Download - Keratitis Nita

7/25/2019 Keratitis Nita

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KERATITISKERATITISNITA JULIANA ANGGRAINI1320221123


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ISIISI

Anatomi Kornea


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KeratitisKeratitis


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PatofisiologiPatofisiologi


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KlasifikasiKlasifikasi


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Keratitis superfisial

Keratitis marginal

Keratitis interstitial


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Keratitis BakteriKeratitis Bakteri

etiologi


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Manifestasi KlinisManifestasi Klinis

mata merah,erair,n!eri pa"a mata !ang terinfe#si,penglihatan silau,

a"an!a se#retpenglihatan men$a"i #aur%

&a"a pemeri#saan ola mata e#sternalhiperemis peri#ornea,lefarospasme,e"ema #ornea,infiltrasi #ornea


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KERATITIS BAKTERIALKERATITIS BAKTERIAL


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TERAPITERAPI

&engoatan "imulai "engan gentam!'in (1)mg*ml+atau toram!'in (1)mg*ml+ e!e"rops "engan"itamah 'ephaoline (-0mg*ml+, setiap setengah$am atau satu $am selama eerapa hari "an

"i#urangi men$a"i setiap 2 $am% .ila memai#, oat"apat "iganti "engan antiioti# !ang leih lemahseperti / iprofloa'in (0%3+ e!e "rops, or

4floa'in (0%3+ e!e "rops, or

Gatifloa'in (0%3+ e!e "rops%

Antiioti# sistemi# iasan!a ti"a# "ieri#an, tetapi"apat "ieri#an 'iprofloa'in oral (25-0 mg+


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TerapiTerapi


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. Keratitis Fungi (Jamur. Keratitis Fungi (Jamur

etiologi


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Manifestasi klinisManifestasi klinis

Ri6a!at trauma terutama tumuhan,pema#aian steroi" topi#al lama Lesi satelit

Tepi ul#us se"i#it menon$ol "an #ering, tepi!ang ireguler "an ton$olan seperti hifa "ia6ah en"otel utuh &la# en"otel 7!pop!on, #a"ang8#a"ang re#uren 9ormasi 'in'in se#eliling ul#us Lesi #ornea !ang in"olen


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a.a. 9ungal #eratitis, !. fungal 'orneal ul'er, ".".9ungal 'orneal ul'er, 6ith e'essi:e :as'ulariation%

Keratitis fungi


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TerapiTerapi

4at8oat anti $amur !ang "apat"ieri#an meliputi/ Natamycin (-+ e!e "rops

Fluconazol (0%2+ e!e "rops Nystatin (3%-+ e!e ointment ("ieri#an ; < = minggu+

Aoles (imi"aoles "an triaoles+ termasu#

#eto'onaole, >i'onaole, flu#onaol,itra'onaole, e'onaole, "an 'lotrimaolesistemi# "apat "ieri#an 2 < 3 minggu


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Keratitis #irusKeratitis #irus

?tiologi

7erpes @imple#s irus (7@+ merupa#an

salah satu infe#si :irus tersering pa"a#ornea


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PatofisiologiPatofisiologi


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Manifestasi KlinisManifestasi Klinis

n!eri,fotofoia,penglihatan #aur,mata erair,mata merah,ta$am penglihatan turun terutama $i#a

agian pusat !ang ter#ena


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Lesi pa"a 7@ "iagi men$a"i 2, !aitu/

$A% Primary herpes

1% @#in lesions

2% on$un'ti:a8a'ute folli'ular 'on$un'ti:itis

3% orneai% 9ine epithelial pun'tate #eratitis

ii% oarse epithelial pun'tate #eratitis

iii% Ben"riti' ul'er

$B% Recurrent herpes

1%Active epithelial keratitis

i% &un'tate epthelial #eratitis

ii% Ben"riti' ul'er

iii% Geographi'al ul'er

2% Stromal keratitis

3% Trophic keratitis (meta-herpetic)

)% Herpetic iridocyclitis


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Lesions of re'urrent herpes simple #eratitis/Lesions of re'urrent herpes simple #eratitis/

A, &un'tate epithelial #eratitisC . an" , Ben"riti' ul'erCA, &un'tate epithelial #eratitisC . an" , Ben"riti' ul'erC

Biagramati's "epi'tion an" lini'al photographBiagramati's "epi'tion an" lini'al photograph

B, Geographi'al ul'er an" ?C an" Bis'iform #eratitis%B, Geographi'al ul'er an" ?C an" Bis'iform #eratitis%

a. b.

c.

d. e.


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&erpes 'oster ftalmika&erpes 'oster ftalmika

>anifestasi #linis/&a"a herpes oster oftalmi#us, leih seringmengenai saraf frontal "ian"ing#an saraf la#rimal"an nasosiliar%-0 "ari #asus herpes oster oftalmi#us men"apat#ompli#asi o#ular%The 7ut'hinsonDs rule, ter"apat #eterliatan o#ularila agian tip (pun'a#+ hi"ung ter"apat :esi#el,

tetapi ti"a# selalu ter$a"i%Lesi han!a ter"apat pa"a satu agian "ari #epalatergantung pa"a $aras !ang ter#ena%


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T!pes of oster #eratitis / A, &un'tate epithelialT!pes of oster #eratitis / A, &un'tate epithelial

#eratitisC ., >i'ro"en"riti' epithelial ul'erC , Nummular#eratitisC ., >i'ro"en"riti' epithelial ul'erC , Nummular

#eratitisC B, Bis'iform #eratitis%#eratitisC B, Bis'iform #eratitis%


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Keratitis #irus &erpesSimplek

&erpes 'osterp)talmi"us


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TTerapierapi

Beri"ementTerapi 4at

@teroi" topi#al "ieri#an ) #ali sehari IBU (I"ouri"ine+ analog pirimi"in (ter"apat "alam larutan

1 "an "ieri#an setiap $am, salep 0,- "ieri#an setiap) $am+

Asi#lo:ir (salep 3+, "ieri#an setiap ) $am selama 2minggu%

Asi#lo:ir oral "apat ermanfaat untu# herpes mata erat,#hususn!a pa"a orang atopi !ang rentan terha"ap pen!a#itherpes mata "an #ulit agresif%

Terapi .e"ah Keratoplasti penetrans mung#in "iin"i#asi#an untu#

rehailitasi penglihatan pasien !ang mempun!ai parut#ornea !ang erat


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Keratitis AlergiKeratitis Alergi

?tiologi

Rea#si hipersensiti:itas tipe I !ang

mengenai #e"ua mata,iasan!a pen"erita sering menun$u##an

ge$ala alergi terha"ap tepung sari rumput8rumputan


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Manifestasi KlinisManifestasi Klinis.entu# palpera/ 'ole stone (pertumuhanpapil !ang esar+, "iliputi se#ret mu#oi"%.entu# limus/ tantras "ot (penon$olaner6arna au8au, seperti lilin+Gatal9otofoia@ensasi en"a asing>ata erair "an lefarospasme


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TerapiTerapi

.iasan!a semuh sen"iri tanpa "ioati @teroi" topi#al "an sistemi# Kompres "ingin

4at :aso#onstri#tor romol!n so"ium topi#al Koagulasi 'r!o 42% &eme"ahan #e'il (e#sisi+%

Antihistamin umumn!a ti"a# efe#tif Kontrain"i#asi untu# pemasangan lensa#onta#


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Keratokon*ungti+itis FliktenKeratokon*ungti+itis Flikten

>erupa#an ra"ang #ornea "an #on$ungti:aa#iat rea#si imun pa"a alergen en"ogen!ang tersensitisasi

?tiologi /rea#si hipersensiti:itas tipe I(respon lamat+ pa"a protein mi#roialen"ogen% Alergen #ausatif/ protein tuer#ulosis, protein

stafilo#o#us, "an alergen lainn!a 9a#tor pre"isposisi / usia 3 < 1- tahun, 6anitaE pria, malnutrisi, higinitas, "an musim panas


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Phylctenular conjunctivitisFascicular corneal ulcer has

a prominent parallel leash

of blood vessels


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KeratKeratokon*ungti+itis fliktenokon*ungti+itis flikten


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Keratokun*ungti+itis #ernalKeratokun*ungti+itis #ernal

>erupa#an pen!a#it re#uren, "enganpera"angan tarsus "an #on$ungti:ailateral%

.iasan!a men!erang ana#8ana# usia )