Glaucoma pada pasien Wanita

Glukoma pada pasien Wanita

60 tahun
Glaucoma pada pasien Wanita

Dian Farhani_102020121
 Skenario 3
Seorang wanita usia 60 tahun riwayat operasi katarak mata kiri 10 tahun
yang lalu. Datang dengan keluhan penglihatan mata kanan buram sudah 3
tahun terakhir ini namun baru benar benar dirasakan sangat buram 3 bulan
terakhir ini. Pada pemeriksaan didapatkan pemeriksaan 1/300, injeksi silier,
kornea tampak adanya micro bullae, palpasi bola mata N++.
 Rumusan Masalah
Seorang wanita usia 60 tahun riwayat operasi katarak mata kiri 10 tahun
yang lalu. Dengan keluhan penglihatan mata kanan buram 3 tahun terakhir,
sangat buram 3 bulan terakhir ini.
 Mind Mapping
Penyebab Glaucoma Akut
Glaukoma
Patofisiologi Glaucoma Akut

Penanganan Dokter Umum

Tindakan Lanjutan Spesialis

Mata
Glaucoma pada pasien Wanita
 Sasaran Belajar
1 2 3

mampu mengetahui mengetahui

mendiagnosa penyebab-penyebab patofisiologi
glaucoma akut glaucoma akut glaucoma akut

4 5

mengetahui mengetahui tindakan

penanganan yang lanjutan yang akan
dapat dilakukan dokter dilakukan oleh
umum spesialis mata
 Anamnesis
 KU : keluhan penglihatan mata kanan
buram sudah 3 tahun terakhir ini namun
baru benar benar dirasakan sangat
buram 3 bulan terakhir ini.
 Riwayat operasi katarak mata kiri 10
tahun yang lalu.
Pemeriksaan Fisik
 Visus : pemeriksaan 1/300.
 Injeksi silier.
 Kornea tampak adanya micro bullae.
 Palpasi bola mata N++.
 Pemriksaan Penunjang

Glaucoma pada pasien Wanita

-
Pemriksaan Penunjang Tambahan
Glaucoma pada pasien Wanita

1. Lapang pandang
2. Pemeriksaan TIO
3. Lampu celah biomikroskop (Slit lamp biomicroscopy)
4. Gonioskopi
5. Funduskopi
6. Biometri Okular
 Diagnosis Banding

Katarak

 Proses degeneratif berupa kekeruhan di lensa bola mata sehingga menyebabkan

menurunnya kemampuan penglihatan sampai kebutaan. Kekeruhan ini disebabkan
oleh terjadinya reaksi biokimia yang menyebabkan koagulasi protein lensa.
 Katarak matur adalah katarak yang serat kortikalnya menjadi buram, tampak
berwarna putih susu dan putih. Katarak menyebar ke tepi lensa pada tahap matur
dan mempunyai pengaruh besar pada penglihatan. Mengganggu aktivitas sehari-
hari.
 Katarak imatur adalah katarak yang lensa matanya menjadi keruh, agak buram, di
bagian tengahnya
 Diagnosis Banding
Faktor Berbeda Katarak mature Katarak immature

 Penuaan
 Pertambahan usia  Kelainan genetik yang diturunkan
 Konsumsi alkohol berlebihan  Pernah menjalani operasi mata atau
Penyebab  Riwayat katarak dalam keluarga  Kondisi medis seperti diabetes atau tekanan
 Katarak tahap awal yang tidak diobati darah tinggi.
 Penggunaan obat steroid jangka panjang.
 MerokokPaparan sinar matahari berlebihan
 Gangguan penglihatan
 Terlihat bercak putih pada mata  Gangguan sebagian
Gejala  Tidak ada bayangan iris  Bintik putih perlahan Bayangan iris
 Tidak ada reflek merah  Usia muda dan bayi baru lahir, usia 40-50
 Usia > 55 thn tahun

 Mempengaruhi kehidupan sehari-hari Anda dan mengganggu aktivitas normal seperti mengendarai mobil atau menonton televisi.
Komplikasi  Kemungkinan kehilangan penglihatan total
 Memburuknya penglihatan
 Menyebabkan katarak matur
 Diagnosis Banding

Glaukoma

 Merupakan penyakit mata yang menyebabkan menyempitnya lapang pandang dan

hilangnya fungsi penglihatan dan merupakan salah satu penyebab utama kebutaan
permanen diseluruh dunia.
 Disebabkan karena bertambahnya produksi cairan mata oleh badan siliar serta
berkurangnya pengeluaran cairan mata di daerah sudut bilik mata atau celah pupil.
Pada glaukoma akan terdapat melemahnya fungsi mata dengan terjadinya cacat
lapang pandang dan kerusakan anatomi yang berakhir pada kebutaan.
 Diagnosis Banding
Faktor Berbeda Glaukoma tertutup Glaukoma terbuka

 iris tertekan ke kornea, menghalangi saluran uveosklera dan jalan trabekula (TIO  Iris dalam posisi yang tepat, dan saluran
naik). drainase uveoscleral jelas, tapi trabecular
Penyebab meshwork tidak mengalir dengan baik (TIO
naik).

 Mendadak penglihatan sangat kabur.

 mata merah disertai dengan rasa sakit pada sekeliling mata.  menurunnya penglihatan perifer, atau
Gejala  pelangi di sekitar lampu. penglihatan di bagian samping mata.
 mual dan kadang-kadang muntah.  Kebanyakan pasien tidak menyadari hilangnya
penglihatan perifer mereka.

 Mempengaruhi kehidupan sehari-hari Anda dan mengganggu aktivitas normal seperti mengendarai mobil atau menonton televisi.
Komplikasi  Kemungkinan kehilangan penglihatan total
 Memburuknya penglihatan
 Menyebabkan katarak matur
 Working Diagnosis
Glaukoma Sudut Akut Tertutup
Glaucoma pada pasien Wanita
 Etiologi
 Glaukoma sudut tertutup mempengaruhi total 20 juta orang
 sudut bilik mata depan yang sempit,
 bilik mata depan (BMD) yang dangkal,
 panjang bola mata pendek,
 posisi lensa lebih ke anterior, dan
 ketebalan lensa yang meningkat.
 Umumnya terjadi pada usia diatas 40
tahun
 Adanya riwayat keluarga
 Ras asia timur
Epidemiologi
di seluruh dunia
 Jumlah tersebut di perkirakan meningkat menjadi 23 juta
pada tahun 2020
 Dan 32 juta pada tahun 2040.
 Dikenal sebagai salah satu penyebab utama kebutaan
ireversibel di seluruh dunia
 Tingkat ACG di laporkan di Inuit dan populasi Asia.
 Di Indonesia pevalensi glaucoma adalah 4,6 per 1.000
populasi pada tahun 2007
 ACG akut adalah kedaruratan mata sejati yang
membutuhukan manajemen yang cepat dan tepat untuk
mendapatkan prognosis yang baik.
Patofisiologi
Faktor Risiko
 Turunkan Tekanan

Ringankan Kurang rasa Kurangi rasa mual

blok pupil TIO sakit dan muntah
Acetazolamid Venus has a beautiful Teteskan
e 500 mg name, but also high pilocarpine
IV/oral temperatures 2% / 4%
Turunkan Tekanan
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10:00 am Jupiter is the biggest planet Uranus is a gas giant

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12:00 pm The Sun is a star The Moon is a satellite

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Ceres is located in the Despite being red, Mars is a Venus is the second planet
main asteroid belt cold place, not hot from the Sun

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Uranus is a gas giant Pluto is a dwarf planet Neptune is far away

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Task Description To do Done

Mars Mars is actually a very cold place

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Neptune It’s the farthest planet from the Sun

Mercury It’s the closest planet to the Sun

Focus on your goals

Purpose Motivation
● Mars is a cold place, not hot ● Venus has a beautiful name
● Earth is where we all live ● Mercury is the smallest planet

Challenges Results
● Venus has a beautiful name ● Jupiter is very big
● Neptune is far away from us ● Saturn is a gas giant
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25 % Venus has a beautiful name and is
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It’s terribly hot—even hotter than
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 Daily flight connections

Mars
Mars is actually a
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It’s the farthest planet
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Time Tasks Notes Complete

7:00 am Mars Mars is actually a very cold place

8:00 am Venus It’s the second planet from the Sun

9:00 am Saturn Saturn is the ringed planet

10:00 am Neptune It’s the farthest planet from the Sun

11:00 am Jupiter It’s the biggest planet of them all

12:00 pm Mercury It’s the closest

planet to the
Sun
 Monthly expense

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Mercury is the closest Venus is the second planet Despite being red, Mars is a
planet to the Sun from the Sun cold place
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 Graph
10% Venus
Venus has a beautiful name and is the second
planet from the Sun. It’s terribly hot

Mercury
30% Mercury is the closest planet to the Sun and the
smallest one in the Solar System

Mars
60% Despite being red, Mars is a cold place, not hot.
The planet is full of iron oxide dust

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