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All Journal Medical Journal of Indonesia Ophthalmologica Indonesiana
Aziza, Yulia
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Health Professions Medicine & Pharmacology Public Health

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INTO THE DARKNESS AND SILENCE: EVISCERATION IN A DEAF-MUTE- BLIND PATIENT WITH NEGLECTED GLAUCOMA: Poster Presentation - Case Report - Resident Lumita, Ferdinand Inno; Laksmita, Yulinda Arty; Sieman, Andrew John; Iskandar, Ferdy; Paramita, Carennia; Aziza, Yulia
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/n2m27f33

Abstract

Introduction : Glaucoma can have a potentially devastating effect on patient’s vision and quality of life if not treated properly. We described a neglected glaucoma case in a deaf-mute-blind patient that leads to evisceration. Case Illustration : A 64-year-old deaf-mute female came to our emergency room with chief complaint of bloody discharge from her right eye 12 hours prior to admission with no history of trauma. Patient’s right eye has been blind for the last four years; her left eye has been nonfunctional since she was in her 30s. She went to a primary clinic during this time but did not get any diagnoses. Physical examination revealed uveal prolapse of the right eye with infiltrates around the remaining cornea; and phtisical left eye with IOP of 30 mmHg and opaque cornea. We performed evisceration with dermato-fat graft of the right eye. Discussion : Glaucoma is a challenging disease, especially in developing countries. It is difficult to diagnose due to its nature to be asymptomatic until late in the disease course. The loss of vision is painless and insidious; resulting in late diagnosis unless patients are screened for glaucoma early on. Patient in this report is particularly difficult for the caretaker since she is a deaf-mute patient; resulting in a suspected undiagnosed glaucoma that leads to evisceration and blindness. Conclusion : Glaucoma care generally necessitates routine follow-up for monitoring of disease progression and medication adjustments. Good screening system, family support, and integration of eye care into existing healthcare systems is needed for early detection to reduce blindness from glaucoma.
A case of mixed mechanism glaucoma: diagnostic and management challenges Iskandar, Ferdy; Oktariana, Virna Dwi; Aziza, Yulia
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.258092

Abstract

Mixed mechanism glaucoma occurs when secondary causes contribute to glaucoma in an eye with preexisting primary open-angle glaucoma (POAG) or primary angle-closure glaucoma. This study highlights its diagnostic and management challenges. A 63-year-old female presented with blurry vision and right eye pain for 2 months. She had undergone cataract surgery in the right eye 6 months earlier and developed elevated intraocular pressure (IOP) afterward. Her visual acuity in the right eye was hand movements, and IOP was 34 mmHg despite medications. Examination revealed signs of uveitis, leading to a diagnosis of secondary glaucoma. A glaucoma drainage device (GDD) was implanted, successfully controlling IOP. Follow-up revealed POAG signs in the left eye, prompting a revised diagnosis of mixed mechanism glaucoma in the right eye. GDD implantation was effective, but continued monitoring remained essential to maintain the target IOP.
Defeating Mooren Ulcer: Timely Diagnosis and Strategic Interventions for Swift Recovery Priscilia, Florentina; Paramitha, Dewa Ayu Anggi; Aziza, Yulia
Majalah Oftalmologi Indonesia Vol 52 No 1 (2026): Ophthalmologica Indonesiana
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/oi.v52i1.101757

Abstract

Introduction: Mooren ulcer is a unique and rare manifestation of peripheral ulcerative keratitis of idiopathic origin, triggered by immunological abnormalities, genetic predispositions, and environmental factors. Case Report: We report the successful treatment of a rare case involving a 43-year-old man who presented with a significant worsening of white tissue covering cornea, severe pain, redness, and blurred vision in the left eye. An examination revealed a peripheral ulcer extending centrally with scleral sparing. Ancillary examinations yielded unremarkable findings. The patient was diagnosed with Mooren ulcer and initially treated with topical steroid, which showed no improvement. Therefore, a simultaneous conjunctival resection combined with immunosuppressive therapy was performed. At 1-year follow-up, no pain was reported, vision improved (6/21 to 6/12), and resolved ocular surface inflammation. Discussion: Mooren ulcer is often prone to misdiagnosis due to clinical signs that resemble other differential diagnoses. A meticulous examination is essential to carefully exclude autoimmune and corneal infection. The treatment goals are to arrest the destructive process and facilitate re-epithelization. A stepwise aggressive approach is crucial, starting with topical steroids to control inflammation. However, this single treatment modality may not prevent rapid progression, making conjunctival resection imperative to eliminate the source of collagenase production by cutting off the perilimbal blood vessels’ access to ulcer cites. Combining this with an immunosuppressant effectively maintains a stable condition. Conclusion: This case underscores the importance of timely diagnosis and aggressive treatment in preventing the swift progression of Mooren ulcer.  
Affordable HLA-B27 Detection in Resource-Limited Settings: Evaluating Conventional PCR for Uveitis and Spondyloarthropathy in Indonesia Nora, Rina La Distia; Edwar, Lukman; Susiyanti, Made; Aziza, Yulia; Putera, Ikhwanuliman; Sifyana, Ulifna Alfiya; Riasanti, Mei; Waliyuddin, M Zakiy; Wibawa, Maria Valentina; Ethelind, Rachel; Widodo, Erica; Sitompul, Ratna
Majalah Oftalmologi Indonesia Vol 52 No 1 (2026): Ophthalmologica Indonesiana
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/oi.v52i1.102039

Abstract

Introduction: HLA-B27 is a genetic marker strongly associated with spondyloarthropathy (SpA) and acute anterior uveitis (AAU). Detection of this allele can support earlier diagnosis and targeted management. However, commercially available HLA-B27 tests are costly and often inaccessible in low- and middle-income countries, including Indonesia. Methods: A cross-sectional study was conducted involving 42 subjects: 14 with SpA, 19 with AAU, and 9 healthy controls. DNA was extracted from peripheral blood samples and analyzed using both conventional PCR (targeting exon 3 of HLA-B27) and a commercial HLA-B27 strip assay. Sensitivity, specificity, and diagnostic accuracy of conventional PCR were calculated against the commercial kit as the reference standard. Results: Conventional PCR showed high sensitivity (100%) and accuracy (85.71%) in SpA patients, indicating its potential as a reliable screening tool in this group. However, its performance in AAU patients was suboptimal, with lower sensitivity (40%) and specificity (55.56%). False positives and false negatives were observed, likely due to limitations in allele coverage by conventional primers. Conclusion: Conventional PCR is a promising, affordable alternative for HLA-B27 detection in SpA patients, particularly in resource-limited settings. However, its lower reliability in AAU cases highlights the need for careful clinical application and further optimization. Larger studies and local allele mapping are recommended to enhance diagnostic precision in diverse populations.
Co-Authors Ethelind, Rachel Ikhwanuliman Putera Iskandar, Ferdy Laksmita, Yulinda Arty Lukman Edwar Lumita, Ferdinand Inno Made Susiyanti Nora, Rina La Distia Oktariana, Virna Dwi Paramita, Carennia Paramitha, Dewa Ayu Anggi Priscilia, Florentina Ratna Sitompul Riasanti, Mei Sieman, Andrew John Sifyana, Ulifna Alfiya Waliyuddin, M Zakiy Wibawa, Maria Valentina Widodo, Erica