhele 2: Pehea e hōʻoia ai aia ka lens i loko o kou maka (Ke pale nei i ka hōʻeha ʻo "Phantom Lens")¶

Ma mua o kou hoʻolilo ʻana i 20 mau minuke i ka ʻili ʻana a i ʻole ka hoʻololi ʻana i kou lihilihi, e hōʻoia ʻaʻole i puka mua ka lens ma luna o kāu pahu pahu, kāwele, pālule, a i ʻole ka uluna.

1. No ke aha i like ai kou maka me he leki lā i paʻa i loko ma hope o kona hāʻule ʻana i waho¶

Inā ʻānai ʻia kekahi leki hoʻopili maloʻo i kou maka a i ʻole i puka ʻino ʻia i ka wā hiamoe a i ʻole ka hamo ʻana i ka maka, e waiho ana ia ma hope o kahi ʻōpala microscopic a i ʻole kahi maloʻo maloʻo ma ka ʻili o ka ʻili (a superficial punctate epithelial erosion). No ka mea, ʻo ka ʻāʻī o ke kanaka ke kiʻekiʻe kiʻekiʻe loa o nā aʻalolo ʻeha (** trigeminal nerve C-fibers**) o kekahi ʻiʻo i loko o ke kino, ʻo kahi ʻōpala microscopic 1-milimeter e hoʻoulu i kahi ** Foreign Body Sensation **, kahi i 100 pakeneka o kou lolo e noho mau ana kahi ʻāpana plastik ma lalo o kou lihilihi luna i ka wā ʻole maoli ka maka.

2. ʻO ka 60-Second Optical Verification Test¶

1. Uhi i kou mau maka ʻē aʻe (ʻaʻole i hoʻopilikia ʻia) me kou lima: E nānā me wale ka maka i hoʻopilikia ʻia ma ka uaki pā mamao a i ʻole ma ka lumi, a laila e nānā i nā paʻi maikaʻi ma ka ʻōmole 30 kenimika (12 iniha) ka mamao.
2. Inā ʻike ʻoe (myopic, e laʻa, -3.00 D prescription) a pohihihi loa ka kikokikona i ka heluhelu ʻana i ka kikokikona ma 15 a 25 kenimika (6 a 10 iniha) he aniani ʻoi loa, ʻaʻole ** kau ʻia kāu leki hoʻopili i kou kino.
3. Eia nō naʻe, inā paʻa ka lens ma waenakonu o kou koʻo** (e hana pinepine ʻia ke poina i kekahi ua hoʻokomo ʻo ia i kahi lens a poina paha i ka lawe ʻana i waho), e pili ana kāu ʻike ma ia maka i kāu ʻōlelo kuhikuhi i hoʻoponopono ʻia (koe ke hoʻopaʻa ʻole ʻoe i ʻelua mau lens ma luna o kekahi, e pāpālua i kou mana kuhikuhi).
4. Hoʻālohilohi i kahi kukui a i ʻole ke kukui uila ma kahi kihi ʻaoʻao 45-degere ma ke alo o kou maka ma ke aniani:
5. Mai hoʻomālamalama pololei i kāu haumāna. E hoʻopaʻa i ke kukui uila ma kahi kokoke i kou pepeiao a e hoʻomālamalama i ke kukui ** ma ka ʻaoʻao o ka dome o kou maka ** oiai e nānā ana i loko o ke aniani hoʻonui.
6. E nānā i ka sclera keʻokeʻo 1 a i 2 millimeters ma waho o ke apo iris waihoʻoluʻu: inā e kau ana kekahi leki hoʻopili palupalu ma ka piko o kou ʻāʻī, e hoʻolei ʻia ke kukui o ka ʻaoʻao i kahi laina aka poʻomanaʻo ʻē aʻe a puni ka lihi o waho o ka lens ma ka sclera keʻokeʻo.
7. Inā ʻaʻole ʻoe e ʻike i kēlā apo makamae ma ka sclera keʻokeʻo, mai ʻoki i waenakonu o kou maka, no ka mea, ʻo ka mea āu e nānā nei, ʻo ia kou ʻāʻī a ʻalohilohi.

Māhele 3: Nā ʻenehana wehe ʻanuʻu i kēlā me kēia hiʻohiʻona "lens paʻa"¶

E koho i ka ʻenehana lapaʻau pololei ma lalo e pili ana i kahi o kāu lens a me ke ʻano o ka lens āu e ʻaʻahu ai.

Hoʻohālikelike i nā hiʻohiʻona hoʻopaʻa lens contact 4 a me nā ʻano hoʻokuʻu palekana¶

Kūkākūkā kikoʻī 1: Hoʻomaʻemaʻe a lana i kahi lens palupalu i paʻa i waenakonu o kou maka¶

Ke ala aʻe ʻoe ma hope o ka hiamoe ʻana me nā lens hoʻopili palupalu (a i ʻole ma hope o ka hana ʻana no nā hola i ka ea maloʻo a i ʻole ka ea o ka mokulele mokulele), lilo ka lens hydrogel i ka 15 pākēneka o kona ʻano wai a pili pono i ka cornea. 1. E hoʻokomo i kahi ʻauʻau paʻakai mau: E hoʻopololei i kou poʻo i hope e kū pono ana i ke kaupaku. Huki i kou lihilihi haʻahaʻa no ka hana ʻana i kahi ʻauwai liʻiliʻi a ʻomi iā ** 6 a 10 kulu o nā kulu hoʻomaʻemaʻe ʻana o ka lens contact sterile, nā waimaka hana ʻole preservative-free, a i ʻole saline sterile** ma luna o ka lens. 2. Pani a e poni mālie no 90 a 120 kekona: Mai komo koke me kou manamana lima. Pono ʻo Hydrogel plastic i ka 1 a 3 mau minuke piha o ka hoʻoluhi ʻana e hoʻihoʻi i ka wai i loko o kāna matrix polymer cross-linked a hoʻomaha i kona curvature. ʻOiai e pani ʻia kou maka, e kau i ka pā palahalaha o kekahi manamana lima maʻemaʻe ma luna o kou lihilihi i pani ʻia a hana i nā ʻoni lomilomi liʻiliʻi liʻiliʻi (me ke kaomi ʻole ʻana i lalo i ka pōpō maka). 3. E hana i ka "Push-Test" Ma mua o ke kuʻi ʻana: E wehe i kou maka i mua o ke aniani. E kau i hoʻokahi manamana lima ma ka ʻili o kou ** lihilihi haʻahaʻa ma ka laina lihilihi** a hoʻokuʻu mālie i ka ʻaoʻao o ka poʻi haʻahaʻa i luna ma ka ʻaoʻao lalo o ka lens pili. - Inā ʻaʻole e neʻe iki ka lens: E kū koke no ka mea ʻaʻohe wai. E hoʻohui i 6 kulu hou o ka saline sterile, e pani i kou maka, a kali i 2 mau minuke. - Inā wili iki ka lens a paheʻe i ka 2 a i ka 3 millimeters i luna: Ua haki ka sila hoʻomoe. 4. E hoʻoheheʻe i ka Sclera Keʻokeʻo e wehe: E nānā iki i luna i ke kaupaku (a i kou ihu), e hoʻohana i kou papa manamana lima maloʻo e ** hoʻoheheʻe i ka leki pulu mai ka ʻili koʻikoʻi ma luna o ke keʻokeʻo o ka maka (ka sclera)** (kahi i ʻoi aku ka palahalaha o ka ʻāʻī o ka maka a e wili iki ka lens ma waena o kou manamana lima a kuʻi mālie ma waena o kou manamana lima. nā manamana lima).

Kūkākūkā kikoʻī 2: ʻimi a wehe ʻana i kahi lens palupalu i hoʻopaʻa ʻia ma lalo o ka lihilihi luna.¶

ʻOi aku ma mua o 80 pākēneka o nā leki hoʻopili "nalo" e pelu ʻia i ka hapalua e like me ka ʻāpana taco hapalua mahina a hoʻopaʻa ʻia i loko o ka superior conjunctival fornix (ma lalo o ka ʻili o luna, ma luna o ka cartilage-like tarsal plate).

KaʻAnuʻu A: ʻO ka Downward-Gaze ​​Lid-Lift a me ka Nasal Sweep (E hana ana ma 75% o nā hihia o luna)¶

1. E hoʻi i kou poʻo i hope a hoʻokomo i ka ** 8 a 10 kulu o ka paʻakai sterile a i ʻole ka solution lens contact multipurpose** i loko o ka maka. No ke aha mai? I ka wā e pelu ai ka lens palupalu i ka hapalua ma lalo o kou poʻi, pili nā ʻaoʻao polimer maloʻo ʻelua i kekahi i kekahi e like me ke kāʻei ʻilika. ʻO ka hoʻopiha ʻia ʻana o ka ʻeke me ka paʻakai e hoʻomaka hou ai ka lens i pelu ʻia, me ka pāpālua ʻana i kona ʻili i laila e hoʻokuʻu ʻia e ka lihilihi.
2. E ʻimi i nā makamaka luna a huki i ka poʻi luna i waho mai ka ʻōpoʻo maka: ʻOiai e nānā ana i ke aniani, e hopu mālie i nā maka o kou poʻi luna ma waena o ka manamana nui a me ka manamana lima, huki i ka lihilihi luna ** i mua (ma waho o kou pōʻai maka) me 3 millimeters**, a ʻoiai e hoʻopaʻa ana i ka poʻi i waho, ** e nānā pololei i kou maka i lalo.
3. ** No ke aha e hana ai kēia mechanically:** Ke kaʻi ʻana o kou pōpō maka i lalo, ʻolokaʻi ka sclera luna mai loko mai o ka ʻeke fornix kiʻekiʻe a ʻo ka lihilihi i hāpai ʻia e hoʻokuʻu i ka gravity a me ka paakai e holoi i ka lens i wehe ʻia i lalo i ka keʻokeʻo o kou maka.
4. Ka Maka Paʻa ʻOuter-to-Inner Sweep: Inā paʻa ka lens i luna, e nānā i lalo, e pani mālie i kou mau lihilihi, e kau i kou manamana lima ma ka ** kihi o waho (ʻaoʻao o ka luakini)** o kou lihilihi i pani ʻia ma lalo pono o ka iwi lae, a e hahau mālie i ka ** kihi i loko o kou ihu)** (ka medial canthus)**. E hana hou i 4 a 5 mau manawa; e puka pinepine ana ka lens ma ke ʻano he puʻupuʻu liʻiliʻi i ʻōwili ʻia ma ke kihi ʻulaʻula o loko o kou maka (ka lacrimal caruncle).

KaʻAnuʻu B: Pehea e hoʻohuli ai i kou lihilihi luna ma luna o kahi pulupulu pulupulu (Upper Eyelid Eversion)¶

Inā hoʻopaʻa ʻia ka lens i pelu ʻia a i ʻole ʻāpana haehae ʻia i ka ʻaoʻao maʻemaʻe ma lalo o kou lihilihi luna (ʻo ka tarsal conjunctiva), ʻo ka hoʻohuli ʻana i ka lihilihi o luna i waho (** hoʻohuli i ka poʻi**) e hōʻike i ka ʻeke huna i loko o 5 kekona me ka ʻeha ʻole. Hana nā Optometrist i kēia hana ma kēlā me kēia nānā maka maʻamau.

   [ HOW TO FLIP (EVERT) THE UPPER EYELID WITH A COTTON SWAB ]
   ===========================================================
   1. Look straight DOWN at the floor (keep looking down the whole time)
   2. Place a cotton swab horizontally across the upper eyelid crease (1 cm above lashes)
   3. Grasp upper eyelashes with the other hand, pull OUT and fold UP over the swab

1. E kū i mua o ke aniani mālamalama maika'i a pa'a i kahi ** pulupulu ma'ema'e (Q-tip)** (a i 'ole ka pahu ma'ema'e a ma'ema'e o ka peni) ma kou lima.
2. E nana pololei ilalo i ka papahele me na maka elua a me ka manao e pale aku i ka manao e nana iluna a i ole e komi i kou mau lihilihi, no ka mea, e hoomaha ka levator palpebrae i ka lihilihi maka me ka ikaika ole.
3. Me kou manamana nui ʻole a me kou manamana lima kuhikuhi, e kuʻi mālie i ka maka waena o luna a huki iki i ka lihilihi o luna i lalo a i waho mai ka pōpō maka.
4. E kau i ka piko o ka pulupulu ** ma ka ʻaoʻao o ka ʻili o waho o kou lihilihi luna ma ka ʻaoʻao lihilihi maoli** (ma kahi o 1 kenimika / 0.4 ʻīniha ma luna o ka laina lihilihi, ʻo ia ka lihi luna o ka pā tarsal oolea).
5. E kaomi maʻalahi i ka pulupulu pulupulu i lalo e pili ana i kēlā ʻeke ma ke ʻano he hinge fulcrum oiai e hāpai ana i nā maka maka ** i luna a pelu hou i ka poʻi ma luna o ka pulupulu pulu** i kou kuʻemaka.
6. Wehe i ka pulupulu pulupulu i ka wā e paʻa mālie ana nā maka maka i kou lae luna me ka manamana lima (a hoʻomau i ka nānā ʻana i lalo). ʻO ka ʻaoʻao ʻulaʻula ma lalo o kou lihilihi luna ua ʻike ʻia i loko o ke aniani, a ʻo kāu leki hoʻopili i pelu ʻia a i ʻole ʻāpana ʻāhaeha e noho pololei ana i ka ʻike maopopo.
7. E hoʻomaloʻo i ka hope maʻemaʻe o ka pulupulu me ka paʻakai maʻemaʻe a hoʻopā māmā iā ia i ka leka hoʻopili i pelu ʻia, e pili koke i ka pulupulu pulu a hāpai pono.
8. No ka hoʻihoʻi ʻana i kou lihilihi i ka mea maʻamau, e hoʻokuʻu wale i nā maka maka, ** nānā pololei i luna i ke kaupaku, a hoʻomoe hoʻokahi**; paʻi hou ka lihilihi i kona kūlana maʻamau.

Kūkākūkā kikoʻī 3: Wehe i kahi ʻāpana lens hoʻopili i haehae ʻia¶

ʻO nā lens hydrogel palupalu i kekahi manawa e haehae i ka hapalua i loko o ka maka. No ka mea, ʻo kahi huinakolu hydrogel mākū a akaka, ʻo ia ka ʻōlelo kuhikuhi refractive like me kou mau waimaka, hiki ke ʻike ʻole ʻia i ka keʻokeʻo o kou maka i ka wā e hoʻoulu ai i ka naʻau ʻoi loa me kēlā me kēia maka. 1. E hana hou i ka "Jigsaw Puzzle" ma ka Po'e Po'ele'ele: Mai hoolei aku i ka apana o ka lens hoopili i unuhi mua ia. E kau i kēlā ʻāpana i hoʻihoʻi hou ʻia i loko o kahi kulu o ka paʻakai ma luna o kahi pākaukau ʻeleʻele a i ʻole kou manamana lima i wehe palahalaha. E nānā i kona outline: ʻaʻohe mahina puʻu liʻiliʻi ma ka ʻaoʻao hoʻokahi, a i ʻole ua ʻoki paha ka lens i 50/50 ma waena? Ke wehe ʻoe i ka ʻāpana i koe mai kou maka, e waiho i nā ʻāpana ʻelua i kēlā me kēia ʻaoʻao e hōʻoia i ka helu ʻana o ka 100 pakeneka o ka lens (no laila ʻaʻole ʻoe e ʻike i ke koena ʻekolu ʻāpana). 2. Ka Ipu Maka / Bowl Immersion Blink Flush: Inā ʻaʻole hiki iā ʻoe ke ʻike i ka ʻāpana akaka, e hoʻopiha i kahi aniani pana maʻemaʻe, ʻāʻī ʻawaʻawa, a i ʻole kīʻaha liʻiliʻi a hiki i ka lihi me sterile 0.9% saline solution (a i ʻole sterile multipurpose contact lens hoʻoheheʻe wai, ʻaʻole hoʻi i ka wai). E hili i kou maka i lalo, e hoʻoheheʻe i kou maka hāmama pololei i loko o ka ʻauʻau paʻakai maʻemaʻe, a 'ōpuʻu wikiwiki i 10 manawa i ka wā e kaʻa ana i kou maka hema, ʻākau, luna, a lalo. E pohō ka ʻāpana hydrogel mai ka maka i lalo o ke aniani a i ʻole ke kīʻaha. 3. Ka Wet Cotton-Swab a i ʻole Tissue Capillary Touch: Ke ʻike aku ʻoe i ka ʻaoʻao translucent o ka ʻāpana i haehae ʻia e kau ana ma luna o ka sclera keʻokeʻo (a i ʻole i loko o ka ʻāʻī o ka lihilihi haʻahaʻa), mai hoʻāʻo e ʻoki i kahi ʻāpana liʻiliʻi i haehae ʻia me nā manamana lima ʻelua. Akā, e wili i ke kihi o kahi ʻiʻo maka maʻemaʻe ʻole ka lint i kahi wahi palupalu (a i ʻole e hoʻohana i ka pulupulu pulupulu i hoʻomāmā ʻia me hoʻokahi kulu o ka paʻakai) a ** hoʻopā pololei i ka piko i ka ʻāpana ma ka keʻokeʻo o ka maka (ʻaʻole e hoʻopā i ke koʻa waena). ʻO ka huki ʻana o ka Capillary e hoʻopili koke i ka ʻāpana hydrogel lahilahi i ka ʻiʻo a i ʻole ka pulupulu.

Māhele 4: ʻO ka hoʻāʻo ʻana i ka lāʻau lapaʻau ma hope o ka wehe ʻana i nā leki pili (Corneal abrasion vs. infectious ulcer)¶

Ma hope o ka wehe ʻana i nā lens hoʻopili paʻakikī, ʻaneʻane e nānā mau kou maka i ka ʻulaʻula maʻemaʻe (conjunctival hyperemia) a me ka huhū iki mai ka hoʻoheheʻe ʻana i ka mīkini a me ka paʻakai. Pehea ʻoe e hoʻokaʻawale ai i ka huhū ma hope o ka wehe ʻana mai kahi pilikia olakino?

1. ʻO ke kānāwai 2-Hour a me ke kauoha "Haʻalele i nā Hoʻokaʻaʻike".¶

• E hoʻolei koke i ka Lens i Wehe ʻia: ʻOiai inā i puka mai kahi ʻāpana palupalu ma ka ʻāpana hoʻokahi ma hope o ka pelu ʻia ʻana ma lalo o kou lihilihi no nā hola, ua loaʻa i kona ʻili polymer nā ʻāpana microscopic, nā waimaka lihi, a me nā waihona protein. E kiola aku a wehe i kahi ʻeke pohū hou wale nō ma hope o ke ola ʻana o kou maka.
• E hāʻawi i kou Kone 24 hola o ka Oxygen i loko o nā maka aniani: Mai ** ʻaʻole** e hoʻokomo i kahi leki hoʻopili hou ma hope koke o ka hoʻoikaika ʻana e wehe i kahi leki paʻa a nahae paha. Inā hana kou manamana lima a i ʻole ka lens maloʻo i kahi ʻāʻī liʻiliʻi, e paʻi ana i kahi leki hoʻopili hou ma luna o ka bacteria traps scratch (Pseudomonas aeruginosa a i ʻole Staphylococcus) e kū pono ana i ka pale corneal haʻi i loko o kahi incubator haʻahaʻa o ka oxygen. E kau i kou maka aniani no ka liʻiliʻi loa he 24 hola.

2. Nā hōʻailona hae ʻulaʻula e koi ana i ka lā hoʻokahi optometrist, ophthalmologist, a i ʻole ka loiloi mālama wikiwiki.¶

E ʻimi i ka nānā maka ʻoihana (me ka slit-lamp biomicroscope a me ka fluorescein dye stain) i kēia lā inā ʻike ʻoe i kekahi o kēia mau mea: 1. Ke ʻike ʻole ʻia e ke kino ʻē a i ʻole ka ʻeha ʻoi aku ma mua o 2 a i 3 mau hola ma hope o ka wehe ʻia ʻana: Inā ʻaʻole hiki iā ʻoe ke hōʻoia inā e waiho ʻia kahi ʻāpana i loko o kou maka, a i ʻole e mau ana ka ʻeha ʻeha ma mua o 2 mau hola ma hope o ka wehe ʻana i ka lens a hoʻomaha i kou maka paʻa, hiki i ka optometrist a i ʻole ke kauka pilikia ke hoʻokomo i hoʻokahi kulu o ka maʻi ʻeha ʻole** ke kukui cobalt-blue i kou maka. ʻO nā ʻāpana lens hoʻopili huna ** ʻālohilohi ʻōmaʻomaʻo ʻōmaʻomaʻo ʻōmaʻomaʻo** ma lalo o ke kukui cobalt-blue, a ʻike maopopo ʻia kekahi abrasion corneal no laila hiki ke kuhikuhi ʻia nā kulu antibiotic. 2. Photophobia (ʻEha ke nānā aku i ke kukui o loko maʻamau a i ʻole ka lā): ʻO ka ʻeha ʻana o ka naʻau kukui i hui pū ʻia me ka spasms o ka lihilihi maka ʻole (blepharospasm) a me ka haʻalulu wai mau e hōʻike ana i ka hōʻeha nui o ka epithelial corneal a i ʻole iritis mua. 3. ** Keʻokeʻo a hinahina paha ma luna o ka iris kala/kornea a i ʻole ka melemele-'ōmaʻomaʻo:** e nānā pono i ke aniani i ka ʻaoʻao akaka ma luna o kou iris waihoʻoluʻu: inā ʻike ʻoe i kekahi wahi **keʻokeʻo, hina, a ʻeleʻele paha ** ma ka cornea (he corneal infiltrate a ulcer), a i ʻole ka maʻi maʻi mucopurulent mānoanoa. Pili-lens pili Pseudomonas corneal ulcers hiki ke holomua wikiwiki i loko o 24 mau hola a koi aku i ka lāʻau lapaʻau i hoʻopaʻa ʻia i ka fluoroquinolone antibiotic kulu maka.

Nā helu ulia pōpilikia āpana a me nā protocols oihana¶

Nīnau pinepine¶

ʻAʻole hiki ke paheʻe ka lens hoʻopili ma hope o koʻu poʻo i loko o koʻu poʻo?¶

ʻAʻole, he 100 pakeneka hiki ʻole ke anatomically. ʻO ka membrane ʻulaʻula maʻemaʻe e hoʻopaʻa ana i loko o kou mau lihilihi (ka palpebral conjunctiva) e hoʻopuni a puni ma kahi hohonu o 8 a 10 millimeters (emi ma lalo o ka hapalua ʻīniha) ma lalo o kou poʻi luna a pili mau i ka ʻili keʻokeʻo o kou maka (ka bulbar conjunctiva). Hoʻokumu kēia i kahi ʻeke pōʻai makapō i hoʻopaʻa ʻia i kapa ʻia ʻo **conjunctival fornix**. ʻAʻohe mea ma ka ʻaoʻao mua o kou maka, inā he lens hoʻopili palupalu, lens RGP paʻakikī, ka maka maka, a i ʻole ka ʻāpana lens i haehae ʻia, hiki ke hele i kēlā pā i hoʻopaʻa ʻia e hele ma hope o ka honua o kou maka.

Pehea wau e ʻike ai inā paʻa mau ka lens hoʻopili i koʻu maka a i ʻole hāʻule i waho a ua ʻoki wale au i koʻu ʻili?¶

ʻO ka mua, e uhi i kou maka ʻē aʻe a e hoʻāʻo i kou ʻike ma kahi mamao a kokoke e ʻike inā e kau mau ana kāu hoʻoponopono ʻana ma luna o kāu haumāna. ʻO ka lua, e hoʻomālamalama i ke kukui uila ma kahi kihi ʻaoʻao 45-degere ma kou maka a nānā pono i ke aniani i ka sclera keʻokeʻo ma kahi o 1 a 2 millimeters wale nō ma waho o kou iris kala: inā he leki palupalu ma kou cornea, e ʻike ʻoe i kona ʻaoʻao pōʻeleʻele o waho. Inā ʻaʻole ʻoe e ʻike i kēlā ʻaoʻao o waho ma ka keʻokeʻo o ka maka, ** hoʻōki koke i ke kiko waena o kou maka**. Ua like ka ʻāʻī ʻana o ka ʻāʻī liʻiliʻi me ka lens hoʻopaʻa paʻa ("phantom lens sensation"), a ʻo ke kui ʻana i kou kino ʻole ke kumu o ka ʻeha epithelial.

He aha inā ʻaʻohe kaʻu mea hoʻonā lens contact a i ʻole ka hoʻomaʻemaʻe ʻana me aʻu a paʻa koʻu lens?¶

Inā haʻalele ʻoe i ka home me ka ʻole o ka hoʻoheheʻe ʻana o ka leki hoʻopaʻa maʻemaʻe, nā kulu hoʻomaʻemaʻe hou ʻana, a i ʻole nā ​​​​waimaka hana ʻole mālama ʻole, **mai hoʻokomo i ka wai paipu, wai inu ʻōmole, a i ʻole kohu i loko o kou maka**. Akā, e pani i nā maka ʻelua a waiho i kou waimaka hoʻomaʻamaʻa maoli no 3 a 5 mau minuke (e nānā i lalo a lomilomi mālie i kou lihilihi i pani ʻia mai ka ʻaoʻao o waho a hiki i kou ihu e hoʻoulu ai i ka waimaka lacrimal), a i ʻole e hele i kahi lāʻau lapaʻau, hale kūʻai, a hale kūʻai ʻoluʻolu paha e kūʻai i ka ʻōmole paʻakai sterile a i ʻole lubricating kulu maka.

Ua paheʻe kaʻu lens gas-permeable (RGP / hard) i ka keʻokeʻo o koʻu maka a ua ʻoki ʻia: pehea wau e wehe ai?¶

No ka mea, ʻoi aku ka palahalaha o ka maka keʻokeʻo (ka sclera) ma mua o ka piko waena, ʻo kahi lens RGP paʻakikī e paheʻe ma luna o ka sclera e like me ke kīʻaha liʻiliʻi. **Mai hopu a kauo paha i ka leki paa i hoohuoiia ma ka pololei o kou maka.** E hookahe mua i ka maka me na kulu lubricating. A laila, e nānā i loko o ke aniani no ka ʻimi ʻana i ka lens, e kau i kou manamana lima maʻemaʻe ma ka ** ʻili waho o kou lihilihi** ma ka ʻaoʻao pono o ka ʻaoʻao o waho o ka lens paʻakikī, a kaomi mālie i ka ʻaoʻao lihilihi ** i loko o ka sclera keʻokeʻo ma waho o ka palena o ka lens**. ʻO ka hoʻokomo ʻana i ka sclera ma ka ʻaoʻao o ka ʻaoʻao o ka lens e wāwahi ai i ke sila ʻūhā no laila e paheʻe ka ea ma lalo o ka lens, e ʻae iā ia e lana kaʻawale.

Hiki iaʻu ke hele i ka hiamoe inā ʻaʻole hiki iaʻu ke kiʻi i kahi leki hoʻopili i pelu ʻia mai lalo o koʻu lihilihi luna i ka pō?¶

Inā ʻoluʻolu ʻia kahi lens hoʻopili palupalu i loko o ka ʻeke fornix conjunctival kiʻekiʻe (ma waho o ka cornea waena), ʻaʻole ** e ʻeha nui kou maka, nalo ka ʻike, a i ʻole ke kahe ʻana o ka purulent, a ua hoʻopiha ʻia ʻoe me ka paʻakai sterile me ka lanakila ʻole i ka pō, ʻoi aku ka palekana o ka hoʻōki ʻana i kou maka, hoʻomoʻi i nā kulu lubricating, hele i ka optometrist maka mua i ke kakahiaka. 2:00 AM. I nā manawa he nui, hana maoli ka hana waimaka i ka pō a me ka neʻe ʻana o ka maka REM ma lalo o kahi lihilihi paʻa i hoʻomaha ʻia e hana maoli i ka leki pelu a hiki i ke kihi o loko o kou maka i ke kakahiaka.

He aha ka hopena inā hele au i ka optometrist a i ʻole ka mālama koʻikoʻi no ka leki hoʻopaʻa paʻa a nahae paha?¶

ʻO ka wehe ʻana i kahi leki paʻa paʻa a haehae ʻia paha i loko o ke keʻena optometrist a i ʻole ke keʻena maka maka wikiwiki e emi iho ma mua o 2 mau minuke a ʻaʻohe ʻeha. Hoʻokomo ke kauka lapaʻau i hoʻokahi kulu o ka **fluorescein dye ** (a me ka hāʻule ʻana o ka anesthetic inā ʻeha kou maka), e hoʻohuli mālie i kou lihilihi luna me ka mea hoʻopili pulupulu ma lalo o kahi **slit-lamp biomicroscope** i hoʻonui ʻia me kahi kukui cobalt-blue, hoʻokiʻekiʻe i ka ʻāpana ʻōmaʻomaʻo ʻōmaʻomaʻo i waho a i ʻole ka pulu ʻōmaʻomaʻo. kornea e ʻike pono ʻaʻohe ʻakaʻaka e koi i nā kulu antibiotic.

Nā alakaʻi pili¶

• ʻO ke kolu nui ma nā lihilihi, nā lehelehe, a i ʻole ka ʻili: Acetone vs. aila hoʻokuʻu
• ʻAle ʻia ka niho niho, ka lei aliʻi, a me nā makaaniani haʻihaʻi a i ʻole ke kōkua lohe
• ʻO ka lāʻau lapaʻau i nalowale: Hoʻopiha hou a me ka hoʻihoʻi ʻana
• Nā helu ulia pōpilikia honua a me ka hoʻouna ambulance

Nā kumu a me ke alakaʻi kūhelu¶

• American Academy of Ophthalmology (AAO, ʻAmelika Hui Pū ʻIa): Alakaʻi Kauka no ka Hoʻopaʻa ʻana i nā Lens Hoʻopili i ka Superior Conjunctival Fornix, ʻĀpana Eversion ʻEleʻele, a me ke Kāohi ʻana i ka Iatrogenic Corneal Epithelial Abrasions.
• Nā kikowaena no ka hoʻopaʻa ʻana a me ka pale ʻana i ka maʻi (CDC, ʻAmelika Hui Pū ʻIa): Nā Hoʻohana ʻana i nā Lens Hoʻopili Ola a me nā alakaʻi alakaʻi: Kāohi ʻana i ka Acanthamoeba Keratitis, pāpā ʻana i ka ʻike maka o ka wai, a me ka Microbial Keratitis Red Flags.
• U.S. Food and Drug Administration (FDA, United States): E pili ana i ka Lens Riskes, Wehe Palekana o Dehydrated Hydrogel and Rigid Gas-Permeable (RGP) Lenses, a me Hydrogen Peroxide Solution Solutions Warnings Safety Warnings.
• Ke Kulanui o nā Optometrists a me ka National Health Service (NHS, United Kingdom): Nā Kūlana Hoʻokele Hoʻomalu no nā ʻĀpana ʻO Corneal, Nā ʻāpana Lens Hoʻopaʻa Paʻa, a me Fluorescein Slit-Lamp Examination.
• ʻAhahui Optometric ʻAmelika (AOA, ʻAmelika Hui Pū ʻIa): *Ka mālama ʻana i ka mea maʻi Lens Contact: Hoʻoponopono ʻana i nā Lenses Soft Adherent, Scleral Lens Suction Release, a me ka loiloi Corneal Post-Retrieval *.