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Manifestasi Okular dan Non Okular Sindrom Rubella Kongenital Pada Penderita Katarak Kongenital Josiah Irma; Iwan Sovani; Maya Sari Wahyu; Feti Karfiati
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1148

Background: Maternal infection with rubella in the first trimester of pregnancy result in congenital rubella syndrome (CRS). It caused blindness, deafness, congenital heart dissease and mental retardation. One of the main cause of blindness in CRS is congenital cataract. Infant affected with CRS worldwide estimated 238.000 each year and 46.000 live in South East Asia.Objective: This study aimed to looked for other ocular and non ocular manifestation from 0-11months old congenital cataract infants based on World Health Organization (WHO) CRS case definiton: suspected, clinically confirmed and labaratory confirmed.Methods:This is a retrospective observational study. We colected all data from computer base medical record, patient with congenital cataract 0-11 months old that came to Pediatric Ophthalmology unit Cicendo Eye Hospital from January 2012 until December 2013. Age, sex, laterality, axial length, cataract morphology, retinopathy pigmentary, cardiac dissorder, hearing impairment, mental dissorder and laboratory serology rubella for IgM and IgG were recorded.Results: We found ninety three patients diagnosed with CRS from congenital cataract cases. Ocular manifestation include microphthalmia in 63 eyes (33.9%), microcornea in 30 eyes (16.1%), and pigmentary retinopathy in 1 eye (0.5%) . The most common type of cataract morphology was nuclear type (49.9%.). Non-ocular manifestation include cardiac dissorder in 16 cases (17.2%), hearing impairment in 1 case (1.1%) and mental retardation in 6 cases (6.4%). Case definition based on WHO criteria were 93 cases (100%) for suspected, 20 cases (25.8%) for clinically confirmed and 15 cases (42,8%) for laboratory confirmed.Conclusion: Ocular manifestation for CRS in congenital cataract 0-11 months old were microphthalmia, microcornea, pigmentary retinopathy. Other manifestation found were cardiac disorder, hearing impairment and mental retardation.

The Calamity Among Medical Students: Sleep Deprivation and Dry Eye Disease Anastasia Johanna Salim; Jonathan Salim; Josiah Irma
Medicinus Vol 10, No 2 (2022): June 2022 - September 2022
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.5676

Background: Medical students’ burden upon academic and professional duties often blinded them from attending to themselves. Piling works and nightshifts interfere ferociously with their self-care behavior, including adequate sleep. The matter not only disrupts concentration and consciousness but also tolls the eye by reducing tear secretion. Hence, the present study urgently assesses sleep quality and dry eye disease (DED) among medical students.Methods: The cross-sectional study observed 172 eyes among medical students in Indonesia. We assessed sleep quality and dry eye disease through Pittsburgh Sleep Quality Index and Schirmer test. Independent statistician analyzed the data with chi-square.Result: From the eligible samples, there is a dominancy of females (55.8%) with poor sleep quality (55.2%). There is no significant difference in DED or sleep quality across gender though they lean toward females. Contrarily, poor sleepers significantly correspond to 2.96 times more risk of DED than an adequate sleeper.Conclusions: Medical students’ well-being is crucial. Aside from the academic burden, institutions and individuals shall strongly emphasize better sleep habits and eye care.

EMPTY SELLA SYNDROME: THE GREAT IMITATOR OF VISUAL COMPLAINTS Josiah Irma; Serena Onasis; Dr.Saraswati Rizki; Dr.Retno Ketaren; Patricia Budimulia
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 5 No 1 (2023): Jurnal Oftalmologi
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v5i1.47

Introduction : Empty Sella Syndrome is a rare condition of sella turcica malformation, resulting in pituitary gland shrinkage. It may manifest as neurological symptoms, endocrine disorders, visual disturbances or even incidental findings during imaging. However, patients rarely come with typical complaints thus an extended course and review of this case is needed to prompt suspicion and aid in the diagnosis of ESS. Case Presentation: We report a 45-year-old woman who presented with cephalgia and bitemporal hemianopia and previous transient bilateral visual loss and foggy vision. A history of ovarian cancer was noted. Physical examination showed myopic astigmatism ocular dextra sinistra (ODS) with increased intraocular pressure and bitemporal hemianopia ODS. Posterior chamber examinations were within normal limits. Optical coherence tomography showed nasal retinal nerve fiber layer ODS being the thinnest among the rest, although still within normal limits. Neurological examinations also suggested presence of central vertigo. This subsequently resulted in a suspicion towards space occupying lesion chiasmal compression through metastasis. Discussion: MRI revealed an empty sella turcica. A laboratory examination was then ordered and showed normal endocrinology results. The diagnosis of Primary Empty Sella Syndrome with ocular hypertension was established. The patient was prescribed with timolol, codeine and dexamethasone. A month later during her follow-up, the patient did not show improvement and was suggested to do an MRI with contrast, however this patient was lost to follow up. Conclusion: This case report highlighted the manifestation to raise suspicion and aid in the diagnosis of ESS for an optimal and improved diagnosis and treatment of ESS.

Outcomes of Treating a late case of Herpes Zoster Ophthalmicus masquerading as Orbital Cellulitis: A Case Report: Poster Presentation - Case Report - Ophthalmologist JOSIAH IRMA; Saraswati Anindita Rizki; Jennifer Angelina; Jovita; Jennifer Handiokho
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/sa8pth15

Abstract Introduction : Herpes zoster ophthalmicus (HZO) refers to a reactivated varicella-zoster virus involving the V1 nerve division. Although rare, previous reports have mentioned HZO cases masquerading as orbital cellulitis (HZO-OC). This report depicts the use of acyclovir, corticosteroids and citicoline in our HZO-OC patient with treatment delay. Case Illustration : A healthy 66 year old man presented to our clinic 4 weeks after signs of orbital cellulitis followed by vesicular rash following the CN V(1) dermatome were felt which was untreated. The right palpebra was edematous and erythematous. Hazy cornea, mixed injection, grade IV reverse RAPD, diminished direct and consensual reflex and external ophthalmoplegia of the right eye were noted. The diagnosis of HZO-OC with multiple cranial neuropathies OD was established. Topical and symptomatic treatment were given resulting no improvement. Ptosis of the right palpebra became present. The patient was then given systemic acyclovir, methylprednisolone and citicoline. Ophthalmoplegia improved after 2 months and ptosis improved after 4 months. Discussion : The use of systemic acyclovir and corticosteroids in HZO-OC patients were given promptly in previous literature. Multiple cranial nerve in our patient was thought to occur due to treatment delay. As improvement was not noted after topical treatment, these systemic treatments along with citicoline were added. Citicoline was added due to its ability to promote neural regeneration. Conclusion : Systemic acyclovir, corticosteroids and citicoline may still be beneficial for HZO-OC patients with delayed treatment.

The Calamity Among Medical Students: Sleep Deprivation and Dry Eye Disease Salim, Anastasia Johanna; Salim, Jonathan; Josiah Irma, Josiah x
Medicinus Vol 12, No 1 (2022): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.7015

Background: Medical students’ burden upon academic and professional duties often blinded them from attending to themselves. Piling works and nightshifts interfere ferociously with their self-care behavior, including adequate sleep. The matter not only disrupts concentration and consciousness but also tolls the eye by reducing tear secretion. Hence, the present study urgently assesses sleep quality and dry eye disease (DED) among medical students.Methods: The cross-sectional study observed 172 eyes among medical students in Indonesia. We assessed sleep quality and dry eye disease through Pittsburgh Sleep Quality Index and Schirmer test. Independent statistician analyzed the data with chi-square.Result: From the eligible samples, there is a dominancy of females (55.8%) with poor sleep quality (55.2%). There is no significant difference in DED or sleep quality across gender though they lean toward females. Contrarily, poor sleepers significantly correspond to 2.96 times more risk of DED than an adequate sleeper.Conclusions: Medical students’ well-being is crucial. Aside from the academic burden, institutions and individuals shall strongly emphasize better sleep habits and eye care.

Lower Lid Entropion in a 78-year-old Female: A Case Repor Irma, Josiah; Onasis, Serena; Permatasari, Nivia
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 4 No 2 (2022): Jurnal Oftalmologi
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v4i2.31

Introduction: Entropion is a malposition of the eyelids in which the eyelid margin folds inward and causes irritation to the eye. It can be caused by congenital, spastic, cicatricial and involutional entropion. Involutional entropion affects 10.6% in group over the age of 60, especially in Asian races as compared to Caucasian races.1 It can have adverse effect on the eye such as trichiasis in which the eyelashes protrudes inwards towards the eyeball, leading to persistent erosions of punctate epithelium, pannus formation or ulcers. Definitive treatment for entropion is surgical intervention when feasible, such as the Jones procedure. The prognosis of corrective surgical intervention is highly correlated to the successfulness of the surgery and wound healing process of the patient, thus needing highly accurate and cautious procedure.2 Methods: This case report was taken from the Eye Clinic of Rumah Sakit Umum Siloam, in February 2022. Results: A 78 years-old female presented with complaints of discomfort, foreign body sensation, irritation, itching, and glare in both eyes since 1 year ago. She had a history of cataract surgery 3 years ago. Conclusions: Anamnesis and ophthalmological examinations results lead to suspected glaucoma, involution entropion ODS and pseudophakia ODS. Blepharoplasty was performed on the patient with appropriate surgical and therapeutic techniques. The post-operative examination showed results indicating a good prognosis in this patient.

EMPTY SELLA SYNDROME: THE GREAT IMITATOR OF VISUAL COMPLAINTS Irma, Josiah; Onasis, Serena; Rizki, Dr.Saraswati; Ketaren, Dr.Retno; Budimulia, Patricia
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 5 No 1 (2023): Jurnal Oftalmologi
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v5i1.47

Introduction: Empty Sella Syndrome is a rare condition of sella turcica malformation, resulting in pituitary gland shrinkage. It may manifest as neurological symptoms, endocrine disorders, visual disturbances, or even incidental findings during imaging. However, patients rarely come with typical complaints thus an extended course and review of this case is needed to prompt suspicion and aid in the diagnosis of ESS. Case Presentation: A 45-year-old woman with cephalgia, bitemporal hemianopia, previous transient bilateral visual loss, and foggy vision. A history of ovarian cancer was noted. Physical examination showed myopic astigmatism ocular dextra sinistra (ODS) with increased intraocular pressure and bitemporal hemianopia ODS. Posterior chamber examinations were within normal limits. Optical coherence tomography showed nasal retinal nerve fiber layer ODS being the thinnest among the rest, although still within normal limits. Neurological examinations also suggested the presence of central vertigo. This subsequently resulted in a suspicion of space-occupying lesion chiasmal compression through metastasis. Discussion: MRI revealed an empty sella turcica. A laboratory examination was then ordered and showed normal endocrinology results. The diagnosis of Primary Empty Sella Syndrome with ocular hypertension was established. The patient was prescribed timolol, codeine, and dexamethasone. A month later during her follow-up, the patient did not show improvement and was suggested to do an MRI with contrast, however, this patient was lost to follow-up. Conclusion: This case report highlighted the manifestation to raise suspicion and aid in the diagnosis of ESS for an optimal and improved diagnosis and treatment of ESS.

Manifestasi Okular dan Non Okular Sindrom Rubella Kongenital Pada Penderita Katarak Kongenital Irma, Josiah; Sovani, Iwan; Wahyu, Maya Sari; Karfiati, Feti
Medicinus Vol. 6 No. 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1148

Background: Maternal infection with rubella in the first trimester of pregnancy result in congenital rubella syndrome (CRS). It caused blindness, deafness, congenital heart dissease and mental retardation. One of the main cause of blindness in CRS is congenital cataract. Infant affected with CRS worldwide estimated 238.000 each year and 46.000 live in South East Asia.Objective: This study aimed to looked for other ocular and non ocular manifestation from 0-11months old congenital cataract infants based on World Health Organization (WHO) CRS case definiton: suspected, clinically confirmed and labaratory confirmed.Methods:This is a retrospective observational study. We colected all data from computer base medical record, patient with congenital cataract 0-11 months old that came to Pediatric Ophthalmology unit Cicendo Eye Hospital from January 2012 until December 2013. Age, sex, laterality, axial length, cataract morphology, retinopathy pigmentary, cardiac dissorder, hearing impairment, mental dissorder and laboratory serology rubella for IgM and IgG were recorded.Results: We found ninety three patients diagnosed with CRS from congenital cataract cases. Ocular manifestation include microphthalmia in 63 eyes (33.9%), microcornea in 30 eyes (16.1%), and pigmentary retinopathy in 1 eye (0.5%) . The most common type of cataract morphology was nuclear type (49.9%.). Non-ocular manifestation include cardiac dissorder in 16 cases (17.2%), hearing impairment in 1 case (1.1%) and mental retardation in 6 cases (6.4%). Case definition based on WHO criteria were 93 cases (100%) for suspected, 20 cases (25.8%) for clinically confirmed and 15 cases (42,8%) for laboratory confirmed.Conclusion: Ocular manifestation for CRS in congenital cataract 0-11 months old were microphthalmia, microcornea, pigmentary retinopathy. Other manifestation found were cardiac disorder, hearing impairment and mental retardation.

The Calamity Among Medical Students: Sleep Deprivation and Dry Eye Disease Salim, Anastasia Johanna; Salim, Jonathan; Josiah Irma, Josiah x
Medicinus Vol. 12 No. 1 (2022): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.7015

Background: Medical students’ burden upon academic and professional duties often blinded them from attending to themselves. Piling works and nightshifts interfere ferociously with their self-care behavior, including adequate sleep. The matter not only disrupts concentration and consciousness but also tolls the eye by reducing tear secretion. Hence, the present study urgently assesses sleep quality and dry eye disease (DED) among medical students.Methods: The cross-sectional study observed 172 eyes among medical students in Indonesia. We assessed sleep quality and dry eye disease through Pittsburgh Sleep Quality Index and Schirmer test. Independent statistician analyzed the data with chi-square.Result: From the eligible samples, there is a dominancy of females (55.8%) with poor sleep quality (55.2%). There is no significant difference in DED or sleep quality across gender though they lean toward females. Contrarily, poor sleepers significantly correspond to 2.96 times more risk of DED than an adequate sleeper.Conclusions: Medical students’ well-being is crucial. Aside from the academic burden, institutions and individuals shall strongly emphasize better sleep habits and eye care.

The Impact of Attitude and Knowledge on Consent Decisions for Cataract Surgery: A Study at Siloam Hospitals Lippo Village, Building B Wibisono, Atria Puspitaloka; Irma, Josiah; Rizki, Saraswati Anindita
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10149

Introduction: Cataracts account for 77.7% of blind cases in Indonesia, indicating that many cataract patients have not had surgery. Low levels of knowledge, attitude, and decision-making among cataract patients regarding surgery may limit the number of procedures performed in Indonesia. Therefore, this study aims to assess cataract patients’ knowledge, attitude, and decision-making concerning surgery at Siloam Hospitals Lippo Village in Tangerang. Objective: To determine the relationship between knowledge, attitude, and decision-making regarding cataract surgery among Siloam Hospitals Lippo Village Building B patients. Methods: This cross-sectional study involves 64 cataract patients visiting Siloam Hospitals Lippo Village Building B. The collected data were analysed using SPSS Statistics bivariate analysis. Results: Out of the 64 respondents, 7 (10.9%) demonstrated low knowledge, 4 (6.3%) displayed a negative attitude, and 4 (6.3%) indicated unwillingness to undergo surgery. A significant relationship exists between knowledge and attitude, attitude and decision, and knowledge and decision regarding cataract surgery, with a p-value of 0.000 as determined by the Pearson Chi-Square test. Conclusion: A significant relationship exists between knowledge, attitude, and the decision to undergo cataract surgery.

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