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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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A Mystery Unsolved: A Spontaneous Lens and Uveal Prolapse in a New-born: Poster Presentation - Case Report - Resident NABILA ALJUFRI; Shafiq Advani; Dany Petra; Agnesstacia Vania L; Yulia Aziza; Julie D Barliana; Rio Rhendy
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: 10.35749/00a4a776

Abstract

Introduction : Corneal rupture in new-born, especially during the first week of life is rare. Some of these cases occur because of ocular trauma during deliveries, systemic infection, and congenital anomalies. We aim to deliver a rare case of spontaneous lens and uveal prolapse in new-born and management in treating the case. Case Illustration : A-2-day-old full-term-baby was referred due to bleeding of the right eye 6 hours post-partum by spontaneous vaginal delivery with no trauma. The mother, a 23-year-old, having the second born with no history of medical illness or vaginal discharged during pregnancy. Measurements of birth weight and length were normal. Eye examination of the right eye (RE) was uveal and lens prolapse and left eye (LE) cloudy cornea with leukoma and prominent neovascularization. Orbital CT-Scan revealed bilateral vitreous bleeding of both eyes. Laboratory examination showed reactive IgM for herpes simplex virus, reactive IgG for both toxoplasma and rubella. Corneal swab culture was sterile. Systemic and topical antibiotics were administered then switched to systemic antivirus. The 12-day-old-patient showed partial epithelization of cornea, less uveal volume with it partially shrank. Close observation was conducted and evisceration was postponed. Discussion : Although etiologic work-up has been addressed, exact etiology remains unknown with the possibility of congenital cause. It has been postulated that structurally malformed eyes are more prone to corneal perforations. Management should be personalized based on the patient’s need. Conclusion : Thorough examination is vital a rare case with undisclosed aetiology especially new-born. Patient monitoring is sufficient if no infections and bleedings found.
A Rare Case of Congenital Bilateral Upper Eyelids Ectropion in Down’s Syndrome : Conservative or Operative? Poster Presentation - Case Report - General practitioner Mischka Scalvinni Suvero Suyar; Nazhira Janani; Ferdian Ramadhan; Balgis Desy Sulistyowati
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/wkk9y007

Abstract

Introduction : Congenital upper eyelids ectropion, is a very rare congenital condition characterized by everted upper eyelids associated with Ichthyosis, Blepharophymosis Syndrome, birth trauma and prominently appears in Down’s syndrome. This case aimed to report a rare case of congenital ectropion in an Down’s syndrome with further management considerations, conservative or operative. Case Illustration : A three-month-old baby with bilateral red upper eyelids swelling since birth with conjunctival swelling followed by yellowish discharge. Born through section caesarean from a mother with history of pre-eclampsia and being incubated for 24 days. Ophthalmic examination revealed bilateral upper eyelids eversion, minimal conjunctival chemosis, epicantal fold. The upper eyelids able to be repositioned in relaxed state and re-everted with forced lid closure. Treatment of the eyelids eversion was conservative, combining antibiotics, topical steroids and lubricants. We referred to the pediatrician for the management of Down’s Syndrome, the further management for the eyelids eversion still debatable. Discussion : Most infants with congenital ectropion showed excellent anatomic and functional results with conservative treatment if managed timely and promptly. However, infants with Down’s syndrome have a more complicated course due to complex periorbital anatomy and facial anomalies such as flattened face, almond shaped eyes and large nose’s bridge. If congenital ectropion accompanied by lagophthalmos and exposure keratopathy, surgical management should be considered. Conclusion : Congenital eyelids ectropion can be managed conservatively or surgically depend on the clinical courses. Mild case able to be managed conservatively with excellent results if managed timely but surgical management supposed to be considered in complicated case.
Management of Recurrent Entropion in Traumatic Proptosis: Poster Presentation - Case Report - Ophthalmologist ANGGA KARTIWA; George Raden Mas Said; Niluh Putu Ayu Dewi Wardhani; Shanti Fitrianti Boesoirie; Mohamad Rinaldi Dahlan
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: 10.35749/0a7grr81

Abstract

Introduction : Shortening of posterior lamella due to fibrotic tissue is the pathomechanism of cicactricial entropion. It may be complicated by proptosis in a post traumatic patient which may require repeated repair procedure. Case Illustration : A 29-year-old woman came with complaints of protruding left eye since being hit by an iron tip 2 months prior. She also complained off double vision. Left eye presenting visual acuity was 0.08 with hipotropic position, proptosis, lid retraction, and entropion of the inferior lid. CT scan examination showed unremarkable results. The patient then underwent forced duction test, exploration, and muscle restriction release on the left eye, followed by inferior rectus recess and superior rectus resect procedures 3 months later. A month later the patient underwent entropion repair in the left eye using the tarsal fracture method. However, a week later the patient complained of a recurrent entropion, thus a grey line splitting procedure combined with retractor repositioning and tightening of the tarsus was performed. At the 7 days follow-up time, the eyelid margin was succesfully everted with an acceptable result. Discussion : Skin graft procedure is one of the option for cicatricial entropion. However, its risk of recurrences and more difficult secondary repair can be harrowing. Thus, a grey line splitting procedure is an alternative that can be considered. Conclusion : Combined procedure of grey line splitting, retractor repositioning, and posterior lamellar tightening showed a good cosmetic result in an uncommon case of entropion.
Anterior Orbitotomy with Transcutaneous Approach as Management of Orbital Cavernous Hemangioma: Poster Presentation - Case Report - Resident Sheilla Selvina; M. Rinaldi Dahlan; Shanti F Boesoirie; R. Angga Kartiwa; Niluh Putu Ayu Dewi
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: 10.35749/7ss9mn24

Abstract

Introduction : Orbital cavernous hemangioma is the most common benign orbital lesion in adults. Management of cavernous hemangioma depends on the presented symptoms. Visual impairment is indication of surgical management. Anterior orbitotomy is the preferred surgical technique for cavernous hemangioma. Case Illustration : A 34-years-old male came with chief complaint of mass in the inferior palpebra left eye (LE) accompanied with double vision for three years. Visual acuity of the right eye (RE) was 1.0 and LE was 0.8. Ophthalmology examination revealed hypertropia, non-axial proptosis, mass lesion sized 4 x2 cm in the left inferior palpebra and RAPD grade I in the LE (Figure 1). Funduscopy examination in both eyes was within normal limit. CT-Scan examination showed intraconal and extraconal inhomogen mass lobulated in the left inferomedial which obliterate inferior and medial rectus muscle (Figure 2). Patient was diagnosed with proptosis and compressive optic neuropathy in LE caused by suspected orbital cavernous hemangioma. Anterior orbitotomy with transcutaneous approach was done (Figure 3). Histopathological examination showed proliferation of large blood vessels lined with endothelial cells as characteristic of cavernous hemangioma (Figure 4). There was improvement of visual acuity and no RAPD after surgery (Figure 5). Discussion : Orbital cavernous hemangioma can compress optic nerve which will cause visual disturbances. Anterior orbitotomy with transcutaneous approach provides wider space when surgeon take out hemangioma completely. It will reduce bleeding caused by truncated mass of hemangioma and increase successful rate of surgery. Conclusion : Anterior orbitotomy with transcutaneous approach can correct globe displacement and visual disturbances caused by orbital cavernous hemangioma.
Periocular Capillary Hemangioma Treated With Low Dose Oral Propranolol - Presentation and Outcome of 2 patients: Poster Presentation - Case Report - Ophthalmologist TEGUH ANAMANI; PRIMA SUGESTY NURLAILA
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/w32cav51

Abstract

Introduction : Infantile hemangioma (IH) is the most common benign vascular tumor of infancy. IH arises in the first few weeks of life, then displays a period of active growth followed by spontaneous involution.[1,2] Most IHs are uncomplicated, do not require intervention, and regress spontaneously.[3] Infantile hemangioma (IH) having an incidence of 4%–5%.[4-6] Case Illustration : First patient is 6 -month-old girl weighing 6.2 kg, with Periocular lesions on the superior palpebra since 2 weeks after birth. Second patient is 6-month-old girl weighing 6.3 kg, with Periocular lesions on the superior palpebra since 1 weeks after birth. The lesions rapidly increased in size within 1 months. The lesions made it difficult to open superior palpebra. Both patient was diagnosed with periocular infantile hemangioma. The diagnosis was established by clinical examination, and was given oral propranolol therapy. Initially, a dose of propranolol was 1 mg/kg body weight in divided doses for 2 weeks then increased to 2 mg/kg body weight. Patients have followed up at 4-week intervals until the final follow-up was reached according to the response of treatment. The lesions were significantly decreased and bith pastients could open their right eye normally after 3 months of propranolol therapy Discussion : Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects. Conclusion : Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes
Reconstruction Management for Neglected Tripod Fracture with Ophthalmic Injuries: A Case report: Poster Presentation - Case Report - Resident Priscillia Tondolambung; Vera Sumual; Victor Pamolango; 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: 10.35749/5vh07e40

Abstract

Introduction : Tripod fracture or zygomatico-maxillary complex fracture are among the most common injuries to facial structures, which can make reconstruction more difficult. This case highlights the reconstruction of neglected tripod fracture. Case Illustration : A 17-year-old male was presented with enophthalmos in his right eye. He had an accident three months prior and had received head surgery. After that, the patient came back with a pan-facial fracture. VA on RE was 1/300, limited movement upwards, 4 mm lagophthalmos, negative Bell’s phenomenon, infiltrates and cicatrices on the cornea. CT-scan examination showed tripod fractures. The surgery was performed by the reconstruction division with an oral and maxillofacial surgeon. Nineteen days after surgery, there has been some improvement in the orbital misalignment. Discussion : Delayed intervention in this case, increased the difficulty of surgical treatment and could lower the success rate of surgery. If the indication is obvious, an immediate intervention will give better results because soft tissue scarring is minimized and fractures are easily reduced. During the procedure, we released the orbital muscle entrapment and repaired the deviated bone and callus with an osteotome to achieve mobility. Therefore, the tripod fracture was fixed with three-point fixation, followed by reconstruction of the maxilla and mandible. The result after surgery showed some improvements in aesthetics but not in vision. Conclusion : Orbital reconstruction with mini-plate implants in three-point fixation as the management of orbital fractures is effective, but its accuracy is difficult to assess during surgery, especially when coupled with delayed intervention cases. Early reconstruction is recommended for a better cosmetic result.
Disaster of Retrobulbar Hemorrhage: Poster Presentation - Case Report - Resident AMELIA DEVY INDRIASARI; Purjanto Tepo Utomo; Agus Supartoto; Banu Aji Dibyasakti; Irene Titin Darajati; Datu Respatika
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/myqp3t94

Abstract

Introduction : Retrobulbar hemorrhage is a rare case, 3.6% of which are caused by ocular trauma. However, this case is an ophthalmic emergency and must be treated quickly and accurately. We present a case of neglected traumatic retrobulbar hemorrhage with compartment-syndrome and opportunistic bacterial infection which underwent dilemmatic exenteration and orbitectomy. Case Illustration : A 39-year-old man was referred with a history of being beaten, 11 days before admission. He felt a dark vision, pain and swelling in his left eye. The visual acuity was no light perception. Eyelid necrosis with proptosis and periorbital edema. We found severe chemosis and cloudy cornea. Negative-light reflex with increase intraocular pressure and limited eye movement in all directions. We did three surgeries due to serious complication. First, evacuation of retrobulbar bleeding. The second was total exenteration. The last was left orbitectomy, necrotomy and reconstruction performed together with plastic-surgeon and neuro-surgeon. Patient was hospitalized for 1.5 months. Discussion : Accumulation of blood in retrobulbar space leads to increased orbital pressure, which can stretch the optic nerve and impair blood flow in the eye which can lead to orbital compartment-syndrome. Unwanted complications can be prevented with prompt treatment within the first-two hours. Orbital decompression with lateral canthotomy and inferior cantholysis is considered as an emergency procedure. In this case, our patient had chronic compartment-syndrome and had no previous orbital decompression. Conclusion : Retrobulbar hemorrhage is an ophthalmic emergency. Early diagnosis and treatment are critical to ensure the best clinical outcome. Delayed treatment causes blindness and opportunistic infections can destroy the surrounding structure, a disaster.
Ocular Penetration Trauma due to Bamboo Resulting in Evisceration: A Case Report: Poster Presentation - Case Report - General practitioner Indah Latifah; dr. Lailus Sofatul Layyin, Sp. M
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/phcy8570

Abstract

Introduction : Penetrating ocular trauma includes open-eye trauma, which leads to the time and a precision of eye- penetrating trauma’s management determine the advanced vision prognosis. In this case a male experience penetration trauma of the right eye due to exposure to the bamboo, delaying and inadequate management resulted in evisceration of the right eye. A 42-year-old male came to ER RSUD Prof. Soekandar mojokerto with bloody right eye and pain from getting a piece of bamboo from two days before entering the hospital. The patient also complained that the right eye is swollen so that it is unable to open the eyes. vision examination revealed LP (-) in the right eye, visual acuity in the left eye was 6/6, soft palpation in the right eye, normal palpation in the left eye, examination of the right anterior segment of the eye revealed that part of the eyeball content had prolapsed and for the left eye within the normal range. During laboratory tests, 15.280 white blood cells were found, which confirmed the infection of the right eye. Case Illustration : Descriptive Study Discussion : The observations on these patients include covered the right eye, antibiotic, steroids, and analgesic by intravenous injection. Based on the condition of the patient's right eye, it is advisable to do evisceration of the right eyeball under general anesthesia. Conclusion : Penetrating ocular trauma resulting in extensive intra ocular tissue damage and poor vision prognosis, considered for evisceration, in order to prevent the development of the sympatetic ophthalmia.
Levator Resection in Neurogenic Ptosis Oculi Sinistra et causa Third Nerve Paresis + Type II Diabetes: A Case Report: Poster Presentation - Case Report - Resident Retno Tharra Handayani; Riani Erna
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/hjr14v60

Abstract

Introduction : Neurogenic ptosis is abnormal position of the upper eyelid caused by dysfunction or damage to the oculomotor or sympathetic nerves supplying the eyelids. Third nerve palsy (35.7%) is the most common cause among others. We report a case of neurogenic ptosis managed surgically by levator resection. Case Illustration : A 67-year-old male complained of drooping left upper eyelid, getting worse in 7 months. He had history of falling off motorcycle 6 months ago. Clinical histories of hypertension and diabetes mellitus were found. Right and left eyelids measurements in millimeter showed horizontal palpebral fissure (HPF) 28/26, vertical palpebral fissure (VPF) 6/3, margin reflex distance 1 (MRD1) 2/-2, margin reflex distance 2 (MRD2) 6/5, margin limbal distance (MLD) 8/4, and levator function (LF) 8/3. Bell’s phenomenon was negative in both eyes. Ice pack test was negative. There were ocular movement restriction in his left eye. Patient underwent a maximum levator resection and had better levator function after 3 weeks follow up. Discussion : Neurogenic ptosis caused by third nerve injury is associated with microvascular ischemia such as diabetes mellitus and hypertension. Operative management is carried out after 3 to 6 months observation. Evaluation of levator function allows the clinician to correctly classify the degree and type of ptosis. Maximal levator resection is the treatment of choice for ptosis with poor levator function. Conclusion : Although various surgical techniques have been developed, ptosis correction should be performed according to the indications and clinical condition of the patient.
Intravenous Catheter Use for Inferior Lacrimal Canalicular Laceration Reconstruction: A Life Hack in Low Resource Setting: Poster Presentation - Case Series - Ophthalmologist ISNA KUSUMA NINTYASTUTI; Ni Nyoman Geriputri
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: 10.35749/38dvfc62

Abstract

Introduction : Silicone tube was the standard for stenting canaliculi in lacrimal canalicular laceration. But it was not always in stock at a hospital in remote area with low resource. Use of intravenous catheter to exchange the unavailable slicone tube was a possible option. Case Illustration : We reported two cases of inferior canalicular laceration at NTB provincial hospital. Both cases were adult, one female and one male. First case caused by nail and second because of traffic accident. There were no globe involvement in both case. Reconstruction surgeries with monocanalicular approach were performed. Intravenous catheter was used for stenting the canaliculus. First case was using a 24G, the other was 22G. The catheters were well inserted and planned to be removed at3 month. At the day 7 follow-up, the 24G catheter was extruded spontaneously while the patient with 22G was not. Both patients did not complain of profuse tearing. Discussion : The diameter and length of 24G iv catheter were 0.7mm and 19mm, while 22G were 0.9mm and 25mm. The diameters were similar with the silicone tube (0.6mm) and the lengths were long enough to pass the lower and common canaliculus which has a total 15mm long. The catheter in the first case was extruded possibly because in 24G there was only 4mm inside th lacrimal sac. A high pressure air from the nose would push the catheter backward and extruded. The 22G would have 10mm inside the sac. Conclusion : Intravenous catheter was an alternative option for inferior canalicular laceration stenting in low resource setting.

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