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Visual Acuity Improvement of Cataract Patients After Cataract Surgery at Sumbawa Hospital in 2018 Siska Takarai; I Wayan Gede Jayanegara; Anak Agung Mas Putrawati Triningrat; Ni Made Ari Suryathi; Ariesanti Tri Handayani; Anak Agung Ayu Sukartini Djelantik; Angelo Doniho; Anthea Casey; Giovani Faustine
Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement) Vol 8, No 4 (2022)
Publisher : Direktorat Pengabdian kepada Masyarakat Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpkm.72478

A cataract is the most common cause of vision impairment and blindness worldwide. The Rapid Assessment of Avoidable Blindness survey held in 2014 - 2016 showed that the prevalence of blindness in West Nusa Tenggara was the second highest in Indonesia. This prevalence was expected to be higher in rural areas due to cultural barriers, patient education, and accessibility to eye-care facilities. This study aims to evaluate visual acuity improvement after cataract surgery and observe the sight restoration rate. The participants of this study were cataract patients who underwent surgery at Sumbawa Hospital West Nusa Tenggara between 27 - 30 August 2018 in a social service program held by the Sanglah General Hospital team. Surgery was not performed on patients who did not desire surgery, in cases where the surgery would not improve visual function, and on patients who were known to be medically unfit for safe surgical intervention. Demographic data and visual acuity at admission and postoperative day one were recorded and analyzed. The output of this program was qualitatively measured by analyzing the SRR. A total of 86 patients were included in this study. Visual acuity postoperative day one showed improvement, and the blindness percentage dropped to 51.16%. The sight restoration rate observed in this study was 58.14%. Although the benefits of cost-effective cataract surgery are straightforward, challenges to executing the procedure remain high, such as unaffordability surgery costs and accessibility to eye-care facilities and infrastructures. Equitable growth in other fields can automatically increase healthcare services in rural areas and encourage healthcare workers to spread evenly.

Prevalence and Risk Factors of Senile Cataract in Balinese Population Age 50 Years Old or Older Anak Agung Mas Putrawati Triningrat; Putu Adhi Surya Pradana; Ariesanti Tri Handayani; Gde Ngurah Indraguna Pinatih; Made Agus Kusumadjaja; Wayan Gede Jayanegara
Journal of Global Pharma Technology Volume 10 Issue 07: (2018) July 2018
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Objective: Cataract is the leading cause of blindness in the world with increasing trend both in prevalence and incidence. Surgery is the only definitive treatment for cataract but often unaffordable for society in developing countries. The incidence of cataract could be prevented by understanding its risk factors and formulate health programs according to them. The purpose of this study was to assess the prevalence and risk factors of senile cataract among 50 years old or older Balinese population. Method: The population-based cross-sectional study was conducted from September 2015 until July 2016 in Bali province. The variable’s data were obtained through direct examination and interview. Poisson regression analysis was used to assess the definitive correlation between risk factors and cataract. A p-value <0.05 or value which falls within 95% confidence interval were considered significant. Result: 550 subjects were enrolled during the study. The number of cataracts found in this study was 231 (42%). According to the analyses, cataract was significantly associated with older age (PR: 3.05; p=0.001), low educational level (PR: 2.18; p=0.04), diabetes (PR: 2.96; p=0.001), and the rate of ultraviolet exposure (PR: 1.92; p=0,002). Conclusion: The prevalence of cataract among 50 years old or older in Balinese population was 42%. Older age, low education, diabetes mellitus, and ultraviolet exposure were found to be significant and independent risk factors for cataract in 50 years old or older Balinese population.Keywords: Cataract, Prevalence, Risk factor.

Searching The New Culprit of Optic Neuritis: The Role of Vitamin D: Poster Presentation - Case Report - Ophthalmologist ANAK AGUNG MAS PUTRAWATI TRININGRAT; Made Paramita Wijayati; Putu Ayu Wulansari
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/ga8bd617

Abstract Introduction : Low vitamin D status has long been associated in multiple sclerosis patient with higher risk of disease progression and frequent relapses. Vitamin D plays an important role in modulating the immune process responsible for demyelination. To this date, the study on vitamin D deficiency in optic neuritis case is still rare. Case Illustration : Female, 20 years old, presenting with bilateral sudden visual loss since 1 week prior. The patient looked relatively pale and complained of accompanying headache and myalgia. Visual acuity in both eyes were light perception with dilated pupils and posterior segment showing optic disc swelling. CBC, infection and autoimmune screening came within normal limit and brain MRI further confirmed the presence of optic neuritis. The patient was given high dose intravenous steroid but showed no improvement. Later, she was screened for nutrient deficiency and found sign of low serum 25-hydroxyvitamin D. After one week of oral supplementation and neuroprotective agents, her vision drastically improved to 6/6 in both eyes. Discussion : Vitamin D deficiency nowadays is getting more prevalent in high risk individuals with low dietary intake and sunlight exposure. Recent study found that mean serum vitamin D level were significantly lower in autoimmune optic neuritis (ON) and were associated with ON attack severity. Vitamin D sufficiency is associated with better inflammatory outcome and long term neurodegenerative measures in demyelinating diseases, as shown by improvement in RNFL thickness after attack. Conclusion : Screening for vitamin D deficiency is essential to consider in managing patient with atypical optic neuritis.

Ocular Involvement as the Primary Presentation of Suspected Systemic Lupus Erythematosus: A Case of Bilateral Papilledema and Macular Edema Junetta Airene Priskila Taba; Anak Agung Mas Putrawati Triningrat; Made Paramita Wijayati; I Made Agus Kusumadjaja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1303

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease known for its varied clinical presentations, often affecting multiple organ systems. Ocular involvement is common in SLE, but posterior segment manifestations like papilledema are rare, occurring in only about 1% of SLE patients. This case report details a unique instance of bilateral papilledema and macular edema as the primary presentation of suspected SLE in a young female patient. Case presentation: A 24-year-old female presented with a one-week history of sudden-onset blurry vision in both eyes. Ophthalmological examination revealed reduced visual acuity (6/45 in both eyes), bilateral optic disc swelling, and macular edema. Further investigations, including Optical Coherence Tomography (OCT) and Magnetic Resonance Imaging (MRI), confirmed macular edema and optic nerve sheath distention. A positive Antinuclear Antibody (ANA) test suggested an autoimmune etiology. Lumbar puncture results were normal, ruling out idiopathic intracranial hypertension. The patient was diagnosed with bilateral papilledema and macular edema, with suspected underlying SLE. Prompt treatment with high-dose corticosteroids and acetazolamide led to significant clinical improvement. Conclusion: This case highlights the rarity of bilateral papilledema and macular edema as initial presenting features of suspected SLE. It emphasizes the importance of thorough ophthalmological examination and relevant investigations in patients with sudden vision loss. Early recognition of such rare presentations is crucial to prevent potentially sight-threatening complications. This case underscores the need for a multidisciplinary approach for accurate diagnosis and management of complex presentations of systemic autoimmune diseases.

Post-Pandemic Prevalence and Distribution of Refractive Errors in Balinese Schoolchildren: A Cross-Sectional Analysis Dharmi Lestari, Ni Putu; Ariesanti Tri Handayani; Anak Agung Mas Putrawati Triningrat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1377

Background: Uncorrected refractive errors are a leading cause of preventable visual impairment in children worldwide, impacting academic and social development. The COVID-19 pandemic disrupted routine pediatric eye health services and altered children's lifestyles, creating an urgent need to re-evaluate the burden of these conditions. This study aimed to determine the prevalence and geographical distribution of refractive errors among elementary school children across six districts in Bali, Indonesia, during the post-pandemic period (2022–2023). Methods: A descriptive cross-sectional study was conducted using secondary data from the John Fawcett Foundation (JFF) school eye health screening program. The final analysis included 2,145 elementary school children (47.5% male, 52.5% female) from 13 schools across six districts in Bali, screened between January 2022 and December 2023. Visual acuity was measured using a Snellen chart, followed by non-cycloplegic autorefraction for all children failing the initial screening. Ametropia was defined based on established spherical equivalent and cylindrical thresholds. Prevalence was calculated for each district, and a Chi-square test was used to analyze the association with gender. Results: The overall prevalence of ametropia was 4.1% (88/2,145). Myopia was the most common refractive error, accounting for 58 cases (2.7% of all children), followed by astigmatism with 22 cases (1.0%) and hypermetropia with 8 cases (0.4%). Significant geographical disparities were observed, with prevalence rates ranging from a low of 1.8% in Tabanan district to a high of 6.9% in Denpasar district. The highest prevalence rates were found in the urban and semi-urban districts of Denpasar (6.9%) and Buleleng (6.3%). There was no statistically significant association between gender and the presence of refractive error (p=0.115). Conclusion: The post-pandemic prevalence of refractive errors in this large cohort of Balinese schoolchildren reveals a significant public health challenge defined by a sharp urban-rural divide. The concentration of refractive errors, primarily myopia, in urban centers like Denpasar points to the profound impact of environmental and lifestyle factors on visual development. This evidence provides a clear mandate for the strategic deployment of targeted pediatric eye care resources to the island's most affected communities, ensuring the early detection and management necessary to prevent lifelong visual impairment and secure the future well-being of Bali's next generation.

Ocular Involvement as the Primary Presentation of Suspected Systemic Lupus Erythematosus: A Case of Bilateral Papilledema and Macular Edema Junetta Airene Priskila Taba; Anak Agung Mas Putrawati Triningrat; Made Paramita Wijayati; I Made Agus Kusumadjaja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1303

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease known for its varied clinical presentations, often affecting multiple organ systems. Ocular involvement is common in SLE, but posterior segment manifestations like papilledema are rare, occurring in only about 1% of SLE patients. This case report details a unique instance of bilateral papilledema and macular edema as the primary presentation of suspected SLE in a young female patient. Case presentation: A 24-year-old female presented with a one-week history of sudden-onset blurry vision in both eyes. Ophthalmological examination revealed reduced visual acuity (6/45 in both eyes), bilateral optic disc swelling, and macular edema. Further investigations, including Optical Coherence Tomography (OCT) and Magnetic Resonance Imaging (MRI), confirmed macular edema and optic nerve sheath distention. A positive Antinuclear Antibody (ANA) test suggested an autoimmune etiology. Lumbar puncture results were normal, ruling out idiopathic intracranial hypertension. The patient was diagnosed with bilateral papilledema and macular edema, with suspected underlying SLE. Prompt treatment with high-dose corticosteroids and acetazolamide led to significant clinical improvement. Conclusion: This case highlights the rarity of bilateral papilledema and macular edema as initial presenting features of suspected SLE. It emphasizes the importance of thorough ophthalmological examination and relevant investigations in patients with sudden vision loss. Early recognition of such rare presentations is crucial to prevent potentially sight-threatening complications. This case underscores the need for a multidisciplinary approach for accurate diagnosis and management of complex presentations of systemic autoimmune diseases.

Post-Pandemic Prevalence and Distribution of Refractive Errors in Balinese Schoolchildren: A Cross-Sectional Analysis Dharmi Lestari, Ni Putu; Ariesanti Tri Handayani; Anak Agung Mas Putrawati Triningrat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1377

Background: Uncorrected refractive errors are a leading cause of preventable visual impairment in children worldwide, impacting academic and social development. The COVID-19 pandemic disrupted routine pediatric eye health services and altered children's lifestyles, creating an urgent need to re-evaluate the burden of these conditions. This study aimed to determine the prevalence and geographical distribution of refractive errors among elementary school children across six districts in Bali, Indonesia, during the post-pandemic period (2022–2023). Methods: A descriptive cross-sectional study was conducted using secondary data from the John Fawcett Foundation (JFF) school eye health screening program. The final analysis included 2,145 elementary school children (47.5% male, 52.5% female) from 13 schools across six districts in Bali, screened between January 2022 and December 2023. Visual acuity was measured using a Snellen chart, followed by non-cycloplegic autorefraction for all children failing the initial screening. Ametropia was defined based on established spherical equivalent and cylindrical thresholds. Prevalence was calculated for each district, and a Chi-square test was used to analyze the association with gender. Results: The overall prevalence of ametropia was 4.1% (88/2,145). Myopia was the most common refractive error, accounting for 58 cases (2.7% of all children), followed by astigmatism with 22 cases (1.0%) and hypermetropia with 8 cases (0.4%). Significant geographical disparities were observed, with prevalence rates ranging from a low of 1.8% in Tabanan district to a high of 6.9% in Denpasar district. The highest prevalence rates were found in the urban and semi-urban districts of Denpasar (6.9%) and Buleleng (6.3%). There was no statistically significant association between gender and the presence of refractive error (p=0.115). Conclusion: The post-pandemic prevalence of refractive errors in this large cohort of Balinese schoolchildren reveals a significant public health challenge defined by a sharp urban-rural divide. The concentration of refractive errors, primarily myopia, in urban centers like Denpasar points to the profound impact of environmental and lifestyle factors on visual development. This evidence provides a clear mandate for the strategic deployment of targeted pediatric eye care resources to the island's most affected communities, ensuring the early detection and management necessary to prevent lifelong visual impairment and secure the future well-being of Bali's next generation.

Metabolic and Hematologic Synergism in Idiopathic Intracranial Hypertension: Reversal of Bilateral Papilledema via Multidisciplinary Gynecological and Systemic Interventions Anak Agung Putri Satwika; Anak Agung Mas Putrawati Triningrat; Made Widhi Asih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1590

Background: Idiopathic Intracranial Hypertension (IIH) conventionally presents with elevated intracranial pressure without structural etiologies, heavily associating with central adiposity. Emerging clinical frameworks recognize the intersecting roles of hematologic and metabolic abnormalities, notably iron deficiency anemia and hypovitaminosis D. Case presentation: A 41-year-old obese female (Body Mass Index 30.04 kg/m2) presented with progressive, painless bilateral visual blurring. Initial evaluation revealed a right eye visual acuity of 6/7.5 and a severely reduced left eye visual acuity of 1/60, alongside prominent bilateral papilledema and flame-shaped hemorrhages. The patient was incorrectly diagnosed with optic neuritis externally. Upon referral, rigorous evaluation successfully dismantled the misdiagnosis; intact pupillary reflexes, absence of a relative afferent pupillary defect, and an enlarged blind spot pointed definitively to papilledema. A lumbar puncture confirmed an elevated opening pressure of 340 mmH2O with normal cerebrospinal fluid composition. Targeted systemic profiling uncovered severe iron deficiency anemia (Hemoglobin 7.90 g/dL) driven by chronic menorrhagia from a uterine myoma, compounded by marked hypovitaminosis D. A tailored multidisciplinary intervention was initiated. A conservative acetazolamide dosage (500 mg/day) was utilized to minimize systemic stress, combined with cholecalciferol supplementation, ferrous sulfate, and a laparotomic myomectomy. One month post-operatively, hemoglobin normalized to 11.70 g/dL, visual acuity was fully restored to 6/6 bilaterally, and papilledema completely resolved. Conclusion: IIH is a multifactorial systemic syndrome. Prompt identification and aggressive correction of hematologic and metabolic drivers, including surgical eradication of hemorrhagic etiologies, are imperative for reversing intracranial hypertension and preventing permanent optic neuropathy.

Metabolic and Hematologic Synergism in Idiopathic Intracranial Hypertension: Reversal of Bilateral Papilledema via Multidisciplinary Gynecological and Systemic Interventions Anak Agung Putri Satwika; Anak Agung Mas Putrawati Triningrat; Made Widhi Asih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1590

Background: Idiopathic Intracranial Hypertension (IIH) conventionally presents with elevated intracranial pressure without structural etiologies, heavily associating with central adiposity. Emerging clinical frameworks recognize the intersecting roles of hematologic and metabolic abnormalities, notably iron deficiency anemia and hypovitaminosis D. Case presentation: A 41-year-old obese female (Body Mass Index 30.04 kg/m2) presented with progressive, painless bilateral visual blurring. Initial evaluation revealed a right eye visual acuity of 6/7.5 and a severely reduced left eye visual acuity of 1/60, alongside prominent bilateral papilledema and flame-shaped hemorrhages. The patient was incorrectly diagnosed with optic neuritis externally. Upon referral, rigorous evaluation successfully dismantled the misdiagnosis; intact pupillary reflexes, absence of a relative afferent pupillary defect, and an enlarged blind spot pointed definitively to papilledema. A lumbar puncture confirmed an elevated opening pressure of 340 mmH2O with normal cerebrospinal fluid composition. Targeted systemic profiling uncovered severe iron deficiency anemia (Hemoglobin 7.90 g/dL) driven by chronic menorrhagia from a uterine myoma, compounded by marked hypovitaminosis D. A tailored multidisciplinary intervention was initiated. A conservative acetazolamide dosage (500 mg/day) was utilized to minimize systemic stress, combined with cholecalciferol supplementation, ferrous sulfate, and a laparotomic myomectomy. One month post-operatively, hemoglobin normalized to 11.70 g/dL, visual acuity was fully restored to 6/6 bilaterally, and papilledema completely resolved. Conclusion: IIH is a multifactorial systemic syndrome. Prompt identification and aggressive correction of hematologic and metabolic drivers, including surgical eradication of hemorrhagic etiologies, are imperative for reversing intracranial hypertension and preventing permanent optic neuropathy.

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