Ndi kuwuka kwa myopia padziko lonse m'zaka zaposachedwa, palibe kuchepa kwa odwala omwe amafunikira chithandizo.Kuchuluka kwa matenda a myopia pogwiritsa ntchito Census ya 2020 yaku US kukuwonetsa kuti dziko lino limafuna mayeso a maso 39,025,416 kwa mwana aliyense yemwe ali ndi myopia chaka chilichonse, ndi mayeso awiri pachaka.imodzi
Mwa pafupifupi 70,000 optometrists ndi ophthalmologists m'dziko lonselo, katswiri aliyense wa chisamaliro cha maso (ECP) ayenera kusamalira ana 278 miyezi isanu ndi umodzi iliyonse kuti akwaniritse zofunikira za chisamaliro cha maso kwa ana omwe ali ndi myopia ku United States.1 Izi ndi za ana opitilira 1 myopia omwe amapezeka ndikusamalidwa patsiku.Kodi machitidwe anu ndi osiyana bwanji?
Monga ECP, cholinga chathu ndi kuchepetsa kulemedwa kwa myopia yopita patsogolo ndikuthandizira kupewa kuwonongeka kwa nthawi yayitali kwa odwala onse omwe ali ndi myopia.Koma kodi odwala athu amaganiza chiyani za kuwongolera kwawo ndi zotsatira zake?
Zikafika ku orthokeratology (Ortho-k), mayankho oleza mtima pa moyo wawo wokhudzana ndi masomphenya amakhala omveka.
Kafukufuku wa Lipson et al., pogwiritsa ntchito National Institute of Eye Diseases with Refractive Error Quality of Life Questionnaire, anayerekezera akuluakulu omwe amavala magalasi ofewa a masomphenya amodzi ndi akuluakulu ovala magalasi a orthokeratology.Iwo adatsimikiza kuti kukhutitsidwa kwathunthu ndi masomphenya zinali zofanana, komabe pafupifupi 68% ya ophunzira adakonda Ortho-k ndipo adasankha kupitiriza kugwiritsa ntchito kumapeto kwa phunzirolo.2 Ophunzira adanenanso kuti amakonda masomphenya osakonzedwa masana.
Ngakhale kuti akuluakulu angakonde Ortho-k, nanga bwanji za kuyang’anira pafupi kwa ana?Zhao et al.adawunikidwa ana asanakhale ndi miyezi itatu atavala orthodontic.
Ana omwe amagwiritsa ntchito Ortho-k amasonyeza khalidwe lapamwamba la moyo ndi zopindulitsa pazochitika zawo za tsiku ndi tsiku, anali okhoza kuyesa zinthu zatsopano, anali odzidalira kwambiri, otanganidwa kwambiri, komanso amatha kusewera masewera, zomwe pamapeto pake zinapangitsa kuti nthawi yambiri ikhale yochuluka. chithandizo.pamsewu.3
N'zotheka kuti njira zonse zochizira myopia zingathandize kupitiriza kuchita odwala ndikuthandizira mokwanira kutsata ndondomeko ya mankhwala yomwe ikufunika kuti athetse myopia.
Ortho-k yapita patsogolo kwambiri pakupanga magalasi ndi kapangidwe kazinthu kuyambira pomwe FDA idavomereza magalasi olumikizana a ortho-k mu 2002. Mitu iwiri ikuwoneka bwino kwambiri m'zachipatala masiku ano: Magalasi a Ortho-k okhala ndi kusiyana kozama komanso kuthekera kosintha mawonekedwe. awiri a masomphenya zone kumbuyo.
Ngakhale magalasi a meridian orthokeratology nthawi zambiri amaperekedwa kwa odwala myopia ndi astigmatism, zosankha zowakwanira zimaposa zowongolera myopia ndi astigmatism.
Mwachitsanzo, molingana ndi malingaliro a wopanga, empirically kwa odwala omwe ali ndi corneal toricity ya 0,50 diopters (D), kusiyana kumodzi kobwerera kozama kumatha kuperekedwa mozama.
Komabe, kachipangizo kakang'ono ka toric pa cornea, kuphatikizidwa ndi lens ya Ortho-k yomwe imaganizira za kusiyana kwakuya kwapakati, idzaonetsetsa kuti misozi iwonongeke komanso kukhazikika bwino pansi pa lens.Choncho, odwala ena angapindule ndi kukhazikika komanso kukwanira bwino koperekedwa ndi mapangidwe awa.
M'mayesero aposachedwa azachipatala, magalasi a orthokeratology a 5 mm rear vision zone diameter (BOZD) adabweretsa zabwino zambiri kwa odwala myopia.Zotsatira zinasonyeza kuti 5 mm VOZD inawonjezera kuwongolera kwa myopia ndi 0.43 diopters paulendo wa tsiku la 1 poyerekeza ndi 6 mm VOZD kupanga (control lens), kupereka kuwongolera mofulumira ndi kusintha kwa maonekedwe (Zithunzi 1 ndi 2).4, 5
Jung ndi al.adapezanso kuti kugwiritsa ntchito lens ya 5 mm BOZD Ortho-k kunachepetsa kwambiri m'mimba mwake mwa malo opangira mankhwala.Chifukwa chake, kwa ma ECP omwe akufuna kupeza ma voliyumu ang'onoang'ono a chithandizo kwa odwala awo, 5 mm BOZD idakhala yopindulitsa.
Ngakhale kuti ma ECP ambiri amadziŵa bwino magalasi oyenerera kwa odwala, kaya mwachidziwitso kapena mwachidziwitso, tsopano pali njira zatsopano zowonjezeretsera kupezeka ndi kuphweka njira zoyenera zachipatala.
Choyambitsidwa mu Okutobala 2021, pulogalamu yam'manja ya Paragon CRT Calculator (Chithunzi 3) imalola madotolo azadzidzi kuti afotokoze magawo a odwala omwe ali ndi Paragon CRT ndi CRT Biaxial (CooperVision Professional Eye Care) orthokeratology system ndikuwatsitsa ndikungodina pang'ono.Order.Maupangiri ofikira mwachangu amakupatsirani zida zothandiza zachipatala nthawi iliyonse, kulikonse.
Mu 2022, kufalikira kwa myopia mosakayikira kudzawonjezeka.Komabe, ntchito ya ophthalmic ili ndi njira zochiritsira zapamwamba komanso zida ndi zothandizira kuti zithandizire kusintha miyoyo ya odwala omwe ali ndi myopia.