Amblyopia

Isifo i-Amblyopia sithinta izingane ezifika ku-3-4% emhlabeni wonke, okwenza kube enye yezinkinga zokubona ezivame kakhulu entsheni. Lesi simo, esivame ukubizwa ngokuthi i-amblyopia lazy eye, siqala lapho ubuchopho neso kuyeka ukusebenza ndawonye ngendlela efanele. Ubuchopho buqala ukuthembela kakhulu esweni elilodwa kuyilapho ungazinaki izimpawu ezivela kwelinye, okuholela ekwehleni kokubona esweni elibuthaka. Masiqonde izimbangela, izimpawu, kanye nezinketho zokwelapha ze-amblyopia yeso elivilaphayo ukuze sisize abazali nabanakekeli benze izinqumo eziphusile mayelana nempilo yamehlo yengane yabo.

Iyini i-Amblyopia?

I-Amblyopia yisimo esibucayi sokubona esiba khona lapho ubuchopho neso kwehluleka ukusebenzisana ngendlela efanele. Lesi simo ngokuvamile sithinta iso elilodwa, nakuba ezimweni ezingavamile, singathinta womabili amehlo. Lapho ingane ine-amblyopia, ubuchopho bayo kancane kancane iyama ukubona izimpawu ezivela esweni elithintekile, okuholela ekwehleni kokubona kulelo hlo.

Lesi simo siqala ebuntwaneni, ngokuvamile kusukela ekuzalweni kuya eminyakeni eyi-7, futhi singaba sibi kakhulu uma singelashwa. Ezinganeni ezine-amblyopia, ubuchopho buqala ukuthembela kakhulu esweni eliqinile kuyilapho ungaziba izimpawu ezibonakalayo ezivela esweni elibuthakathaka. Lokhu kudala umehluko omkhulu kwikhwalithi yombono phakathi kwamehlo amabili.

Izimbangela Nezingozi Ze-Amblyopia (Iso Elivilaphayo)

Izimo eziningana zingavimbela amehlo engane ukuba enze izithombe ezicacile, ezigxilile, okuholela ekuthuthukisweni kwe-amblyopia. Imbangela eyinhloko ye-amblyopia ingahlukaniswa ngezinhlobo ezintathu eziyinhloko:

• I-Strabismus (Ukungalingani Kwemisipha): Lapho amehlo engahambisani kahle, neso elilodwa libheke ngaphakathi, ngaphandle, phezulu, noma phansi. Lokhu kungahambi kahle kuthumela izithombe ezingqubuzanayo ebuchosheni, kucindezela ukubona esweni elingaqondile.
• Amaphutha Okubukisayo: Umehluko omkhulu embonweni phakathi kwamehlo amabili, okuhlanganisa:
  • Ukubona eduze (myopia)
  • Ukubona kude (hyperopia)
  • I-Astigmatism (i-cornea engavamile)
• Ukuncishwa: Ukuvaleka ngokomzimba kokubona, njengendawo eguqubele ku-lens (i-cataract) noma izinkinga ne-cornea, okuvimbela ukukhula kombono ocacile.
• Izimo zeso lesakhiwo: Izimo eziningana zamehlo zingathinta ukusebenza kwamehlo engane, okuholela ekuboneni okufiphele kanye ne-amblyopia. Lokhu kufaka phakathi i-ptosis (amajwabu amehlo), izinkinga ze-cornea, kanye ne-cataract.  

Kunezici eziningana ezandisa ithuba lokuthuthukisa i-amblyopia. Lezi izi:

• Izingane ezizalwe ngaphambi kwesikhathi noma ezinesisindo esiphansi (ngaphansi kuka-2,500 gm) 
• Ukuba namalungu omndeni wemvelo anenkinga yamehlo neyokubona 
• Izingane ezinokulibaziseka kokukhula 

Izimpawu ze-Amblyopia

Ukuthola izimpawu ze-amblyopia yeso kungase kube inselele, njengoba izingane eziningi azikhonondi ngezinkinga zokubona. Izingane ezine-amblyopia zingabonisa izimpawu ezihlukahlukene zomzimba nezokuziphatha:

• Ukushayisana njalo ezintweni, ikakhulukazi ohlangothini olulodwa lomzimba wazo
• Ukuklolodela njalo noma ukuvala iso elilodwa
• Ukutshekisa ikhanda okungaguquki lapho ubuka izinto
• Ukuphambana kwamehlo okuphawulekayo
• Ukuwa kwejwabu leso
• Ubunzima bokubona ukujula
• Ukungasebenzi kahle kwesandla neso
• Ukukhubeka noma ukuwa njalo
• Ukucwayiza okwedlulele noma ukucikica iso
• Izikhalazo ezivamile zekhanda

Izinkinga

I-amblyopia engalashwa ingaholela ezinkingeni ezibalulekile zesikhathi eside ezidlulela ngale kwezinkinga zombono. Uma siyekwa singalawulwa, lesi simo singaholela ekulahlekelweni umbono unomphela, ikakhulukazi uma iso eliqinile lilimala noma kuba nezinye izimo ezifana nolwelwesi lwamehlo.

Umthelela we-amblyopia udlulela ezicini ezihlukahlukene zokuphila kwansuku zonke. Abantu abane-amblyopia engalashwa bavame ukuzwa:

• Ukubona ukujula okwehlisiwe okuthinta ezemidlalo nokushayela
• Ubunzima bokufunda nemisebenzi yokufundisa
• Imikhawulo ekukhethweni kwemisebenzi
• Izinselele ekwenzeni imisebenzi enemininingwane
• Ukwanda kwengozi yokulahlekelwa ukubona okuphelele
• Izinkinga ngokusebenzisana komphakathi
• Ukucindezeleka nokukhathazeka okwandayo kubangela ubudlelwano bomndeni obunzima. 

Sifo

Inqubo yokuxilonga ihlanganisa izivivinyo ezibalulekile ezimbalwa:

• Ukuhlolwa kwe-Visual Acuity: Ukuhlolwa kwamehlo kwendabuko "20/20" kusetshenziswa amashadi ezinhlamvu zezingane ezindala ezikwazi ukufunda
• I-retinoscopy: Ukuhlolwa okukhethekile kusetshenziswa i-retinoscope ukuze kukale ukuthi ukukhanya kuvela kanjani ku-retina
• Ukuhlolwa Kwekhava: Ukushintshanisa ukuvala iso ngalinye ukuze ubuke impendulo yengane
• Ukuhlolwa kwe-Prism: Ukulinganisa ukungaboni kahle kwamehlo kusetshenziswa amathuluzi amise okweprism
• Ukuhlolwa kwe-Reflex ebomvu: Ukuhlola ukuthi ukukhanya kuveza kanjani ngemuva kweso
• I-retinoscopy: uchwepheshe uveza ukukhanya emehlweni engane (engakakwazi ukukhuluma noma ukufunda) futhi abheke ukuthi kuvela kanjani kuyi-retina. 

Ukwelashwa kwe-Amblyopia

Isihluthulelo sokwelashwa okuphumelelayo sisekuqaleni kusenesikhathi kanye nokugcina ukungaguquguquki kuso sonke isikhathi sokwelashwa esinqunyiwe. Ucwaningo lubonisa ukuthi izingane ezithola ukwelashwa ngaphambi kweminyaka emithathu zinethuba eliphansi ngo-70% lokuthuthukisa i-amblyopia eyinsalela uma kuqhathaniswa nalabo abaqala ukwelashwa kamuva.

Izinketho zokwelapha eziyinhloko zihlanganisa:

• Izingubo zamehlo ezilungisayo: Izibuko noma amalensi othintana naye abhekana namaphutha e-refractive futhi ngokuvamile asebenza njengomugqa wokuqala wokwelapha
• I-Occlusion Therapy: Ukusebenzisa i-eye patch esweni eliqinile amahora angu-2-6 nsuku zonke ukuqinisa iso elibuthakathaka
• I-Atropine Eye Drops: Kufakwe esweni eliqinile ukuze kufiphazwe okwesikhashana, okukhuthaza ukusetshenziswa kweso elibuthakathaka
• Izihlungi ze-Bangerter: Izihlungi ezikhethekile ezixhunywe kumalensi engilazi yamehlo ezinciphisa ukubona esweni elinamandla
• Ukwelashwa Kombono: Izivivinyo ezinqunyiwe zokuthuthukisa amakhono okubuka nokusebenzisana kwamehlo
• Izindlela zokwelapha ezisekelwe emdlalweni: Basebenzisa amaphilisi akhethekile nezinhlelo zekhompyutha. Lezi zindlela ezintsha zibonise imiphumela ethembisayo, ikakhulukazi ekuthuthukiseni ukuthobela ukwelashwa phakathi kwezingane.

Uzoyibona Nini Udokotela

Odokotela bamehlo batusa ukuhlolwa kwamehlo kokuqala okuphelele ngeminyaka emi-3, nakuba ukuhlolwa kwangaphambili kubalulekile uma kusolwa izinkinga zokubona noma uma kunomlando womndeni wezimo zamehlo. Ukwelashwa ngokushesha kuyadingeka uma abazali beqaphela:

• Iso lengane yabo liyazulazula ngemva kwamasonto ambalwa okuqala ezelwe
• Izinguquko ekuziphatheni kokubuka kwengane noma ekucaceni kwayo
• Ukwanda kokuthanda uhlangothi olulodwa lomzimba wabo
• Ukunciphisa ukuzethemba ekuhambeni
• Ukuklolodela noma ukuma kwekhanda okungajwayelekile ngenkathi ubuka izinto

Prevention

Odokotela bamehlo bagcizelela izinyathelo ezimbalwa ezibalulekile abazali nabanakekeli abangazithatha ukuze bavikele ukubona kwezingane zabo:

• Hlela ukuhlolwa kwamehlo okuphelele kusukela esemncane
• Gcina ama-aphoyintimenti okulandelela angashintshi nochwepheshe bamehlo
• Landela izinhlelo zokwelapha njengoba kushiwo
• Gada ukuthuthukiswa kombono ngezikhathi ezibalulekile zokukhula
• Bika noma yiziphi izinguquko embonweni noma ekumisweni kwamehlo ngokushesha
• Qinisekisa ukuthi izingane zigqoka ama-eyewear amisiwe njalo

Isikhathi esibalulekile sokuthuthukiswa kombono kwenzeka phakathi neminyaka embalwa yokuqala yokuphila, sidlulela ebuntwaneni. Ngalesi sikhathi, ubuchopho bakha ukuxhumana okubalulekile kokucubungula okubonakalayo. Uma i-amblyopia ihlala ingelashiwe phakathi nalesi sikhathi, ukonakala kombono kuba unomphela, kuthinte kakhulu izinga lempilo yengane.

Isiphetho

I-Amblyopia ime njengenselele enkulu yombono ethinta izingane emhlabeni wonke, kodwa intuthuko yezokwelapha inikeza ithemba lokwelashwa okuphumelelayo. Abazali badlala indima ebalulekile ekuboneni izimpawu eziyisixwayiso kusenesikhathi nasekufuneni ukunakekelwa okufanele. Umthelela walesi simo udlulela ngalé kombono, uthinta ukukhula kwezemfundo, ukuxhumana nabantu, nemisebenzi yansuku zonke, okwenza ukunakwa okusheshayo kube okubalulekile enhlalakahleni yengane iyonke. Ukuhlolwa kwamehlo okuvamile, ukuqapha ngokucophelela, kanye nokubambelela ekwelashweni ngokungaguquki kudala indlela engcono kakhulu eholela ekuboneni okuthuthukisiwe kanye nemiphumela engcono yokuphila yezingane ezine-amblyopia. Abazali kufanele bakhumbule ukuthi nakuba uhambo lungabonakala luyinselele, ukuqondiswa okufanele kwezokwelapha nokusekelwa kungaholela ekuthuthukisweni okuphawulekayo kombono wengane yabo.

Imibuzo Evame Ukubuzwa

1. Ivame kangakanani i-amblyopia?

Ucwaningo lubonisa ukuthi i-amblyopia ithinta cishe u-4.3% wezingane emhlabeni jikelele. Lesi simo sikhombisa ukwanda kancane kwabesilisa (1.40%) uma kuqhathaniswa nabesifazane (1.24%). Lezi zibalo zenza i-amblyopia ingenye yezimbangela eziphambili zokukhubazeka kwamehlo ezinganeni ezingaphansi kweminyaka engu-15 ubudala.

2. Iso elivilaphayo liwuthinta kanjani umbono?

I-Amblyopia idala umehluko omkhulu kwikhwalithi yombono phakathi kwamehlo amabili. Iso elithintekile liyahlangabezana:

• Ukuncipha kokubona kahle
• Ukubona ukujula okunciphile
• Ubunzima ngemisebenzi emihle yezimoto
• Ukubona kahle kwe-binocular

3. Ingabe i-amblyopia ingalungiswa?

I-Amblyopia ingalungiswa ngokwelashwa okufanele. Amazinga empumelelo ayahluka futhi ancike eminyakeni yokuxilongwa kanye nokuqalwa kokwelashwa. U-53% wezingane ezineminyaka engu-7-12 ubudala ubonisa ukuthuthuka ngokwelashwa, kuyilapho u-47% wentsha eneminyaka engu-13-17 nayo ithola izinzuzo zokubona.

4. Iyini iminyaka yobudala ye-amblyopia?

Nakuba ungekho umkhawulo weminyaka eqinile wokwelashwa, ukusebenza ngempumelelo kuvame ukuba phezulu ngesikhathi sobuntwana. Ukwelashwa kubonisa imiphumela emihle kakhulu lapho kuqalwa ngaphambi kweminyaka engu-7, nakuba ukuthuthukiswa kungenzeka ngokuthomba futhi, kwezinye izimo, ngisho nokuba umuntu omdala.

5. Kunini lapho sekwephuze kakhulu ukuphatha amehlo avilaphayo?

Ucwaningo lwakamuva luphonsela inselelo umbono wendabuko weminyaka eqinile yokunqanyulwa kokwelashwa. Ucwaningo lubonisa ukuthuthukiswa kombono okunengqondo kungenzeka ngisho nakwabancane nakubantu abadala, nakuba ubude bokwelashwa bungase bube bude futhi kubangele ukungathandeki kakhulu kuzingane ezincane.

6. Ingabe iso elivilaphayo lingahamba?

I-Amblyopia ayixazululi ngokuzenzakalelayo ngaphandle kokwelashwa. Kodwa-ke, ukuthuthukiswa kombono okuphawulekayo kuyafezeka ngokungenelela okufanele kwezokwelapha kanye nokunamathela ngokungaguquki ekwelashweni okunqunyiwe. Isimo sidinga ukuphathwa kochwepheshe ukuze kube nemiphumela eyimpumelelo.

UDkt. Neelu Mundhala

CARE Medical Team

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