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Kelainan Mata Pada Penyakit Kusta Riani Erna
JURNAL KEDOKTERAN DAN KESEHATAN Vol 1, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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Kelainan mata pada kusta dapat menyebabkan perubahan pada kelopak mata akibat gangguan saraf dan otot kelopak mata, kelenjar lakrimalis, kelainan pada kornea dan kerusakan pada iris.Penyakit kusta ditularkan secara langsung dari penderita kusta aktif pada orang lain melalui saluran pernapasan dan kulit. Penyebaran kuman kusta ke mata umumnya terjadi secara hematogen, ascenden dari hidung atau perluasan secara langsung dari kulit muka dan dahi atau penularan melalui kulit dan saluran pernapasan.Di Indonesia jumlah kebutaan akibat lepra sekitar 350.000-400.000 dari seluruh kasus. Komplikasi pada mata terjadi pada Â± 50-90% pasien lepra.Secara klinis diagnosis kelainan kusta pada mata dapat ditegakkan berdasarkan anamnesis seperti adanya riwayat kontak dengan penderita kusta, pemeriksaan oftalmologi dan pemeriksaan penunjang yang sesuai dengan gejala klinis.Tindakan pencegahan lebih baik dibandingkan perawatan pasien buta akibat lepra sehingga penting dilakukan skrining mata untuk deteksi dini pada seluruh penderita kusta. Untuk mengenal lebih jauh kelainan mata pada kusta dan masih adanya sindroma fobia terhadap penderita kusta, maka penulis merasa perlu menjelaskan gejala klinis, etiopatogenesis, cara menegakkan diagnosis serta penatalaksanaanya.

Treatment of Congenital Myogenic Ptosis with Frontalis Suspension Surgery Shaelva Lassa Sabatini; Riani Erna
JURNAL KEDOKTERAN DAN KESEHATAN Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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Ptosis repair is a challenging oculoplastic surgical procedure that requires correct diagnosis, thoughtful planning, thorough understanding of eyelid anatomy, experience, and good surgical technique. Ptosis can causefunctional problem and cosmetic issue.Thisstudywasreport 2 cases of congenital myogenic ptosis which were treated with frontalis suspension surgery.Case report,a 11-year old and a 20-year old girl came to our clinic with chief complain drooping in the upper eyelid RE since their childhood. Patients also complained difficulty of reading. The degree of ptosis during the day was the same. No diplopia, dysphonia, dyspnea, and dysphagia. VA 20/20 in the both eyes. Ocular motility were normal. MRD1 0 mm, FP 5 mm, no upper eyelid crease, LF 4 mm, no lagophthalmos, eyelid lag present, upper eyelid RE higher than LE in down gaze, and Bells phenomenon normal. Light reflex of pupil positive and diameter 3 mm in standard room illumination. Schimer test and TBUT were within normal. We diagnosed these patients with congenital myogenic ptosis RE and performed frontalis suspension surgery with autogenous tensor fascia lata.Postoperative, for first patient we got MRD1 2 mm and FP 7 mm. For second patient we got MRD14 mm and FP 9 mm. Patients had no complain drooping in the upper eyelid RE and difficulty of reading anymore.Frontalis suspension surgery is a way to treat patient with congenital myogenic ptosis who have poor levator function.

UJI DIAGNOSTIK DERAJAT KEPARAHAN PROPTOSIS MENGGUNAKAN EKSOFTALMOMETER HERTEL DIBANDINGKAN DENGAN CT SCAN ORBITA Mohammad Fiqih; Riani Erna; Safyudin Safyudin
Majalah Kedokteran Sriwijaya Vol 50, No 4 (2018): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v50i4.8569

Proptosis merupakan suatu kondisi penonjolan bola mata ke depan yang merupakan manifestasi umum dari berbagai penyakit orbita. Pemeriksaan yang rutin dilakukan untuk mendiagnosis proptosis berupa eksoftalmometri dan juga CT Scan Orbita. Penelitian ini bertujuan untuk mengetahui nilai diagnostik eksoftalmometer Hertel terhadap CT Scan orbita (gold standard) dalam menilai derajat keparahan proptosis di Poliklinik Mata RSUP dr. Mohammad Hoesin Palembang.Penelitian ini menggunakan desain uji diagnostik dan menggunakan data sekunder berupa rekam medis pasien di Poliklinik Mata RSUP dr. Mohammad Hoesin Palembang dalam periode 1 November 2016 – 31 Oktober 2018. Didapatkan besar sampel total sebesar 81 orang pasien proptosis. Dari 81 orang pasien proptosis, terdapat 66 proptosis unilateral dan 15 proptosis bilateral sehingga jumlah pemeriksaan mata proptosis yang dilakukan adalah 96. Data dianalisis menggunakan teknik uji diagnostik dan kemudian disajikan dalam bentuk tabel 2x2.Terdapat 81 kasus proptosis, 44,4% berusia 40-49 tahun dan 64,2% adalah perempuan. Etiologi proptosis terbanyak adalah neoplasma (44,4%) diikuti oleh endokrin (19,8%). Tipe proptosis terbanyak adalah unilateral yaitu sebesar 81,5%. Eksoftalmometer Hertel dalam menilai proptosis derajat ringan dan derajat sedang memiliki sensitivitas yang cukup tinggi yaitu 86,8% dan 81,3% dan spesifisitas yang tinggi yaitu 91,4% dan 90,6%. Eksoftalmometer Hertel dalam menilai proptosis derajat berat memiliki sensitivitas dan spesifisitas yang tinggi yaitu 95,6% dan 94,5%.Eksoftalmometer Hertel mumpuniuntuk digunakan sebagai alat skrining dan diagnostik dalam menentukan derajat keparahan proptosis di wilayah kerja puskesmas.

CENTELLA ASIATICA EXTRACT EFFECT ON POSTOPERATIVE WOUND HEALING Elza Iskandar; Theodorus Theodorus; Anang Tribowo; Riani Erna; Fatimah Syakirah
International Journal of Islamic and Complementary Medicine Vol. 2 No. 2 (2021): International Journal Islamic Medicine
Publisher : International Islamic Medicine Forum

Wound healing is a complex process that is divided into four phases, namely the hemostasis, inflammation, proliferation, and tissue remodeling phase. Centella asiatica is a widely used and very popular traditional plant in the field of health for a long time. Various in vitro and in vivo studies have proven the efficacy of Centella asiatica extract in the wound healing process. This literature review uses literature search methods from Pubmed, Science Direct, and Cochrane Library with keywords Centella asiatica, wound healing, surgery. This study aims to study the effects of Centella asiatica extract on postoperative wound healing.

WHAT WE SHOULD DO FOR CROUZON SYNDROME ? Poster Presentation - Case Report - Resident RYAN AQUARI; Linda Trisna; Riani Erna
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/ts8b2590

Introduction : Crouzon syndrome is a rare genetically disease characterized by craniosynostosis resulting in skull and facial deformities. Fortunately, not all patient requires surgery so we will review the workup of Crouzon syndrome and describes the collaboration of health professionals needed to manage this condition. Case Illustration : A 10 years old boy came to hospital with exophthalmos since birth. There is decreasing of visual acuity on RE caused by atrophy papil and leads to sensoric exotropia. There is also lagophthalmos 1 mm on the both eyes. Brain CT shown there are craniosynostosis and thickening of the rectus muscles. This patient also do a bone Survey with the result are asymmetrical calvarial thickening, cooper beaten skull, shallow orbits, depressed nasal bridge and hypoplasia maxilla. This case is managed by multidisciplinary to correct the maldevelopment of the midface and orbits to prevent blindness, airways obstruction and intellectual disability related. Discussion : The combination of detailed family history, the use of various imaging modalities and genetic testing help differentiate the spectrum of craniosynostosis syndromes. The management is complex and requires a team of subspecialists including pediatricians, oral maxillofacial surgeons, plastic surgeons, neurosurgeons, otorhinolaryngology, and ophthalmologists (pediatric and oculoplastics). Long-term follow up needed to monitor ocular development due to the propensity strabismic amblyopia and atrophy optic. Conclusion : An interprofessional team approach will provide the best outcomes and recognizing possible complications for crouzon syndrome.

Levator Resection in Neurogenic Ptosis Oculi Sinistra et causa Third Nerve Paresis + Type II Diabetes: A Case Report: Poster Presentation - Case Report - Resident Retno Tharra Handayani; Riani Erna
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/hjr14v60

Introduction : Neurogenic ptosis is abnormal position of the upper eyelid caused by dysfunction or damage to the oculomotor or sympathetic nerves supplying the eyelids. Third nerve palsy (35.7%) is the most common cause among others. We report a case of neurogenic ptosis managed surgically by levator resection. Case Illustration : A 67-year-old male complained of drooping left upper eyelid, getting worse in 7 months. He had history of falling off motorcycle 6 months ago. Clinical histories of hypertension and diabetes mellitus were found. Right and left eyelids measurements in millimeter showed horizontal palpebral fissure (HPF) 28/26, vertical palpebral fissure (VPF) 6/3, margin reflex distance 1 (MRD1) 2/-2, margin reflex distance 2 (MRD2) 6/5, margin limbal distance (MLD) 8/4, and levator function (LF) 8/3. Bell’s phenomenon was negative in both eyes. Ice pack test was negative. There were ocular movement restriction in his left eye. Patient underwent a maximum levator resection and had better levator function after 3 weeks follow up. Discussion : Neurogenic ptosis caused by third nerve injury is associated with microvascular ischemia such as diabetes mellitus and hypertension. Operative management is carried out after 3 to 6 months observation. Evaluation of levator function allows the clinician to correctly classify the degree and type of ptosis. Maximal levator resection is the treatment of choice for ptosis with poor levator function. Conclusion : Although various surgical techniques have been developed, ptosis correction should be performed according to the indications and clinical condition of the patient.

PENETRATING EYELID INJURY DUE TO FISHING HOOK : AN UNUSUAL CASE: Poster Presentation - Case Report - Resident BIMA RYANDRA PUTRA; RIANI ERNA
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/vt9ps910

Introduction : Ocular penetrating injury due to fishing hook is rarely reported. Identifying organ structures involved and determining appropriate approach will affect the outcome. This special case explained penetrating eyelid injury due to fishing hook without ocular involvement. Case Illustration : R, boy, 12y.o, came to M.Hoesin ED in January 2023 with complaint of left eye was exposed to fishing hook one hour before admission. Patient was experiencing mild pain with pain scale of three, no blurry vision, excessive tears nor blood. History of immunization was uncomplete.There was no significant visual disturbance. On left superior palpebra, there was a fishing hook penetrated into the medial superior palpebra (partial thickness) without any marginal involvement, no active bleeding, and corneal abrasion in central-paracentral nasal 6-9 o’clock direction. Patient was diagnosed with penetrating eyelid injury due to fishing hook. Intraoperatively back-out technique were performed to extract the fishing hook. Patient was prescribed with 250IU Tetagam injection, chloramphenicol eye ointment, and oral analgetic. Discussion : Ocular penetrating fishing hook injury could cause severe complications. In this patient, it only penetrates the eyelid until the dermis layer without marginal involvement. Complications occurred were only corneal erosion with minimal pain. After the operative procedure, topical antibiotic and analgetic were administered. There was no decreased levator palpebra function and corneal erosion was resolved in three days after topical antibiotics were administered. Conclusion : Management of ocular penetrating fishing hook injury is challenging. Determining the best technique to extract the fishing hook depends on the depth and type of fishing hook.

PENETRATING EYELID INJURY DUE TO FISHING HOOK : AN UNUSUAL: Poster Presentation - Case Report - Resident BIMA RYANDRA PUTRA; RIANI ERNA
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/gkqzbc24

Introduction : Ocular penetrating injury due to fishing hook is rarely reported. Identifying organ structures involved and determining appropriate approach will affect the outcome. This special case explained penetrating eyelid injury due to fishing hook without ocular involvement. Case Illustration : R, boy, 12y.o, came to M.Hoesin ED in January 2023 with complaint of left eye was exposed to fishing hook one hour before admission. Patient was experiencing mild pain with pain scale of three, no blurry vision, excessive tears nor blood. History of immunization was uncomplete.There was no significant visual disturbance. On left superior palpebra, there was a fishing hook penetrated into the medial superior palpebra (partial thickness) without any marginal involvement, no active bleeding, and corneal abrasion in central-paracentral nasal 6-9 o’clock direction. Patient was diagnosed with penetrating eyelid injury due to fishing hook. Intraoperatively back-out technique were performed to extract the fishing hook. Patient was prescribed with 250IU Tetagam injection, chloramphenicol eye ointment, and oral analgetic. Discussion : Ocular penetrating fishing hook injury could cause severe complications. In this patient, it only penetrates the eyelid until the dermis layer without marginal involvement. Complications occurred were only corneal erosion with minimal pain. After the operative procedure, topical antibiotic and analgetic were administered. There was no decreased levator palpebra function and corneal erosion was resolved in three days after topical antibiotics were administered. Conclusion : Management of ocular penetrating fishing hook injury is challenging. Determining the best technique to extract the fishing hook depends on the depth and type of fishing hook.

THE EFFECT OF ALOE VERA TOPICAL GEL EXTRACTION ON TGF-β1 EXPRESSION IN THERMAL BURN PALPEBRA GRADE II RATS MODEL: Oral Presentation - Experimental Research - Ophthalmologist RIANI ERNA
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/efrsj280

Abstract Introduction & Objectives : Grade II palpebral burns are burns that reach the epidermis and part of the dermis of palpebrae and can have impaired wound healing. TGF β1 has the broadest spectrum of action, affecting all cell types involved in all stages of wound healing. Decreased expression of TGF β1 is associated with impaired wound healing. Aloe Vera has long been known in Indonesia as a healing plant. Aloe Vera extract contains a variety of bioactive compounds that play a role in stimulating wound healing. The administration of Aloe Vera extract on thermal burns aims to reduce inflammation, increase collagen content, and increase the rate of re-epithelization. The administration of Aloe Vera gel extract allows faster healing of thermal burns and rebuilds the vascularity of the wound tissue. Methods : Objective: To determine the expression of Transforming Growth Factor Beta 1 (TGF β1) in a rat model of thermal burn injury grade II of the eyelids treated with topical Aloe Vera gel extract with the concentrations of 20%, 40%, Balanced Salt Sodium (BSS) and a control group that was not given burn intervention. Results : Methodology: an experimental study with the post-test-only approach with a control group design. 24 Rats have induced grade II eyelid thermal burns, divided into four groups: Normal (without treatment), negative control (BSS), given Aloe vera 20%, 40%. Then TGF β1expression was quantified Conclusion : The highest rise in TGF β1expression was found in the group with 40% Aloe vera gel, followed by 20% Aloe vera gel compared to the negative control (BSS Balanced Salt)

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