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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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Transconjunctival Approach with Lateral Skin Extension in Orbital Fracture Reconstruction: Poster Presentation - Case Series - Ophthalmologist MIA NURSALAMAH; R. Angga Kartiwa; Ilman Fathony 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: 10.35749/234fjn28

Abstract

Introduction : Orbital fractures are commonly featured in various type of facial fracture, including zygomaticomaxillary, naso-orbito-ethmoid, frontal-sinus, Le Fort II, and III fracture patterns. Multidisciplinary surgery is required to restore physiological and aesthetic functions. Case Illustration : Three midfacial fracture operations with lower transconjunctival incision approach to 6, 18, and 25 years old patients were performed by maxillofacial team in Al Islam Hospital Bandung. The steps started with lateral canthotomy and continued with transconjunctival incision in a lateromedial direction. With dissection towards the infraorbital rim, lower eyelid is mobilized and can be retracted anteromedially. Two patients was given titanium orbital floor implants and plates, while the youngest patient received absorbable plates. This approach successfully gave wider access to orbital bone and less bleeding during surgery. No complication has been reported with good outcome. Discussion : Fracture of the orbital floor may be repaired through transcutaneous, transconjunctival or endoscopic approaches. Transconjunctival approach is the most effective surgical access to infraorbital rim and orbital floor or even to medial orbital wall. The ability to reach periosteum further allows access to great portion of the orbit. Lateral canthotomy allows periosteum to be elevated superiorly for repair of fracture frontozygomatic suture. This approach may decrease the risk of postoperative eyelid retraction than subciliary approach and is aesthetically superior to other approaches. Conclusion : Transconjunctival approach has provided wider intraoperative access during orbital fracture reconstruction with easier post operative care, also giving good functional and aesthetic outcome.
PENETRATING EYELID INJURY DUE TO FISHING HOOK : AN UNUSUAL CASE: Poster Presentation - Case Report - Resident BIMA RYANDRA PUTRA; 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/vt9ps910

Abstract

Introduction : Ocular penetrating injury due to fishing hook is rarely reported. Identifying organ structures involved and determining appropriate approach will affect the outcome. This special case explained penetrating eyelid injury due to fishing hook without ocular involvement. Case Illustration : R, boy, 12y.o, came to M.Hoesin ED in January 2023 with complaint of left eye was exposed to fishing hook one hour before admission. Patient was experiencing mild pain with pain scale of three, no blurry vision, excessive tears nor blood. History of immunization was uncomplete.There was no significant visual disturbance. On left superior palpebra, there was a fishing hook penetrated into the medial superior palpebra (partial thickness) without any marginal involvement, no active bleeding, and corneal abrasion in central-paracentral nasal 6-9 o’clock direction. Patient was diagnosed with penetrating eyelid injury due to fishing hook. Intraoperatively back-out technique were performed to extract the fishing hook. Patient was prescribed with 250IU Tetagam injection, chloramphenicol eye ointment, and oral analgetic. Discussion : Ocular penetrating fishing hook injury could cause severe complications. In this patient, it only penetrates the eyelid until the dermis layer without marginal involvement. Complications occurred were only corneal erosion with minimal pain. After the operative procedure, topical antibiotic and analgetic were administered. There was no decreased levator palpebra function and corneal erosion was resolved in three days after topical antibiotics were administered. Conclusion : Management of ocular penetrating fishing hook injury is challenging. Determining the best technique to extract the fishing hook depends on the depth and type of fishing hook.
Challenging Management in Work-Related Eye Injuries: A Case Report of Steam Boiler Explosion-Induced Open Globe Injury: Poster Presentation - Case Report - Resident Rifhani Atthaya Putri; Rodiah Rahmawaty Lubis
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/n3szef56

Abstract

Introduction : Work-related eye injuries (WREIs) are major health problems leading to vision loss worldwide. In this study, we reported a case of WREIs from blast injury caused by a steam boiler explosion Case Illustration : A 55-year-old male, laundry worker presented to the emergency unit with pain, bleeding, and sudden vision loss in the left eye, 8-hours after a blast injury from steam boiler. He was conscious with normal vital signs. He had lacerations to his left eyelid, frontal, and temporoparietal. Ocular examination revealed a visual acuity of no light perception, full-thickness laceration of the lower eyelid and inferior canalicular, diffuse subconjunctival hemorrhage, corneoscleral laceration with choroidal expulsion, and active bleeding. On investigation, B-scan ultrasonography revealed vitreous hemorrhage and CT scan showed no orbital fracture. He underwent evisceration, eyelid reconstruction, and lacrimal canaliculi repair surgery under general anesthesia and planned to custom-made ocular prosthesis. Discussion : WREIs include eyeball injuries, eye adnexa injuries, eyelid lacerations, and orbital wall fractures that occur during work-related activities. The incidence of WREIs is higher in men aged 20-40 years. In this case, the patient presented with an open globe injury resulting in sudden vision loss, requiring urgent surgical intervention to prevent further complications. Ocular prostheses can provide acceptable aesthetics and improve the patient's quality of life by helping them to integrate into society. Conclusion : WREIs can lead to permanent vision loss and require urgent surgical intervention. Employers must prioritize workplace safety by providing adequate training and appropriate eye protection such as safety goggles to minimize the risk of eye injuries.
Involutional Entropion of The Upper Eyelid: A Rare Case Report: Poster Presentation - Case Report - Resident Patrick Toar Panelewen; Yuliana Hartono
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/f0f7fg25

Abstract

Introduction : Entropion is a condition in which the eyelid folds inward or the edge of the eyelid folds inward, causing the eyelashes, eyelid margin, and skin to touch the eyeball. The most common entropion is involutional which caused by the aging process, but reports of cases of involutional entropion in the upper eyelid are rare. Case Illustration : A 66-years-old woman presented with redness, foreign body sensation and teary on both eyes. No history of trauma or foreign body exposure. She had a history with similar complaint 2 years ago. Upper eyelid turn inward, dermatochalasis, and corneal abrasion of both eyes were found in ophtalmic examination. Patient was diagnosed with involutional entropion of the left upper eyelid and treated with anterior lamellar repositioning (ALR). A week after the ALR procedure, on examination it was found that the position of the left eye's upper eyelid was good, there was still minimal swelling, with intact sutures. Discussion : Involutional entropion generally occurs in elderly patients over 60 years old and is more common in women. Progressive senile changes in the structure of the eyelid cause the occurrence of involusional entropion. Involutional entropion in the upper eyelid is associated with dermatochalasis. One management option for involutional entropion is ALR, which aims to pull the folded-in eyelid margin outward. Conclusion : This case shows that involutional entropion on the upper eyelid can still occur, albeit very rarely. ALR can be a simple and safe surgical option for patients with involutional entropion on the upper eyelid.
CLINICAL OUTCOME USING MODIFIED LATERAL TARSAL STRIP AND RESCESS LEVATOR IN PATIENTS WITH OCULAR PROBLEM DUE TO FACIAL NERVE PALSY: Poster Presentation - Case Report - Resident RIF’AT NURFAHRI; Ratna Doemilah
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: 10.35749/3pc1r909

Abstract

Introduction : Facial nerve palsy is a condition that affects various organ including the eyes. We report a case of facial nerve palsy with eye manifestations in one patient that requires immediate action to save the cornea. Case Illustration : A 63-year-old male presented to our OPC with the primary complaint of right eyelid inability to close since September 2021after brainstem tumor excision, which had worsened since May 2022. Visual acuity: 2 meters counting fingers; IOP: 11 mmHg. Anterior segment examination revealed lagophthalmos (8 mm) in the right eye, a pinch test result of 10mm (horizontal laxity), conjunctival hyperemia, conjunctivalization of the cornea, a fluorescein test result of 7 x 4 mm, and band keratopathy. The wrinkles on the patient's right face disappeared. There was numbness, and the smile was asymmetrical. Patient underwent right eye modified lateral tarsal strip and recesses levator 8mm. The patient's eyelids can close tightly almost symmetrically with the left eye and no ptosis after operations. One week after operation, patient feels more comfortable, and the conditionof the cornea has improved. The facial nerve is vulnerable to trauma because of its path from the brainstem through the temporal bone to the facial muscles. In conditions of irreversible facial nerve palsy, managements are focus to overcome the complications. Modified lateral tarsal strips and levator recesses are relatively simple and inexpensive techniques that can help to overcome lagophthalmos. Discussion : Conclusion : Ocular manifestations can occur in patients with facial nerve paresis. Modified lateral tarsal strips and recesses levator eyelids can help protect the cornea.
KISSING NEVUS RECONSTRUCTION WITH A SUPRACLAVICULAR GRAFT: A RARE CASE REPORT: Poster Presentation - Case Report - Resident Lissa Novia Permatasari; Ratna Doemilah
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/bgnm6d65

Abstract

Introduction : Kissing nevus is a rare form of congenital nevus that occurs on upper and lower eyelid of one eye, forming a large nevus when the eyelids are closed. This condition causes functional and aesthetic problems thus the reconstruction is essential. Case Illustration : A 23-years old female presented to our ophthalmology outpatient clinic with complain of having painless, black colored, non-progressive nevus over left upper and lower eyelids since birth that cosmetically unpleasing. The dark brown-black colored was sized 55x30 mm with hypertrichosis covering approximately two third of both left upper and lower eyelid margins and extending to cheek. The entire nevus was excised and reconstructed by supraclavicular full thickness skin graft, lateral canthopexy and canthoplasty. Three weeks after operation showed satisfactory results. Histological examination revealed intradermal nevus pigmentosus. Discussion : The reconstruction of eyelid after excision remains a challenge because of its specialized function and cosmetic significance. Ideally, the reconstruction should provide a stable eyelid margin, protect the ocular surface, and sustain mobility. Free skin grafts harvested from the control lateral eyelid, postauricular, supraclavicular, and upper arm region have been the most common reconstructive approach. The supraclavicular area is a reliable donor option to cover large head and neck defects due to its similarity in colour, thickness, and flexibility. Conclusion : Free supraclavicular graft is safe, reliable and cosmetically acceptable choice for reconstruction head and neck defects.
UNSALVAGEABLE EYE: HOW CAN WE DO MORE? Poster Presentation - Case Report - General practitioner Jessica Jovia; Gladys Kusumowidagdo; Randy Sarayar; Hisar Daniel
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/jwzkqe25

Abstract

Introduction : Unsalvageable eye, consisting of total visual loss, orbital wall fracture, and disfigured globe, is devastating for both patients and caretakers. This impairment is a challenge for ophthalmologists to manage. Although visual rehabilitation is impossible, the appropriate management results in outcome that would improve patient’s quality of life (QoL). We aim to report our successful case of orbital reconstruction with satisfactory outcome. Case Illustration : A 75-year-old male presented to our clinic with total visual loss of right eye (RE) after motorcycle accident three months prior. Examination revealed phthisical RE, partially-healed full-thickness inferior palpebral laceration, and inferomedial blow out fracture (BOF). Electroretinography and visual evoked potential examination showed a decrease of right optic nerve conduction. The patient expressed discontentment with his current physical condition. Simultaneous procedures of orbital floor and medial wall fracture repair using silicone block followed by lid reconstruction, and mucous membrane grafting for ocular surface were performed. An ocular prosthesis was fitted. The patient was pleased with the outcome. Discussion : Ophthalmologists are often left with little room to aid patients with this condition. More can be done to unsalvageable eye cases. This case shows that improvement of patient’s QoL can be achieved by orbital reconstruction and ocular prosthesis fitting. Conclusion : The main objective of managing unsalvageable eye is to restore patient’s orbital anatomical features, hence, improving his QoL.
Perforating Ocular Sickle Knife Trauma: a Case report: Poster Presentation - Case Report - Ophthalmologist DEWI KANIA MAEMUNAH
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/vjjfjg97

Abstract

Introduction : Perforating ocular injury can lead to disability or even mortality. Most individuals sustaining eye injuries are male in young age. This is a report of an extreme case when a sickle knife stabbed in the right eye of a young male cause perforating of the eyeball. Case Illustration : Seventeen years old young male presented to Emergency Room of Sukabumi Regional Public Hospital with pain and bleeding in his right eye an hour before. He had been hacked during a brawls. There was a wound in the right supraorbita area and a big sickle knife stuck in the head and tear the eye ball. Visual acuity was no light perception in his right eye. Anterior segment examination of the right eye revealed perforated sclera and cornea. X-ray examination showed fracture of the roof of the right orbit and a metal object had stuck into the Orbits. The sickle knife extraction, enucleation and superior orbit reconstruction of the right eye was done. Discussion : Identification of wounds caused by sharp metal foreign body is very important for the subsequent treatment of injuries. If the eyeball cannot be preserved, then enucleation can't be avoided. In this case, hard impact of sharp object around of the eye are also cause fracture of superior orbital rim. Reconstruction of the orbital roof using titanium and micro screws given the most stable and effective results. Conclusion : Removing a metal foreign body and anatomical defect management is important for a good outcome.
EYEBALL SAVING ON UNILATERAL OCULAR TRAUMA AFTER MOTOR VEHICLE ACCIDENT: AN EMERGENCY ROOM CASE REPORT: Poster Presentation - Case Report - General practitioner Fatina Qonita; Umi Yuliani
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: 10.35749/53stk432

Abstract

Introduction : One of the main causes of reduced or lost vision is ocular trauma. The second common cause of ocular trauma, particularly among younger people, was motor vehicle accidents (MVA). Case Illustration : A 16-year-old female with a history of MVA was brought to the emergency room. She complained of pain with her left eye. Visual acuity was no light perception. Linear wound was found from limbus to limbus and 0.5cm beyond the limbus to medial. The lens cannot be assessed because of the prolapse of the iris and choroid, abnormal corneal and iris structures, and active hemorrhage. CT Scan showed collapsed and deformed on the left bulbi. Discussion : In this case, initial surgery was performed by exploration and reposition of the eyeball then close the wound through primary hecting on the cornea. Following surgery, 8 days later, patient went for an eye ultrasonography checked and showed that the left globe was ruptured, along with a subcutaneous hematoma and emphysema. Even though, patient’s visual acuity improved into the stage of light perception. The left eye's follow-up examination revealed hyperemic conjunctiva, a hazy cornea with a horizontal scar-forming, and securely closed sutures. Iris seems superior, however, it was impossible to see the pupil. Conclusion : Ocular trauma causes tremendous morbidity as well as psychological and social distress, and an economic burden. Thus, proper diagnosis and therapy are related to the prognosis of visual acuity, eye anatomy, and future complications.
Chemical Eye Burn Injury Due to Polyester in Industrial Worker: A case report: Poster Presentation - Case Report - General practitioner Zahira Rikiandraswida; Ayu Anggraini Kusumaningrum
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/vg8zwg18

Abstract

Introduction : Chemical eye burns are common causes of work-related eye injuries. Prompt and appropriate emergency management may be the most important factor in determining the visual outcome. Case Illustration : A 50-year-old man who works in a plastic factory immediately went to the emergency room after being exposed to melted polyester in his right eye. He complained of hurt and hotness in his eye. The emergency primary survey was stable. Triage of ophthalmology was an emergency. Initial Uncorrected Visual Acuity (UCVA) was light perception with correct projections. Physical examination revealed 2nd-degree combutio on the forehead and left cheek. Anterior right eye examination revealed palpebral edema, polyester debris on the eyelid, conjunctival mixed injection, ischemia of less than 1/3 of the limbus, corneal edema, corneal opacity, and polyester sticking to the cornea. The damage was determined as Roper-Hall grade II. In the Emergency room, Eye was immediately irrigated with 1 L of normal saline. A referral was made to the ophthalmologist and Immediate debridement was carried out. Wide corneal erosion was found after the procedure. Treatment was continued with antibiotic eye drops, lubricant eye drops, oral vitamin, and oral analgetic. The patient had improved visual acuity to 20/20 f2 with corneal scar and opacity 1 month after surgery. Discussion : The combined management of this case consisted of ocular lavage, surgery, and medication. A Chemical Eye Burn requires immediate management to prevent extensive damage leading to visual impairment. Conclusion : Initial treatment in the emergency department and referral to the ophthalmologist can improve patient outcomes.

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