Pemicu 5

Winsen Haryono
405120122
Kelompok 10
LO 1
Penyakit kelopak mata
 Blefaritis anterior Blefaritis posterior
Definisi Radang bilateral menahun umum di tepian palpebra Disfungsi kelenjar meibom  peradangan palpebra
Etiologi S. aureus. S. epidermidis, seboroik Disfungsi kelenjar meibom
Perubahan sekresi kelenjar meibom
Tanda Blefaritis stafilokokus Blefaritis seboroik • Sekresi kelenjar meibom >> dan abnormal
• Bersisik keras • Hiperaemia dan • Hiperaemia dan telangiektasis
• Konjungtivitis papil sedang dan konjungtiva; berminyak, sisik • Cairan meibom yang keruh
hiperaemia kronik halus dan saling • Air mata berminyak, berbusa, dan berbuih menumpuk
• Jangka lama  luka dan tonjolan madarosis, melekat
trikiasis dan poliosis
• Sindrom mata kering
• Keratokonjungtivitis atopik pada pasien
dermatitis atopik.
Gejala Terbakar, berpasir, fotofobia sedang, mengeras, merah di kelopak mata dengan remisi dan eksaserbasi, gejala memburuk saat pagi hari
Talak Higiene kelopak mata
Antibiotik:
Topikal: asam sodium fusidik, eritromisin, bacitracin, azitromisin / chloramphenicol
Oral: doxycycline (50–100 mg 2x1 selama 1 minggu, 1x1 selama 6-24 minggu), tetrasiklin, atau azithromisin (500 mg 3x1 selama 3 hari
Topical steroid. fluorometholone 0.1% atau loteprednol 4x1 selama 1 minggu
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Hordeolum Chalazion (Kista Meibom)
Definisi Infeksi kelenjar palpebra Radang granulomatosa kronik pada Meibom atau Zeis
Etiologi Staphylococcus aureus Mempertahankan sekresi sebasea
Klasifikasi Interna: infeksi kelenjar meibom  pembengkakan besar  Histopatologi: inflamasi kronik lipogranulomatosa krn lemak
pecah ke arah kulit atau permukaan konjungtiva extraselular oleh lipid-laden epithelioid cells, multinucleated giant
Eksterna: infeksi kelenjar Zeis atau Moll  pembengkakan cells dan limfosit
kecil  pecah ke arah kulit
Tanda dan Sakit, bengkak, merah Nodul
gejala Lesi multiple dan abses Subakut/kronik: tidak atau sedikit sakit sekitar nodul
Akut: infeksi bakteri dengan selulitis, infeksi sekunder hordeolum
interna
Talak Kompres panas 3-4x/hari selama 10-15 menit Antibiotik oral, Konservatif, Kompres panas
48 jam  insisi vertikal atau horizontal dan drainase purulen Expresi
Salep antibiotik pada sakus konjungtiva tiap 3 jam Injeksi steroid
Antibiotik sistemik jika terjadi selulitis Operasi, profilaksis tetrasiklin sistemik

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Entropion involusional Entropion sikatriks
Definisi Pelipatan kelopak mata ke arah dalam disebabkan Pelipatan kelopak mata atas atau bawah ke arah dalam
proses penuaan disebabkan jaringan parut
Patogenesis • Kelemahan kelopak horizontal
• Tidak stabilnya kelopak vertical
• Over-riding pretarsal
• Orbital septum laxity
Gejala Iritasi, erosi epitel, kasus berat  pembentukan pannus dan ulkus

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Trikiasis
Definisi Bulu mata mengenai kornea mengakibatkan trauma
Etiologi Entropion, epiblefaron, atau pertumbuhan yang salah arah
Tanda Erosi epitel, ulserasi, iritasi diperburuk o/berkedip cepat
Jangka panjang  ulkus kornea dan panus
Talak Epilasi  pencabutan bulu mata, tapi rekuren 4-6 minggu lagi
Elektrolisis  kelopak ditusuk jarum elektrocautery  koagulasi  cabut; rekuren 40%
Krioterapi  menggunakan suhu -20°C u/menghancurkan folikel rambut
Ablasi laser argon  laser diarahin ke pangkal rambut, terbentuk lubang
Operasi

Bowling B. Kanski’s Clinical Ophthalmology. 7th ed. New South Wales: Elsevier; 2011.
http://emedicine.medscape.com/article/1213321-clinical
LO 2
Mata merah visus turun
 Glaukoma akut
Definisi Penyakit optic neuropati, peningkatan tekanan intraokular  “optic disc cupping” dan kehilangan lapang pandang
Klasifikasi • Primary angle-closure suspect (PACS)
• Primary angle-closure (PAC)
• Primary angle-closure glaucoma (PACG)
Mekanisme Pupillary block, Non-pupillary block, Lens-induced angle-closure, Retrolenticular, Combined mechanism, Reduced
aqueous outflow
Faktor resiko • Umur > 60 tahun, ♂ < ♀, riwayat keluarga
• Refraksi
• Ukuran axial
Gejala Asimtomatik
Akut: halo pada edema kornea, sakit mata dan sakit kepala
Pandangan buram
Tatalaksana PACS
Laser iridotomi, pilocarpine 1%
PAC dan PACG
Acetazolamide 500mg IV jika TIO >50mmHg, oral jika TIO <50mmHg
Topikal apraclonidine 1%, timolol 0.5%, prednisolone 1% atau dexamethasone 0.1%
Pilocarpine 2-4% 1 tetes diulangi 1,5 jam

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Klasifikasi
Primary angle-closure • Gonioscopy  posterior meshwork ITC in 3 or more quadrants but
suspect (PACS) no PAS.
• Many patients with less ITC have evidence of intermittent angle
closure, and a lower threshold for diagnosis such as two quadrants
of ITC, pigment smudging or even a very narrow angle approach
(perhaps 20° or less) may be justified.
• Normal IOP, optic disc and visual field.
• No peripheral anterior synechiae (PAS).
• The risk of PACG at 5 years may be around 30%.
Primary angle-closure • Gonioscopy  3 or more quadrants of ITC with raised IOP and/or
(PAC) PAS, or excessive pigment smudging on the TM
• Normal optic disc and field.
• Some authorities further classify PAC into non-ischaemic and
ischaemic, the latter showing anterior segment evidence of prior
substantial IOP elevation such as iris changes or glaukomflecken
Primary angle-closure • ITC in 3 or more quadrants, with glaucomatous optic neuropathy.
glaucoma (PACG) • Optic nerve damage from an episode of severe IOP elevation, such
as acute angle closure, may not appear as typical glaucomatous
cupping

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.

Pupillary block
Non-pupillary block
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Mekanisme
• Failure of physiological aqueous flow through the pupil leads to a pressure differential between the
anterior and posterior chambers, with resultant anterior bowing of the iris
• Usually anatomically relieved by iridotomy, which equalizes anterior and posterior chamber pressure.
Control of IOP if elevated will be achieved provided the angle has opened adequately; this may not
occur if there are substantial PAS or an additional mechanism of angle closure is in effect. TM damage
can prevent normalization of IOP even with an anatomically open angle.
• The lens vault quantifies the portion of the lens located anterior to the anterior chamber angle; a
common definition is the distance between the anterior pole of the lens and a horizontal line joining
the scleral spur at diametrically opposite locations. A large lens vault is independently associated with
angle closure, though it is not clear whether this is entirely via a pupillary block or non-pupillary block
(see next) mechanism, or both
• Thought to be important in many Far Eastern patients.
• Associated with a deeper anterior chamber (AC) than pure pupillary block.
• Patients with non-pupillary block, particularly those with plateau iris, tend to be younger than those
with pure pupillary block.
• An element of pupillary block is invariably present, but angle closure is not fully relieved by iridotomy.
The term ‘mixed mechanism’ has been suggested to describe glaucoma in which both significant
pupillary block and non-pupillary block iris-induced mechanisms coexist.
• Specific anatomical causative factors include plateau iris (anteriorly positioned/rotated ciliary
processes, and a thicker or more anteriorly positioned iris; a ‘thick peripheral iris roll’ concept has been
introduced by some authorities. A thicker peripheral iris may be relatively important in patients of Far
Eastern ethnic origin
 Mekanisme
Lens-induced angle- • a sudden change in lens volume and/or position leads to an acute or subacute IOP rise.
closure • Usually rapid progression of lens intumescence (phacomorphic glaucoma) or anterior lens subluxation.
• Virtually all pupillary block can be said to have a phacomorphic element that increases with age as the
lens enlarges.
Retrolenticular • Malignant glaucoma (‘ciliolenticular block’ – see previous).
• Posterior segment causes of secondary angle closure
Combined Combination of angle-closure and open-angle elements.
mechanism
Reduced aqueous • Appositional obstruction by the iris.
outflow • Degeneration of the TM itself due to chronic or intermittent contact with the iris or damage sustained
due to elevated IOP.
• Permanent occlusion of the TM by PAS; the prognosis for IOP control correlates well with the extent of
PAS

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Bacterial keratitis
• Only develops when the ocular defences have been compromised
• N. gonorrhoeae, N. meningitidis, C. diphtheriae, H. influenzae  able
to penetrate a normal corneal epithelium  association with severe
conjunctivitis
• Most common :
• Pseudomonas aeruginosa
• Staphylococcus aureus
• Streptococci

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Risk factors Clinical features
• Contact lens wear  most • Pain
important  poor lens
hygiene • Photophobia
• Trauma  include • Blurred viision
refractive surgery  linked
to bacterial infection • Mucopurulent or
• Ocular surface disease purulent discharge
• Other factors  local or
systemic • Reduce corneal
immunosuppression, sensation
diabetes and vit A
deficiency

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Examination DD
• Corneal scraping • Keratitis due to other
microorganisms
• Conjunctival swabs
• Marginal keratitis
• Contact lens cases  • Sterile inflammatory
culture corneal infiltrates
• Gram staining  associated with contact
lens wear
susceptible,
intermediate, resistant • Peripheral ulcerative
keratitis
• Toxic keratitis

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Treatment
General considerations Local therapy
• Hospital admission • Antibiotic monotherapy  has
the major advantage over
duotherapy  fluoroquinolone
• Discontinuation of (ciprofloxacin or ofloxacin,
contact lens wear moxifloxacin and gatifloxacin)
• Antibiotic duotherapy  first-
• A clear plastic eye shield line empirical treatment
should be worn between • Subconjunctival antibiotics 
only if there is poor compliance
eye drop instillation if with topical treatment
significant thinning (or • Mydriatics  prevent the
perforation) is present formation of posterior
synechiae and to reduce pain
• Steroids

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Systemic antibiotics
• Potential for systemic involvement :
• N. meningitidis  IM benzylpenicillin, ceftriaxone or cefotaxime, or oral
ciprofloxacin
• H. influenzae  oral amoxicillin with clavulanic acid
• N. gonorrhoeae  3rd generation cephalosporin  ceftriaxone
• Severe corneal thinning with threatened or actual perforation 
ciprofloxacin (antibacterial), tetracycline (anticollagenase effect)
• Scleral involvement  oral or IV treatment

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Fungal keratitis
• Major cause of visual loss
• Main types of fungi  keratitis :
• Yeasts (e.g. genus Candida)  ovoid unicellular organisms  reproduce by budding
• Filamentous fungi (e.g. Fusarium and Aspergillus)  multicellular organisms  produce
tubular projection  hyphae
• Predisposing factors :
• Chronic ocular surface disease
• Long term use of topical steroids
• Contact lens wear
• Systemic immunosupression
• Diabetes
• Filamentary keratitis  trauma
 Candida and filamentous keratitis
• Gradual onset of pain, grittiness, photophobia, blurred vision and watery or mucopurulent discharge
• Signs :
• Candida keratitis :
• Yellow-white densely suppurative infiltrate
• A collar-stud morphology may be seen
• Filamentous keratitis :
• A grey or yellow-white stromal infiltrate with indistinct fluffy margins
• Progressive infiltration  satelite lessions
• Feathery branch-like extensions or a ring-shaped infiltrate may develop
• Rapid progression with necrosis and thinning can occur
• Penetration of an intact descement membrane may occur and lead to endophthalmitis
without evident perforation

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 • Epithelial defect  not invariable  sometimes small when present
• Other features : anterior uveitis, hypopyon, endothelial plaque, raised IOP,
scleritis and sterile or infective endophthalmitis
• DD :
• Bacterial, herpetic and acanthamoebal keratitis

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Examination
• Staining :
• Gram and Giemsa
• Periodic acid-Schiff (PAS) and Grocott-Gomori methenamine-silver (GMS)
• Culture  corneal scrapes
• Corneal biopsy  indicated in the absence of clinical improvement
after 3-4 days and if no growth develops from scrapings after a week
• Confocal microscopy

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Treatment
• Removal of the epithelium over the lesion
• Topical treatment :
• Candida  amphotericin B 0,15% or econazole 1%; alternatives : natamycin 5%, fluconazole 2%, and
clotrimazole 1%
• Filamentous  natamycin 5% or econazole 1%; alternatives : amphotericin B 0,15% and miconazole 1%
• Broad-spectrum AB  to address or prevent bacterial co-infection
• Subconjunctival fluconazole  severe cases
• Systemic antifungals  severe cases, lession are near the limbus, or for suspected endophthalmitis
• Tetracycline  for anticollagenase effect when there is significant thinning
• IOP  monitored
• Superficial keratectomy  effective to de-bulk the lesion
• Therapeutic keratoplasty  when medical therapy is ineffective or following perforation

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Microsporidial keratitis
• Most common general infection is enteritis and the most common
ocular manifestation is keratokonjunctivitis
• Signs :
• Bilateral chronic diffuse punctate epithelial keratitis
• Unilateral slowly progressive deep stromal keratitis may rarely affect
immunocompetent patients
• Biopsy and histology  characteristic spores and intracellular
parasites

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Treatment
• Medical therapy
• Epithelial disease  topical fumagillin
• Stromal disease  combination of topical fumagillin and oral albendazole
400mg daily for 2 weeks
• Keratoplasty  may be indicated although recurrence of disease can
occur in the graft periphery; cryotherapy to the residual tissue may
reduce this risk

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed.
New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical
Ophthalmology. 8th ed. New
South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier;
2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Endoftalmitis (abses korpus vitreum)
Definisi Kondisi inflamasi pada cavitas intraocular dikarenakan infeksi
Etiologi • Endogenous: Candida albicans
• Exogenous: S epidermidis, S. aureus
Tanda dan • Mata merah
gejala • Nyeri
• Kehilangan penglihatan
• Kelopak bengkak
• Kemosis
• Inj. Konjungtiva
• Ada discharge
• Inflamasi berat
Pemeriksaan • PF Mata : kelopak mata bengkak, inj. Konjungitva
• Conjungtival swabs
• B- scan ultrasound (singkirkan DD retina detach)
Talak • Intravitreal antibiotics (Ceftazidime 2 mg in 0,1 ml dan
Vancomycin 2 mg in 0,1 ml)
• Injeksi antibiotik periocular (Vanco 50 mg & Cefta 125 mg)
• Antibiotik topikal
• Antibiotik oral (Moxifloxacin 400 mg)

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
http://emedicine.medscape.com/article/799431-overview#showall
LO 2
Mata merah visus normal
 Perbedaan Jenis-Jenis Konjungtivitis
Penemuan klinis & sitologis Virus Bakteri Klamidia Alergi
Gatal-gatal Minimal Minimal Minimal Berat
Hiperemia Menyeluruh Menyeluruh Menyeluruh Menyeluruh
Lakrimasi Amat banyak Sedang Sedang Sedang
Eksudasi Minimal Amat banyak Amat banyak Minimal
Adenopati preaurikular Biasanya ada Langka Biasanya hanya pada Tidak ada
konjungtivitis inklusi
Pewarnaan kerokan Monosit Bakteri, PMN PMN, plasma, badan Eosinofil
konjungtiva & eksudat inklusi
Kaitan dengan sakit Kadang- Kadang-kadang Tidak pernah ada Tidak pernah ada
kerongkongan & demam kadang ada ada

Vaughan & Ausbury’s General Ophthalmology 18th Ed

Pingueculum
• Bilateral, asymptomatic ‘elastotic’
degeneration of the collagen fibres of
conjunctival stroma
• Signs  a yellow-white mound or
aggregation of smaller mounds on the bulbar
conjunctiva adjacent to the limbus
• Pingueculum  pingueculitis  weak
steroid (fluorometholone)
• Excision

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
 Pterygium
• A triangular fibrovascular subepithelial ingrowth of
degenerative bulbar conjunctival tissue over the
limbus onto the cornea
• Histology  collagenous degenerative changes in
vascularized subepithelial stromal collagen
• Symptoms : asymptomatic, irritation and grittiness,
interference with vision, intermitten inflamation
similar to pingueculitis
• Wear contact lens  irritation at an earlier stage due
to edge lift
• If pseudopterygium is suspected  may be a history
of a causative episode

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
• Signs  3 part : a ‘cap’, a head and a body
• Type 1  extends less than 2mm onto the cornea  a deposit of iron
(Stocker line)
• Type 2  4mm of the cornea and may be primary or recurrent following
surgery
• Type 3  encroaches onto more than 4mm of the cornea and involves the
visual axis
• Pseudopterygium  caused by a band of conjunctiva adhering to an area of
compromised cornea at its apex  forms a response to an acute
inflammatory episode

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
• Treatment :
• Tear substitutes
• Topical steroids  inflammation
• Use sunglasses
• Surgical
 Skleritis
Definisi Gangguan granulomatosa kronik ditandai destruksi kolagen, sebukan sel,
kelainan vaskular
Etiologi Hipersensitivtas tipe IV dan III, penyakit sistemik
Tanda dan • Nyeri konstan dan tumpul  sulit tidur
gejala • Ketajaman penglihatan sedikit berkurang, kecuali peradangan COA
• Bola mata berwarna ungu gelap  dilatasi pleksus vascular di sclera
dan episklera
Pemeriksaan Slitlamp  menilai kedalaman dan indentifikasi penyakit kornea
Talak NSAID: indometasin 100mg/hari atau ibuprofen 300mg/hari 
pengurangan peradangan
Steroid: prednisone 80mg/hari 2 minggu  10mg/hari
Berat  prednisolone 1g IV/minggu
imunosupresif: siklofosfamid

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier;
2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South
Wales: Elsevier; 2015.
 Episkleritis
Definisi Peradangan lokal sklera dengan
kemungkinan hipersentivitas
Klasifikasi Simple epikleritis
Nodular epikleritis
Tanda dan Simple:
gejala Merah, berpasir, fotofobia
Nodular:
Mata merah saat bangun  progresif 2-3
hari  tidak nyaman
Pemeriksaan Hiperemia local  bola mata warna merah
muda atau keunguan
Infiltrasi, kongesti, edema episklera,
konjungtiva di atasnya, dan kapsula Tenon di
bawahnya
Talak Sembuh sendiri 1-2 minggu, rekuren selama
bertahun-tahun
Topikal:
Deksametason 0,1% meredakan peradangan
3-4 hari
NSAID: flurbiprofen 300mg/hari, diturunkan
jd 150mg/hari setelah gejala terkontrol,
atau indometasin 300mg/hari

Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Bowling B. Kanski’s Clinical Ophthalmology. 8th ed. New South Wales: Elsevier; 2015.
Dakrioadenitis
• Inflamasi glandula lakrimalis yang disebabkan o/
Virus: Bakteri: Jamur : Penyakit:
- Mumps - Staph. aureus - Histoplasmosis - Sjogren Syn.
- Epstein Bar Virus - N. gonorrhoeae - Blastomycosis - Grave diseases
- Herpes Zoster - T. palidum - Sarcoidosis
- Mononukleosis - M. leprae
- Coxsackievirus A - Streptococcus

• Patofisiologi blm jelas.

↑agen penyebab yg masuk melalui konjungtiva  duktis lakrimal 
glandula lakrimalis
Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed
&
emedicine.medscape.com
Tanda & Gejala
• Akut
– Unilateral, nyeri hebat, merah,
– Onset beberapa jam-hari
– Pembengkakan kelopak mata lateral  S-Shaped Ptosis
– Sekresi lakrimal <
– Injeksi porsio palpebra & sekitar palpebra
• Kronik
– Unilateral/bilateral, pembengkakan glandula lakrimalis yg tidak nyeri
– Berlangsung lebih dari 1 bulan
Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed
emedicine.medscape.com
Vaughan & Ausbury’s General Ophthalmology 18th Ed
Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed
Dakrioadenitis

Pemeriksaan DD
• CT Scan  pembesaran glandula • Ruptured dermoid cyst
lakrimalis, opasitas jaringan • Tumor glandula lakrimalis
sekitar
• Ptosis
• Kultur bila terdapat discharge
purulen • Chalazion
• Hordeolum

emedicine.medscape.com
Tatalaksana
• Akut • Kronik
– Virus  Self limiting, – Bila pembengkakan tidak
kompres, NSAID oral mengecil dalam 2 minggu 
– Bakteri  Sefalosporin biopsi glandula lakrimalis
generasi 1
– Jamur  Antifungal

emedicine.medscape.com
Resep
dr. Winsen
Jln. Tawakal Ujung, Grogol, Jakarta Barat
Telp: 021-543210
SIP: 405120122
Jakarta, 3 September 2015
R/ Keflex 250 mg caps No. XX
S 2 dd 1 p.c
-----------------------------------------------------R

Pro: Tn. A
Umur: Dewasa
Dakriosistisis
• Infeksi sakus lakrimalis karena obstruksi duktus nasolakrimalis
• Etiologi: Staphylococcal, Streptococcal
• Lebih sering terjadi pada bag. kiri krn d. nasolakrimal & fossa lakrimal
membentuk sudut > di bag. kiri

Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed

emedicine.medscape.com
Vaughan & Ausbury’s General Ophthalmology 18th Ed
Tanda & Gejala
• Akut
– Pembengkakan yg eritem & nyeri pada kantus medial
– Abses mungkin terbentuk
– Ada discharge purulen bila sakus ditekan
• Kronik
– Mata berair
– Pembengkakan di dalam kantus yg tidak nyeri krn mucocele
– Discharge mukopurulen

Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed

emedicine.medscape.com
Vaughan & Ausbury’s General Ophthalmology 18th Ed
Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed
Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed
DD
• Blefaritis
• BCC
• Chalazion
• Konjuntivitis bakterial
• Episkleritis
• Obstruksi nasolakrimal
• Selulitis orbital

emedicine.medscape.com
Tatalaksana
• Kompres hangat
• AB oral (flucoxacillin, co-amociclav)
• Insisi & drainase
• DCR (dacryocystorhinostomy)

Kanski JJ, Bowling B. Clinical Ophthalmology: A systemic approach 7th Ed