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Ophthalmologica Indonesiana
Published by Perhimpunan Dokter Spesialis Mata Indonesia
ISSN : 01261193     EISSN : 2460545X     DOI : 10.35749
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Ophthalmologica Indonesiana is an open accessed online journal and comprehensive peer-reviewed ophthalmologist journal published by the Indonesian Ophthalmologist Association / Perhimpunan Dokter Spesialis Mata (PERDAMI). Our main mission is to encourage the important science in the clinical area of the ophthalmology field. We welcome authors for original articles (research), review articles, interesting case reports, special articles, clinical practices, and medical illustrations that focus on the clinical area of ophthalmology medicine.
Arjuna Subject : Kedokteran - Ophthalmology
Articles 869 Documents
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From Trauma to Triumph: A Successful Outcome of Intraocular Foreign Body: Poster Presentation - Case Report - Resident Primasakti, Pattih; Helvanda, Weni
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: 10.35749/9109hj94

Abstract

Introduction : Intraocular foreign body (IOFB) is a medical condition characterized by the presence of a foreign object within the eye. IOFBs can cause significant damage to the eye, leading to vision loss, ocular inflammation, and even blindness. Case Illustration : We present a case report of a 37-year-old male patient who presented to the emergency department with a history of sudden-onset eye pain and decreased vision in the right eye after a gravel had struck him in the eye while working in a field. Slit-lamp examination revealed a 4mm corneal rupture, iris damage, and traumatic cataract. Computed tomography confirmed the presence of the foreign body in inferonasal quadrant of the retina. The patients underwent vitrectomy and silicone oil tamponade was placed to support the retina. Foreign body had shattered into small pieces and aspirated during vitrectomy. Endolaser photocoagulation was performed to contain the injury site. Lens was removed and iris claw was implanted. Visual acuity improved from hand movement to 20/100. No signs of endophthalmitis, retinal detachment, or other complications were noted during the follow-up period. ultrasound confirmed the absence of foreign body. Discussion : IOFBs is a sight-threatening condition that can result from various occupational or recreational activities, as well as accidental trauma. Depending on the size, shape, and composition of the foreign body, it can cause damage to the cornea, iris, lens, vitreous, and retina, leading to vision loss or permanent visual impairment. Conclusion : The management of IOFBs depends on the location, size, IOFB composition, and severity of ocular trauma. Vitrectomy is an effective approach
THE OUTCOME OF INTRAVITREAL BROLUCIZUMAB FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATMENT: Poster Presentation - Case Report - Resident Graziani, Gabriella; Ihsan, Grimaldi; Widyanatha, Made Indra; Virgana, Rova; Kartasasmita, Arief S.; Iskandar, Erwin
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/nvxrf729

Abstract

Introduction : Age-related macular degeneration (AMD) is a disease that results in irreversible severe loss of central vision in people over 50 years old. Hence, anti-VEGF therapy has become a standard treatment for neovascular AMD. Brolucizumab is a single-chain antibody fragment that inhibits VEGF-A binding to VEGF receptors. It has a higher molar concentration that allows a greater reduction in the central subfield thickness (CST) Case Illustration : A 59-year-old male with a chief complaint of gradually blurred vision in the left eye for 2 years. BCVA of the left eye was 0.3, OCT showed a hyperreflective band in the sub-neurosensory space with subretinal fluid in the left eye (Figure 1), and OCT-A revealed choroidal neovascularization (Figure 2). The patient was diagnosed with AMD AREDS IV in the left eye. He had undergone three monthly injections of brolucizumab. BCVA of the left eye after injection improved to 1.0 and OCT imaging showed no subretinal fluid, no intraretinal fluid, and no pigment epithelial detachment. Discussion : Brolucizumab has a greater reduction in CST because of its high molecular concentration. Results of HAWK and HARRIER concluded that brolucizumab was non-inferior towards aflibercept in BCVA change at week 48. According to the HAWK trial, a greater reduction of CST was seen in week 16 among eyes treated with brolucizumab. Brolucizumab was also well tolerated and adverse event rates were similar to aflibercept. Conclusion : Brolucizumab could be an alternative treatment option considering its efficacy in improving visual acuity and reducing CST.
A Case: The Strategy of Corneal Ulcers: Poster Presentation - Case Report - General practitioner Oktaliani, Rahayu; Waslan, Kuswaya
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: 10.35749/4d65pq34

Abstract

Introduction : Corneal ulcers are considered an ophthalmologic emergency because of their potential to permanently impair vision or perforate the eye. Accurate and quick diagnosis and prompt treatmentis a key to improve clinical and visual outcomes in cases of corneal ulceration. Case Illustration : In this paper, we present the case of male 40-year-old presented with complaints of pain and defective vision in the right eye. Visual examination of the right eye is 1/~. It was found, palpebral edema, hyperemic tarsal conjunctiva. The bulbar conjunctiva showed conjunctival injection, ciliary injection. The cornea looks completely cloudy, the surface is not slippery, infiltrates and edema. The patient was treated with medical and surgical therapy, and then the patient’s have a good clinical response and was able to return to work. Discussion : The diagnosis of corneal ulcers was established based on history, physical examination and clinical examination using a slit lamp and laboratory examinations. Patient's examination revealed the presence of Candida albicans. This examination is important to distinguish the cause of the corneal ulcer so that it can help select an adequate therapy. Conclusion : Indonesian farmers have highrisk of fungal corneal ulcers. Fungal corneal ulcers is important cause of corneal blindness all over the world especially in develoving countries. Fungal corneal ulcers can diagnosis by slitlamp biomicroscopic examination and culture are essential for early specific diagnosis and must be taken consideratiaon to establish the most effective treatment and avoid severe complications
Incidence of Dry Eye Syndrome After Cataract Surgery with Phacoemulsification Technique in Padang Eye Center Hospital: Poster Presentation - Observational Study - General practitioner Khalieta, Amanda; Sastra, Joni
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/wf9nkx19

Abstract

Introduction & Objectives : Dry eyes is one of the most common ophthalmological problems. The etiology of dry eyes is usually multifactorial, such as medication, aging, systemic disease, allergy, computer usage, environmental factors, meibomian gland dysfunction and ophthalmic surgery. Cataract is still one of the leading causes of vision impairment globally. No medical treatment is effective to remove cataract. Thus, the only option is cataract removal surgery. The most common technique of cataract surgery in Padang Eye Center Hospital is phacoemulsification. This study aims to assess the incidence of dry eye syndrome after phacoemulsification surgery without complication in patients with no previous history of dry eye syndrome. Methods : This study was conducted using a prospective study. The evaluation uses Ocular Surface Disease Index ( OSDI ) questionnaire and tear break-up time ( TBUT ) test performed preoperatively and three times postoperatively at one week, one month and three months follow-up after surgery. Results : 110 eyes of 96 patients diagnosed with cataracts who had undergone phacoemulsification surgery were enrolled in this study. The mean age of patients is 62.46 ± 6.14 years, and 59,09% were men. After one week of surgery, only 9,09% had results 0-12 on the OSDI scale, and 43,63% represented moderate dry eye disease ( OSDI score 23-32 ) and TBUT test results from 61,82% of patients had dry eyes, which improved gradually after time. Conclusion : The incidence of dry eye syndrome significantly increased after one-week post-surgery. But after one month postoperative, the patients’ condition gradually improved and returned to normal after three months postoperatively.
Management of Subluxated cataract : A case report: Poster Presentation - Case Report - General practitioner Ufadila, Lulu Hasna; Hitam, Hilman
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/t9zcts64

Abstract

Introduction : Surgical management of ectopia lentis is one of the major challenges faced by cataract surgeons. A cataract is a clouding of the natural crystalline lens inside your eye. Symptoms may include loss of vision, blurry vision or distortion. Case Illustration : A 70 year old man comes of misty eyes in his right eye. History of trauma is unknown to the patient, there is no recurrent red eye, no pain in the eye. Physical examination revealed vital signs within normal limits. Vision right eye 6/12 left eye 1/60 (pseudophakia). Eyeball pressure OD 19 OS 11, good eyeball movement in all directions. The anterior segment of the superior and inferior lids ODS is calm, ODS bulbi conjunctiva is calm, ODS cornea is clear, ODS pupils are round RC +/+ RAPD (-) pupil diameter OD 5.5 mm OS 6 mm, OD lens is subluxated inferonasal. Discussion : The change in the position of the lens with different head positions helps to indicate the severity of subluxation. In eyes with ectopia lentis, the phacoemulsification technique used depends on the degree of zonulopathy and its underlying pathophysiologic origin. Hoffman et al classified the degree of subluxation into three broad groups mild, moderate, severe which the lens edge uncovers more than 50% of the pupil. Conclusion : The natural crystalline lens is held in place by tiny fibres called zonules. When these zonules are disrupted or weakened, the crystalline lens or more commonly the artificial intraocular lens may sublux (dislocated) into the back of the eye.
CORNEAL INJURY AFTER BEING STRUCK BY A PIECE OF STONE - A CASE REPORT: Poster Presentation - Case Report - General practitioner Dianata, Dewa Ayu Ina; Suniarsih, Ni Nyoman
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/mfnnmm65

Abstract

Introduction : Corneal lacerations in oculi trauma are common, any disruption or trauma to the cornea will affect the person's visual acuity. Case Illustration : 50 years old man came to the eye clinic of Sanjiwani General Hospital Gianyar with pain, blurred vision, and redness in his left eye, The symptom appeared abruptly after a piece of stone struck his left eye where the stone penetration looks deep enough and touched the surface of the iris. Visual acuity of his left eye (VOS) was 6/60, and open globe injury suspicion was removed by seidel test negative. He underwent surgery for corpus alienum removal with local anesthesia. During the procedure, the stone appeared to be even with the corneal surface, making it difficult to pick it up directly, so the removal technique is to pry it from the edge. The wound is closed using the suture. One week after the procedure, the patient came for a re-evaluation examination; visual acuity was improved; VOS: 6/7.5, no sign of infection or complication. Discussion : The form of the corneal lacerations can vary, with or without globe rupture. To reduce the risk of infection, tissue necrosis, and anterior peripheral synechiae formation, it is suggested that repair should occur within 24 hours after injury. In addition, repairs within this time limit may also aim to provide comfort and reduce the pain that patients may experience. Conclusion : Immediate recognition and repair procedure of corneal injury in this patient brings good vision results with no complaints of complications.
Anterior Segment Dysgenesis in A Child, A Rare Case Report: What Should We Do? Poster Presentation - Case Report - Resident Permatasari, Devi Sarah Intan; Hermawan, Dicky; Loebis, Rozalina
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: 10.35749/76yvsp50

Abstract

Introduction : Anterior segment dysgenesis affects a various range of ocular structure, including: cornea, iris, ciliary body, anterior chamber, and lens associated with approximate 50% of glaucoma Case Illustration : A 20 month-old boy presented with bilateral corneal opacity. VA was 6/480 on both eye. Examination revealed bilateral central corneal opacity with keratolenticular adhesions, anterior lens dislocation and opacification, aniridia, and posterior segment were difficult to evaluate. The IOP were 17.3 mmHg and 14.6 mmHg in the right and left eye respectively. The aforementioned feature contributed to the diagnosis of Type II Peters Anomaly (PA). Lens aspiration combined with adhesiolysis on the LE was performed. Patient was given topical antibiotic, corticosteroid, and anti- glaucoma medication post-operatively. Postoperative course showed no complication and the corneal opacity diminished Discussion : Lens aspiration in combination with adhesiolysis was performed because the presence of cataract interfered the visual axis and increased the risk of corneal decompensation due to keratolenticular adhesions. We considered to perform the surgery on the LE first because the corneal opacity was milder than the RE. Glaucoma is an almost ineluctable issue and medical therapy are necessary. Further evaluation was required to determine if a similar procedure is needed for the fellow eye and whether the IOL implantation was going to enhance the visual prognosis in the future Conclusion : The keratolenticular adhesions and corneal opacity in type II PA make the surgical approach more challenging. Cautious manipulation can prevent further corneal decompensation. In addition, parents should receive extensive counseling regarding the complications and prognosis
Phacoemulsification in an unable-lying supine patient: why not? Poster Presentation - Case Report - Ophthalmologist Damayanti, 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: 10.35749/2bpzhn09

Abstract

Introduction : This case report describes the author's experiences in performing phacoemulsification on two patients with heart diseases causing them unable to lie flat during surgery. Case Illustration : The first patient, 60 years old woman, with an age-related cataract in her left eye, who's had hypertensive heart disease. The second patient, 73 years old man, with an age-related cataract in his right eye, who's had congestive heart failure and chronic obstructive pulmonary disease. The above conditions have caused them unable to lie flat on the operating table. The surgeon performed both surgeries in a standing position while the patients were lying in a semi-upright position at an angle of 45 degrees (Fowler's position) with legs straight. Discussion : The presence of systemic diseases has caused the patients to be unable to lie flat. This condition can be predicted during the pre-operative examination from the history of comorbid diseases by asking whether the patients can lie comfortably in a supine position. Several things that should be considered are the preparation of patients, beds, and surgeons' positions. Other things that must be properly arranged are the height of the irrigation bottle and the magnification and the position of the microscope. The surgeon's standing position during surgery requires higher concentration, apart from the possible fatigue due to relying heavily on one leg. Conclusion : Cardiovascular, pulmonary, neurologic, and orthopedic conditions can affect positioning during the phacoemulsification phase. Those conditions can be quite a challenge for many surgeons in practice. Ophthalmologists must be prepared when they are confronted with such a case.
Pearls And Pitfalls of Keratoplasty to Achieve and Optimal Visual Function: A Case Report: Poster Presentation - Case Report - Resident Askary, Fadel; Solahudin, Alie
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/bs9q9p06

Abstract

Introduction : Keratoplasty, also known as corneal transplant, is a surgical procedure in which a damaged or diseased cornea is replaced with a healthy donor cornea. One of the common reasons for performing this procedure is to restore vision in people with a leukoma eye. Leukoma, also known as corneal opacification, is a condition in which the cornea becomes cloudy or opaque, leading to impaired vision or even blindness. This case will explain keratoplasty procedures for treating leukoma, the benefits and risks of the surgery, and the postoperative care required for a successful recovery. Case Illustration : A 49 years old Female diagnosed with Leukoma due to her symptoms, signs, and examination with VOD: 1/60 ph (-) and VOS : 6/7.5. The patient then underwent keratoplasty surgery. 7th day post operation, Corneal Graft had 16 interrupted sutures with minimal edema. VOD 6/60 and Intra ocular pressure on the right eye was 13.1 mmHg. Oral and topical corticosteroids Continued and planned to taper off gradually. Discussion : The success of the procedure depends on several factors, including the cell count of donor, determining high/low risk patients, Intraoperative, and the postoperative care provided. Topical corticosteroids remain the mainstay to prevent immunological graft reactions. Regular evaluation of the graft is important as the risk of rejection occur up to years. Conclusion : Keratoplasty has proven to be an effective treatment option for individuals with a leukoma eye. The procedure can significantly improve visual acuity and quality of life for these individuals.
Pseudophakic Pupillary Block Following Cataract Extraction with Anterior Chamber Lens Implantation : A Case Report: Poster Presentation - Case Report - General practitioner Sumantra, Ni Putu Sitha Medha Paramitha; Hikmawati, Ike
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/d5eq3k69

Abstract

Inteoduction : Pupillary block occurs when aqueous humor flow from posterior chamber to anterior chamber is obstructed by functional block between pupillary portion of iris and lens. It is relatively common when pupil is occluded by anterior chamber intraocular lens (IOL). This condition can lead to iris bombe, iridocorneal adhesion formation, increasing intraocular pressure (IOP), and optic nerve damage. Case Illustration : A 65-year-old woman came to local hospital with complaints of blurred left eye five days prior presentation. She had history of bilateral cataract surgery in 2013. On physical examination, BCVA was 6/6 on right eye and 1/300 on left eye. The IOP was 15. 3 on right eye and 31.5 on left eye. Slit lamp examination showed anterior chamber IOL on left eye, shallow camera oculi anterior (COA), no flare/cell, pupillary block was present, and no surgical iridectomy was found. She was previously given timolol 0.5% eye drop and added latanoprost 50 mcg eye drop, sodium chloride 4.4 mg- potassium chloride 0.8 mg eye drop for current therapy. Discussion : Pupillary block is a frequent complication of anterior chamber IOL implantation after cataract surgery. The anterior chamber in this patient was shallow, which indicates partial/total blocked aqueous flow from posterior chamber, causing an elevated IOP, and may disrupt optic nerve that cause decreased vision. Surgical iridectomy is suggested in high-risk procedures such as implantation of an anterior chamber IOL. Conclusion : Elevated IOP may cause visual dysfunction and damage to optic nerve. In cases of high-risk postoperative pupillary block, surgical iridectomy is suggested to prevent further complications

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