Ni Made Ayu Surasmiati
Bagian Ilmu Kesehatan Mata Fakultas Kedokteran, Universitas Udayana, Bali, Indonesia

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Journal : Ophthalmologica Indonesiana

Strabismus Surgery for Traumatic Ocular Misalignment: Twelve Cases in Five Years: Poster Presentation - Case Series - Ophthalmologist NI MADE AYU SURASMIATI; NI LUH MADE NOVI RATNASARI; KEVIN ANGGAKUSUMA HENDRAWAN; I WAYAN EKA SUTYAWAN
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/pdg34475

Abstract

Introduction : Trauma can cause an ocular misalignment due to damage of extraocular muscles, nerves and orbital tissue around the eye. Direct trauma causing extraocular muscle rupture needs immediate surgery, meanwhile indirect trauma resulting in traumatic sixth nerve palsy or other reversible ocular misalignment without orbital floor fracture can be observed for six months. This study describe the characteristic of patients undergo single-step strabismus surgery for traumatic ocular misalignment, mechanism of injury, eye alignment, amount of ocular deviation before and after strabismus surgery. Case Illustration : This was a case series based on medical record of patients underwent strabismus surgery secondary to head or eye injury from 2017 until 2022. Discussion : Twelve individuals with post-traumatic strabismus correction participated in this study. All subjects were male age ranging from 18-51 years. Direct trauma was observed in 6 (50%) patients causing medial rectus muscle rupture in 4 patients and inferior rectus muscle rupture in 2 patients. Indirect trauma was observed in 6 (50%) patients caused by sixth nerve palsy on 4 patients The misalignment was exotropia, esotropia, and hypertropia with amount of 5, 4, and 3 respectively. The deviation was between 30-90 prism dioptre (PD) and 7 (58%) patients had deviation less than 65 PD. Strabismus surgery performed was muscle transposition with or without recession of the antagonist muscle. Conclusion : Single step surgery for traumatic ocular misalignment can provide good result in cases of deviation less than 65 PD
DIAGNOSING OCULAR MALINGERING IN CHILDREN WITH SIMPLE TEST: IS IT POSSIBLE? Poster Presentation - Case Report - Resident KEVIN ANGGAKUSUMA HENDRAWAN; NI MADE AYU SURASMIATI; I WAYAN EKA SUTYAWAN; ANAK AGUNG DEWI ADNYA SWARI; MADE KUSUMA WARDANI
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/c3exwd43

Abstract

Introduction : Malingering is a condition in children which need a thorough and meticulous examination to diagnose the condition. According to several publication, simple test can be done to diagnose this condition without necessarily performing imaging and electrophysiologic tests. Case Illustration : An 8-year-old male patient, came to eye clinic with sudden visual loss on both eyes for the last 3 days, following pain on both eyes and headache which fluctuating over the last 3 weeks. Patient insisted on wearing black glasses during examinations. Preliminary examination revealed visual acuity no light perception on both eyes. Slit lamp examination and pupillary reflex were normal, fundus examination revealed normal fundus. We tried to do surprise test by suddenly swaying hand towards patient’s eyes and record a visual response. Afterwards we asked patient’s parent to wait outside while performing LEA test which revealed visual acuity 6/6 on both eyes. Further history taking revealed that patient got bullied on school that makes him try to avoid attending school. Discussion : Patient with malingering usually come with decreased vision but seldomly come with blindness. Though it was quite challenging, doing some simple test available in daily practice such as surprise test can help us to diagnose the suspicion. Handling such patient needs a cautious analysis towards patient’s condition and gentle approach towards the patient. It is crucial to rule out organic condition before diagnosing patient with malingering. Conclusion : Simple test such as surprise test can be done in assisting malingering diagnosis when carefully done with the support of thorough history taking and physical
Different Retinopathy of Prematurity Severity, Onset Therapy and Outcomes in Triplet Babies: A Case Report: Poster Presentation - Case Report - Resident PUTU ANINDYA AGRASIDI; I WAYAN EKA SUTYAWAN; NI MADE AYU SURASMIATI
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: 10.35749/1de12078

Abstract

Introduction : Retinopathy of prematurity (ROP) is a vasoproliferative disease of the premature infants, characterized by abnormal vascularization at the junction of vascular and avascular retina. Intravitreal anti-VEGF injection is one of promising management of ROP. The aim is to present the therapy outcomes of triplet babies with different severity and onset therapy. Case Illustration : This case shows ROP in triplets born at 25-26 weeks gestational age. First baby, weighed 630 g with Bilateral Stage 2 Zone II Posterior with Plus Disease treated with intravitreal ranibizumab injection at 11 weeks (PMA 36-37 weeks). Second baby, weighed 620 g and get bilateral intravitreal ranibizumab injection a week after first baby, left eye got worse on first week, but getting better on the last follow up. Third Baby, weighed 750 g with bilateral Stage 3 Zone I with Plus Disease (worst eye condition), but because he had worst general condition, so the latest got screening, got no intervention. Two babies were treated with anti-VEGF therapy – bevacizumab. All babies has outcome regression, no recurrence of ROP in those short term end point, and no adverse reactions were observed until the last follow up at 27 weeks old (PMA 52-53 weeks) recorded for all babies. Discussion : Conclusion : Primary prevention through well-managed screening programme for premature infants was the more effective way to manage the ROP. Intravitreal anti-VEGF treatment could be promising for management of ROP if it was given on the right time and early stadium.
Prosthetic Contact Lens Combined with Strabismus Surgery : Confronting Psychosocial Prejudice in Anomalous and Misaligned Eyes: Poster Presentation - Case Report - Resident PRISCILLA DWIANGGITA; Ariesanti Tri Handayani; Ni Made Ayu Surasmiati
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/j2hr6d77

Abstract

Introduction : Patients with defects in the cornea such as abnormal size, opacities as well as misalignment of the eyes may feel inferior about their physical appearance. Such patients will benefit from prosthetic contact lenses (CL) and strabismus surgery to restore anatomical appearance. The majority of patients also seek strabismus surgery for both cosmetic and psychosocial reasons along with decreased levels of anxiety and depression. Our goal not merely cosmetic, but also improving psychosocial health and quality of life. Case Illustration : We reported a 14-year-old male with complaints of white spot on his left eye and squint since birth. On ophthalmology examination, we found 45 degree esotropia with BCVA 6/6 in the right eye and 1/300 in the left eye. Corneal diameter was 10 mm and 9 mm on the right and left eye, respectively. He was diagnosed with right eye posterior embryotoxon, left eye corneal dystrophy, microcornea on both eye, congenital esotropia and deprivative amblyopia. He had developed low self-esteem due to his eyes. To enhance his appearance, left eye lateral rectus resection and medial rectus recession with adjustable suture was done to align the eye. Afterwards, brown-tinted soft contact lens with power -0.50 D, diameter 14,2 mm, and base curve 8,5 mm was given to disguise the corneal opacities and microcornea. Patient felt very satisfied with the result. Discussion : Conclusion : Prosthetic contact lens combined with strabismus surgery provides satisfactory cosmetic and psychosocial benefit with minimal complications. As clinicians, functional, cosmetic and psychosocial indications must be considered for a comprehensive management.