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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 Rare Embryological Phenomenon: Kissing Nevus Incidence and Clinical Features: Poster Presentation - Observational Study - Resident atika syafendra; mardijas efendi; hendrianti
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: 10.35749/71gks843

Abstract

Introduction & Objectives : Kissing nevus is a condition where the nevus extends up to the lid margins, its edges touch or “kiss” when the eyelids are closed. Although commonly presenting at birth, there have been cases where it appeared in later life. This occurs due to a rare embryological phenomenon and thus only 30 cases have been reported worldwide until 2020. Meanwhile in M Djamil Hospital Padang we found 4 cases during 2020-2022. This paper is aim to present this so called rare cases in a modest way Methods : This is a descriptive study related to kissing nevus cases in M Djamil Hospital Padang during 2020-2022. We diagnosed it clinically based on ophthalmology examination. The data were collected into master table and being analyzed. We put patient’s identity (name, age, and gender), nevus location, size, gross anatomy of the nevus and surgical procedure Results : Four patients were discussed in this study. Most of the patients (75%) is a woman. We found more cases in the first 2 decades of life (50%). The predilection location is at the temporal eyelid (50%), it’s size is equal, both (10-19 mm and 20-29 mm) is 50%. In study we only found a melanotic lesion (100%). Most of the patient were treated with excision biopsy + skin flap (75%) Conclusion : The prevalence of kissing nevus in M Djamil Hospital is high. Kissing nevus mostly suffered by young women, most cases affected temporal eyelid, the size 10-29 mm so that skin flap is the most suitable surgical procedure
COMPARATIVE VALIDITY OF LEA CONTRAST SENSITIVITY CHART TO PELLI-ROBSON CONTRAST SENSITIVITY CHART IN NEURO-OPHTHALMOLOGY PATIENTS Valencia, Lovenia; Prihatningtias, Riski
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/ahbbs726

Abstract

INTRODUCTION AND OBJECTIVEThe Pelli-Robson and LEA contrast sensitivity chart are widely used to measure clinical contrastsensitivity. The Pelli-Robson is a gold standard with the limitation of its bulky size. The LEAcontrast sensitivity chart offers a reliable test in a way more practical and portable chart. Thiscondition led to a question of whether we can predict Pelli-Robson score based on the LEA score.This study developed a conversion method to facilitate the transition from the LEA to the PelliRobson and validating the conversion score. METHODSThis study retrospectively examined the relationship between LEA and Pelli-Robson ContrastSensitivity Test. There were 120 eyes included in this study. We produced a conversion tableusing the equipercentile equating method. Then, we evaluated the reliability and accuracy of thisalgorithm to convert the LEA to the Pelli-Robson contrast sensitivity score. RESULTSLEA scores were converted to Pelli-Robson scores according to a conversion table that achieveda reliability of 0.91 based on intraclass correlation. The accuracy of this algorithm was 81.6%within 1 point difference from the raw score. CONCLUSIONSThis study reported a reliable and comparable conversion algorithm for transforming LEA scoresinto converted estimated Pelli-Robson scores. This method will enhance the utility of existing datain clinical and research settings.
RECURRENT CONGENITAL PTOSIS MANAGEMENT BY SUPRAMAXIMAL LEVATOR RESECTION TECHNIQUE: Poster Presentation - Case Report - Resident Desi Kristina Utami; Shanti F. Boesoirie; Raden Angga Kartiwa; Niluh Putu Ayu Dewi Wardhani; 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/tfv2zv98

Abstract

Introduction : Congenital ptosis is an abnormal low position of the eyelid since birth. Levator resection technique is one of the surgery technique for ptosis corection. Recurrence could be occured even after ptosis correction Case Illustration : A 22 year old male presented with a chief complaint of droopy left eyelid since birth. Visual aquity were 0,08 pinhole 0,2 and 0,25 pinhole 0,63 respectively. Opthalmology examination revealed interpalpebral fissure (IPF) 4 mm, margin reflex distance (MRD)1 0 mm, MRD2 4 mm and levator function test (LFT) 6 mm on the left eye (Figure 1). Levator resection technique was conducted on his left eye with a good result, MRD1 2 mm, MRD2 5 mm, IPF 7 mm. But the lid dropped again after3 months (Figure 2). Opthalmology examination of the left eye showed IPF 5 mm, MRD1 0 mm, MRD2 5 mm, LFT 2 mm and lagophtalmos 1 mm. Second surgery was done with supramaximal levator resection technique. Good result was achieved after second surgery, MRD1 3 mm, MRD2 5 mm, IPF 8 mm (Figure 3). Discussion : Recurrent ptosis could occured after ptosis surgery and had challenges due to scar from previous surgery. Frontal suspension technique was recommended for congenital ptosis levator function less than 4 mm. Supramaximal levator resection was done for this patient, with resection of 30 mm levator muscle, which had result as good as of frontal suspension technique. Conclusion : Levator resection technique could be repeated to repair recurrent congenital ptosis. Supramaximal levator resection technique is one of the option.
Epibulbar Choristoma, Dermolipoma: Poster Presentation - Case Report - General practitioner Maykel Sondak; Samuel Samatara
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/gayg7892

Abstract

Introduction : Choriostoma is a tissue anomalie distinguished by distinct cell types that are not typically present at the affected region. Dermolipoma is one type of choriostoma. Case Illustration : A twenty three year old woman is presented with epibulbar mass in the left eye since birth. She wished to remove the mass for cosmetic purposes. She denied any underlying medical condition and ocular history. Her visual acuity was 6/6 in both eyes and intraocular pressure was normal. Slit lamp examination revealed a yellowish white lesion of the external canthus of the left eye, no redness, and no discharge. The mass was 5 x 10 mm. Fundus examination was unremarkable. Patient underwent mass excision with cosmetic indication and has a satisfactory result. Discussion : A dermolipoma is an epibulbar choriostoma made of thick connective tissue and adipose tissue. The benign tumor is rare and makes up 4.2% of all conjunctival lesions. Dermolipoma can be very large, involving the extraocular muscle, lacriminal gland, and orbital tissue. Dermolipoma may be connected to epidermal nevus syndromes, Goldenhar syndrome, or coloboma. The majority of the time, these tumors don't need to be treated unless they are larger or have an unfavorable appearance. Conclusion : Dermolipoma is not cosmetically acceptable may be treated with excision of the mass.
Modified Hughes Tarsoconjunctival Flap Procedure for Lower Eyelid Defect: Poster Presentation - Case Series - Resident aulia; hendriati; mardijas efendi
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/fqfns990

Abstract

Introduction : Hughes procedure of tarsoconjunctival flap is a method of choice in reconstructing full thickness inferior eyelid defect that involves >50% of eyelid margin to restore anatomical integrity, function, and cosmetic of the eyelid. The modified Hughes procedure includes sparing of the marginal upper lid tarsus and removal of the levator muscle aponeurosis from the tarsoconjunctival flap.This article reports 2 patients who underwent modified Hughes procedure after basal cell carsinoma excision. Case Illustration : Two patients underwent inferior eyelid reconstruction using modified Hughes procedure. After wide excision of the tumor, tarsoconjunctival flap was made to reconstruct posterior lamella of the eyelid. Subsequently, anterior lamella of the eyelid were reconstructed using full thickness skin graft and advancement flap, respectively. Both patient then underwent second surgery, tarsus flap release, 6-8 week after the first surgery. Discussion : A tarsoconjunctival flap from the upper eyelid replaces the posterior lamella, whereas a skin graft, a skin flap, or a skin-muscle flap restores the anterior lamella. After surgery, tarsal flap apposition, skin flap/graft, and stitches were intact. After tarsus flap release, wound healing was good. Tumor biopsy showed basal cell carcinoma. Conclusion : Modified Hughes procedure is a treatment of choice in reconstructing full thickness inferior eyelid defect involving >50% of eyelid margin. Full thickness skin graft and advancement flap to reconstruct anterior lamella of the eyelid is choosen after considering skin color and texture similarity and laxity of eyelid and cheek.
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/y9r7ge58

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.
Management of Post Tumor Resection in Inferolateral Eyelid using Periosteal Flap and Canthoplasty Technique – A Case Report: Poster Presentation - Case Report - Resident CLARA VALENTINA; Putu Yuliawati; Ni Made Laksmi Utari
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/vw8zen64

Abstract

Introduction : Eyelid defect repair goals are providing supportive connecting tissue and functional mucosal epithelium. Posterior lamellar reconstruction for tumor resection defect is still challenging. In this case, lower eyelid reconstruction can be accomplished by elevation and rotation of periosteal flap as posterior lamella. Case Illustration : A 68-years-old male came with inferolateral eyelid mass of Left Eye (LE) that was increasing in last 3 months. On LE examination found solitary cystic cutaneous lesion in inferior palpebra near lateral canthal, sized7x5mm, fixated, regular, and chewy consistency. Anterior of mass has same color as adjacent skin with hyperpigmentation lesion and posterior side was translucent with telangiectasia. He was suspected with LE ductal dd epidermoid cyst. Discussion : Periosteal flap and canthoplasty is procedure to repair inferolateral eyelid defect that are large to be closed primarily, however it requires adequate lateral canthal skin and tarsal plate. Posterior lamellais restored to create connective tissue framework, proper contour, and vertical canthal height. Tumor was removed and preperiosteal plan inferior to inferior orbital rim was dissected. The anterior lamella then transposed superiorly to make sure it will cover posterior lamellar reconstruction. Periosteal flap from lateral canthal tendon of infraorbital margin was harvested, flap was crossed to form sharp canthal angle and sutured to tarsal edges of lower eyelids as posterior lamella. A week later, LE showed natural contour and good function without eyelid malposition. Conclusion : Periosteal flap as posterior lamella reconstruction of eyelid defects is effective and efficient to repair eyelid defect due to its simplicity, reliability, and low risk complication.
Management of Full-Thickness Lower Eyelid Defect After MOHS Procedure and Mustard Flap: Poster Presentation - Case Report - Ophthalmologist SRI IRMANDHA KUSUMAWADHANI; HISAR DANIEL; YUNIA IRAWATI
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: 10.35749/1y1njp48

Abstract

Introduction : Large full-thickness eyelid defects are considered a challenging case. This study reports how to manage the reconstruction of eyelid defect in a case with a history of carcinoma cell basal of the eyelid, which is removed with MOHS procedure and mustard flap reconstruction but full-thickness of more than 50% defect of the lower eyelid remains. Case Illustration : A 67 years old woman was referred from the dermatology and venereology clinic with a history of eyelid cancer operation, 13 days prior. The patient's chief complaint was the left lower eyelid felt pulled down. Examination revealed a left lower eyelid full-thickness defect of more than 50% and ectropion at the lateral side. An 8 mm lagophthalmos without corneal exposure was present. The reconstruction was done with a lips mucosa graft to form posterior lamella, at the medial side anterior lamella was formed by the glabellar flap, and at the lateral side was formed by a skin graft due to lack of the anterior lamella from the mustard flap previously. Discussion : Eyelid reconstruction aims to provide adequate globe protection. The principle management of reconstruction in full-thickness eyelid defects horizontally of more than 50% can’t be done by an anterior flap (mustard) only because it's unstable and the eyelid can be retracted. The reconstruction must consist of the anterior and posterior lamella which have to be tight to the periosteum. Conclusion : One step procedure for large defects of the lower eyelid after cancer removal can be done with considering the proper plan of reconstruction technique.
Nocturnal Lagophthalmos in Pediatric Patient with Hydrocephalus: Poster Presentation - Case Report - Resident IZZA ZUKHRUFIA; Yunia Irawati; Julie Dewi Barliana
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/egvmc937

Abstract

Introduction : Nocturnal lagophthalmos is a physiologic and asymptomatic condition observed in 1.4-5% of the population. In unconscious patients, using mechanical ventilation and neuromuscular blocker medication can worsen the lagophthalmos, causing the patient to have exposure keratopathy. This report aims to emphasize the importance of eye care in unconscious patients. Case Illustration : A 5-year-old girl came with a chief complaint of a whitish lesion on the right eye. She got the lesion when hospitalized in Pediatric Intensive Care Unit for two weeks due to seizure attacks. A red and watery eye accompanied the whitish lesion. The patient had history of nocturnal lagophthalmos and Dandy-Walker syndrome, a complex malformation characterized by agenesis or hypoplasia of the vermis and cystic enlargement of the fourth ventricle. The corneal ulcer was treated with antibiotic treatment. After several visits, her infection had subsided but left a corneal cicatrix on her right eye. Discussion : In unconscious patients, it’s important to pay attention to the eyelid. Lagophthalmos can be divided into three groups; where grade 1 has complete eyelid closure; grade 2 has conjunctival exposure; and grade 3 has corneal exposure. It’s important to lubricate the eye in each grade and keep it closed using eyelid tape or cover in grades 2 and 3 to prevent exposure keratopathy. Surgical intervention can be considered when there is a risk of corneal ulcer. Conclusion : Prevention is always better than cure. Establishing standardized eye care in the intensive care unit is crucial to prevent ocular complications and preserve visual acuity.
Giant Cyst as a Dermis Fat Graft Complication in Socket Anophthalmia Post Enucleation: Poster Presentation - Case Report - Resident Ghina Fedora; Yunia Irawati
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: 10.35749/2fzv5443

Abstract

Introduction : Enucleation is often performed in children diagnosed with advanced unilateral group E retinoblastoma as a primary treatment to save life. After performing enucleation, a Dermis Fat Graft (DFG) is often placed inside the socket to give volumes into the orbital cavity. A dermis fat graft hopefully will grow along with the children, promoting orbital bone development. Rare complications following dermis fat graft implant is cyst formation. The purpose is to present a case of giant orbital cyst formation in socket anophthalmia. Case Illustration : A 6 year old boy came with proptotic left socket anophthalmia with history of enucleation with DFG for retinoblastoma. On examination, we found a proptotic socket 1.5 years after enucleation. CT Scan examination revealed cyst formation on left socket anophthalmia. We did a cyst excision using cryo and implanted 16 mm acrylic implant for the socket reconstruction. Discussion : Cyst is minor complications following DFG implantation in socket anophthalmia. It’s estimated occurred in 1.5-3.8% patients. Some of the causes are gaps in between the dermis and recipient bed, epithelial island residue on DFG, or delayed conjunctivalization of the dermis. Cyst excision with careful dissection is the main management for this cases, preferably using cryo probe in order to remove the cyst in toto. Conclusion : Management for the giant cyst removal following DFG implant is a challenging task due to the recurrence possibility. Complete cyst excision and replacement of orbital implant is mandatory in order to re-establish the cosmetic appearance of the patient.

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