Slide Ulkus Hafiz
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Transcript of Slide Ulkus Hafiz
7/21/2019 Slide Ulkus Hafiz
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• Tn. MYNAMA
• 62 tahunUMUR
•Laki-laki JENIS KELAMIN
• KolakaALAMAT
• 11 Juni 2014
TANGGALEMERIKSAAN
• RS UN!AS TEMAT
EMERIKSAAN
•06"616No# RM
ID+&)I)!S P!SI+&
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• $n%lihatan &$nu'un (a)a&ata kananK$luhan
Uta&a
• Diala&i *$+ak , 6 ulan *$$lu& &a*uk
k$ (oliklinik. )i'a*akan *$&akin&$&$'at
• Ri/aat ($k$'+aan )i la(an%an )an*$'in% t$'k$na (a*i' k$&u)ian &$n+a)i&$'ah )an %atal *$hin%%a (a*i$n *$'in%&$n%%o*ok &atana
• Mata &$'ah3# N$'i 3# Ai'&ata$'l$ih 3# Koto'an &ata $'l$ih 3#
• $nu'unan ($n%lihatan 3# N$'i k$(ala-3#
Ana&n$*i*
T$'(i&(in
!&!M&+SIS
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• K$a)aan U&u&
Sakit S$)an%5Gii 7uku(57o&(o*&$nti*
• Tan)a 8ital
TD 1205"
0&&!%
N "9:5&$n
it
20:5&$n
it
S 96.607
S)!)*S (+&+"!'IS!)!
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$&$'ik*aan
O;tal&olo%i
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SEGMEN ANTERIOR
Pmri/saan
D S
Palra E)$&a 3. a%ian *u($'io' E)$&a -3
!aratus
la/rimalis
Lak'i&a*i 3 Lak'i&a*i -3
Silia S$k'$t 3 S$k'$t -3
%onun2ti3a !i($'$&i* 3 &i: in+$<tio !i($'$&i* -3 *ukon+un%ti=al
l$$)in% 3 )a$'ah lat$'al
M/anism
mus/ular
K$ *$%ala a'ah
N$'i %$'ak ola &ata -3
K$ *$%ala a'ah
N$'i %$'ak ola &ata -3
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SEGMEN ANTERIOR
Pmri/saa
n
D S
%orna
Ta&(ak k$k$'uhan (a)a
)a$'ah *$nt'al
J$'nih
#ili/ Mata Dan K$*an no'&al K$*an no'&al
Iris 7oklat. k'i(t$ 3 7oklat. k'i(t$ 3
Puil Bulat, sentral ?ulat. *$nt'al
'nsa J$'nih J$'nih
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F) %'I&IS S
F) %'I&IS D
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8OD@15
8OS @65B.C
VIS*S
Pemeriksaan OD OS
Tensi ocular Tn Tn
Nyeri tekan + -
Massa tumor - -
Glandula pre-aurikuler Tidak ada pembesaran Tidak ada pembesaran
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ENINARAN O?LIK
Pemeriksaan OD OSKonjungtiva Hiperemis +! mi"
injectio
Hiperemis -!
subkonjungtival
bleeding +! pada
daera# lateral
Kornea Keru#, tampak ulkus
di bagian sentral,
$lourescein +!
%erni#
Bilik Mata &epan Kesan Normal Kesan Normal
'ris (oklat, kripte +! (oklat, kripte +!
u(il ?ulat. *$nt'al. R7
3
?ulat. *$nt'al. R7
3
L$n*a J$'nih J$'nih
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SLIT LAM
• SLOD al($'a $)$&a 3 *u($'io'. *$k'$t *ilia3. kon+un%ti=a hi($'$&i* 3 &i: in+$<tio. (a)ako'n$a ta&(ak ulku* )$n%an )ia&$t$' , 1.C &&)i )a$'ah *$nt'al &$nutu(i (u(il. ha*il luo'$*<$in
3. ?MD ta&(ak Fa'$ )an *$l. i'i* <oklat k'i(t$3. (u(il ulat *$nt'al '$F$k* (u(il 3. l$n*a
+$'nih
• SLOS (al($'a $)$&a -3. *$k'$t *ilia -3.kon+un%ti=a hi($'$&i* -3 *ukon+un%ti=al l$$)in%3 (a)a )a$'ah lat$'al. ko'n$a ta&(ak +$'nih.?MD no'&al. i'i* <oklat. k'i(t$ 3. (u(il ulat.
*$nt'al. R$F$k* <ahaa 3. l$n*a +$'nih
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SEGMEN OSTERIOR
4talmos/oi
• FD R$F$k* ;un)u* -3 t$'halan% k$k$'uhan&$)ia '$;'akta
• FS '$F$k* ;un)u* 3 (a(il N#II ata* t$%a*7DR 0.9 A 8 @ 2 9 '$tina ($'i;$' )ala& atalno'&al
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RESUME
S$o'an% laki-laki H tahun. )atan% k$ IRD RS#ahi)in Su)i'ohu*o)o )$n%an k$luhan n$'i(a)a &ata kanan. *$+ak , 1 ha'i *$$lu&naakiat t$'k$na 'antin% (ohon &an%%a# N$'i
3 &ata &$'ah 3 hi($'lak'i&a*i 3 *$k'$t$'l$ih 3. ;oto(oia 3# $'i* -3. *$;al%ia-3. =$'ti%o -3# Ri/aat $'oat )it$t$*i ASIai' *u*u iu3# Ri/aat t'au&a (a)a &ata ki'i
)i(ukul )$n%an tan%an , 2 &in%%u lalu#
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RESUME
Da'i ($&$'ik*aan *ik )i)a(atkan (a*i$n *akit*$)an%. %ii aik. <o&(o*&$nti*# Da'i($&$'ik*aan o;tal&olo%i. OD 8i*u* 560.(al($'a $)$&a 3 *u($'io'. kon+un%ti=a
hi($'$&i* 3 &i: in+$<tion. ko'n$a ta&(akulku* )ia&$t$' ,1.C && (a)a )a$'ah *$nt'al.Fuo'$*$n* 3. ?MD *$l 3 Fa'$ 3. i'i* <oklatk'i(t$ 3. (u(il ulat *$nt'al R7 3. l$n*a
+$'nih# OS 8i*u* 656. (al($'a $)$&a -3.kon+un%ti=a hi($'$&i* -3 *ukon+un%ti=all$$)in% 3 (a)a )a$'ah lat$'al. ko'n$a +$'nih.?MD. i'i*. (u(il. l$n*a )ala& ata* no'&al#
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DIAGNOSA
Dia2nosa %ra
• OD Ulku* Ko'n$a *u*($k akt$'i
Dia2nosa #andin2
• Ulku* ko'n$a $#< +a&u'
• K$'atiti*
• En)o;tal&iti*
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ENATALAKSANAAN
&onFarma/olo2is• ?$at &ata
Farma/olo2is )oi/al
• 7# L 1 t$t$*54 +a&5OD
• 7# !o&at'o 1 t$t$*5" +a&5OD
• 7# R$-$(ith$l 1 t$t$*54 +a&5OD
Farma/olo2is Sistmi/
• a'a<$ta&ol *' 9:2 <th
"n6ana7• $&$'ik*aan KO!
• Kultu' )an *$n*iti=ita* antiiotik
• OD USG ?-S<an
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ROGNOSIS
•Duia $t ?ona&ua a) =ita&
•Duia $t ?ona&ua a)*anation$&
•Mala&
ua a)
=i*u&
•Duia $t Mala&ua a)
ko*&$ti<u&
P"(&SIS
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ULKUS KORNEA
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Ulku* ko'n$a a)alah hilan%na *$a%ian +a'in%an ko'n$a ka'$na k$&atian +a'in%an#
Ulku* ko'n$a )a(at )i*$akan ol$hakt$'i. +a&u'. &au(un in;$k*i =i'u*#
Ulkus Kornea
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Anato&i
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'aisan %orna
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ato%$n$*i*• Stadium Infltrasi
Pro2rsi4
inlt'a*i *$loli&o';onukl$a' )anl$uko*it )a'i *t'o&a k$
$(it$l#
• Stadium *lsrati4!/ti4
!a*il )a'i n$k'o*i* )an($l$(a*an $(it$liu&.la(i*an o/&an )an*t'o&a#
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• Stadium "2rsi
'$*(on antio)i )ani&un *$lul$'#
ulku* &$&aik. $(it$l&ulai tu&uh
• Stadium Si/atri/
$(it$li*a*i )an +a'in%an'ou* &$&$ntuk*ikat'ik n$ula.&akula. )an l$uko&a3
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J$ni* Ulku* Ko'n$a•
*l/us /orna a/tri Pseudomonas aeroginosa,.
Streptococcus pneumoniae
• *l/us /orna 4un2i
Candida, Fusarium, Aspergillus,
Penicillium, Cephalosporium
• *l/us /orna 3irus
Herpes simpleks, Herpes Zoster
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&')GN*'
Anamnesis
• Mata mera#• Nyeri• ilau• engli#atan kabur • i./trauma
• i./pemakaian lensakontakG
Pemeriksaan
Fisis• 0isus• lit 1amp
Pemeriksaan
penunjang• Tes $luoresense• K*H• Kultur ensitivitas
Bakteri
• Histopatologi• e.arnaan Gram
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$natalak*anaan
Tergantung penyebab2
• Bakteri2
)ntibiotik sesuai #asil kultur
)ntibiotik spektrum luas jika belum ada #asil kultur
Kortikosteroid
*perasi
• 0irus2
)ntiviral topikal dan oral!
• %amur2
)ntijamur topikal dan oral!
Analgetik
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Ko&(lika*i
))$*<$&ato<$l$
Glauko&a*$kun)$'
*ikat'ik*$';o'a*iko'n$a
I'i)o*iklitik tok*ik
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• T$'%antun% (a)a tin%kat k$(a'ahan )an <$(atla&atna &$n)a(at ($'tolon%an
• J$ni* &ik'oo'%ani*&$ ($n$ana
• A)a ti)akna ko&(lika*i an% ti&ul
•
K$taatan ($n%%unaan oat
Prognosis
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TERIMA KASI!