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Journal : Vision Science and Eye Health Journal

Good Visual Acuity Outcome from an Ocular Blast Injury with Proper Management in Dr. Soetomo General Hospital Surabaya, Indonesia Rifat Nurfahri; Delfitri Lutfi; Ismi Zuhria
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (866.774 KB) | DOI: 10.20473/vsehj.v1i1.2021.1-5

Abstract

Introduction: Ocular blast injury related to fireworks most often causing corneal erosion (29%), conjunctival erosion (11%), and conjunctival foreign body (10%) with children are more often than adults (65.9%:34.1%), and males far more often than female (71.9%:28.1%). Knowing proper management is very important to achieve the best result. Case presentation: We describe an ocular blast injury that experienced broad erosion and multiple foreign bodies on the corneal and pericorneal surface in the left eye and visual acuity decreased. The foreign body was scattered, and the fluorescein test was positive. We did proper foreign body extraction, irrigation, and ocular bandage. It was treated with chloramphenicol 0.5% eye ointment and homatropine eye drop. In two months, the patient’s left eye had clear cornea with a small scar formation near the visual axis. The visual acuity was 6/7 and BCVA was 6/6 with S-0.5 C-0.5 A 50° correction. Conclusions: Patients with ocular blast injury limited to superficial cornea erosion and and conjunctival erosion have a reasonable probability of achieving the best visual acuity. Foreign body extraction, proper irrigation, and topical medication show promising results. Scar formation near the visual axis can disrupt visual acuity however can be corrected in this case it can be corrected with glasses. Furthermore, public promotion and regulation to control firework using are very important.
Blast Eye Injury After Mobile Phone Battery Explosion: How to Manage it? Ratih Justitia Kartika; Ismi Zuhria
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (584.286 KB) | DOI: 10.20473/vsehj.v1i2.2022.28-34

Abstract

Introduction: Injuries from mobile phone blasts have been on the rise in recent years. Lithium-ion batteries are the most common type found in cellphones and devices. In 2016 around 100 of the 2.5 million phone cell units have been recorded to have exploded. Mobile battery burst is a significantly underappreciated cause of serious ocular morbidity and could be a combination of mechanical, thermal, and chemical effects. Knowing proper management is very important to achieve the best result. Case presentation: We describe an ocular blast injury due to mobile phone battery explosion when plugged in to charge that experienced spasm and burned cilia, limbal ischemia, broad corneal haziness on both eyes, and visual acuity decreased. The fluorescein test was positive. We did proper irrigation and debris extraction around the ocular surface and periorbital tissue. It was treated with quinolone antibiotics eyedrop, atropine sulfate eyedrop, prednisolone eyedrop, and NSAID orally. In four days, the patient’s eye showed good clinical improvement with decreased corneal haziness with minimal epithelial defect. The visual acuity was improved on both eyes. Conclusions: Lithium-ion batteries are used in almost all smartphones and electronics. Lithium explosions can result in chemical and thermal burns on the ocular surface. Ocular alkali chemical injury combined with thermal and mechanical is an emergency case. The vision can be saved if the ocular surface burns are treated promptly and properly. These cases are required to raise public awareness about the potential risks of smartphone use, adopt safe practices as recommendations from the manufacturers, and avoid counterfeit products and such accidents.
Comprehensive Management of Preseptal Cellulitis with Massive Palpebral Abscess in 72-year-old Man Ruth Anastasia; Ismi Zuhria; Susy Fatmariyanti
Vision Science and Eye Health Journal Vol. 2 No. 1 (2022): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v2i1.2022.1-5

Abstract

Introduction: Infectious inflammation of the periorbital and orbital soft tissue can be classified as preseptal (periorbital) or postseptal (orbital) cellulitis. Eyelid abscess, an accumulation of pus in the palpebral tissue, can occur in isolation or in association with preseptal cellulitis. Preseptal cellulitis is nearly three times more common than orbital cellulitis. Case Presentation: The patient, in this case, was admitted with a complaint of swollen left eyelid ten days before being admitted. Swollen eyelid with the inability to open the left eye was accompanied by pus discharge five days before coming to the hospital. Current complaints include eyelid pain, swelling, and discharge of thick yellow fluid. Massive abscess with active pus and crust was present in the left superior and inferior eyelid and frontotemporal area. A head CT scan revealed a soft tissue mass in the left sub galea soft tissue, left frontal region, left orbit, and left temporal region. Multi-department consultations and several workups were done to reveal the etiology and plan the appropriate management of this condition. Conclusion: A comprehensive assessment must be done to distinguish preseptal and orbital cellulitis. Ophthalmology examination and imaging are crucial to detect any extension of the palpebral abscess beyond the orbital septum. Examining an immunocompromised state and focal infection is crucial in determining proper treatment.
Bandage Contact Lens Associated Infection after Amnion Membrane Transplantation in Peripheral Ulcerative Keratitis Case with Spondyloarthritis Permatasari, Devi Sarah Intan; Zuhria, Ismi; Rahmawati, Lita Diah
Vision Science and Eye Health Journal Vol. 4 No. 1 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i1.2024.4-12

Abstract

Introduction: Bacterial keratitis causes around 90% of all cases of microbial keratitis. The global rise in contact lens usage has contributed to an increased risk of microbial keratitis. Peripheral ulcerative keratitis (PUK) is essential to diagnose as it can be the first presenting feature of a sight-threatening and associated with rheumatic autoimmune disease. Case Presentation: The case presents a 35-year-old woman with redness, discharge, and tenderness in her right eye (RE) since the day before, along with light sensitivity and tearing. Three months prior, she underwent multilayer amniotic membrane transplantation (AMT) surgery for corneal thinning due to peripheral ulcerative keratitis (PUK) and wore a contact lens postoperatively as a bandage. She had a history of conjunctival resection related to the PUK a year ago. She received oral cyclosporin and methylprednisolone for spondyloarthritis. Initially, her visual acuity of the RE was limited to hand movement. Diagnosis included RE keratoconjunctivitis related to contact lens and PUK post-AMT surgery; treatment comprised intravenous and topical antibiotics, artificial tears, cycloplegics, analgesics, and oral ascorbic acid. After four days of treatment, clinical signs were improved, with visual acuity progressing from hand movement to counting fingers at one meter. Conclusions: Careful management is essential for PUK patients after AMT surgery, especially those using contact lenses as bandages due to the potential risk of infection. Early PUK identification is crucial, as it may indicate sight-threatening issues and underlying systemic diseases. Meticulous examination and multidisciplinary management are required to ensure patient safety.
Multifocal Keratitis in 23-year-old Woman with β-Thalassemia Asti, Annisa Kinanti; Zuhria, Ismi
Vision Science and Eye Health Journal Vol. 4 No. 2 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i2.2025.50-54

Abstract

Introduction: Multifocal keratitis can result from infectious and non-infectious causes, and its etiology is often challenging to pinpoint. Ocular complications are common in β-thalassemia and can have serious consequences. This case highlights an unusual presentation of multifocal keratitis in a patient with β-thalassemia. Case Presentation: A 23-year-old woman with β-thalassemia, diagnosed 12 years ago, was referred by a hematologist for pain in her right eye persisting for the past two weeks. She reported redness, tearing, and light sensitivity. Six months prior, she experienced similar symptoms, which had left a white spot in her right eye. Recently, this spot had multiplied and spread across the ocular surface. Visual acuity (VA) was 6/40 in the right eye on examination. Findings included palpebral spasm, conjunctival and pericorneal injection, and multiple infiltrates on the anterior corneal surface. Fluorescein staining was positive for numerous infiltrates. Schirmer and break-up time (BUT) tests indicated an unstable tear film. Treatment included antibiotic eye ointment, preservative-free artificial tears, mucous membrane pemphigoid (MMPs) inhibitors, and oral ascorbic acid. Two weeks later, VA improved to 6/9, with a reduction in infiltrates and fluorescein staining. Conclusion: Prompt management is essential for preserving vision and preventing complications in ocular surface diseases while diagnostic procedures are underway.
A Case of Chronic Incomplete Vogt-Koyanagi-Harada (VKH) Disease with Systemic Involvement in a 57-Year-Old Woman Prakoeswa, Camilla A.; Zuhria, Ismi
Vision Science and Eye Health Journal Vol. 4 No. 3 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i3.2025.81-85

Abstract

Introduction: Vogt–Koyanagi–Harada (VKH) disease is a systemic disorder that involves tissues containing pigmented cells. It is thought to be caused by an autoimmune T-cell-mediated process against melanocytes in systemic organs, particularly the eyes. VKH disease is a chronic, bilateral, diffuse, granulomatous panuveitis that involves integumentary, neurologic, and auditory aspects, which affects females and darkly pigmented ethnic groups. Here, we presented a rare case of VKH disease in a seronegative spondyloarthropathy patient. Case Presentation: A 57-year-old woman complaining of blurry vision in both eyes for three years. She was previously diagnosed with spondyloarthropathy, osteoarthritis, type 2 diabetes, hypertension, and dyslipidemia. Both eyelids exhibited periocular vitiligo and poliosis and were slightly hyperemic. Both eyes had perilimbal vitiligo and fine brown keratic precipitates. The anterior chambers were deep and quiet; however, the patient had posterior synechiae in both eyes. The fundus examination showed a sunset glow fundus appearance. Conclusions: VKH is a chronic disease that can relapse and recur. While the disease's prognosis is overall favorable, it is determined by the duration and frequency of recurrent inflammation episodes; thus, early detection and prompt treatment are essential for success. Poor visual prognosis is predicted by a larger number of complications, an older age at disease onset, a longer median duration of the disease, delayed treatment initiation, and a higher number of recurrent episodes of inflammation. To preserve vision, patients often require lifelong immunosuppressive therapy and need to be educated about the signs and symptoms to watch for when their condition relapses.
Neurotrophic Keratopathy Post-Herpes Zoster Ophthalmicus Infection Sarasati, Fani; Zuhria, Ismi
Vision Science and Eye Health Journal Vol. 4 No. 3 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i3.2025.91-94

Abstract

Introduction: Neurotrophic keratopathy (NK) is a degenerative disease of the corneal epithelium caused by disruption of corneal trigeminal innervation, resulting in reduced corneal sensitivity, epithelial damage, and impaired corneal healing. It can be caused by various factors, such as viral infections (e.g. herpes simplex keratoconjunctivitis and herpes zoster), chemical or physical trauma, corneal surgery, and intracranial lesions. Management of NK is based on clinical severity to promote corneal healing and prevent progression to stromal melting or perforation. Case Presentation: A 64-year-old male presented with a three-month history of a whitish plaque on the right eye, accompanied by redness, foreign body sensation, and decreased vision. The patient had a history of herpes zoster ophthalmicus (HZO) on the left side of the forehead in June 2022. Ophthalmologic examination revealed a 4 x 5 mm corneal epithelial defect with stromal infiltrates and decreased corneal sensitivity in the left eye, consistent with stage 2 neurotrophic keratopathy. Ancillary tests revealed reduced tear production and instability of the tear film. The patient was treated with topical antibiotics, lubricants, cycloplegics, and systemic doxycycline, with weekly follow-up and no evidence of active bacterial or fungal infection. Conclusion: Neurotrophic keratopathy can occur as a complication of post-HZO infection. Early diagnosis, severity-based treatment, and close monitoring are crucial for achieving epithelial healing and preventing further corneal damage. Prognosis depends on the degree of sensory impairment and the response to treatment.