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Presentasi KasusIlmu Kesehatan Mata

Pembimbing:

dr. Agah Gadjali, Sp. Mdr. Hermansyah, Sp. M

dr. Mustafa K. Shahab, Sp. Mdr. Gartati Ismail, Sp. M

d. Henry A. Wib!, Sp. M

Presentan: "e#ina A. Kusumadjaja $%&'%(&)'(&*+

KEPANITERAAN KLINIK BAGIAN ILMU KESEHATAN MATAFAKULTAS KEDOKTERAN UNIKA ATMA JAYA

RUMAH SAKIT BHAYANGKARA TK. I RADEN SAID SUKANTO

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Identitas pasien

Nama An.

Tempat! tan""a# #a$i% Ja&a%ta! ' Desem(e% )**+

Jenis &e#amin Pe%emp,an

A"ama Is#amS,&, S,nda

Stat,s pe%ni&a$an Be#,m meni&a$

Pendidi&an SD

Pe&e%-aan Pe#a-a%A#amat J#. Sada/a G". Manin" RT *012*3

Tan""a# peme%i&saan ' Mei )*03

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Anamnesis

Di#a&,&an te%$adap i(, pasien dan pasien

Ke#,$an ,tama4 Ked,a mata me%a$ se-a& ) min"", #a#,

Ke#,$an tam(a$an4 5ai%an da%i mata /an" (enin" dan #en"&et.

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Ria/at Pen/a&it Se&a%an"

Ked,a mata me%a$ se-a& 6 ) min"", #a#,

Tida& dise%tai pen,%,nan ta-am pen"e#i$atan

Gata#

Rasa men""an-a#Ben"&a& pada &ed,a &e#7pa& mata

Se&%et mata (enin"! #en"&et

Ke-adian pe%tama &a#i

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Ria/at Pen/a&it Se&a%an"

Gata# pada dae%a$ $id,n" dan (aa$ mata sete#a$men"&7ns,msi te#,%

Be%7(at dan di(e%i 5end7 8it%7#. Sem(,$! tetapi

&em,dian m,n9,# &em(a#i.

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Ria/at Pen/a&it Da$,#,

Ria/at %$initis a#e%"i! ma,p,n asma disan"&a#.

Tida& pe%na$ men"a#ami $a# se%,pa se(e#,mn/a

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Ria/at Pen/a&it Ke#,a%"a

Ria/at te&anan da%a$ tin""i! &en9in" manis da#am&e#,a%"a disan"&a#

Ria/at at7pi disan"&a#

I(, mende%ita "#a,&7maTida& ada %ia/at &7nta& den"an pende%ita

&7n-,n"ti:itis.

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Peme%i&saan Um,m

Kesada%an K7mp7s mentis

Keadaan ,m,m Tampa& tenan"

La-, nadi ';

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Peme%i&saan O=ta#m7#7"i

- -S

is,s +2+ E +2+ E

P7sisi (7#a mata O%t7=7%ia

Ge%a&an (7#amata

Bai& &e se"a#a a%a$ Bai& &e se"a#a a%a$

TIO pa#pasi N2pa#pasi N2pa#pasi

Pa#pe(%as,pe%i7% danin=e%i7%

Tampa& edema Tampa& edema

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Peme%i&saan O=ta#m7#7"i

- -S

K7n-,n"ti:a ta%sa#s,pe%i7%

Hipe%emisPapi# ?@

Hipe%emisPapi# ?@

K7n-,n"ti:a ta%sa#in=e%i7%

Hipe%emis Hipe%emis

K7n-,n"ti:a (,#(i In-e&si &7n-,n"ti:a In-e&si &7n-,n"ti:a

Se%a Tenan" Tenan"

K7%nea Je%ni$ Je%ni$

Bi#i& mata depan Je%ni$Keda#aman sedan"

Je%ni$Keda#aman sedan"

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Peme%i&saan O=ta#m7#7"i

- -S

I%is Ca%na 97&e#at t,a!%adie% ?@! &%ipta ?@

Ca%na 97&e#at t,a!%adie% ?@! &%ipta ?@

P,pi# Is7&7%! (,#at!diamete% 3 mm

F7t7=7(ia ?>@

Is7&7%! (,#at!diamete% 3 mm

F7t7=7(ia ?>@

Re=#e&s 9a$a/a Lan"s,n" ?@

Tida& #an"s,n" ?@

Lan"s,n" ?@

Tida& #an"s,n" ?@

Lensa Je%ni$ Je%ni$

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F7t7 ODS

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Res,me

Ana& pe%emp,an ,sia ' ta$,n datan" den"an

&e#,$an mata me%a$ se-a& ) min"", #a#, tanpa

dise%tai pen,%,nan &eta-aman pen"e#i$atan.

Mata "ata#! (e%ai% den"an se&%et (enin" dan #en"&et

Pada peme%i&saan =isi& ,m,m didapat&an pap,#>

pap,# $ipe%emis pada dae%a$ nose tip.

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Res,me

Pada peme%i&saan 7=ta#m7#7"i didapat&an Edema pada pa#pe(%a s,pe%i7% dan in=e%i7% &ed,a mata! Hipe%emia dan papi# pada &7n-,n"ti:a ta%sa#is s,pe%i7% &ed,a

mata

In-e&si &7n-,n"ti:a pada &ed,a mata OD 4 +2+ E OS 4 +2+ E

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Dia"n7sis Ke%-a

K7n-,n"ti:itis a#e%"i

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Penata#a&sanaan

K7mp%es din"in

5end7 P7#/ne# ?=#,7%7met$7#7ne@ ODS 1 dd 0 "tt

5end7 e%na9e# ODS 1 dd 0 "tt

Anti$istamin de&7n"estanMen"$inda%i a#e%"en

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P%7"n7sis

,7 ad :itam 4 ad (7nam

,7 ad =,n"si7nam 4 ad (7nam

,7 ad sana9ti7nam 4 d,(ia

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TINJAUAN PUSTAKA

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K7n-,n"ti:a

Mem(%an m,&7sa t%anspa%an pada pe%m,&aanp7ste%i7% &e#7pa& mata ante%i7% (7#a mata

Ba"ian>(a"ian4

K7n-,n"ti:a pa#pe(%a Ma%"ina# Ta%sa#

O%(ita#

K7n-,n"ti:a (,#(i F7%ni&s &7n-,n"ti:a

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St%,&t,% &7n-,n"ti:a Lapisan epite# Lapisan aden7id Lapisan =i(%7sa

Ke#en-a% Mucin secretory glands Accessory lacrimal glands

Sa%a= Long ciliary nerves 5a(an" da%i sa%a= #a&%ima#! in=%at%7ea%! s,p%at%7ea%!

s,p%a7%(ita# =%7nta#

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Pem(,#,$ A%te%i

K7n-,n"ti:a pa#pe(%a =7%ni&speripheral arterial arcade ofthe eyelid

K7n-,n"ti:a (,#(ia%te%i &7n-,n"ti:a p7ste%i7% ante%i7% ena

P#e&s,s :en7sa da%i &e#7pa& mata

ena si#ia% ante%i7%

Lim=ati& Late%a#p%ea,%i&,#a%

Media#s,(mandi(,#a%

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K7n-,n"ti:itis

Hipe%emia pada &7n-,n"ti:a /an" (e%$,(,n"anden"an adan/a discharge/an" (e%ai%! m,&7id!m,&7p,%,#en ata, p,%,#en.

K#asi=i&asi Eti7#7"i K#inis

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K#asi=i&asi

Eti7#7"i In=e&si A#e%"i I%itasi Ke%at7&7n-,n"ti:itis /an" (e%$,(,n"an den"an pen/a&it pada

&,#it dan mem(%an m,&7sa T%a,ma Ke%at7&7n-,n"ti:itis den"an eti7#7"i tida& di&eta$,i

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K7n-,n"ti:itis

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K7n-,n"ti:itis A#e%"i

In=#amasi da%i &7n-,n"ti:a a&i(at %ea&si$ipe%sensiti:itas ata, a#e%"i #an"s,n" ?$,m7%a#@ ata,te%#am(at ?se#,#a%@.

Rea&si $ipe%sensiti:itas tipe 9epat (immediate humoral) Hay fever conjunctivitis Ke%at7&7n-,n"ti:itis :e%na# Ke%at7&7n-,n"ti:itis at7pi& Giant papillary conjunctivitis

Rea&si $ipe%sensiti:itas tipe #am(at ?delayed@ Phlyctenulosis Mild conjunctivitis secondary to contact blepharitis

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Hay ever !onjunctivitis

Rin"an! n7nspesi=i&

Be%&aitan d"n %$initis a#e%"i2memi#i&i %ia/at a#e%"i

Ge-a#a tanda4

Gata#! (e%ai%! &eme%a$an pada mata In-e&si %in"an pada &7n-,n"ti:a pa#pe(%a dan (,#(i Se&%et sepe%ti (enan" ?ropy"@

Tata#a&sana

Anti$istamin :as7&7nst%i&t7% t7pi&a# K7mp%es din"in ,nt,& me%eda&an %asa "ata# E#iminasi a#e%"en

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Ke%at7&7n-,n"ti:itis e%na#

#pring cattarh $ seasonal conjunctivitis $ %arm%eather conjunctivitis

P%e p,(e%ta# $in""a +>0* ta$,n &em,dian! #a&i)

Ria/at a#e%"i pada pasien ata, &e#,a%"aGe-a#a tanda4

San"at "ata# Se&%et sepe%ti (enan"

Mil&y appearanceda%i &7n-,n"ti:a Papi# $a#,s pada &7n-,n"ti:a ta%sa#is p7ste%i7% Dapat ditem,&an cobblestone papillaepada &7n-.ta%sa#is

s,pe%i7%

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Ke%at7&7n-,n"ti:itis At7pi&

De%matitis at7pi& ?e&ema@! (isa se-a& &e9i#

Lipatan si&,! pe%"e#an"an tan"an! #,t,t

Ria/at a#e%"i pada &e#,a%"a ata, di%i pasien

Ge-a#a tanda4 Sensasi sepe%ti te%(a&a% 2 pe%i$

Se&%et m,&7id

Keme%a$an! =7t7=7(ia E%itema pada ma%"in pa#pe(%a Papi##a $a#,s se%in" pada &7n-.ta%sa#is p7ste%i7% Bi#a (e%,#an"men"enai &7%nea

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Giant Papillary !onjunctivitis

Mi%ip den"an &e%at7&7n-,n"ti:itis :e%na#! tetapidise(a(&an pen"",naan #ensa &7nta& ata, mataa%ti=isia# da%i p#asti&

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Phlyctenulosis

Rea&si $ipe%sensiti:itas tipe #am(at te%$adap p%7teinda%i mi&%7(a4 K,man TB Sta=i#7&7&,s Kandida

Lesi &e9i# /an" &e%as ?0>3 mm@! di&e#i#in"i 7na

$ipe%emia den"an (a"ian ten"a$ /an" (e%a%nap,ti$>a(,mem(ent,& ,#&,s$i#an" da#am 0*>0) $a%i

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PEMBAHASAN

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Gam(a%an K#inis

Ked,a mata me%a$ se-a& 6 ) min"",#a#,

Tida& dise%tai pen,%,nan ta-ampen"e#i$atan

Gata# Rasa men""an-a# Se&%et mata (enin"! #en"&et

K7n"esti

is,s n7%ma#

Gata# Kem7sis Se&%et /an" (e%ai%2sepe%ti

(enan"

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Peme%i&saan Fisi& dan O=ta#m7#7"i

Pap,#>pap,# $ipe%emis pada dae%a$nose tip

Edema pada pa#pe(%a s,pe%i7% danin=e%i7% &ed,a mata!

Hipe%emia dan papi# pada&7n-,n"ti:a ta%sa#is s,pe%i7% &ed,amata

In-e&si &7n-,n"ti:a pada &ed,a mata

is,s n7%ma#

Ria/at a#e%"i

Edema pa#pe(%a

K7n"esti Papi#

In-e&si pada &7n-,n"ti:apa#pe(%a dan (,#(i

Tida& ada pen,%,nan :is,s

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Tata#a&sana

K7mp%es din"in 5end7 e%na9e# ODS 1 dd 0 "tt 5end7 P7#/ne#

?=#,7%7met$7#7ne@ ODS 1 dd 0

"tt Men"$inda%i a#e%"en

K7mp%es din"in Anti$istamin t7pi&a# K7%ti&7ste%7id

E#iminasi a#e%"en