REFRAKSI

Yola Valentin Saragih

 Refraksi
Refraksi mata adalah istilah untuk menggambarkan proses masuknya cahaya ke dalam mata
hingga tertangkap oleh retina.

Status refraksi yang ideal disebut emmetropia.

Pada mata emmetropia, kekuatan kornea(40 Dipotri) + lensa(20 Dioptri) digabungkan untuk
memfokuskan sinar sejajar dari obyek yg jauh pada satu titik focus di retina

Gangguan refraksi adalah ketidakmampuan mata memfokuskan cahaya secara akurat pada

retina.
 Media Refrakta
1. Kornea (IB : 1.37)
2. Humor Aquous (IB : 1.33)
3. Lensa (IB : 1.39)
4. Vitreus humor (IB : 1.34)

Sinar datang dari media yang indeks biasnya rapat ke media

yang indeks bias nya tidak rapat maka akan menjauhi garis
normal begitupun sebaliknya.
Rangsang cahaya masuk ke mata melalui kornea, aqueous humor, pupil,
lensa, vitreous humor dan terakhir difokuskan di retina
Pemeriksaan Visus
Macam Kelainan Refraksi
1. Miopia (near-sightendess)
Berkas sinar yang berjalan sejajar masuk ke dalam mata dalam
keadaan istirahat tanpa adanya akomodasi, dibiaskan membentuk
bayangan di depan retina.

Etiologi :
- diameter antero posterior yang panjang
- radius kurvatura kornea dan lensa lebih besar
- perubahan posisi lensa ke depan
- perubahan indeks bias refraksi
Manifestasi Klinis
- Penglihatan jauh yang kabur, kondisi seperti ini pada anak-anak kadang
terabaikan, kecenderungan untuk memicingkan mata saat melihat jauh
- Nyeri kepala, mata cepat lelah

Klasifikasi
- Miopia ringan : <-3.00 D
- Miopia sedang : -3.00 D s/d -6.00 D
- Miopia berat : >-6.00 D
Tatalaksana
- Koreksi miopia dengan pemberian kacamata, lensa kontak atau bedah
refraktif
- Kacamata yang diberikan adalah lensa sferis negatif (concave) atau
minus terkecil yang memberikan tajam penglihatan terbaik

Komplikasi
- Miopia tinggi bisa menyebabkan ablasio retina rhegmatogen
Macam Kelainan Refraksi
2. Hipermetropia (far-sightendess)
Berkas sinar yang berjalan sejajar masuk ke dalam mata dalam
keadaan istirahat tanpa adanya akomodasi, dibiaskan membentuk
bayangan di belakang retina.

Etiologi :
- diameter antero posterior yang pendek
- radius kurvatura kornea dan lensa yang kurang
- perubahan indeks bias refraksi (berkurang)
- Afakia
Manifestasi Klinis
- Kabur melihat dekat dan jauh
- sakit kepal
- penglihatan tidak nyaman dan perasaan mata lelah yang muncul setelah
bekerja lama,
- sensitivitas meningkat terhadap cahaya dan
- spasme akomodas

Klasifikasi
- Hipermetropia ringan : <+3.00 D
- Hipermetropia sedang : +3.00 D s/d +6.00 D
- Hipermetropia berat : >+6.00 D
Klasifikasi
- Hipermetropia Manifes : visus 6/6 dengan sferis positif terbesar tanpa
akomodasi
- Hipermetropia Absolut: visus 6/6 dengan sferis positif terkecil
- Hipermetripia Fakultatif : 6/6 tanpa lensa positif, dengan memicingkan
mata (dibantu akomodasi)
- Hipermetropia Total : 6/6 dengan siklopegik (manifes+laten)

Tatalaksana
- Koreksi hipermetropia dengan pemberian kacamata, lensa
kontakKacamata yang diberikan adalah lensa sferis positif (conveks)
atau plus terbesar yang memberikan tajam penglihatan terbaik
Macam Kelainan Refraksi

3. Astigmatisma
Pembiasaan pada lebih dari satu titik fokus berkas sinar yang
sejajar yang masuk ke dalam mata pada keadaan tanpa
akomodasi.

Etiologi :
Bentuk Astigmatisma
1. Astigmatisma Reguler
Meridian utama yang saling tegak lurus yang masing-masing memiliki
daya bias terkuat dan terlemah
Terdiri dari :
- Astigmat with the rule : pembiasan pada lengkung vertical lebih kuat
daripada horizontal
- Astigmatisma against the rule : pembiasan pada lengkung horizontal lebih
kuat daripada vertical

2. Astigmatisma irregular
Tidak mempunyai 2 meridian yang saling tegak lurus, lengsung kornea
berbeda pada meridian yang sama. Biasanya karna infeksi, trauma, dll
Etiologi
- Herediter
- Pasca operasi, pasca infeksi, pasca trauma

Klasifikasi
1. Astigmatisma miopic simpleks 3. Astigmatisma Hipermetrof simpleks

2. Astigmatisma Miopic kompositus 4. Astigmatisma Hipermetrof kompositus

Klasifikasi
5. Astigmatisma mixtus

Tatalaksana
1. Astigmatisma regular : lensa silinder
2. Astigmatisma irregular : hard contact lens
4. Presbiopi
Bukan kelainan refraksi.

Etiologi :
- Peningkatan usia menyebabkan elastisitas kapsul lensa
menurun, massa lensa lebih padar dan keras.
- Kemampuan akomodasi yang menurun

Manifestasi Klinis
- Kabur melihat dekat
- Pusing
- Mata lelah
Tatalaksana
Addisi :
-40 THN: S + 1.00 D
-50 THN: S + 2.00 D
-≥60 THN: S + 3.00 D
-AFAKIA: S + 3.00
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You can simply impress your audience You can simply impress your audience
and add a unique zing and appeal to and add a unique zing and appeal to
your Presentations. your Presentations.

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Contents Title Contents Title
You can simply impress your audience You can simply impress your audience
and add a unique zing and appeal to and add a unique zing and appeal to
your Presentations. your Presentations.
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Get a modern PowerPoint
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You can simply impress You can simply impress You can simply impress You can simply impress
your audience and add a your audience and add a your audience and add a your audience and add a
unique zing and appeal to unique zing and appeal to unique zing and appeal to unique zing and appeal to
your Presentations . Easy your Presentations . Easy your Presentations . Easy your Presentations . Easy
to change colors, photos to change colors, photos to change colors, photos to change colors, photos
and Text. and Text. and Text. and Text.
 Infographic Style
Contents Title
You can simply impress your audience and add a unique zing
and appeal to your Presentations.

Contents Title
You can simply impress your audience and add a unique zing
and appeal to your Presentations.

Contents Title
You can simply Contents Title
impress your audience
You can simply impress your audience and add a unique zing
and add a unique zing
and appeal to your Presentations.
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Presentations.

Contents Title
You can simply impress your audience and add a unique zing
and appeal to your Presentations.

Contents Title
You can simply impress your audience and add a unique zing
and appeal to your Presentations.
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Insert Your Image Insert Your Image I hope and I believe that this Template will your Time,
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Get a modern PowerPoint Get a modern PowerPoint Get a modern PowerPoint Get a modern PowerPoint
Presentation that is Presentation that is Presentation that is Presentation that is
beautifully designed. You beautifully designed. You beautifully designed. You beautifully designed. You
can simply impress your can simply impress your can simply impress your can simply impress your
audience and add a audience and add a audience and add a audience and add a
unique zing and appeal to unique zing and appeal to unique zing and appeal to unique zing and appeal to
your Presentations. Easy your Presentations. Easy your Presentations. Easy your Presentations. Easy
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and Text. and Text. and Text. and Text.
 Insert Your Image Insert Your Image

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Medical Presentation
You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. Get a modern
PowerPoint Presentation that is beautifully designed. I hope and I believe that this Template will your Time, Money and Reputation. You can simply
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Get a modern PowerPoint Presentation that is beautifully designed. I hope and I believe that this Template will your Time, Money and Reputation. You
can simply impress your audience and add a unique zing and appeal to your Presentations.
Content
You can simply impress your audience and add a unique zing and appeal to your Presentations.
Easy to change colors, photos and Text. You can simply impress your audience and add a unique
zing and appeal to your Presentations. Easy to change colors, photos and Text. I hope and I

One
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Content
You can simply impress your audience and
add a unique zing and appeal to your
Presentations. Easy to change colors,
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photos and Text. You can simply impress
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