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PATOLOGI MATA

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ANA

T

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NORMAL ANATOMY

Palpebra:The eyelids are divided into a!taneo!s and a on"!ntival portion# The $or%er is o%posed o$strati&ed s'!a%o!s epitheli!% and the latter o$ a %!h

thinner on"!ntival epitheli!%#

()in appenda*es o$ eyelids inl!de the sebaeo!s*lands +*lands o$ ,eis and %eibo%ian *lands-. aporine*lands +*lands o$ Moll-. and erine s/eat *lands# Thelari%al *land is lar*ely o$ sero!s type. /ith a %inor%!ino!s o%ponent in the d!tal portion and a layer

o$ %yoepithelial ells in the lar*er peripheral d!ts#

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The orbit ontains. in addition to the o!lar *lobe andthe lari%al *land. the $ollo/in* str!t!res: opti nerve and its %enin*eal overin*. Tenons aps!le. the etrao!lar %!sles. blood vessels. and a

deliate $ra%e/or) o$ &broadipose onnetive tiss!e# The on"!ntiva is a thin %!o!s %e%brane. /hih linesthe inner s!r$ae o$ the eyelids and %ost o$ the anteriors!r$ae o$ the o!lar *lobe The on"!ntival epitheli!% is o%posed o$ t/o to &ve layers

o$ ol!%nar ells that rest on a ontin!o!s basal la%ina# This epitheli!% ontains %!inseretin* *oblet ells and

%elanoytes#

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The ornea onsists o$ si distint layers: epitheli!%. epithelialbasal la%ina. 5o/%ans layer +an aell!lar str!t!re %ade !po$ olla*en &bers-. stro%a. 6ese%ets %e%brane +a tr!e basal la%ina prod!ed by the

!nderlyin* orneal endothelial ells-. and a sin*le layer o$ very 7at

ells traditionally )no/n as 8endotheli!%#8

The slera is %ainly o%posed o$ a dense olla*eno!s stro%aad%ied /ith oasional elasti &bers and sattered&broblasts#

The intrao!lar tiss!es o%prise the !veal trat +iris. iliarybody. and horoid-. the retina. the rystalline lens. and thevario!s intrao!lar

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1# ornea

2# Iris

3# P!pil

0# Lensa

4# ()lera

9# oroid

;# N opti)!s

<# Retina

=# orp!s siliaris

1>#Pi*%en epiteli!%

1

2

30

4

9

;

<=

1>

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;PALP?5RA

1# elen"ar )erin*at

2# !lit per%!)aan

3# Gland o$ ,eis

0# Gland o$ Moll4# M!ara )elen"ar Moll

9# elen"ar %eibo%

;# M!ara )elen"ar %eibo%

<# on"!n*tiva=# Gland o$ @or&n*

1>#Otot

1

2

3

04

9

;

<

=

1>

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MAT?RI

1# ?LAINAN ONG?NITAL G?N?TI:1# TRI(OMI 13

2# TRI(OMI 12

3# I(TA 6?RMOI6

0# GLABOMA

4# CITR?O(A PRIMARIA P?R(I(T?N(9# 6I(PLA(IA R?TINA

;# ATARA ONG?NITAL

2# ?LAINAN P?R?M5ANGAN:

1# (IN6ROMA RB5?LA ONG?NITAL2# DI5ROPLA(IA R?TROL?NTAL

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3. PERADANGAN:1. PENYEBAB

2. JENIS-JENIS1. TRAKOMA

2. KONJUNGTIVITIS

3. KERATOKONJONGTIVITIS

4. KERATITIS5. UVEITIS

6. DLL

4. KELAINAN DEGENERATIF1. PINGUIKULUM

2. PTERIGIUM

3. ARKUS SENILIS4. KATARAK

5. RETINITIS PIGMENTOSA

6. PTISIS BULBI

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4#6?DI(I?N(I1# E?RODTALMIA

9#GALBOMA1# G ONG?NITAL

2# G PRIM?R3# G (?BN6?R

;#R?TINOPLA(TI FIP?RT?N(ID

<#R?TINOPLATI 6IA5?TI

=#A5LA(IO R?TINA1>#PAPIL?6?MA

11#P?NONOLAN 5OLA MATA

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12#N?OPLA(MA1# INA

1# PAPILLOMA

2# N?CB( PIGM?NTO(B(

3# 6LL

2# PRAGANA(1# N?OPLA(MA INTRA?PIT?LIALH ATINI ?RATO(I(H (OLAR ?RATO(I(

2# N?CB( BTIONAL

3# M?LANO(I( AJBI(ITA PRIM?R

3# GANA(1# R?TINO5LA(TOMA

2# M?LANOMA MALIGNA

3# 6LL

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?LAINAN ONG?NITAL G?N?TI:

TRI(OMI 13

TRI(OMI 21

I(TA 6?RMOI6 GLABOMA

CITR?O(A PRIMARIA P?R(I(T?N( 6I(PLA(IA R?TINA

ATARA ONG?NITAL

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TRI(OMI 13(inoni%: Triso%i 6 ata! (indro% Pata!. AR?NA )e*a*alan pe%isahan

)ro%oso% no 13 saat %eiosislini): Mata bersat! +synophtal%!s ylopedia- olobo%a+de$e) pada iris-. palin* serin*:

Pe%b!l!h darah e%brioni) di vitre!s

Adanya t!lan* ra/an +94K- 6ysplasia retina +;4K- Iris dan )ornea tida) terbent!) +9>K- Mata bersat! +"aran*-

o%pli)asi te)anan bola %ata %enin*)at +*la!)o%a )on*enital-

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TRI(OMI 21

(inoni%:

6o/n syndro%aMon*olis%

Lebih rin*an dari triso%i13

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lini):Mata ber"a!han +hyperteloris%-Pada )elopa) %ata terdapat &s!raH elah

palpebra yan* %irin* ata! %elen*)!n*?pi)ant!s bilateral +lipatan )on)a$ pada s!d!t%ata sebelah dala% dari )elopa) %ata-?)tropion +)elopa) %ata ba*ian ba/ah

%enon"ol )el!ar-?versi palpebra s!perior +)elopa) %ata atasterbali). )on"!n*tiva palpebra berada di l!ar-

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lini):Iris yan* berbera)bera) +bera)

5r!sh&eld-atara)

erato)on!s +)ornea bent!) )er!!t-

?sotropiaH "!lin*Miop tin**i.6is)!s opti).Atrop& epitelpi*%en retina

5le$aro)on"!n*tivitis %enah!n

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I(TA 6?RMOI6

Pada s!d!tH pin**ir )elopa) %ata ba*ian atas5ent!) b!lat. lon"on*. l!na). tida) nyeri te)andan !)!rannya 1 %

Mi)ros)opi) +der%olipo%aH )orisoto%a- Massa t!%or bent!) )ista dibatasi oleh epider%is 6er%is terdiri atas adne)sa )!lit L!%ennya berisi %assa )eratin ata! seb!%H

le%a)H s)ret )elen"ar )erin*at

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PALP?5RA

I(TA 6?RMOI6

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1=

6?RMOI6+6?RMOLIPOMA-

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2>6?RMOLIPOMA

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?LAINAN

P?R?M5ANGAN1#(IN6ROMA RB5?LAONG?NITAL

2#DI5ROPLA(IA R?TROL?NTAL

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(IN6ROMA RB5?LA ONG?NITAL

(inoni%: sindro% Gre** atara). *la!)o%a )on*enital. retardasi

%ental dan )et!lian A)ibat in$e)si R!bela saat ha%il

Optal%os)op

?pitel retina berpi*%en %en!n"!))an*a%baran atro& +*a%baran *ara%- danhipertro& +*a%baran lada-

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DI5ROPLA(IA

R?TROL?NTAL(inoni%: retinopati pre%at!ritas

A)ibat )elainan iatro*eni) dari bayipre%at!r yan* %endapat o)si*enden*an )onsentrasi tin**i. sehin**ape%b!l!h darah retina %en*ala%iobliterasi

Penyebab )eb!taan pada de)ade 0>4>an di B(A

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STADIUM PERMULAAN : FASE

VASO-OBLITERATIF

KEMUDIAN: FASE PROLIFERATIF

KALAU OKSIGEN DIHENTIKAN

LALU FASE SIKATRISASI

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RA6ANG

AG?NP?NY?5A5

Cir!s 5a)teri

Ri)ettsia

a%!r

Parasit

Iritasi )i%iaRadiasi

Fipersensitivitas Tra!%a

dll

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5?5?RAPA I(TILAF

on"!n*tivitis +radan* di )on"!n*tiva-eratitis +)ornea-Iritis +iris-

(i)litis +)orp!s siliaris-

Pan!veitisH !veitis +sel!r!h tra)t!r !vea-()leritis +s)lera-oroiditis +)oroid-

Retinitis +retina-

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Tra)ho%a

orioretinitis +retina dan )oroid-5le$aritis +)elopa) %ata-

6a)riosistitis +)anton* air %ata-

6a)rioadenitis +)elen"ar air %ata-

dll

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TRAFOMA

Penyebab: hla%idia tra)ho%atis6i daerah tropis: penyebab !ta%a)eb!taan

Br!tan epitel yan* ter)ena:

1# Dorni)s anterior

2#

on"!n*tiva b!lbi dan3# )ornea

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Mi)ros)opi) +0 stadi!%-.(tadi!% Maallan Tra)o%a (tadi!% IEpitel konjungtiva: ipe!pla"ia #e!at

Sitopla"$a $engan%ung #en%a ele$ente! %an#en%a ini"al &ang #e"a! '#en%a(#en%aHal#e!t"tae%le!(P!o)a*eki+

,a!ingan %i #a)a epitel konjungtiva %anko!nea "e$#a# %an %i"e#uk li$-o"it %an "elpla"$a

Te!ja%i pannu"

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Tr!"#Jisim Halbertstaedler-Prowazeki

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Tr!"#

Pannus

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S$%&'# II M()**+

Ra%ang pa%at te!uta$a %i konjungtiva #agian ata"

%i"e!tai pe$#entukan -olikel li$-oi%

.olikel li$poi% ti%ak %apat %i#e%akan %g &ang%i"e#a#kan kea%aan lain $i" ale!gi

Pannu" ko!nea $enja%i te#al

Mak!o-ag #e"a! $engan%ung %e#!i" "el %i "u#"tantia

p!op!ia konjungtiva 'Leberzellen+

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S$%&'# III M()**+

.olikel %i tepi ko!nea $engilang/

%iganti epitel &ang t!an"pa!an %an

te#al 'He!#e!t0" pit"+

Te!#entuk pa!ut %ekat #ata" ata"

ta!"u" 'ga!i" von A!lt+Te!ja%i ent!opion %an t!ikia"i"

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S$%&'# IV M()**+

Pen&akit ilang "pontan

Ent!opion %an t!ikia"i" $en&e#a#kan

ke!u"akan ko!nea/ ilangn&a epitel ko!nea

Aki#at t"# %i ata" $ata $u%a kena

in-ek"i %an ja!ingan pa!ut %i ko!nea#e!ta$#a 1 $ata #i"a #uta

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Tr!"#Entropion

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3;

ORN?A BLB(

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ALA,ION

Radan* %enah!n dari)elen"ar %eibo% +)alaiondala%- ata!

Radan* dari )elen"ar

sebase!s ,eis +)alasions!per&sial-

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3=

ALA,ION

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0>

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01

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?LAINAN 6?G?RATID

1#PINGB?BLBM

2#PT?RYGIBM

3#ARB( (?NILI(

0#ATARA

4#R?TINITI( PIGM?NTO(A9#PTI(I( 5BL5I

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Pin*!e!l!%

(erin* ter"adiMer!pa)an ton"olan )!nin* didala%)on"!n*tiva de)at li%b!s )ornea

Pada !sia perten*ahan dan lan"!t

Lesi tida) pro*resi$. den*an e)sisi

sa"a "aran* )a%b!h

Mi)ros)opi):

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Mi)ros)opi):elainan pada "arin*an i)at pada la%inapropia +diba/ah lapisan epitel per%!)aan-

di!bah "adi "arin*an elastin +elastosis-?pitel per%!)aan "adi hiper)eratosis. atro&. a)antosis dan tipis# 6an )adan*)adan*%en"adi dis)eratosis +%irip )e*anasan-

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P&+,'!'*'#Makroskopik

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0;

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Ptery*i!%

Mer!pa)an penebalan berbent!) se*iti*adi )orneaepalaH p!na) %en*arah )e te%poral. a)an%el!as hin**a )e )ornea dan dapat

%en!t!pi sel!r!h )ornea dan dapat%enyebab)an b!ta Lebih a*resi$ dibandin* pin*!e)!l!%

Lo)asi terserin* pada li%b!s +&ss!ra

interpalpebra daerah nasal-

Mi)ros)opi): +)elainan sa%a den*an

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Mi)ros)opi): +)elainan sa%a den*anpin*!i)!l!% di )on"!n*tiva-(tro%aH la%ina propia dari )ornea

%en!n"!))an adanya do%inan serab!telastin +a)tini) elastosis- den*an disertaiseb!)an sel radan* %endada) dan%enah!n sertape%b!l!h )on*esti$

(erab!t elastin dan sel radan* dapat%ene%b!s epitelH %e%bran 5o/%an dari)ornea

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DIGBR?: Ptery*i!% that has *ro/n overp!pillary ais and has inter$ered /ith vision#

?M5IOTO(I( ANT?RIORH

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?M5IOTO(I( ANT?RIORHG?RONTOTO(IN

Mer!pa)an inin in&ltrat le%a) di pin**ir )ornea

A/alnya di ba*ian in$erior. )e%!dian %enyebar)e s!perior lal! %elin*)ari )ornea den*an bent!)inin

Pada !sia perten*an hin**a lan"!t. padapenderita hiperlipide%ia

F!b )lini): resi)o penya)it "ant!n* )oroner.ter!ta%a !sia diba/ah 4> th

ATARA

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ATARA e)er!han lensa. apap!n penyebabnya

?tiolo*iH penyebab:1# on*enital

2# Gala)tose%ia

3# Fiperparatiroid

0# Radiasi pada %ata

4# Tra!%a9# Into)si)asi obat +dinitro$enol. steroid "an*)a pan"an*.

na$talen dll-

;# 6iabetes

<#

Pen!aanH )atara) senilis +palin* serin*-

ATARA (?NILI(

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ATARA (?NILI(Pato&siolo*i: Ti%b!l elah diantara serab!t lensa dan bahanlensa yan* %en*ala%i de*enerasi +bendaMor*a*ni- ber)!%p!l di dala% elah +)atara)int!%esen-

(etelah sel!r!h lensa %en*ala%i de*enerasi.

ti%b!l )atara) %at!rCol!%e lensa a)an ter!s %en*eil. )arena debrislensa %e%as!)i a'!eo!s h!%or. terbent!) )atara)hiper%at!r

ATARA (?NILI(

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ATARA (?NILI(

Pato&siolo*i:

Lensa yan* dipadat)an diten*ahbiasanya %en*eras se"alan den*an!sia +)atara) s)lerosis n!)lear- dan

dapat %en"adi o)lat ata! hita%5a*ian )orte)H peri$er lensa %en"adil!na) +)atara) Mor*a*ni-

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K$r! +&*&

Kata!ak #!une"en: #agian tenga len"a le#i

pa%at %an 2oklat

Kata!ak ko!tikal: keke!uan "epe!ti !o%a pe%atiKata!ak intu$e"en: len"a #engkak

Kata!ak Mo!gagni: ko!tek" len"a $en2ai!/ inti

"kle!otik tenggela$ %ala$ ko!tek"

Kata!ak ipe!$atu!: len"a $en2iut

K $ ! ! $&! *

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K$r! !"r$&!*Mikroskopik

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4;

ATARA

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R?TINITI( PIGM?NTO(Aelainan de*enerati$ pada ba*ian retina peri$er

yan* dit!r!n)an seara: A!toso%al resesi$ A!toso%al do%inan (e lin)ed resesi$

elainan biasanya ter"adi pada !sia %!da dan%enyebab)an b!ta saat t!a

Mi)ros)opi) Lapisan retina. ter!ta ba*ian peri$er tida) dite%!)an

lapisan batan*. )er!!t serta sel *an*lion

PTI(I( 5BL5I

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4=

PTI(I( 5BL5I

(tadi!% a)hir dari penya)it

de*enerati$. yan* %enyebab)anbola %ata %en*eil

Penyebab bola %ata %en*eiladalah:airan %ata ber)!ran*

Te)anan bola %ata t!r!nH hipotoni

PTI(I( 5BL5I

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9>

PTI(I( 5BL5IA)ibatnya adalah:

Mata l!na) seperti spon ata! )eras sepertibat! +per)ap!ran-

arin*an par!t. e)s!dat di )a%ar depan danbela)an*. sehin**a %en"adi )atara) lan"!t

Citre!s han!r dan retina lepas se%!aBvea se%bab dan terbent!) e)s!datserosa yan* a)an %e%isah)an s)lera ata!

s)lera "adi )is!t

E?RODTALMIA

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E?RODTALMIA6e&nisi: )elainan str!)t!r %ata. )erena

de&siensi Cit A enis )elainan:

1# on"!n*tiva b!lbi yan* )erin* dan )er!h

2# Atro& )elen"ar air %ata. sehin**a se)rersi air%ata ber)!ran*

3# 5era) 5itot +bera) yan* %enon"ol padali%b!s )ornea-

0# Eerosis )ornea. dan

4# erato%alasia +)ornea "adi l!na)-

B ! B&$ $

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Br(! B&$"$Makroskopik

6asar )elainan: %etaplasi epitel

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p p)on"!n*tiva %en"adi epitel *epen*berlapis tand!)

ala! )eadaan %asih reversibel dan)and!n*an vit A !)!p. sel basal%asih %a%p! !nt!) %en*!bah "adi

epitel nor%al la*ierato%alasia dapat se%b!h. tetapiter"adi &brosis l!as sehin**a dapat

%en*an**! pen*lihatanH b!ta

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Nytalopia +b!ta sen"aH tida) dapat%elihat "i)a ahaya )!ran*

Fe%atropia H adaptasi la%a darite%pat yan* teran* )e te%pat yan*

)!ran* teran*H *elap# arena )!ran*rodopsin pada batan*H iodopsin pada)er!!t %ata

GLABOMA

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GLABOMA

Nor%al te)anan bola %ata +1>2> %%F*-

Gla!)o%a: penin**ihan te)anan bola %ata

Aliran airan intrao)!lar airan %ataH a'!sos h!%or dibent!) oleh

proses!s siliaris. seba*ian den*a ara di$!siplas%a dari pe%b!l!h siliaris. seba*ian%elal!i se)resi a)ti$ epitel proses!s siliaris#

arian tsb %en*alir %elal!i p!pil ata! "ala

trabe)!lar +antara iris dan )ornea- )e )a%ardepan %ata sal!ran hle%% )e vena s)leradan inters)lera

5ila ada aliran terha%bat. %a)a ter"adi

*la!)o%a

1# ornea0

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ALIRAN AIRAN NORMAL

2# Iris

3# Lensa

0# Area )a%ardepan

4# Trabe)!lar%esh/or)

9# anal dari(hler%%

1 2

3

4

9

G* !

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G*'!"#Patogenesis

Gla!)o%a diba*i 3 *olon*an

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Gla!)o%a diba*i 3 *olon*anGla!)o%a s!d!t tert!t!p

Gla!)o%a s!d!t terb!)aGla!)o%a )on*enital

(!d!t: s!d!t yan* dibent!) oleh

)orp!s siliarisH iris den*an lapisan)ornea s)lera di )a%ar depan

Gla!)o%a )on*enital

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9=

Gla!)o%a )on*enital

3 : 4555(35555 #a&i i%up

6ia"an&a %itu!unkan "e2a!a auto"o$alHa$#atan $ungkin te!letak:

Dekat jala t!a#ekula (trabecularmeshwor!

Di %ala$ jala t!a#ekula

Di %ekat pe$#ulu e-e!en"Ga#ungan

Gla!)o%a )on*enital

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Gla!)o%a )on*enital

6e!u#ungan %engan:

Ru#ella

Sin%!o$ Ma!-an

T!i"o$i 37Mik!oko!nea

8it!eu" p!i$a!ia &pe!pla"ti2a

pe!"i"ten"Retino#la"to$a

Gla!)o%a s!d!t tert!t!p

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1#Gla!)o%a pri%erA)ibat s!%batan aliran airan %ata %en*eil dan lensa%e%besarH *la!)o%a a)!t

5iasanya pada oran* t!alini)Nyeri %ata hebatM!ntahPen*lihatan ber)!ran*6is)!s nerv!s opti)!s ben*)a) dan )eb!taan ter"adi dala%beberapa hari

G*'!"# '%'$

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G*'!"# '%'$$r$'$'/

Glauko$a p!i$e!: "u%ut $ata $enge2il 19 ali!an2ai!an $ata te!a$#at

Hi"tologik:

At!o-i "eg$ental %a!i i!i"

Pupil &ang ti%ak te!atu! 'nek!o"i" otot "-ingte! %an %ilato!+

Neova"kula!i"a"i i!i"

"ataract subca#sular$s %$ssem$nata

E%e$a %i"ku" optik

2# Gla!)o%a se)!nder +a)ibat dari

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obstr!)si sal!ran-

1# Ter"adi a)ibat perle)atanantara irisdan )ornea +syne)ia anterior- yan*disebab)an perle)atan iris

2#Pada )as!s r!beosa irides. terbent!)

selap!t neovas)!lar dan disertaiden*an syne)ia anaterior peri$er

G*'!"# '%'$

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$r$'$'/

Glauko$a "ekun%e!: ka!enape!lekatan i!i" %an ko!nea #agian

#elakang '"inekia ante!io! pe!i-e!+

I!iti"

Neova"kula!i"a"i i!i" '!u#eo"i" i!i%e"+

Pe$#ekakan len"a

G*'!"# '%'$

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$r0'!

Glauko$a p!i$e! '2!oni2 "i$ple t&pe+: ka!enape!u#aan %egene!ati- pa%a jala t!a#ekule! %an ja!ingan ikat "ekita! "alu!an S2le$$

Pe$#entukan 2ai!an $ata no!$al/pengelua!ann&a #e!ku!ang

Se#agian #e"a! %itu!unkan "e2a!a auto"o$al!e"e"i-

Hi"tologik: e%e$a N Optik

G*'!"# '%'$

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$r0'!

Glauko$a "ekun%e!: aki#atte!"u$#atn&a "alu!an S2le$$ ole:

Sel %a!a $e!a 'pe!%a!aan $a"i- %ika$a! %epan

Leuko"it 'uveiti"+

Sel tu$o! '$elano$a $alignu$+

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GLABOMA (B6BT T?R5BA PRIM?R

Ter"adi )erena per!bahan de*enerati$ pada iris

+trabe)!lar dan "arin*ani)at se)itar sal!ran

(hle%%-

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GLABOMA (B6BT T?R5BA (?BN6?R

arena

s!%batansal!ran(hle%%.

a)ibat selseldarahdan sel t!%or

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GLABOMA (B6BT T?RTBTBP PRIM?R

A)ibat s!%batan

aliran airan %ata%en*eil danlensa %e%besarH*la!)o%a a)!t

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GLABOMA (B6BT T?RTBTBP (?BN6?R

Ter"adi a)ibatperle)atanantara

iris dan )ornea +syne)iaanterior- yan*disebab)an perle)ataniris

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PAPIL?6?MA

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PAPIL?6?MA6e&nisi: pe%ben*)aan dari )epala N opti)!s

)arena penin*)atan te)anan intra)ranialPenyebab:1# Penin*)atan relati$H absol!t dari te)anan vena

pada la%ina )ribosa dibela)an*nya +*la!)o%aa)!t. t!%or orbitaH ota) dll-

2# Penin*)atan relati$H absol!t dari te)anan venapada la%ina )ribosa didepannya +l!)a t!s!).bedah intrao)!lar dll-

3# Deno%ena lo)al +ane%ia de$ besi. papilitis dll-

Mi)ros)opi)A)

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A)!t:(tro%a ede%a. pe%b!l!h darah )on*esti$#

Perdarahan pada N opti)!s ata! serab!t sara$retinaA)ibatnya vol!%e "arin*an berta%bah dan$!n*si &siolo*isnya rendah

roni):6e*enerasi sara$. *liosis. atro& N opti)!s padaede%a dis)!s opti)

P?NONOLAN 5OLA MATA

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(inoni%:?)so$tal%!sProptosis o)!lar

Da)tor yan* berpen*ar!h:5esarnya )elainanLo)asi )elainan dala% orbita?$e) pada otot e)trao)!lar

Penyebab

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e yebabPenya)it tiroidH Grave disease)elopa) %ata t!r!n )e ba/ah

)elopa) %ata ba*ian atas %en*ala%i retra)si

otot %ata %ele%ah

6iplopia

ede%a periorbitaproptosis berat

Fe%an*io%aPse!dot!%or

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?EOPTFALMB(

onditions

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T!%or epitelial:Papillo%aarsino%a insit!arsino%a invasi$

T!%or berpi*%en:Nev!sMelano%a %ali*naLainlain

Retinoblasto%a

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NEOPLASMA

P!agana":Neopla"ia int!a(epitelial

Nevu" pig$ento"u" jung"ionalMelano"i" akui"ita p!i$e!:

Kalau ti%ak a%a atipia 3;< $enja%i gana"

Kalau a%a atipia 45< $enja%i gana"

T!%ors o$ s!r$ae

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T!%ors o$ s!r$aeepitheli!%

PAPILLOMA Papillo%as are relatively o%%on lesions o$ the on"!ntiva

/ith a tendeny $or re!rrene a$ter apparent o%pleteeision#

In hildren the papillo%as are o$ten %!ltiple# The lesions have a typial papillo%ato!s or 8%!lberry8 s!r$ae

appearane /ith s%all vessels o%in* !p to the s!r$ae

Mirosopially the typial papillo%a reveals prono!nedaanthosis and varyin* de*rees o$ )eratiniation. )oiloytosis.and nonspei& in7a%%ation

F!%an papillo%avir!s type 9H11 has been $o!nd in theselesions by in sit! hybridiation tehni'!es#

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?tensive papillo%a o$ b!lbaron"!ntiva

arino%a in sit!

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arino%a in sit! o$ the b!lbar on"!ntiva variesonsiderably in its linial appearane# It %ay present as an area o$ le!)opla)ia. as a

papillo%a. or as a o%pliation o$ ptery*i!% or pin*!e!la

These are re$erred to as dysplasia o$ the

on"!ntivaQ the s!**estion has been %ade o$plain* these lesions /ithin a spetr!% o$on"!ntival +or orneal- intraepithelial neoplasia#

The dysplasti lesions have been $o!nd to

ontain FPC type 19

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The histopatholo*i harateristis o$arino%a in sit! o$ the on"!ntiva and

ornea are si%ilar to those observedelse/here in the %!o!s %e%branes

or the lesion %ay %i%i 5o/ens

disease o$ the s)in#

arino%a

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Invasive s'!a%o!s ell arino%a o$ the

on"!ntiva is rare b!t is still %ore o%%onthan basal ell arino%a at this site#

linially. arino%as o$ the on"!ntiva/ith si*ni&ant in&ltration are seldo%observed in the Bnited (tates. probablybea!se it is a o%%on pratie to eiseearly preanero!s8 or 8in sit! anero!s8lesions lon* be$ore this sta*e o!rs#

(!h lesions. as /ell as the %a"ority o$ early

invasive arino%as o$ the li%bal area. anbe ade'!ately ontrolled by eisional

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be ade'!ately ontrolled by eisionaltherapy# I$ !ntreated. these t!%ors /illinvade the anterior ha%ber and otherportions o$ the o!lar *lobe#

A hi*h proportion o$ the deeply invasiveon"!ntival arino%as have

adenos'!a%o!s+8%!oepider%oid8-$eat!res#

Radial s!r*ery is neessary in these ases#

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('!a%o!s ell arino%a o$ on"!ntiva#

T!%or *re/ rapidly over 0%onth period#

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Mirosopiallyon"!ntival nevi are al%ost al/ays o$ the "!ntional or

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o%po!nd variety#

o!nterparts o$ the o%%on der%al nev!s o$ the s)in are

rarely observed# A $e/ o$ the on"!ntival nevi are o$ theepithelioid or spindleell type#

Dre'!ently. there are n!%ero!s solid and ysti inl!sionso$ on"!ntival epitheli!% inti%ately inorporated into thes!bepithelial o%ponent o$ these nevi#

At ti%es the epithelial inl!sions %ay so do%inate thelinial and histopatholo*i pit!re that the nevoid nat!reo$ the lesion is overloo)ed

The presene o$ the epithelial inl!sions is s!pportiveevidene $or beni*nity. sine they are rare in %elano%as#

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Pi*%ented lesion at li%b!sthat proved to be beni*n

M?LANOMA MALIGNA

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Pada oran* )!lit p!tih dan "aran* pada

)!lit hita%6ibent!) dari:Pra *anas +"!ntional nev!s-

Melanosis a'!isita pri%erMelanoyti proli$erative lesion o$ the on"!ntiva

that has also been re$erred to as pri%ary a'!ired%elanosis. preanero!s %elanosis. atypial

%elanoyti hyperplasia. and %ali*nant %elano%ain sit!#

6e novo +den*an sendirinya-

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Melano%a intra o)!larter"adi pada

Tra)t!s !vea +<4K-horoid +1>K-

orp!s siliaris +4K-

lasi&)asi allender:1# enis )!%paran type A

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1# 5ent!) sel seperti )!%paranH ra%pin*

2# 5ent!) inti %e%an"an*H spindel

3# Ana) inti tida) ada0# Pro*nosis bai) +1> year s!rvival rate <4K-

2# enis )!%paran type 5

1# 5ent!) sel b!lat dan oval

2# 5ent!) inti lon"on*

3# Ana) inti ada

0# Pro*nosis bai) +1> year s!rvival rate <>K-

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3#enis epiteloid1#5ent!) sel b!lat. !)!ran besar

2# Inti b!lat dan bervariasiH pleo%or&)

3#Mitosis banya)

0#Pro*nosis b!r!)+1> year s!rvivalrate S 24K-

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Mali*nant %elano%a o$ on"!ntiva in lo/er !ldesa arisin* $ro% lesion o$ a'!ired %elanosis#

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1>0

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1>4

MM J+&K T& A

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1>9

K'#/r+T&/ AMikroskopik

MM J+& E/&$*"&%

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1>;

J /Mikroskopik

R?TINO5LA(TOMA

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R?TINO5LA(TOMA

Me!upakan tu$o! gana" int!aokula!/ a"aln&a %a!i !etina

Se!ing pa%a anak(anak

6i"a #ilate!al '=5(74 <+.!ekuen"i: 3:34555(7>555 '"ela$a=5 t te!aki! ti%ak #e!u#a+

Laki(laki ? pe!e$puan

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1>=

R?TINO5LA(TOMA

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ara pen!r!nan:(o%ati)H tida) dit!r!n)anH

sporadi) +;>K-6it!r!n)an. seara a!toso%aldo%inan +3>K-

R?TINO5LA(TOMA

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Fipotesa n!dsen +t/o hitH d!a )e"adian-

1# 6it!r!n)an: M!tasi perta%a di dala% sel *er%inal

+pray*oti-

(ehin**a hanya perl! sat! %!tasi sa"a

!nt!) %en"adi t!%or2# Tida) dit!r!n)anH so%ati): M!tasi di l!ar sel *er%inal +posty*oti-

Bnt!) %en"adi t!%or. perl! 2 )ali %!tasi

pada sel so%ati) yan* sa%aH )ed!a hithar!s ter"adi pada sel so%ati) yan* sa%a

R?TINO5LA(TOMA

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R?TINO5LA(TOMA

Ma)ros)opi)Ada 4 bent!)

?ndo&ti)

?)so&ti)

a%p!ran

In&ltrasi di$!s danRe*resi spontan-

Mi)ros)opi) Massa t!%or den*an pola pert!%b!han di$!s.

di i d b ) )h l

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disertai ada bent!)an )has roset Dlener@interste%er +bent!) )elen"ar di%ana sel epitel

)ol!%nar tin**i %en*elilin*i %e%bran basal- danpse!doroset +selsel t!%or yan* %en*elilin*ipe%b!l!h darah ata! area ne)rosis-

(elsel t!%or ber!)!ran )eil. bent!) b!lat den*ansitoplas%a sedi)it# ro%atin inti hiper)ro%ati)

(elsel t!%or *anas )has %e%bent!) roset ata!pse!doroset

Pro*nosis dari penderita ter*ant!n* pada

i$ i i l

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6i$erensiasi sel

!%lah roset

!%lah 7e!ret +sel t!%or yan* ber!saha%e%bent!) )er!!t dan l!%en-

Invasi +s)lera. N opti)!s dll-

Adanya r!beosis iridis

B)!ran t!%or

Lo)asinya dari dis)!s N opti)!s

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R?TINO5LA(TOMA

R"$ F*+r&+$r$&+rMikroskopik

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&+$r$&+rMikroskopik

F*'r$Mikroskopik

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11;

Mikroskopik

R"$ "#r r&,$Mik k ik

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11<

Mikroskopik

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11=

R?TINO5LA(TOMA INCA(IN II

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03mata New

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