203422282 Referat Glaukoma Akut

8/10/2019 203422282 Referat Glaukoma Akut

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DAFTAR ISI

HALAMANJUDUL...........................................................................................

..... iHALAMANPENGESAHAN.................................................................................... ii

KATAPENGANTAR............................................................................................. iii

DAFTARISI.......................................................................................................... v

BAB I.

PENDAHULUAN...................................................................................1

BAB II.

EPIDEMIOLOGI....................................................................................3

BAB III.

ETIOLOGI.............................................................................................6

BAB IV.

PATOFISIOLOGI....................................................................................7

BAB V. MANIFESTASI DAN GEJALAKLINIS.......................................................9

BAB VI.

PEMERIKSAAN...................................................................................17

BAB VII.

i


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DIAGNOSIS.........................................................................................15

BAB VIII.DIAGNOSIS

BANDING........................................................................22

BAB I.

PEN!EGAHAN....................................................................................23

BAB .

PENATALAKSANAAN......................................................................

....26BAB I.

PROGNOSIS........................................................................................37

BAB II.

RINGKASAN........................................................................................3"

DAFTARPUSTAKA..............................................................................................39

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BAB I

PENDAHULUAN

P#$# $#%#&'(#) *+',+-i#/#' 0#'%i# +&,#'/', $#&i #'#/0i

-# 0#/#) i%/-,i 4#&i',#' 0#/#) $#' %i-,i $#&i *&%+% *+',+-i#/#'

i/ %+'$i&i. K+-#i'#' $#&i #'#/0i -# 0#/# 0#'%i#) '/'(# %#4#

#'/#-0i) /+'/ #8#' 0+'(+#8#' 8+/##' (#', *+&0#'+') %+#

%+# #'#/0i%) -# 0#/# (#', $i,'#8#' '/8 0+-i#/) /i$#8

/+&+'/8. A/#*' 8+-#i'#' *#$# 4#&i',#' -# 0#/#) '/'(# 8+/i/i%

$+',#' i'-// (#', /+&-+/#8 /+*#/ $i 4#-& *+',+-i#/#') /+'/'(# #8#'

0+',,#',, *+0+'/8#' #(#',#' (#', #i8 '/8 $i/#',8#* &+/i'#

$#' $i*&%+% -+ /#8 0#'%i#. K+-#i'#' $#&i ',%i -# 0#/#)

'/'(# *#$# ,-#80# $i0#'# /+&4#$i *+'+8#'#' *#$# %# */i8

%+i',,# %/i0-% (#', %+#&%'(# $#*#/ $i%#0*#i8#' '/8 $i*&%+% $i

/#8 0+'4#$i /+&,#',, #8#' %#0*#i 0+'(+#8#' 8+/##'.1)2

P#$# 8+%+0*#/#' i'i) *+'-i% #8#' 0+0##% 0+',+'#i,-#80#) %#-# %#/ 8+-#i'#' 0#/# (#', $i0#'# /+&$#*#/ 8+-#i'#' *#$#

8+/i,# #8/& /#0# (#', /+-# $i%+/8#' $i#/#%. G-#80# %+'$i&i

+%#- $#&i 8#/# ('#'i glaukos (#', +&/i i4# 8+i') (#',

/+&8+%#' *#$# *+0+&i8%##' **i- $#&i *+'$+&i/# ,-#80#.1)2 G-#80#

0+&*#8#' 8+-#i'#' $i0#'# /+&4#$i'(# *+'i',8#/#' /+8#'#' i'/ 8-+&

(#', 0+'(+#8#' /+&4#$i'(# *+'&'#' 8+0#0*#' *+',+-i#/#' $#&i

*+'$+&i/# ,-#80#. N#0' ,-#80# /i$#8 %+-#- 0+0/8#' /+8#'#'i'/ 8-+& (#', -+i /i',,i $#&i '&0#-'(# '/8 $#*#/ 0+'i0-8#'

,#',,#' *+',+-i#/#') '/'(# %#4# *#$# *+'$+&i/# -:;/+'%i'

,-#80#) $i0#'# /+8#'#' i'/ 8-+& /i$#8 0+'#*#i #/#% (#', *#//

$i&i,#i ,-#80# '#0' /+&4#$i *&%+% *+'&'#' 8+0#0*#' 0+-i#/

*#%i+' %+*+&/i *#$# ,-#80# (#', 8-#%i8.

G-#80# %+'$i&i $#*#/ $i8-#%i8#%i8#' 0+'4#$i $# +&$#%#&8#'

*&%+% *+#-#'#' *+'(#8i/'(#) (#8'i ,-#80# %$/ /+&8# $#'

1


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,-#80# %$/ /+&//*. K+$#'(# 0+0i-i8i /#'$# $#' ,+4#-# (#',

+&+$#) '#0' $#%#& /+*i ,-#80# *#$# 8+$#'(# /+/#* %#0#) (#i/

0+'&'8#' /+8#'#' i'/ 8-+& $#&i -# 0#/#. T+8#'#' -# 0#/#

$i*+',#&i -+ $# #-) (#8'i *&$8%i $#&i #


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BAB II

EPIDEMIOLOGI

II. 1. EPIDEMIOLOGI

DI i'$'+%i# ,-#80# 8', $i8+'#- -+ 0#%(##/) *#$##-

#',8# 8+/##' (#', /+&4#$i 8#&+'# ,-#80# /+&0#%8 /i',,i. U00'(#

*#$# 8+-#i'#' ,-#80# 8&'i8 #/# ,-#80# %$/ /+&8#) *+'&'#'

8+0#0*#' 0+-i#/ $#&i *#%i+' /&' %+# *+&-##') %+i',,# %+&i',

8#-i *#%i+' /i$#8 0+'(#$#&i'(# %#0*#i 8+&%#8#' %# (#', /+&4#$i %$#

%#',#/ -#'4/. N#0' ,-#80# #8/ #/# ,-#80# %$/ /+&//* %+&i',

8#-i 4,# /+&-+:#/8#' 8#&+'# 8','(# 8+0#0*#' *+/,#% 8+%+#/#'

$#-#0 0+',+'#-i /#'$# $#' ,+4#-# $#&i ,-#80# #8/. S+-#i' i/)

&+'$#'(# /i',8#/ *+'$i$i8#' 0#%(##/ i'$'+%i# 0+'(+#8#' *#%i+'

0+'4#$i -+i *#%i $#-#0 0+'#&i #'/#' 0+$i%) %+i',,# %+#,#i

%+', $8/+&) #&% $#*#/ 0+'4#$i %+%+', (#', */i $#-#0

0+'$+/+8%i $#' 0+'+,# /+&4#$i'(# 8+/##' 8#&+'# ,-#80# $+',#'

# 0+-#88#' %&++'i', /+8#'#' -# 0#/# %+# &/i'.3

Di*+&8i#' 5>>>> ', $i A0+&i8# S+&i8#/ 0+'$+&i/# 8+/##'

8#&+'# ,-#80#. P&+v#-+'%i ,-#80# %+# ##8 *#$# ', +&%i#

-+i $#&i => /#' #$#-# 1)5?. N#0' *+',#& % 4,# %#',#/ +%#&)

8#&+'# *&+v#-+'%i ,-#80# *#$# ', +&8-i/ i/#0 +&%i# =5;65

/#') 15 8#-i -+i +%#& $#&i ', +&8-i/ */i.=

Di I'$'+%i#) ,-#80# 0+&*#8#' *+'(+# 8+/##' (#', 8+/i,#)

$+',#' *&+v#-+'%i ,-#80# %++%#& >)=? $#' 0+'(+#8#' 8+/##'

%+i',,# >)16? $#&i 8+%+-' *+'$$8 I'$'+%i#. R#% #%i# 0+0i-i8i

8++'$+&',#' '/8 0+',#-#0i ,-#80# %$/ /+&//* (#', -+i

+%#& $i#'$i',8#' $+',#' % -#i''(#.5

B+&$#%#&8#' 0&) ,-#80# #8/ -+i %+&i', /+&4#$i 8+/i8#

%+%+', %$# +&0& -+i $#&i 5> /#' $#' 4#', /+&4#$i i-#

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%i#''(# $i#:# 5> /#'. R#% 0',-i#) vi+/'#0;#0+&i8#) 4+*#',) $#'

i'# 0+0i-i8i 8++'$+&',#' (#', -+i +%#& $i#'$i',8#' $+',#' %

-#i''(#.5

II. 2. FAKTOR RESIKO

S+%#i $+',#' *+'(+# /+&4#$i'(# ,-#80# #8/) $i0#'#

/+&4#$i'(# *+'(+0*i/#' #8#' *+'(0#/#' $#&i %$/ *+',+-#'

#


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R#% 8-i/ i/#0 00'(# -+i 0$# 0+',#-#0i ,-#80# %#0*#i

7 8#-i $i#'$i',8#' % +&8-i/ */i

P#$# *#%i+' *+'$+&i/# i*+&/+'%i) 4,# +'$+&', -+i %+&i',

0+',#-#0i ,-#80# %#0*#i 6 8#-i -+i %+&i',

P+8+&4# -#% 4,# -+i %+&i', /+&8+'# %#0*#i = 8#-i -+i %+&i',

Di#+/+% M+--i/% 4,# 0+'i',8#/8#' &+%i8 i',,# 2 8#-i -+i

%+&i',

5


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BAB III

ETIOLOGI

P#$# $#%#&'(# ,-#80# 0+&*#8#' %+# 8+#$##' $i0#'#

/+8#'#' i'/ 8-+& 0+'i',8#/ 0+-+ii 8+0#0*#' 80*+'%#%i

4#&i',#' %# $#' v#%8-+& $i -# 0#/# #- /+&%+/ $#*#/ $i%+#8#'

-+ $# 8+0',8i'#' (#i/ /+&4#$i'(# *+'i',8#/#' *&$8%i #


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BAB IV

PATOFISIOLOGI

T+8#'#' i'/-#& $i/+'/8#' -+ $+#/ *&$8%i #


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P+0+&i#' #/ 0i$&i#/i8 4,# $#*#/ 0+'(+#8#' /+&4#$i'(#

,-#80# #8/) 8#&+'# *&%+% 0i$&i#%i% 0+'(+#8#' *+'+#-#' $#&i i&i%

*+&i+& $#' #- /+&%+/ #8#' 0+'/* %$/ 0#/# $#' 0+'i',8#/8#'

/+8#'#' i'/-+&.=

"


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BAB V

MANIFESTASI DAN GEJALA KLINIS

M#'i+%/#%i ,-#80# +&+$#;+$# %+%#i 4+'i%'(#) +&i8/

#$#-# 4+'i%;4+'i% ,-#80# $+',#' *+'(+#;*+'(+#'(# @

A. Glaukoma Prm!r "

1. G-#80# %$/ /+&8# ; $i%+/ 4,# ,-#80# %i0*-+8%)

,-#80# %i0*-+8% 0+'#') B+'/8 i'i #$#-# (#', *#-i',%+&i', $i40*#i.

2. G-#80# %$/ /+&//* $i%+/ 4,# ,-#80# %$/ %+0*i/

# A8/

S#8/ #/# 0+'#'

I&i% *-#/+#

B. Glaukoma Ko#$!#%al "

1. G-#80# 8',+'i/#- *&i0+&) ,-#80# #(i) /+8-$i%,+'+%i%

2. G-#80# (#', +&8#i/#' $+',#' #'0#-i 8',+'i/#- @

# G-#80# +&*i,0+'

A'i&i$i#

Si'$&0 AC+'+-$

$ Si'$&0 S/&,+ ++&

+ G-#80# #(i (#', /+&+'/8'(# 8+0$i#'

Si'$&0 M#'

, N+&&0#/%i%

9


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Si'$&0 L:+

iMi8&8&'+# #/# M+,#-8&'+#

&. Glaukoma S!ku#'!r

1. K#&+'# K+-#i'#' L+'%#

# Di%-8#%i

I'/0+%+'%i

F#8-i/i8

$ Si'$&0 E8%-i#%i

2. K#&+'# K+-#i'#' Uv+#

# Si'+8i# #'/+&i& *+&i+& SAP S$/ /+&//* /#'*#

#0#/#' **i-

I&i$%i8-i/i%

T0&

$ A/& I&i% +%+'%i#-

3. K#&+'# +$+

# P+&$##' 0#%i 8+ $#-#0 i-i8 0#/# $+*#'

P+&$##' 0#%i 8+ $#-#0 i-i8 0#/# +-#8#',

R+8#' 8&'+# #/# -i0% $+',#' *+''4-#' i&i% 8+ $#-#0-8#

$ P+&,+%+' #8#& i&i% 8+ +-#8#', *#%# +'/'

=. P#%#+$#

# P+&/0#' +*i/+- 8+ $#-#0 i-i8 0#/# $+*#'

K+,#,#-#' &+%/%i i-i8 0#/# $+*#' *#%# +8%/%i 8#/#

1>


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5. B+&8#i/#' $+',#' &+%i%

6. B+&8#i/#' $+',#' +8%/#-0% +&$+'(/

7. B+&8#i/#' $+',#' 8&/i8%/+&i$ /*i8#-

". P+'(+#;*+'(+# ,-#80# %+8'$+& -#i' (#', -#',8#

1)2)=)6

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S+*+&/i (#', /+-# $i4##&8#' *#$# # %++-0'(#) +/i-,i

,-#80# $#*#/ +&,#'/', *#$# #'(#8 #-) '#0' *#$# 00'(#

%+#'(# /i$#8 $i8+/#i %+# *#%/i) /+&/#0# ,-#80# *&i0+&.

U00'(# *#%i+' $+',#' ,-#80# *&i0+& 0+0i-i8i #8/& *&+$i%*%i%i

+&*# 8+-#i'#' *+&/0#' i-i8 0#/# $+*#' ,'i$i%,+'+%i% )

/+8-$i%,+'+%i%) i&i$$i%,+'+%i%) #/# 8&&'+$i%,+'+%i%.

T+8-$i%,+'+%i% 0+&*#8#' 8+-#i'#' $i0#'# /+&$#*#/'(# 0+0'

(#', 0+'/*i *+&08##' /+8-# $#' +&%i#/ *+&%i%/+') $#' 4,#

$i$#*#/8#' i&i% (#', +&i'%+&%i *#$# *+&08##' /+8-# /+*#/ *#$#

%8-+- %*& #/# #,#8 -+i 8+ $+*#'. U00'(#) ,-#80# *&i0+&

+&%i#/ i-#/+- $#' /i$#8 %+-#- %i0+/&i% $+',#' %$/ i-i8 0#/# /+&8#

#/#*' /+&//*.1)2

P#$# *#%i+' (#', 0+'$+&i/# G-80# *&i0+& #/# ,-#80#

%i0*-+8% 8&'i8 ,-#80# %$/ /+&8# 00'(# *#%i+' /i$#8

0+0i-i8i 8+-#' (#', #8/ #/# /i$#8 0+'(#$#&i #$#'(# *+'&'#'

vi%%) 8#&+'# *#$# ,-#80# i'i *#%i+' /i$#8 0+%#8#' ,+4#-# #*#*'

%#0*#i *+',+-i#/#' (#', /+&%i%# #'(#-# *+',+-i#/#' %+'/- ( tunnel

vision ). T#'$# (#', $#*#/ $i-i#/ /+'/'(# #$# *+'i',8#/#' /+8#'#'i'/-+& (#', /i$#8 +8%/&i0) '#0' %$# 8* '/8 0+0#/

*+'&'#' vi%% (#', *&,&+%i.6

P#$# ,-#80# #8/ #/# ,-#80# %$/ /+&//* /+,i 0+'4#$i

= #%+) (#8'i #%+ *&$&0#-) #8/) #%-/) $#' /+i& #%+ $+,+'+/i @

G-#80# #8/ #%+ *&$&0#-

P+',+-i#/#' 0+'4#$i 8#&) 8+/i8# 0+-i#/ ##(# $#*#/ 0+-i#/ #-)

0#/# /+%# +/. U00'(# ,+4#-# 0+',i-#', 8+/i8# *#%i+'

+&i%/i#/ #/# 0+-i#/ %i'#& (#', /+',) 8#&+'# 0i%i% **i- #8#'

0+'(+#8#' *&%+% %i&8-#%i #


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/#*i *+#' #80$#%i #8#' /+/#* #$#) %+i',,# *#%i+' i#%#'(#

0+0/8#' 8##0#/# $+8#/ (#', #&.

G+4#-# $i#/#% $#*#/ $i*+&+/ +&,#'/', *#$# 8+#$##' *#%i+')

'/'(# i'%0'i#) %/&+%%) *+',,'##' #/ 0i$&i#/i8) #%*#' #i&

(#', /+&-#- #'(#8.

F#%+ i'i $#*#/ /+&4#$i +&-#', 8#-i i-# 0+',#-#0i &+%-%i /+&%;

0+'+&% $+',#' i'/+'%i/#% (#', %+0#8i' +/.

G-#80# #8/ #%+ #8/ P+'&'#' vi%% (#', 0+'$#$#8 N(+&i (#', +#/ $+',#' *+'4#-#' (#', %+%#i %# 8+ V

M#-) 0'/# I'4+8%i %i-i+& $#' 8'4',/iv# (#', +8%/+'%i P#-*+ (#', 0+0+',8#8) 8+0%i% K&'+# 8+& !OA $#',8#-) /+&$#*#/'(# #/+&% *#$# !OA **i- (#', +'$+&', 8+ # 0i$&i#%i% TIO (#', %#',#/ /i',,i $#*#/ 0+'#*#i 6>;7> 00H, U00'(# *#%i+' #8#' %#',#/ 8+%#8i/#') $#' i#%#'(# *+&-

#'/#' ', -#i' '/8 $i/'/' 8+ &0# %#8i/ S+',#' i'i $#*#/ /+&4#$i %+# 0+'$#$#8 $#' 00'(# /+&4#$i

*#$# 0#-#0 #&i 8#&+'# TIO 00'(# 0+'i',8#/ %+%#i $+',#'

%i8-% $i&'#- P#$# *+0+&i8%##' '$%8*i $#*#/ $i-i#/ *+',,#',#' $#&i $i%8%

*/i8%) '#0' 00'(# i-# %+$#', /+&4#$i #%+ #8/) *+'i-#i#'

%-i/ $i-#88#' 8#&+'# 00'(# 8&'+#'(# 8+&

Pi,0+' *#$# i&i% $#*#/ /+&-+*#% $#' 0+'(+#8#' 8+8+' *#$#

# $#' *#$# 8&'+#

G-#80# #%+ #%-/ P#%i+' %$# 0+'4#$i /# 8#&+'# 8+&%#8#' %# (#', /+&4#$i M#/# *#%i+' %#',#/ 8+% %+*+&/i #/ 8#&+'#' TIO (#', %#',#/

/i',,i D#*#/ /+%# '(+&i (#', /+&% 0+'+&% (#', $i8+'#- %+#,#i

#%-/ $-&%# T#'$#;/#'$# 8',+%/i %$# i-#',

K&'+# $#*#/ 4+&'i #/# 8+& i-# /+&$#*#/ *i,0+';*i,0+' $#&ii&i%

13


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P*i- 0i$&i#%i% $#' /i$#8 &+%*'%i I&i% 0+'4#$i #/&) 8+-#) $#' /i*i% !OA 0+'4#$i $#',8#- $#' 8+&

F'$%8*i 0+''48#' $i% **i', $#' #/& %#

G-#80# #%+ $+,+'+/i Vi%% >) #/# /# D#*#/ /+&4#$i &+%&%i #$#' vi/&+% (#', 0+'(+#8#' #/& -i D+,+'+%i 8&'+# D#*#/ /+&4#$i %/#-0# *#$# %8+-) $i0#'# i-# v+%i8+-;v+%i8+-'(#

*+# $#*#/ 0+'i0-8#' -8% 8&'+# (#', 0+'(+#8#'

0$#'(# /+&4#$i i'+8%i %+i',,# $#*#/ +&-#'4/ 0+'4#$i

*+&%i) i&i$%i8-i/i%) +'$/#-0i/i%) *#'/#-0i/i%) (#', +i&*#$# #/& -i

Bi%# $i$#*#/8#' %i'+8i# #'/+&i& *+&i+&

1)2)=)6

U'/8 *#%i+' *+'$+&i/# ,-#80# %+8'$+&) ,+4#-# (#', /i0-

+&,#'/', *#$# *+'(#8i/ (#', 0+'$#-i) /#*i 00'(# /+&i*/#

,-#80# #8/) '/'(# *#$# v+i/i%) $i0#'# /+&4#$i i'-/%i -+8%i/

*#$# 4#&i',#' /+8-#& $#' *&%+% *+$#',#' (#', +'$+&',

0+0*+&0$# /+&4#$i'(# %i'+8i# *%/+&i& (#', 8+0$i#' 0+0*+&+/

/+8#'#' i'/-+&. J#$i *#$# ,-#80# +/ 8#%# 8#/#) ,+4#-# (#',

/+&4#$i %+&*# $+',#' ,-#80# #8/) *#$# v+i/i% ,-#80# /+&4#$i

$+',#' ,+4#-#;,+4#-# *+$#',#' %+*+&/i *#$# v+i/i%.=

1=


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TABEL 1. GLAUKOMA

GLAUKOMA

SUDUT

TERTUTUP

GLAUKOMA

SIMPLEKS

GLAUKOMA

INFANTIL

S+',#' D+8#$+ 8+;5 D+8#$+ 8+;6 B#(i

Bi-i8 M#/# D+*#' D#',8#- N&0#- D#-#0 %+8#-i

S$/ Bi-i8 M#/#

D+*#'S+0*i/ Bi#%#'(# /+&8#

K+-#i'#'

8',+'i/#-

H#- ; ;

P#*i- E8%8#v#%i i-#-#'4/

D#*#/ /+&4#$i*+',,#',#'

D#-#0 %+8#-i

T+8#'#'N#i8 i-#

$i*&v8#%i

V#&i#%i $i&'#-

/i',,iTi',,i

P+',#/#' Di'i) i&i$+8/0i

M+$i8#0+'/%#)

i-# ,#,#-

$i-#88#' *+%i

-/%i

G'i/0i

P&,'%i% Bi-# $i'i) #i8 S+$#',;&8 B&8

1)2)=)6

15


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Ta(!l 2. STADIUM GLAUKOMA AKUT

PRODORMA

LAKUT ABSOLUT

DEGENERAT

IF

Vi%% M+'&'S#',#/

M+'&'> >

H#- ; ;

K'4',/iv#N&0#-K+0

/i8K+0/i8 ; ;

I'4+8%i Si-i+& &i',#'MiC+$

i'4+/i'

MiC+$

I'4+/i';

K&'+#

A,#8 8+&

$+',#'

+$+0# &i',#'

K+&

$+',#'

+$+0# +/

K+&

D+,+'+%i

8+/*-#%/

( --%#

!OA D#',8#- D#',8#- D#',8#-

Si'+8i#

#'/+&i&

*+&i+& $#'

*+'(+#'*i,0+' i&i%

I&i%N&0#-%+$i8i

/ +$+0#

K+-#)

+$+0#

A/&) -#/)

*#/A/&

P*i-S+$i8i/

0+-+#&

M+-+#& $#'

-'4',

S#',#/

0+-+#& $#'

00'(#

+&:#&'#

i4#

S#',#/

0+-+#& $#'

i4#

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16


19/42

BAB VI

PEMERIKSAAN

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20/42

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21/42

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22/42

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23/42

P#$# *+0+&i8%##' i'i) *#%i+' $i0i'/# +&%4$ %+-#0# 1 4#0)

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21


24/42

BAB VII

DIAGNOSIS

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22


25/42

BAB VIII

DIAGNOSIS BANDING

Di#,'%i% #'$i', '/8 ,-#80# #8/ #$#-# %+0# *+'(#8i/

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26/42

Ta(!l ). DIAGNOSIS BANDING GLAUKOMA AKUT

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27/42

G!*ala

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28/42

BAB I3

PEN&EGAHAN

P#$# 00'(# ,-#80# $#*#/ /+&4#$i %+# /i#;/i# +&,#'/',

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#-i' #


29/42

BAB 3

PENATALAKSANAAN

P#$# $#%#&'(# *+',#/#' '/8 ,-#80# #8/ #$#-#

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8+%+#/#' (#', +&+$#) (#8'i @

PELAANAN KESEHATAN MATA PRIMER PE!

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27


30/42

o A%+/#-#0i$+ 5>> 0, $ii8/i = C 25> 0,) K!- 3 C >)5 ,& #&io O#/ i*+&%0/i8 $#*#/ $i+&i8#' i-# *+'$+&i/# $i:#/)

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%i8-$+%/&8%i $i-#88#' *+',+&%#8#' %+#,i#' #$#' %i-i#& %+i',,#

*&$8%i #i' 0#/# +&8',. 5

P+0+$##' #-/+&'#/i (#', $#*#/ $i-#88#' *#$# ,-#80# %$/

/+&//* #$#-# /+8-*-#%/i -#%+&. T+8-*-#%/i -#%+& $i-#88#'

$+',#' 0+0#8#& $#+ #'(#0#' /+8-0 (#', #8#' 0+0*+&+*#/

*+',#-i' #i' 0#/# 8+-#&. Ti'$#8#' i'i $i-#88#' $+',#' +/

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4#-#' $i0#'# /i'$#8#' -#%+& 0+0#8#' :#8/ /i$#8 -+i $#&i 1 4#0) /#'*#

0+0+&i8#' %# %#8i/. 5

P#%# +$# *#%i+' #&% 0+0#8#i *+'/* 0#/# $#' 0#/# (#',

$i+$# /i$#8 -+ /+&8+'# #i&. U'/8 %+0+'/# *#%i+' *#%# +$#

,-#80# $i-#', +8+&4# +/. Ti'$#8#' *+/i $i-#88#' i-# TIO

(#', /i',,i %$# $#*#/ $i/+'#',8#'. Bi-# *+%i $i-#88#' 8+/i8# TIO

0#%i /i',,i $#*#/ 0+'(+#8#' ,-#80# 0#-i,'#) $i %#0*i', #$#'(#

8+0',8i#'#' *&-#*% $#&i i%i -% 8-i $#' *+'$##'. S+,+

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8+ $+*#') %+i',,# #


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BAB 3I

PROGNOSIS

G-#80# #8/ #$#-# %+# *+'(#8i/ (#', $#*#/ 0+'i0-8#'

8+/##'' i-# /i$#8 $i/#',#'i $+',#' +*#/ $#' /+*#/) i-# *#%i+' $#*#/

$i+&i8#' *+'#',#'#' (#', /+*#/ 0#8# *&,'%i%'(# #i8. Bi-# /+&4#$i

8+-#-#i#' $#-#0 *+0+&i#' /+*#i '/8 *+'$+&i/# ,-#80# #8/) +%#&

8+0',8i'#' /+&4#$i'(# 8+/##') i-# /i$#8) i%# /+&4#$i ,-#0 +8+')

%i'+8i#) $#' (#', +&4', *#$# 8+&%#8#' *+&0#'+' &,#' 0#/#.

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BAB 3II

KESIMPULAN

G-#80# #8/ 0+&*#8#' *+'(#8i/ (#', /+&,-', $#&/ $+',#'

*/+'%i 0+'&''(# #',8# 8#-i/#% i$*. G-#80# #8/ 4,# %+&i', 8#-i

/+&-+:#/i -+ 8+/i$#8#8#*#' /+'#,# 0+$i% (#', 0+0+&i8%# $#'

8','(# *+',+/##' 0#%(##/ 0+',+'#i *+'(#8i/ i'i. P#$# % #%i#

4+'i% (#', /+&4#$i #$#-# ,-#80# %$/ /+&//* #/# (#', #8/. S+-#i'

i/ *#$# ',;', $+',#' #8/& *&+$i%*%i%i #'#/0i% 4,# -+i0$# 0+',#-#0i ,-#80#.

G-#80# 0+&*#8#' *+'(#8i/ $+',#' /&i#% (#', 8#%) (#8'i

*+'i',8#/#' TIO) *+'&'#' -#*#',#' *#'$#',) $#' +8%8#v#%i $#&i $i%8%

*/i8%. P#/%i-,i $#%#&'(# #$#-# /+&4#$i'(# *+'i',8#/#' *&$8%i

#?.

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DAFTAR PUSTAKA

1. I-(#% S. M#/# M+ D+',#' Vi%% M+'&'. P+''/' I-0 P+'(#8i/

M#/# E$i%i K+/i,#. J#8#&/# @ B#-#i P+'+&i/ F#8-/#% K+$8/+'

U'iv+&%i/#% I'$'+%i#Q 2>>5Q 6 @ 91 =

2. I-(#% S. M#/# M+ D+',#' P+',+-i#/#' T&' M+'$#$#8. I-0

P+'(#8i/ M#/# E$i%i K+/i,#. J#8#&/# @ B#-#i P+'+&i/ F#8-/#%

K+$8/+' U'iv+&%i/#% I'$'+%i#Q 2>>5Q 6 @ 167 "

3. I-(#% S) M#-i#',8#( H) T#i0 HGB) S#0#' RR) Si0#&0#/# M) i$$

PS. G-#80#. I-0 P+'(#8i/ M#/# U'/8 D8/+& U00 D#'

M##%i%:# E$i%i K+$#. J#8#&/# @ S#,', S+/ Q 2>>2 Q 15 @ 239 62

=. V#,#' DG) A%&( T. G-#0#. G+'+- O*/#-0-,( 17/

E$i/i'. !''+/i/ @ A**-+/' L#',+ Q 2>>" Q 11 @ 212 27

5. I-(#% S. K+&%#8#' S# M#/# A8i#/ G-#80#. G-#80# T+8#'#'

B-# M#/# Ti',,i E$i%i K+/i,#. J#8#&/# @ S#,', S+/ Q 2>>7 Q 7 @ 19;22

6. i4#'# N. G-#80#. I-0 P+'(#8i/ M#/# E$i%i K++'#0. J#8#&/# @

S#,', S+/ Q 1993 Q 12 @ 167 "7

7. I-(#% S. G-#80# A8/. K+$#&/#' D#-#0 M#/#. J#8#&/# @ B#-#i

P+'+&i/ F#8-/#% K+$8/+' U'iv+&%i/#% I'$'+%i# Q 2>>> Q 2 @ 97

1>>

". I-(#% S. G-#80#. D#%#& T+8'i8 P+0+&i8%##' D#-#0 I-0 P+'(#8i/

M#/# E$i%i K+$#. J#8#&/# @ B#-#i P+'+&i/ F#8-/#% K+$8/+'

U'iv+&%i/#% I'$'+%i# Q 2>>6 @ 179;223

9. G'$:i#&$4 TD) Si0#'4/'/#8 GS. G-#80# A8/. P#'$#'

M#'#4+0+' K-i'i% P+&$#0i. J#8#&/# @ !V ONDO Q 2>>6 Q 7 @ 36 =>

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1>. M#'%4+& A) T&i(#'/i K) S#vi/&i R) #&$#'i i) S+/i:-#' .

I-0 P+'(#8i/ M#/#. K#*i/# S+-+8/# K+$8/+'. J#8#&/# @ B#-#i

P+'+&i/ F#8-/#% K+$8/+' U'iv+&%i/#% I'$'+%i# Q 2>>> Q 2 @ 59;

6>

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