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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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Blast Eye Injury After Mobile Phone Battery Explosion: A Case Report: Poster Presentation - Case Report - Ophthalmologist Ariany, Dessira Rizka Tri; Eclipsia Yuniar, Merry Giovedi
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/ztrr5w55

Abstract

Introduction : Injuries from mobile phone blasts have been on the rise in recent years. Mobile phone blasts cause serious ocular morbidity. We report a rare case of blast eye injury after mobile phone battery explosion. Case Illustration : A 16 years old woman presented with burning sensation on both the eyes, following a smartphone battery blast. Immediately, after disconnecting the phone from the charger, the battery exploded and the phone blew apart. Her presenting visual acuity was 1/300 and 1.0 in right eye and left eye. Examination revealed broad corneal haziness on right eye, charred lashes, circumciliary congestion, and multiple soot particles embedded over the cornea, conjunctiva, and the lid margins. The eyes were washed with copious ringer lactate and the debris was carefully removed. Topical preservative free lubricants, broad-spectrum antibacterial agent, corticosteroid, and cycloplegic agent were prescribed along with systemic nonsteroidal anti-inflammatory drug. The healing of epithelial defects started on the next day and was complete by the 14th day. Discussion : We describe an ocular blast injury due to mobile phone explosion. The mechanism of injury from battery blast could be a combination of mechanical (battery pieces), thermal, and chemical injuries. The vision can be saved if the ocular surface burns are treated promptly and properly. Conclusion : Mobile blast injury is emerging as a new mode of ocular trauma. Knowing proper management is very important to achieve the best result.
Managing Iris Cysts with Surgical Excision: A Case Series: Poster Presentation - Case Series - Ophthalmologist Sitorus, Tigor Santoso; Afifah, Azzahra; Dini Dharmawidiarini; Farida Moenir; Napitupulu, Sanata PH
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/bba0bz36

Abstract

Introduction : Iris cysts are uncommon iris tumors. Primary iris cysts are congenital and usually not detected until late into the first or second decade of life. Secondary iris cysts have history of trauma or intraocular surgery. Small and asymptomatic iris cysts should be monitored, whereas larger cysts require treatment as they cause complications. Case Illustration : Case 1 a 17-year-old teenager had blurred vision without prior intraocular trauma or surgery. Anterior segment examination of the left eye revealed an oval, light brown, and semi-translucent cyst. Case 2 a 15-year-old girl had blurred vision and enlarging white spot in right eye with history of penetrating ocular trauma. Patient had undergone immediate penetrating repair followed by combination of pupilloplasty and cataract surgery. Anterior segment examination of the right eye showed corneal scar and cystic lesion. Both cysts extended to corneal endothelium and were managed surgically. Discussion : Larger cysts, especially with complications, require cyst aspiration, laser therapy, injections of antiproliferative agents, or surgery. We decided to surgically aspirate and excised iris walls to remove both iris cysts which were vital to achieve good result. Post-operative periods were uneventful with no significant inflammatory reactions associated with the procedure. Conclusion : Different modalities, with varying degrees of success, have been reported for the treatment of iris cysts. Surgical intervention remains the last option which can give a good functional outcome with minimal inflammatory complications, especially when less invasive options do not seem feasible due to the extensive nature of the cyst.
SURGICAL OUTCOME OF THREE MUSCLES SURGERY IN ONE SINGLE PROCEDURE OF LARGE-ANGLE EXOTROPIA: A CASE REPORT: Poster Presentation - Case Report - Resident Jatikusuma, Anas; Prastyani, Reni
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: 10.35749/9r4c5228

Abstract

Introduction : The management of large-angle horizontal strabismus poses special difficulties. Literature has outlined large-angle strabismus in a variety of ways. A threshold of 40 to 60 PD has been employed to determine large-angle strabismus. Case Illustration : A 19-year-old male with complaint of right eye that had been crossed outward since he was 12 years old. There was 90 prism diopter exotropia in near, distance, upgaze, and downgaze. The patient underwent bilateral lateral rectus recession of 10 mm and unilateral medial rectus resection of 6.5 mm in the right eye. Post-operative outcome revealed orthophoria without any misalignment of prism diopter examination in 1 day, one week, and two weeks follow-up. Discussion : When the deviation exceeds 50 prism diopter, there is no established consensus regarding the number and quantity of extraocular rectus muscles for surgery. The lack of uniform criteria and suggested surgical dosage is the greatest obstacle in using three muscles surgery. In this case, we used surgical dose according to Kenneth Wright exotropia binocular surgery table. We performed bilateral rectus lateral recession of 10 mm and a right rectus medial resection of 6.5 mm. This surgical dose gives good outcome. Moreover, this option can leave one horizontal rectus muscle unharmed. Conclusion : Determination of the surgical dose is essential in the management of large-angle exotropia. Appropriate surgical dose results in excellent outcomes with low risk of residual deviation.
A Case of Pediatric Eyelid Laceration ec Unusual Foreign Body: Poster Presentation - Case Report - Resident Olivia, Mokolensang Gabriella; Umboh, Roy; Umboh, Anne
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/taa1bm15

Abstract

Introduction : Eyelid lacerations refer to partial or full-thickness defects in the eyelid and constitute a significant subset of facial trauma which is often accompanied by other injuries including foreign bodies. Case Illustration : A 16-year-old boy was brought to the emergency department with a laceration and penetrating orbital injury in his right upper eyelid. On examination, there was a 4 cm x 0,5 cm upper eyelid laceration caused by tooth penetrating, CT scan revealed a high density foreign body measuring 1,5 cm x 0,5 cm in the right upper eyelid as deep as levator muscle and no globe injury. The patient underwent an emergency operation under general anesthesia, the foreign body was removed completely and the size of the foreign body was 2,6cm x 0,5cm. After the removal of the foreign body, debridement was performed and then sutured layer by layer. After surgery, he was treated with Tetanus prophylaxis, antibiotic, and analgetic. Discussion : Eyelid laceration is one of the most encountered ocular trauma, but needed to be evaluated and treated carefully. Although the rate of ocular foreign bodies found was low, it can lead to devastating ocular morbidities. After surgery and treatment, there is no other complaint from the patient. Visual acuity and ophthalmology examination are all in normal condition. ConclusionEyelid trauma with foreign bodies must undergo a complete examination. A good prognosis and outcomes can be achieved when appropriate medical and surgical treatment is performed.
LARGE V PATTERN EXOTROPIA WITH BILATERAL INFERIOR OBLIQUE OVERACTION AND ITS CHALLENGING MANAGEMENT: Poster Presentation - Case Report - Resident Rahmah Kartika, Amelia; Prastyani, Reni
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/hhv5ax77

Abstract

Introduction : V pattern exotropia is a strabismus pattern with greater divergence in upgaze than downgaze. Various surgical treatment options were defined. This report demonstrates the management of largeV pattern exotropia with bilateral inferior oblique overaction (IOOA) by performing multiple surgeries. Case Illustration : A 20-year-old male came with a chief complaint of squinting eyes outward in both eyes since 9 years old. There was 90 PD exotropia in upgaze, 70 PD in primary gaze, 50 PD in downgaze. Bilateral IOOA grading was +3. Management in this patient was bilateral rectus lateral recession with partial hang back technique 11 mm and inferior oblique anteriorization of both eyes 1 mm posterior to inferior rectus muscle insertion. The IOOA on both eyes was eliminated post-operative, but there was 30 PD residual exotropia. The second step will be bilateral medial rectus resection. Discussion : A large V pattern with IOOA is challenging for management because it requires surgery of 2 muscles for each eye. The lateral rectus and inferior oblique muscles are close, so it was advantageous to operate simultaneously. Large exotropia requires surgery on many muscles, however operating on more than two muscles in one eye at a time can cause anterior segment ischemia. Therefore, bilateral medial rectus resection for residual exotropia will be done at different times. Conclusion : Large V pattern exotropia with inferior oblique overaction is a challenging case to manage. Due to its complex nature, it is advantageous to operate adjacent muscles.
Ocular Toxocariasis in The Anterior Chamber of The Eye: Poster Presentation - Case Report - Resident Chandra, Monica Camilla; MD, Anne Umboh,; Rares, MD, Laya
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: 10.35749/97195m22

Abstract

Introduction : Ocular toxocariasis (OT) is a zoonotic infection caused by Toxocara canis and Toxocara cati. Dogs and cats, the definitive hosts of the roundworm, pass unembryonated eggs via their feces into the environment (often into the soil). Transmission to humans occurs through ingestion of soil or contaminated food, or the fecal– oral route. Case Illustration : A 14 years old male presented with pain and redness in the right eye 2 months prior to the visit. Complaints are redness, itching, and pain especially in the night on the right eye. The patient had habits of eating raw meat and walking around in dirt without any footwear. Ophthalmologic examination showed a toxocara sp. larvae in the anterior chamber of the right eye. This patient treated with surgical removal of the worm, given antihelminth and topical corticosteroid. Discussion : Toxocariasis results from infection with Toxocara cati (an intestinal parasite of cats) or Toxocara canis (an intestinal parasite of dogs). Children acquire the disease by close association with pets and by eating dirt (pica) contaminated with Toxocara ova. The ingested ova form larvae that penetrate the intestinal mucosa and gain access to the systemic circulation and finally to the eye. Systemic or local corticosteroids should be given when there is evidence of significant intraocular inflammation. Conclusion : This case described a patient who was diagnosed with a living worm as foreign bodies in the right eye.
Thyroid Eye Disease and Rare Manifestations of Severe Restrictive Strabismus with Large Hypertropia: A Case Report and Treatment Considerations: Poster Presentation - Case Report - General practitioner Akla, Nurul; Bakri, Annisa; Sulistyowati, Balgis Desy; Janani, Nazhira
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: 10.35749/7e8rrg94

Abstract

Introduction : Restrictive strabismus with large hypertropia is an infrequent manifestation of thyroid eye disease that arises due to severe thickening of the superior rectus muscle. This condition can lead to losing the visual axis in the primary gaze position, and prompt management is essential. Case Illustration : A Forty-seven-year-old man came to the hospital and presented with misalignment in both eyes, known for five months before admission. Ophthalmology examination revealed visual acuity for both eyes was 0.4—Large hypertropia with 50 prism diopters and exotropia with 20 prism diopters, and down shoot restrictions were found in both eyes. The patient had a history of hyperthyroidism since eight months ago and regularly took PTU medication. CT scan of the orbit showed hypertrophy on the extraocular muscle. Discussion : Continued fibroblast stimulation results in collagen deposition and subsequent fibrosis, ultimately leading to restrictive strabismus in TED patients. For patients with large hypertropia, the primary surgical approach remains recession of the involved restricted muscles, with or without tendon elongation surgery. Vertical rectus muscle resection is preferred for its low inflammation and restriction risk, while hemi hang-back is another suitable option. Conclusion : The recession of restricted muscles and tendon elongation, preferably vertical rectus muscle resection, is necessary for patients with rare manifestations of restrictive strabismus and large hypertropia in thyroid eye disease.
Enucleation and Dermato-fat Graft for Retinoblastoma Management : A Case Report: Poster Presentation - Case Report - Resident SIMANJUNTAK, dr. AGNES ANGELA MAHDALENA; Anne, Umboh; Freili, Akay
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/r1wmmr93

Abstract

Introduction : Retinoblastoma is the most common intraocular malignant tumor found in children before 3 years old can occur unilaterally, bilaterally, hereditary or sporadic. Incidence of about 1:14,000-20,000 individuals. This tumor originated from embryogenic retinal cells. Retinoblastoma gene (RB1) located in the 13q14 chromosome Case Illustration : A 3-year-old girl presented with leukocoria. Her parents notice whitish in her right eye swollen, teary, painful since 2 months ago. No family history. Visual acuity (VA) on the oculus dextra ( OD) no light perception, oculus sinistra (OS) 6/6. Intraocular pressure on OD n-1/palpation, OS n/palpation. Examination under anasthesia for diagnostic found there weren’t palpebral edema, conjunctival injection, hazy cornea, pupil, lens couldn’t be evaluated on OD. Ultrasound showed sugest vitreous seeding and ptisis. CT scan showed solid mass with calcification and diagnosed retinoblastoma stage group E. Patient was treated with chemoreduction using Vincristine, Etoposide, Carboplatine combined enucleation with dermato-fat graft. We did nervus opticus dissection and histopathological examination which showed retinoblastoma. Discussion : The common signs of retinoblastoma is leukocoria. The priority is saving life followed by globe preservation. Treatment based on the stage of the disease. We did chemotherapy in this patient, followed by enucleation and dermato-fat graft. Enucleation stills the main therapy for saving life with nervus opticus dissection as possible. Dermato-fat graft has been shown to grow along with the expanding orbit in children therefore shows cosmetics. Conclusion : This report illustrates a case of Retinoblastoma. The chemotherapy and enucleation using safe dermato-fat graft procedure with implant followed by a well fitted prosthesis for better cosmetics
Binocular Diplopia in Miller Fisher Syndrome Pediatric Patient: A Rare Case Report: Poster Presentation - Case Report - Resident Zhafira, Dinda; Prastyani, Reni; Gunawan, Prastiya Indra; Noviandi, Riza; Samosir, Sunny Mariana
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: 10.35749/36zz6w74

Abstract

Introduction : Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré syndrome that usually presents with ataxia, areflexia and ophthalmoplegia. It is more common among patients in their 40s and number of cases in pediatric patients is significantly smaller. Our objective is to report a rare case of diplopia in Miller Fisher. Case Illustration : An 11 years old boy came with complaint of double vision and history of gaze restriction. Patient had history of inpatient admission due to acute progressive generalized limb weakness and walking difficulty followed by respiratory failure. Patient also had history of chewing and swallowing difficulty. Inpatient treatment included intravenous immunoglobulin (IVIG) for 5 days which resultedin clinical improvement. Electromyography examination done while hospitalization showed normal results. Orthoptic examination revealed 15 degrees exotropia of left eye with 30 prism dioptres (PD) at near and far distance. Worth four dot test resulted in cross diplopia with no abnormality in head CT scan. After 2 months follow-up with push-up pencil exercise, patient showed improvement of symptoms. Discussion : MFS is a clinical diagnosis that can be assessed by clinical triad of ataxia, areflexia and ophthalmoplegia. Diagnosis can be supported by ancillary test such as cerebrospinal fluid analysis, electrophysiologic studies or antibody anti-GQ1b . Treatment of MFS are mainly for supportive care with respiratory support and immunotherapy if needed in severe cases. Conclusion : The outcome of MFS is usually good with a complete recovery. The improvements generally begin within two to four weeks after the onset of neurological symptoms and complete within six months.
CHALLENGES IN THE SURGICAL MANAGEMENT OF BILATERAL POSTERIOR LENTIGLOBUS: Poster Presentation - Case Report - Resident RAHMANI, SYIFA; Memed, Feti Karfiati; Caesarya, Sesy; Amiruddin, Primawita Oktarima; Irfani, Irawati; Kuntorini, Mayasari Wahyu
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/awdxnd05

Abstract

Introduction : Lentiglobus is a lens deformation characterized by spherical bulging of the lens surface. The weakness of the posterior capsule in the lentiglobus makes the surgery challenging. We present a case of bilateral posterior lentiglobus and its management. Case Illustration : A 5-year-old boy was presented with the chief complaint of gradually blurred vision since 1 year ago. Visual acuity were 0.1 and closed face finger counting in the right and left eyes, respectively. An ophthalmology examination revealed lens opacities with partially reabsorbed lens material and protrusion of the lens surface posteriorly in both eyes (figure 1). The patient was diagnosed with developmental cataracts of the membranous type and posterior lentiglobus in both eyes. The patient underwent a surgical intervention for cataract extraction with aspiration technique. A spontaneous posterior capsule rupture was found with a shape like a lentiglobus. An anterior vitrectomy was performed. An intraocular lens was implanted. At one month after surgery, the best corrected visual acuities were 0.5 in both eyes (figure 2). Discussion : Several difficulties can be encountered during pediatric cataract surgery with the posterior lentiglobus morphology because of the thin or ruptured capsule. Previous studies have found preoperative and intraoperative posterior capsule rupture in 25% and 3.13% of lentiglobus cases, respectively. Hydrodissection should be avoided due to the weakness of the posterior capsule. ConclusionAppropriate surgical techniques to anticipate posterior capsule defects in the lentiglobus are required to produce a favorable outcome.

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