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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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Recalcitrant Epithelial Ingrowth After LASIK: An Unexpected Complication: Poster Presentation - Case Report - Resident Putri Pamulani; Angga Fajriansyah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram
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/daqk0f55

Abstract

Introduction : Post-LASIK Epithelial Ingrowth (PLEI) is an uncommon complication of laser in situ keratomileusis (LASIK). Treatment for PLEI can be done surgically and medically, but recurrence is possible. Case Illustration : A 20-year-old female came with the appearance of white opacity on her right cornea, which has grown bigger in size over the last two months (Figure 1A and 1B). She had undergone three debridement surgeries prior to the visit due to the same complaint and history of LASIK surgery two years before. Visual acuity of the right eye showed 0.32 pinhole 0.63, epithelial ingrowth Probst/Machat grade III in 9 o’clock direction approximately 3mm x 3mm (Table 1), pooling on fluorescein test, intact flap, and punctate epithelial erosion (PEE). A surgery of flap reopening, epithelial debridement, corneal suture, and corneal crosslinking was conducted (Figure 2 and 3). Discussion : The incidence of PLEI, as reported by published studies, is relatively low. Hence, treatment in such cases is largely based on anecdotal case reports and small case series. Treatment of choice can be done according to clinical manifestation and severity of PLEI. Conclusion : A thorough and careful management of PLEI should be carried out to prevent its progress and recurrence.
The Importance of Initial Management in Ocular Chemical Burn: A Case Series: Poster Presentation - Case Series - Ophthalmologist dr. ANDREAS SURYA ANUGRAH, Sp.M; dr. Reny Setyowaty, 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/ezp4nr16

Abstract

Introduction : Ocular chemical injuries are true emergency which requires immediate intervention. Delayed management may result in severe eye injuries. This report aims to describe the effectivity of initial management and medical treatment of ocular chemical burns. Case Illustration : We reported four cases of ocular chemical injuries due to alkaline, acidic, and unspecified chemical compound. All subjects were men, aged 30 to 50 years old. They had injuries at work and none of them used eyewear protector. Each was brought to emergency unit in less than 2 hours. They were given initial timely irrigation until pH neutralized. Ocular damages were evaluated using Roper-Hall Classification, three cases were Roper-Hall 2 and other was Roper-Hall 3. After initial management, all cases were treated with medical treatment and showed significant improvement. After 6 months follow up, there weren’t any long-term sequelae in all subjects. Discussion : Serious eye damage results from strongly alkaline or acidic compounds. Most critical factor is timely delivery of irrigating fluid. Irrigation should ideally be performed with isotonic saline or lactate ringer solution and continued until the pH neutralized to a physiological level. Any method of irrigating the eye is preferable than delay in elimination of the destructive chemical. Medical treatments in acute management of severe ocular chemical burns are anti-inflammatory therapy, halting epithelial and stromal breakdown, promoting re-epithelialization and promoting corneal stromal healing. Conclusion : Timely irrigation of the eye effectively reduces severity of chemical burns, reduces need for surgical intervention, and improves final visual acuity if combined with medical treatment in golden period.
Ocular Gnathostomiasis in A Farmer From South Sulawesi, Indonesia: Poster Presentation - Case Report - Resident Dian Trisnawaty 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/bn63f803

Abstract

Introduction : Ocular Gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of the spiruroid nematode. It is a food-borne zoonosis caused by the consumption of raw or undercooked freshwater species of fish, amphibians, reptiles, birds, and mammals. Case Illustration : A 37-year-old farmer complained of seeing moving objects in his left eye accompanied by blurred vision. The patient had a history of red left eye with increased intraocular pressure. The visual acuity of the left eye was 20/30. Slit lamp examination showed slight hyperemia of the conjunctiva and a live worm moving in the anterior chamber. The worm was immediately removed using corneal clear incision and sent for parasitological examination. By finding four rows of hooks on the head and fine spines covering the body, the worm was identified as a stage 3 larva of gnathostome sp. Discussion : Surgical removal of the larvae is considered the most effective treatment. In this case, the patient was then treated with Albendazole 400 mg daily for 21 days and Prednisolone 50 mg for 7 days with reduced doses of 10 mg weekly for three weeks Conclusion : Ocular Gnathostomiasis by third-stage larvae of spiruroid nematode was found at the eye of a man from Siwa, South Sulawesi. The intracameral worm was successfully extracted from the eye. Patients with complaints of recurrent redness of the eyes accompanied by increased intraocular pressure and a history of living in an area with a habit of eating raw freshwater fish should be considered the possibility of harboring helminth in the eye.
PANOPHTHALMITIS SECONDARY TO RETAINED INTRAOCULAR FOREIGN BODY , SETTING IN RURAL AREA: Poster Presentation - Case Report - Ophthalmologist WAHYU ENDAH PRABAWATI
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/vv3r9f86

Abstract

Introduction : IOFB can be serious and result in vison threatening complication. We report IOFB presenting with panophtalmitis secondary to delay in seeking medical attention and misdiagnosed in emergency ward by general practitioner. Case Illustration : A 40-years-old male presented with pain and outward bulging of his right eye with no light perception after trauma to his right eye by a small metallic object while working as electric grasscutter. He presented to our department 3 days following the incident. Systemically, he had a fever, headache and nausea. 2 days after incident, he visited to emergency ward but he was given eye drop only. On Slit lamp examination, corneal melting with keratinization and lacerated wound in cornea at 12 o'clock about 3 mm. Non-contrast CT showing a linear hyperdense foreign body in the right globe likely metal, measuring 3 mm x 4 mm was found. The patient was admitted ceftriaxone intravenous, twice daily. No light perception of visual acuity, ocular penetrating, persistence of the active inflammation, and risk of spread, a decision was made to eviscerate the eye. A metallic foreign body was found in eviscerated tissue. Discussion : Conclusion : Important to suspect foreign body in all cases ocular trauma. Detailed examination and imaging should be performed. Delay treatment from the time of injury, result in poor prognosis. Surgical treatment such as evisceration, should be informed to patient about the visual prognosis.
Efficacy of 0.1 % Sodium Hyaluronate versus 0,5 % Carboxymethylcellulose in Dry Eye Disease : A Meta-Analysis: Poster Presentation - Observational Study - General practitioner ALDILA SAVITRI; FITRIAN HANIF
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: 10.35749/70r92c41

Abstract

Introduction & Objectives : Dry eye is a disorder that involves either insufficient tear production or excessive tear evaporation. Artificial tears are the main treatment for dry eye disease. Sodium Hyaluronate (AH) and Carboxymethylcellulose (CMC) are the two most frequently prescribed and used. To analyze the efficacy of 0,1% sodium hyaluronate compared with 0,5% carboxymethylcellulose toward the symptom score, tear break up time, corneal stain fluorescein in dry eye through a meta-analysis. Methods : A systematic search was performed using Medline and Cochrane database up to December 2022. Review was performed according to the PRISMA Statement. The eligible studies were RCTs which comparing Sodium hyaluronate with Carboxymethylcellulose. Results : From 88 retrieved articles, 6 trials involving total 373 patients were included. The median follow-up period of the studies was 6 weeks. Sodium hyaluronate significantly increases tear break up time compared to Carboxymethylcellulose (Mean Difference (MD): 0.46, 95%CI [0.09-0.84], p=0.01, I2=76%), and significantly decrease corneal stain fluorescein (MD: -0.54, 95%CI [-0.86-(-0.23)], p=0.0008, I2=88%). The analysis shows insignificantly decrease in subjective symptom scores (MD: -0.08, 95%CI [-0.40-0.23], p<0.60, I2= 79 %). Conclusion : In dry eye disease, 0,1% sodium hyaluronate significantly improves tear break up time and significantly decreasing corneal stain fluorescein, while insignificantly decrease subjective symptom scores.
When Retinal Vasculitis Wears a Mask: Unveiling Retinal Vasculitis Presented as Branch Retinal Vein Occlusion in a Young Male Patient: Poster Presentation - Case Report - Resident Lia Amanda; Andi Marsa Nadhira; Yulia Aziza; Rina La Distia Nora
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: 10.35749/982cvw55

Abstract

Introduction : Retinal vasculitis can present with a range of clinical features. Correct diagnosis and prompt treatment are essential to prevent permanent visual loss. We describe a case of retinal vasculitis with branch retinal vein occlusion (BRVO) as initial diagnosis, which is a rare manifestation in a young individual without any vascular risk factors. Case Illustration : A 24-year-old male was referred to our center with a sudden onset of blurry vision of his left eye. He was previously diagnosed with BRVO. The patient denied having any chronic diseases, fever, or sore throat. Visual acuity was 6/18 on the left eye and 6/6 on the right eye, respectively. The anterior segment showed no abnormalities. However, fundus examination revealed prominent retinal sheathing, retinal whitening at the inferior quadrant, and macular star. Systemic diseases, such as Bechet disease, sarcoidosis, and systemic lupus erythematosus were excluded by ancillary tests. One month after the initial examination, the patient reported worsening of vision. Funduscopic examination revealed preretinal hemorrhages and macular star. The patient then received intravitreal injection of anti-vascular endothelial growth factor (VEGF), which helped to resolve the hemorrhage and improve vision. Discussion : Further investigations, such as fundus fluorescein angiogram, may aid in the diagnosis and management of this condition. Anti-VEGF therapy may be a useful treatment option for retinal vasculitis-associated hemorrhages. Conclusion : Our case highlights the importance of considering retinal vasculitis as a differential diagnosis in young patients presenting with BRVO, even in the absence of traditional risk factors.
MULTIPLE GIANT CHALAZIA IN HYPERIMMUNOGLOBULINEMIA E SYNDROME: A CASE REPORT: Poster Presentation - Case Report - Resident Lily Raudah Putri; Florentina Priscilia; Dany Petra Pranata Barus; Annisa Windyani; Muhammad Shafiq Advani; Lukman Edwar
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: 10.35749/8gxvc748

Abstract

Introduction : Hyperimmunoglobulinemia E syndrome (HIES) is a rare primary immunodeficiency disorder that manifests as elevated level of serum immunoglobulin E (IgE) higher than 1.000 IU/mL and multisystem disorder characterized by recurrent skin and pulmonary abscesses caused by autosomal dominant or recessive disorder with gene mutation. We present a case of multiple giant chalazion ina patient with HIES. Case Illustration : A 15-year-old boy was referred to Ophthalmology Department with multiple giant lumps on the left eyelid for the last 2 weeks. He had a history of recurrent multiple lumps on the left lower eyelid in the last 1 year. He was diagnosed with HIES since 8 years ago. He had normal visual acuity of both eyes. Multiple giant chalazion were observed on the left upper and lower eyelid. The patient also presented with scalp and neck infection. Laboratory studies showed elevated total serum IgE level of 53,032 IU/mL and eosinophilia. Discussion : Ocular manifestations in HIES patients are not common. Some cases reported chalazia, keratoconus, and blepharitis. Surgical incision drainage was performed in our patient. Medications and surgical intervention had produced only transient improvement. The patient was treated conservatively. Riskof chalazia recurrence remains unknown as reported cases presented with diverse clinical presentation and follow-up serum IgE evaluation is not routinely performed. Conclusion : Recurrent multiple giant chalazia may occur as an ophthalmic feature of HIES. HIES should be considered and investigated in patients presenting with recurrent giant chalazia.
OCULAR INVOLVEMENT IN SNAKEBITE PATIENT: A CASE TO REMEMBER: Poster Presentation - Case Report - General practitioner Novianti; Elisa Yopitasari
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: 10.35749/4ed84r81

Abstract

Introduction : Snake bite cases in Indonesia are not rare with mild to catastrophic consequences on the bitten subject due to its hemolytic and neurotoxic effects. This case represents a rare ocular neurotoxic effect of snake’s venom that cause binocular diplopia and ptosis in a child. Case Illustration : A 9 year-old boy was consulted to ophthalmologist with chief complaint of binocular diplopia. He was hospitalized after being bitten by a snake on his right hand and had an episode of delirious state. Ophthalmologic examination revealed ptosis and exotropia of his left eye in primary position. Further examination of anterior and posterior segments showed good results. His visual acuity was unaffected. Intravenous antivenom was administered and the bite wound was taken care. The boy was discharged from the hospital with a good general condition but still an opthalmoplegia. After a week of follow up the diplopia diminished and his ocular motility was recovered. Discussion : Ocular manifestations in snake bite case might be missed because of delirious state of the patients. Snake venom can cause ptosis and ophthalmoplegia (neurotoxic) along with uveitis, optic neuritis, central retinal artery occlusion or vitreous and retina hemorrhage due to its hemolytic effect. Time interval between the bite and treatment is one of crucial factor that indicate the patient’s prognosis. Conclusion : Thorough examination of anterior to posterior ocular segments is needed in every snake bitten patients to rule out any further ocular complication. An early administration of intravenous antivenom is still a mandatory.
Management of Streptococcus pyogenes Preseptal Cellulitis in Multisystem Inflammatory Syndrome in Children (MISC): Poster Presentation - Case Report - Resident ANAK AGUNG DEWI ADNYA SWARI; N.K. Niti Susila; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
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/rsy2ek75

Abstract

Introduction : Preseptal cellulitis were more common in children than adults. Preseptal cellulitis was an infection involving the anterior part of the orbita septum. Management of preseptal cellulitis, especially in children, were important to save visual function. Case Illustration : A boy, 1 year 8 months, was complained by his mother with swollen and redness on both eyes. The patient has a history of Multisystem Inflammatory Syndrome in Children (MISC) and Global Developmental Delay (GDD). Both eyes were edema, hyperemia, excoriation, bleeding, tenderness on eyelid, and conjunctival injection. Blood Culture examination results showed Streptococcus pyogenes bacteria. Patient was receiving therapy of antibiotics cefoperazone-sulbactam, amikacin, methylprednisolone intravena, enoxaparin subcutaneous injection, moxifloxacin and prednisolone asetat eye drops during hospitalization at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Discussion : A patient with fever and respiratory tract infection was diagnosed with preseptal cellulitis. Preseptal cellulitis is a common infection of the eyelid and periorbita soft tissues characterized by acute eyelid erythema and edema. Antibiotic therapy had been started before blood culture examination. This study discusses toddler with preseptal cellulitis treated with antibiotics showing good results. ConclusionPreseptal cellulitis due tue multisystem inflammatory syndrome in children was an infection of the soft tissues of the eye that requires a multidisciplinary approach in management therapy. Early detection and adequate therapy have been proven to significantly improve patient survival rates and quality of life.
Unusual Presentation of Lipemia Retinalis Presented with Visual Field Defect: Poster Presentation - Case Report - Resident Regina Ivanovna; Irma Suwandi Sadikin; Dearaini; Eduard Jordi Luminta; Rina La Distia Nora; Yulia Aziza
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/axa0en30

Abstract

Introduction : Lipemia retinalis is an ocular presentation that associated to hypertriglyceridemia. Most cases are usually asymptomatic, with changes detected only from fundus examination. This case report highlights a case of lipemia retinalis with decreased peripheral visual field. Case Illustration : Thirty four year-old female came with complaint of blurry right eye (RE) 3 months before hospital visit, especially on inferotemporal part of her right eye. She had history of diabetes mellitus and hypertriglyceridemia. Her sister also has known history of hypertriglyceridemia. Ophthalmological examination revealed 6/6 visual acuity on both eyes, with normal anterior segment of both eyes. Fundus examination showed creamy retinal vessels on both eyes. Humphrey perimetry result showed inferotemporal visual field defect of RE. At time of visit, triglyceride level was 1440 mg/dL. Patient was prescribed fenofibrate 1x300 mg daily by Endocrinology Department. After 6 months of fenofibrate therapy, serum triglyceride level was decreasing to 185 mg/dL. Ophthalmology exam revealed a significant decrease of creamy white vessel on right eye and normal vessel of left eye. Humphrey perimetry showed decreased visual field defect Discussion : Hypertriglyceridemia can result from familial or secondary to systemic diseases. Creamy vessel appearance in lipemia retinalis is resulted from presence of triglyceride-laden chylomicrons in the plasma. Lipemia retinalis rarely manifests with reduced peripheral vision, which is presented in this case. Conclusion : Lipemia retinalis is often overlooked due to its asymptomatic nature. Prompt recognition might be live saving from life-threatening condition resulting from hypertriglyceridemia. Triglyceride- lowering drug therapy is very useful in improving peripheral field defect as presented in our case report.

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