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JENIS KERATITIS Keratitis Herpes Simpleks

ETIOLOGI ir!s Herpes Simpleks

PATOGENESIS " #e$t!k% epit&elial 'a$ str(ma) Epitelial%


Pem#ela&a$ 2ir!s 'i 'alam epitel Ker!saka$ sel epitel T!kak k(r$ea s!per1isial

Str(ma%
Reaksi im!$(l(+ik pasie$ t&' sera$+a$ 2ir!s K(mpleks a$ti+e$*a# #ereaksi 'i 'alam sel str(mak(r$ea Me$arik sel ra'a$+ 'a$ le!k(sit Sel ra'a$+ 'a$ le!k(sit me$+el!arka$ e$<im pr(te(litik Str(mal 'a$ 6ari$+a$ sekitar$-a r!sak

MANIFESTASI KLINIS SUBYEKTIF OBYEKTIF Keratitis Epitelial% Keratitis Epitelial% * Ti'ak 'ikel!&ka$ * Iritasi -a$+ * Kel(pak mata ri$+a$. se'ikit se'ikit #e$+kak mera& * Berair * Mata #erair * !$ilateral seri$+ 'i!saple,et palpe#ra Keratitis str(ma% Keratitis str(ma% * sila! * i$6eksi * mata #erair k($6!$+ti2a * pe$+li&ata$ * i$6eksi silier ka#!r * pa'a k(r$ea t'p i$1iltrate str(ma -+ 'apat 'isertai !2eitis 'a$ &ip(pi($

DIAGNOSIS Epitelial% /pl+ seri$+0 Ditem!ka$ +am#ara$ 'e$'ritik pa'a k(r$ea Str(mal% Ditem!ka$ +am#ara$ 'iski1(rmis pa'a k(r$ea

PENGOBATAN O#at t(pi,al a$tiretr(2iral% * IDU /i'(3!ri'i$e0% T(ksik. ti'ak #(le& 'ipakai l#& 'ari " mi$++!. tp pl+ m!ra& Lar!ta$ 45. 'i#erika$ setiap 6am Salep 7.85 setiap 9 6am * i#ra#i$% Dalam #e$t!k salep * Tri1l!ri'i$e Tetes mata 4 5 setiap " 6am * Asikl(2ir Salep :5 tiap 9 6am U; me$+atasi pra'a$+a$ p1 keratitis str(ma% AINS De#ri'eme$t% !; me$+&ila$+ka$ sel*sel -+ sakit Ka!terisasi '+$ as) Kar#(lat ata! kar!ta$ -('i!m !; me$+&ila$+ka$ sel*sel -+ sakit 'a$ me$,e+a& perl!asa$ pe$-akit ke lapisa$ str(mal ata! -+ le#& 'alam l+ K(rtik(ster(i' k($trai$'ikasi p' keratitis epitelial

KOMPLIKASI U2eitis

Keratitis Herpes =(ster

ir!s ari,ella =(ster

ir!s &erpes <(ster Me$+i$1eksi +a$+li($ Gaseri $) tri+emi$!s Ga$++!a$ p' ke: ,#+ $) ter!tama ,#+) (1talmika

* Rasa $-eri pa'a 'aera& mata * E'ema k!lit -+ tampak kemera&a$ serta 2esikel pa'a 'aera& 'a&i. alis. kel(pak mata atas /ses!ai '+$ 'ermat(m -+ 'ipersara'i (le& $) 0 * Pe$+li&ata$ #erk!ra$+ * Mata #erair. sila! * t'p #e$6(la$ p!ti& kemera&a$ 'i pi$++ira$ mata * sila! 'isertai rasa sakit * pe$+li&ata$ ka#!r

* Er!psi k!lit pa'a 'aera& -+ 'iper,a#a$+i (le& $)tri+emi$!s * Er!psi !$ilateral * Di epitel k(r$ea t'p #er,ak* #er,ak -+ terse#ar 'a$ 'pt meli#atka$ str(ma

Keratitis Flikte$ /kerat(* k($6!$+ti2itis 1likte$0

Reaksi im!$(l(+ik t&' sta1il(k(k!s a!re!s.k(ksi'i('es imiitis serta #akteri pat&(+e$ lai$$-a

Reaksi im!$(l(+ik Pe$im#!$a$ sel lim1(i'. akti2asi sel e(si$1il Me$-era$+ k(r$ea

De+e$erasi &iali$ k(r$ea 'aera& -+ #e>ar$a kp!ti&a$

* t'p #e$6(la$ p!ti& kek!$i$+a$ p' 'aera& lim#!s -+ 'ikelili$+i (le& 'aera& k($6!$+ti2a -+ &iperemis * 'item!ka$ +#ra$ i$1iltrat 'a$ $e(2ask!larisasi * k&as$-a t#tk$-a pap!la ata! p!st!la p' k(r$ea ata! k($6!$+ti2a /kerat(* k($6!$+ti2a 1likte$0

Keratitis Sika /kerat(* k($!$+ti2its sika0

K!ra$+$-a sekresi kele$6ar lakrimal 'a$ ata! sel G(#let

Bila #el!m sampai mer!sak k(r$eaSi$'r(m 'r- e-e% * Mata +atal * Mata seperti

P' ti$+kat 'r- e-e% * ke6er$i&a$ perm!kaa$ k($6!$+ti2a 'a$ k(r$ea &ila$+ * Tes S,&irmer #erk!ra$+

* N-eri 'isertai er!psi k!lit ti'ak mele>ati +aris me'ia$ * Ditem!ka$ pem#e$+kaka$ kele$6ar pre* a!rik!ler re+i($al -+ sesisi '+$ ,a#a$+ (1talmik $) -+ terke$a * Dapat 'isertai !2eitis. k($6!$+ti2itis. skleritis. $e!ritis. +la!k(ma * Ditem!ka$ +#ra$ pap!la ata! p!st!la p' k(r$ea ata! k($6!$+ti2a /kerat(* k($6!$+ti2a 1likte$0 * T'p 1likte$ p' k(r$ea #er!pa #e$6(la$ #er#atas te+as #er>ar$a p!ti& kea#!a$. '+$ $e(2ask!larisasi-+ me$!6! ke ara& #e$6(la$ ts#) * Biasa$-a #ersi1at #ilateral -+ 'im!lai 'ari 'aera& lim#!s * Tes S,&irmer a#$(rmal * Tes <at >ar$a R(se Be$+al k($6!$+ti2a me$-erap >ar$a

Pe$+(#ata$ simt(matik * Asikl(2ir (ral ata!p!$ t(pi,al * Tetes mata metilsel!l(sa * Sikl(pe+ia * O#at"a$ !; me$i$+katka$ im!$itas% 2it)? '(sis ti$++i. (#at" $e!r(tr(pik * I$1eksi sek!$'er #akteri% a$ti#i(tik

* U2eitis * Parese (t(t pe$++erak mata * Gla!,(ma * Ne!ritis (pti,

* Tetes mata ster(i' '+$ &ati" /6ika a'a TB? ti'ak 'ia$6!rka$0 * T(#rami,i$

* T!kak k(r$ea * Pe$-em#!&a$ 'apat me$i$++alka$ 6ari$+a$ par!t -+ 'isertai $e(2ask!larisasi k(r$ea

* Jika k(mp($e$ air mata -+ k!ra$+air mata tir!a$ * K(mp($e$ lemak -+ k!ra$+le$sa k($tak * Pe$+!apa$ -+

* Ulk!s k(r$ea * K(r$ea tipis * I$1eksi sek!$'er (le& #akteri * Keker!&a$ 'a$ $e(2ask!larisasi k(r$ea

Keratitis Lepra

I$1eksi Mycobacterium leprae

I$1eksi M)leprae mer!sak sara1 k(r$ea

#erpasir * Pe'i& * Keri$+ Bila s'a& smp mer!sak k(r$ea% +e6ala 'i atas 'i tam#a&% * Sila! * sakit * ka#!r * #erair * A'a$-a pem#e$+kaka$ -+ kemera&a$ p' palpe#ra 'isertai ta$'a*ta$'a lai$ p' #+$ t!#!&

* Tear*#reak !p #erk!ra$+ * S!sa& me$++erakka$ kel(pak mata Kelai$a$ k(r$ea 'pt #er!pa% * Er(si k(r$ea * keratitis p!$+tata. * keratitis a2ask!ler% lesi p!$+tata #er>ar$a p!ti& -+ #atas$-a ti'ak 6elas spt #erka#!t * $e#!la% lesi" -+ me$-at! mem#e$t!k keker!&a$s!#* epitelial. t'p 'ep(sit kalsi!m 'isertai 'str!ksi mem#ra$ B(>ma$ * Fase la$6!t% $e(2ask!larisasi s!per1isial pa$$!s lepr(mat(sa Ter'apat 'e1ek epitel k(r$ea

mera& * Tear*1ilm #reak !p @47 'etik

#erle#i&a$pe$!t!pa$ p!$+t!m lakrimal

* Pem#e$+kaka$ sara1 k(r$ea 'isertai #ea' ($ stri$+ * G#ra$ kli$ik p' #a+ia$ t!#!& lai$

* pe$+(#ata$ t&' mik(#akteri!m leprae% 'aps($e 'a$ ri1ampisi$ * Jika a'a 'e1(rmitas palpe#ra -+ 'apat me$-e#a#ka$ ker!saka$ k(r$ea 'ilak!ka$ pem#e'a&a$

Keratitis Filame$t(sa% keratitis -+ 'isertai a'a$-a 1ilame$t m!k(i' 'a$ 'esk!amasi sel epitel p' perm!kaa$ k(r$ea

Ti'ak 'iketa&!i) Dpt 'isertai pe$-) Lai$. spt% * DM * Pemakaia$ le$sa k($tak * Tra!ma 'asar (tak * Pemakaia$ a$ti&istami$ * E'ema k(r$ea * Kerat(*

* * * * * *

Rasa kelilipa$ Sila! Mata mera& Ble1ar(spasme Epi1(ra Ber6ala$ me$a&!$ ata! ak!t

Ditem!ka$ 1ilame$ -+ ter'iri atas sel 'a$ sisa m!k(i') Di 'ekat 1ilame$ 'item!ka$ 'e1ek epitel 'isertai keker!&a$ epitel #er>ar$a a#!*a#!

* Lar!ta$ &ipert($ik Na?l 85 * Air mata &ipert($ik * Me$+a$+kat 1ilame$

Keratitis F!$+al

k($6!$+ti2itis sika * Trak(ma * sark(i'(sis * Aki#at 6am!r. spt F!sari!m. ?e(&al(,ep&ari !m. 'a$ ?!r2!laria

* sakit mata -+ &e#at * #erair * sila!

Keratitis I$terstitial L!etik% ma$i1estasi la$6!t 'ari i$1eksi si1ilis k($+e$ital

* reaksi im!$(l(+ik t&' trep($ema pali'!m) Pera'a$+a$ 'apat #er!pa e'ema. i$1iltrasi lim1(sit 'a$ 2ask!larisasi str(ma

* * * *

Kel!&a$ sakit Sila! Ka#!r Lakrimasi

Keratitis Skler(tika$s

Ti'ak 'iketa&!i

* sakit * 1(t(1(#ia * ti'ak a'a sekret

* p' mata aka$ terli&at i$1iltrat -+ #er&i1a 'a$ satelit #ila terletak 'i 'alam str(ma) * A'a ,i$,i$ e$'(tel 'isertai (la>!e. +am#ara$ satelit k(r$ea 'a$ lipata$ 'es,emet Trias H!t,&i$s($% * keratitis i$terstitial * +a$++!a$ p$'e$+ara$ samapi t!li * kelai$a$ p' +i+i seri atas +e6ala lai$ -+ me$i$6!kka$ ta$'a" si1ilis k($+e$ital. spt seri$+ 6!+a 'item!ka$ &i'!$+ pela$a * keker!&a$ k(r$ea -+ terl(kalisasi 'a$ #er#atas te+as. ##tk se+iti+a '+$ p!$,ak me$!6! ke ara& k(r$ea #+$ se$tral * k(r$ea tl&at p!ti& spt sklera)

* '+ melak!ka$ p) Mikr(sk(p '+$ KOH 475 t&' ker(ka$ k(r$ea -+ me$!$6!kka$ a'a$-a &i1a

* 'ira>at * 'i#erika$ $atamisi$ 85 setiap 4*" 6am saat #a$+!$ * Sikl(pe+ik * O#at (ral a$ti+al!k(ma 6ika TIO me$i$+kat * Kerat(plasti 6ika '+ (#at"a$ ti'ak #er&asil

E$'(1talmitis

* #'srka$ trias &!t,&i$s($ * kelai$a$" 1isik spt sa''le $(se * pe$($6(la$ (s)1r($tal * reaksi ser(l(+i /STS0 -+ p(siti1

* 'pt sem#!& se$'iri /Sel1*limiti$+0 * 6ika a'a !2eitis% pem#eria$ tetes mata k(rtik(ster(i' 'a$ s!l1as atr(pi$ ata! sk(p(lami$

* !2eitis +ra$!l(mat(sa * k(r(i'itis 'isertai keker!&a$ #a'a$ ka,a

* Ti'ak a'a -+ spesi1ik * Skleritis% k(rtik(ster(i' 'a$ a$ti ra'a$+ $($ ster(i' * Iritis% tetes mata atr(pi$

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