Ep.2 Pertanganan Pertama Trauma Mata - DR Ikhwan
Ep.2 Pertanganan Pertama Trauma Mata - DR Ikhwan
§ Trauma kimia
§ Asam/Basa Kompetensi 3B
Are YOU ready? J
§ Kesimpulan (Take Home Message)
Pendahuluan
§ Trauma pada mata merupakan penyebab penurunan fungsi visual hingga kebutaan
monocular pada dewasa muda
§ Kualitas hidup ê
§ Dampak sosio-ekonomi
§ Lampu (penlight)
§ Anestesi topikal
§ Cotton-tip applicator
§ pH strip
EROSI KORNEA
Erosi kornea
• relax ciliary muscle spasm which may otherwise cause aching eye pain and light sensitivity
Edukasi: Edukasi untuk tidak diberikan air sirih, urin, atau air lainnya
Pada kasus tertentu, dapat dilakukan patching atau bandage contact lens
TRAUMA TAJAM
Terminologi
Klasifikasi trauma Birmingham Eye Trauma Terminology (BETT)
Trauma tajam
§ Multipel?
§ Bagaimana mekanisme cederanya?
§ Apakah Terdapat tanda-tanda infeksi (endoftalmitis?)
NEVER remove an intraorbital foreign body without first obtaining imaging to evaluate
the depth and direction of penetration. Premature removal may result in intracranial
bleeding, cerebrospinal fluid leakage, etc
Pemberian anti-tetanus
Protect the eye with a rigid covert (not with a patch!)
ü If foreign body fragments are found, gently remove with a cotton bud – if adherent and
not easily removed leave for ophthalmologist.
ü Do not evert the upper lid if there is any possibility of a penetrating injury as you may
expulse intraocular contents
1. Pupillary tears;
2. iridodialysis;
3. angle recession;
4. cyclodialysis;
5. meshwork tears;
6. ruptured zonules;
7. retinal dialysis
Evaluasi dan tatalaksana hifema
§ Detail cedera
§ Adanya penyakit pembekuan darah
§ Reassurance, konservatif
§ Artificial tears
TRAUMA KIMIA
“Chemical injury is an absolute emergency in which literally every second counts…”
“Intervention must precede the steps of a traditional examination such as detailed history taking or even recording
the visual acuity…”
Penyebab: Asam vs Basa
§ Agen basa cenderung penetrasi:
merusak stroma kornea, endotel
kornea, hingga anterior chamber
Trauma mata dapat disebabkan oleh trauma mekanik (tumpul & tajam) dan kimia
Cegah cedera lebih lanjut, tatalaksana awal dengan baik dan lakukan rujukan yang
tepat
Referensi
§ Gerstenblith AT, Rabinowitz MP (editors). The Will’s Eye Manual : Office and
Emergency Room Diagosis and Treatment of Eye Disease 6th Ed. 2012