Ulkus Kornea Ec Bakteri by Ayie

7/24/2019 Ulkus Kornea Ec Bakteri by Ayie

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ULKUS KORNEA ECBAKTERI

RATNA MEGA SARY

NIM. 1408465676

Pembimbing

Dr. Amirudin, S.M

BAGIAN ILMU PENYAKIT MATA

FAKULTAS KEDOKTERAN UNIVERSITAS RIAU

RSUD ARIFIN ACHMAD PEKANBARU

2015

Laporan Kasus



P!ru" !#ib!" u$%er!%i #&rne! #ebu"!!nd!n g!nggu!n eng$i'!"!n di duni!

D!!" di(eg!' di!gn&%i% dini

Tr!um!, bend! !%ing, en)!#i" m!"! )gmen)eb!b#!n m!%u#n)! b!#"eri* +!mur er!d!ng!n

Pendahuluan



Anatomi kornea



Kornea terdiri dari 5 lapis



$#u% #&rne! !d!$!' 'i$!ngn)! %eb!gi!nermu#!!n #&rne! !#ib!" #em!"i!n +!ring!n#&rne!, )!ng di "!nd!i deng!n !d!n)!in-$"r!" %uur!"i di%er"!i dee# #&rne!berg!ung d!n di%#&n"inui"!% +!ring!n#&rne! )!ng d!!" "er+!di d!ri ei"e$ %!m!i%"r&m!

!e"enisi



In%iden%i 1// diind&ne%i! 5,*100.000endudu# dg redi%&%i%i "r!um!, $en%!#&n"!#, "id!# di #e"!'ui

Sing!ur! ,5 "!'un d!ri 11 #!%u% u$#u%#&rne! bere"i&$&gi +!mur 2eu%"!#!!n SA $!#i3$!#i $ebi' b!n)!#

menderi"! eremu!n

Epidemiolo#i



A!%#u$er er"!'!n!n !#"u er!d!ng!n"id!# %eger! d!"!ng b!d!n #&rne!,endering (e$$ d!n %e$3%e$ $!in d!$!m%"r&m! m!gr&!g di$!"!%i em. d!r!'$imbu% %eb!g!i in+e#%i eri#&rne! in-$"r!%i %e$3%e$ m&n&nu#$e!r, %e$ $!%m!,$eu#&%i", PMN "imbu$n)! in-$"r!" ber(!#ber!rn! #e$!bu

Pato$siolo#i



Ine#%i b!#"eri, +!mur, iru%,!(!n"'!m&eb!

N&n ine#%i b!'!n #imi!, r!di!%i !"!u %u'u,

%indr&m %+&rgen, de-%ien%i i"!min A, &b!"3&b!"!n Si%"em imun

Etiolo#i



$#u% #&rne! %en"r!$ $#u% #&rne! b!#"eri!$i% $#u% #&rne! ungi $#u% #&rne! iru% $#u% #&rne! !(!n"'!m&eb!

$#u% #&rne! erier $#u% m!rgin!$ $#u% m&&ren u$#u% %eringin&%! #r&ni#*u$#u%

r&den $#u% (in(in ring u$(er

Klasi$kasi



%ani"estasi klinis&e'ala Su('ekti" •Eri"em! !d! #e$&!# m!"!d!n #&n+ung"i!•Se#re" mu#&uru$en•Mer!%! !d! bend! !%ing dim!"!•

P!nd!ng!n #!bur•M!"! ber!ir•9in"i# u"i' !d! #&rne!,%e%u!i $&#!%i u$#u%•Si$!u•N)eri•

In-$"!" )!ng %"eri$ d!!"menimbu$#!n %edi#i" n)eri, +i#! u$#u% "erd!!" !d!erier #&rne! d!n "id!#di%er"!i deng!n r&be#!n$!i%!n ei"e$ #&rne!.

&e'ala O('ekti" •In+e#%i %i$i!r•:i$!ngn)! %eb!gi!n +!ring!n#&rne!, d!n !d!n)! in-$"r!"•:i&i&n



An!mne%i% Pemeri#%!!n -%i# Pemeri#%!!n #$ini% %$i" $!m

!ia#nosis



emeri#%!!n di!gn&%"i# %eer"i 2e"!+!m!n eng$i'!"!n Te% rer!#%i

Te% !ir m!"! Pemeri#%!!n slit-lamp 2er!"&me"ri engu#ur!n #&rne! Re%&n re;e# ui$ Pe!rn!!n #&rne! deng!n <!" fuoresensi.



Su$!% !"r&in S#&&$!min %eb!g!i midri!"i#! An!$ge"i#

An"bi&"i# An"i +!mur An"i ir!$

Penatalaksanaan



2!u"eri%!%i Penger&#!n ei"e$ )!ng %!#i" #er!"&$!%"i

%en#hindari pen'alaran



=indungi m!"! d!ri %eg!$! bend! )!ngmung#in bi%! m!%u# #ed!$!m m!"!

>i#! m!"! %ering #ering, !"!u !d! #e!d!!n#e$&!# m!"! "id!# bi%! menu"u%emurn!, gun!#!n "e"e% m!"! !g!r m!"!%e$!$u d!$!m #e!d!!n b!%!'

>i#! mem!#!i $en%! #&n"!# '!ru% %!ng!"

dier'!"i#!n (!r! mem!#!i d!n mer!!"$en%! "er%ebu".

Pen)e#ahan



◦ 2ebu"!!n !r%i!$ !"!u #&m$i" d!$!m !#"u%!ng!" %ing#!"

◦ 2&rne! er&r!%i d!!" ber$!n+u" men+!diend&"!$mi"i% d!n !n&"'!$mi"i%

◦ Pr&$!% iri%◦ Si#!"ri# #&rne!

◦ 2!"!r!#

◦ G$!u#&m! %e#under

Komplikasi



I!ENTITAS PASIEN N!m! Tn A Pendidi#!n SD mur 47 "!'un Ag!m! I%$!m >eni% #e$!min =!#i3$!#i S"!"u% Meni#!' A$!m!" Du"! !$m! %eberid! IN: MRS 13103015 Pe#er+!!n Pe"!ni MR /04117

Laporan Kasus



Ri*a+at pen+akit sekaran# Se+!# 1 minggu SMRS, !%ien "eren"!$ bi+i %!i" di m!"!

%ebe$!' #iri, d!n !%ien menge$u'#!n !nd!ng!nn)! "er!%!#!bur, d!n n)eri !d! m!"! )!ng 'i$!ng "imbu$ d!ndir!%!#!n men+!$!r %!m!i #e #e!$!. Dem!m "id!# !d!.

Se+!# 4 '!ri SMRS !%ien memb!! ber&b!" #e #$ini# medi#!d!n di beri "e"e% m!"! %er"! %!$! m!"! n!mun !%ien "id!#"!'u n!m! &b!"n)!. 2e$u'!n "id!# ber#ur!ng, m!"! "er!%!!n!% d!n mengg!n+!$, !%ien %ering mengu(e#3ngu(e#

m!"! #!ren! mer!%! g!"!$ d!n m!"! mu$!i ber!ir d!n mer!'. Se+!# '!ri SMRS !%ien mer!%! #e$u'!n "id!# ber#ur!ng

deng!n &b!" )!ng di d!!" di #$ini# medi#! "er%ebu" d!n!%ien membe$i &b!" "e"e% m!"! %endiri di !&"i# n!munn!m! &b!"n)! +ug! "id!# "!'u.

Keluhan utama M!"! #iri "er"en"!$ bi+i %!i" d!n "erd!!" ber(!#u"i' !d! m!"! #iri, !nd!ng!n "er!%! #!bur %e+!#1 minggu SMRS



Ri*a+at pen+akit dahulu :ier"en%i 3 Di!be"e% me$i"u% 3 Ri!)!" %!#i" +!n"ung 3

Ri*a+at pen#o(atan 1 minggu )!ng $!$u ber&b!" #e #$ini# medi#! diberi

&b!" "e"e% m!"! d!n %!$! m!"! n!mun !%ei!n

"id!# "!'u n!m! &b!"n)!. '!ri SMRS !%ien membe$i &b!" %endiri di !&"i#

n!mun !%ie +ug! "id!# "!'u n!m! &b!"n)!.



Ri*a+at Pen+akit Keluar#a :ier"en%i 3 Di!be"e% me$i"u% 3

Ri!)!" %!#i" +!n"ung 3 2eg!n!%!n 3



Pemeriksaan $sik 2e!d!!n mum T!m!# %!#i" %ed!ng 2e%!d!r!n 2&m&%men"i%

?i"!$ Sign TD 10*80 mm:g, ND 88@*i, T 7,B Pemeri#%!!n eri!uri(u$er Tid!# !d!

embe%!r!n 2G9



O! OS

6*603

?i%u% "!n! #&re#%i?i%u% deng!n #&re#%i

*603

Cr"&&ri! P&%i%i b&$! m!"! Cr"&&ri!

9!i# #e%eg!$! !r!' Ger!#!n b&$! m!"! 9!i# #e%eg!$! !r!'

N&rm!$ !$!%i Te#!n!n b&$! m!"! Mening#!" !$!%i

Tid!# !d! #e$!in!n P!$ebr! S!%me

Ten!ng 2&n+ung"i! In+e#%i #&n+ung"i! In+e#%i %i$ier

>erni' 2&rne! $#u% ber!rn! u"i' #eru',#&"&r. 'i&i&n

Ten!ng S#$er! In+e#%i %i$ier

N&rm!$ BCA :i&i&n 1,5 mi$i

9u$!", regu$er, %en"r!$Re;e#% (!'!)! $!ng%ung

, re;e#% (!'!)! "id!#$!ng%ung , iri% !rn!

Iri%* ui$ Iri% !rn! (&#$!"Pui$ %u$i" dini$!i

Status opthalmolo#i



,ernih Lensa Sulit dinilai

Medi! +erni', re;e#%undu% ,

P!i$ bu$!" b!"!%"eg!% ! Re"in! "id!# !d!

#e$!in!nM!#u$! re;e#%(emer$!ng

Fundu% Tid!# di$!#u#!n

G!mb!r



S 9er(!# u"i' !d! m!"! #iri d!n !nd!ng!n #!bur%e+!# 1 minggu SMRS. M!"! "er!%! n)eri d!n men+!$!r%!m!i #e #e!$! be$!#!ng. Ter!%! g!"!$, !n!%,ber!ir d!n !d! )!ng mengg!n+!$ di m!"! #irin)!.2e$u'!n ini dir!%!#!n %e"e$!' "eren"!$ bi+i %!i".

C D!ri emeri#%!!n &"'!$m&$&gi m!"! #iri did!!"#!n

?i%u% *60

P!$ebr! %!%me

S#$er! in+e#%i %i$ier , in+e#%i #&n+ung"i! 2&rne! u$#u% !rn! u"i' #eru', #&"&r. 'i&i&n

Resume



!ia#nosis ker'a $#u% #&rne! CS e( b!#"eri

!ia#nosis (andin# $#u% #&rne! CS e( +!mur $#u% #&rne! CS e( iru%



An'uran Pemeriksaan Pe!rn!!n gr!m Pemeri#%!!n 2C: 2u$"ur d!n u+i %en%i"ii"!%

Terapi Gi;&@ ED g"" 1 CS T&br&% ED g"" 1 CS

A%!m meen!m!" 500 mg "!b @1 G$!u(&n "!b @1 A%!r 2 "!b 1@1



Pro#nosis u& !d i"!m b&n!m u& !d un("i&n!m dubi! !d m!$!m

u& !d #&%me"#um dubi! !d m!$!m



TERIMA 2ASI:

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Ulkus Kornea Ec Bakteri by Ayie

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