Slide Ulkus Hafiz

7/21/2019 Slide Ulkus Hafiz

http://slidepdf.com/reader/full/slide-ulkus-hafiz 1/30



• 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+&



• $n%lihatan &$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



• 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!)!



$&$'ik*aan

O;tal&olo%i



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



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



F) %'I&IS S

F) %'I&IS D



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



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



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



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



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#



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#



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*



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



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



ULKUS KORNEA



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



Anato&i



'aisan %orna



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#



• 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



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





&')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



$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



Ko&(lika*i

))$*<$&ato<$l$

Glauko&a*$kun)$'

*ikat'ik*$';o'a*iko'n$a

I'i)o*iklitik tok*ik



• 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



TERIMA KASI!

Documents

Slide Ulkus Hafiz