6a.corneal Disorder - Dr Artati
Transcript of 6a.corneal Disorder - Dr Artati
![Page 1: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/1.jpg)
Blok Organ Indera
Dr. Artati Sri Redjeki Sp.MDr. Artati Sri Redjeki Sp.M
KELAINAN KORNEA
![Page 2: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/2.jpg)
Kornea Jaringan transparan Dinding depan bola mata Jernih, tembus pandang Media refrakta Struktur teratur, deturgesen/dehidrasi
relatif, pompa bikarbonat pada endotel Kerusakan endotel > epitel Epitel sawar terhadap mikroorganisme
![Page 3: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/3.jpg)
Anatomi
Kornea:1. Epithel2. Membran Bowman3. Stroma4. Membran Decemet5. endotel
![Page 4: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/4.jpg)
![Page 5: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/5.jpg)
Kelainan kornea kongenital Peradangan
Infeksi Allergi Neuro paralitik lagoftalmos
degeneratif Pigmentasi Kekeruhan
![Page 6: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/6.jpg)
Kelainan Kongenital Mikro kornea Megalo kornea Sklero kornea Kornea plana keratektasia
![Page 7: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/7.jpg)
Microcornea• Very rare, hereditary, unilateral or bilateral• Corneal diameter is 10 mm or less• Shallow anterior chamber but other dimensions are normal
Associated systemic syndromesTurner, Ehlers-Danlos, Weill-Marchesani andWaardenburg
Ocular associationsGlaucoma, cataract, cornea plana, leukoma and iris abnormalities
![Page 8: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/8.jpg)
Megalocornea
• Renal carcinoma and mental handicap
Systemic associations• Marfan, Apert, Ehlers-Danlos and Down syndromes• Osteogenesis imperfecta
• Very rare, hereditary, bilateral• Corneal diameter 13 mm or more• Very deep anterior chamber
• High myopia and astigmatism • Occasionally lens subluxation
![Page 9: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/9.jpg)
Sclerocornea• Very rare, usually bilateral• Peripheral opacification and vascularization of cornea• ‘Scleralization’ makes cornea appear smaller
![Page 10: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/10.jpg)
Kornea Plana Sangat jarang Bilateral Kelengkungan minim Hipermetrop Kamera ant’or dangkal Sering terjadi glaukoma
![Page 11: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/11.jpg)
Keratoconus
![Page 12: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/12.jpg)
Keratectasia• Very rare, usually unilateral• Severe corneal opacification and protruberance• Probably caused by intrauterine keratitis
![Page 13: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/13.jpg)
Degenerasi kornea Keratokonus Arkus senilis Penyakit Terrien Keratopati pita <berkapur> Degenerasi Noduler Salzman Distrofi kornea
Epitel kornea Stroma kornea Membran posterior kornea
![Page 14: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/14.jpg)
Arcus senilis• Innocuous and extremely common in elderly• Occasionally associated with hyperlipoproteinaemia
• Bilateral, circumferential bands of lipid deposits• Diffuse central and sharp peripheral border
• Peripheral border separated from limbus by clear zone
• Clear zone may be thinned ( senile furrow)
![Page 15: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/15.jpg)
Fuchs’s Endothelial Dystrophy
Corneal Dystrophy Herediter
![Page 16: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/16.jpg)
Band keratopathy
• Interpalpebral limbal opacification
• Common, unilateral or bilateral depending on cause• Subepithelial calcification
• Central spread of calcification• Small holes within calcified area• Separated by clear zone
Progression
![Page 17: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/17.jpg)
Peradangan Keratitis
Superfisial Ulserosa / epitelial Non ulserosa /sub epitelial
Profunda / stroma Ulserosa
Sentral perifer
Non ulserosa
Endotelial
![Page 18: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/18.jpg)
Infeksi kornea Bakteri
Ulkus kornea pnemokokus Ulkus kornea pseudomonas
Jamur Candida, fusarium, aspergillus
Virus Herpes Simpleks
Epitelial disciformis
Herpes Zoster / varicella zoster Acanthamoeba
![Page 19: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/19.jpg)
Gejala umum Keratitis Keluhan
Visus turun Fotopobi, nyeri, rasa kelilipan
Klinis Mata merah – inj. Perikorneal Hiper / hipoesthesi Kornea edem Infiltrat Ulkus hipopion
![Page 20: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/20.jpg)
Keratitis Bakterialis Onset 24 – 48 jam post inokulasi Ulkus berbatas tegas Warna kelabu, hipopion
![Page 21: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/21.jpg)
Keratitis bakterial Predisposisi
Penggunaan lensa kontak Penyakit kronis mata luar Hipoesthesi
Gambaran klinis Ulkus berbatas tegas Menyebar tak teratur Dari tepi ke sentral
Terapi Antibiotika lokal & sistemis
![Page 22: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/22.jpg)
Keratitis Fungi Klinis
trauma bahan organik Ulkus putih ke abu2 an Infiltrat bentuk bulu Sering ada lesi satelit Hipopion
terapi Anti jamur lokal & sistemik keratoplasti
![Page 23: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/23.jpg)
Keratitis epitelial herpes simpleks •Ulkus dendritik denganterminal bulbs• tes fluorescein
•Meluas berbentuk geografik
•Salep mataAciclovir 3% x 5 daily•Trifluorothymidine 1% tetes setiap 2 jam
•Debridemen bila tidak ada perbaikan
Terapi
![Page 24: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/24.jpg)
Keratitis disciformis herpes simpleks
• edem sentralentral epithelial and stromal
• lipatan membrana Descemet
• keratik precipitat halus
- Steroid topikal dengan anti viral
• sering disertai dengan cincin Wessely
Terapi
tanda Gejala tambahan.
![Page 25: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/25.jpg)
Herpes zoster keratitis
• Develops in about 50% within 2 days of rash• Small, fine, dendritic or stellate epithelial lesions• Tapered ends without bulbs• Resolves within a few days
• Develops in about 30% within 10 days of rash• Multiple, fine, granular deposits just beneath Bowman membrane• Halo of stromal haze
Nummular keratitisAcute epithelial keratitis
• May become chronic
Treatment - topical steroids, if appropriate
![Page 26: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/26.jpg)
Keratitis Parasit
Microfilaria
![Page 27: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/27.jpg)
Keratoplasty Lekoma Cornea
![Page 28: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/28.jpg)
Protozoal Disease Predisposisi
Pemakai lensa kontak cairannya
sakit tidak sesuai gejala Ulkus
indolen Cincin stroma Infiltrat perineural
Terapi Chlorhexidine, paromomycin
![Page 29: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/29.jpg)
Leukoma Kornea dengan Neovaskularisasi
Abses Kornea dengan Hipopion
![Page 30: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/30.jpg)
Komplikasi – Penyembuhan Sikatriks Nebula Makula lekoma Panus Stafiloma kornea Desmetocel Pseudo pterigium
![Page 31: 6a.corneal Disorder - Dr Artati](https://reader030.fdocuments.us/reader030/viewer/2022012823/55cf9800550346d03394f39b/html5/thumbnails/31.jpg)