Mata Kornea

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Prof, DR, dr Rukiah Sawal SpM (K)

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Mata Kornea

Transcript of Mata Kornea

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Prof, DR, dr Rukiah Sawal SpM (K)

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Anatomy and PhysiologyAnt part of the eye

• Avascular

• Transparant

• Refracting and Protective “ window” of

Route light rays


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Fig .Anatomy

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Fig. Histology

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TransparancyUniform Structure• Avascular

• Deturgescence

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NutritionPerilimbal capillaries• Air + tear film

• Aqueous humor

Innervation : N V1

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Desease of the corneaExtremely serious

Permanent visual impairment


Prompt diagnosis and prompt treatment

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Inflamation : Keratitis




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KeratitisKeratitis : - Superficial - Profunda (interstitial) - Non ulceration - Cornea Ulcer

Superficial : epithel and superficial stroma

Cornea ulcer: defect / discontinuity

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Superficial KeratitisFig histology

Ethiology :

- Infective

- Degenerative

- Allergic

- Toxic

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Classification Cornea Ulcer1. Bacterial2. Viral3. Fungal4. Hypersensitivity reaction5. Neurothropic6. Exposure7. Idiopathic

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Clinical PresentationPainPhotophobiaLacrimationBlepharo spasmeBlurred visionPericorneal / ciliary injectionInfiltrate, edem, defect cornea

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Bacterial Corneal UlcerSight – threatening- Progressive stromal in flurocen- Progresive tissue destruction- Cornea perforation- Infection to adjacent tissue

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Risk FactorsContact lens wearTrauma Contaminated ocular medicationImpaired defense mechanismAltered structure of corneal surface

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Clinical PersentationPain, photophobia, blepharospasme lacrimation, decreased visionPericorneal injection – red eyeSharply demarcated epithelial defect Stromal edema Suppurative Stromal inflamationAnt chamber reaction : KP. Hypopyon

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Viral Corneal ulcerClinical presentationHSK Foreignbody sensation, photophobia Lacrimation, blurred visionPericornea injection / ciliary flushRose bangal, fluoroscein Staining (+)Reduced corneal sensation

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Keratitis herpes simpleks

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HZ0Zoster dermatitis affected N V1Punctate or dendritic epithelial keratitis50% decreared corneal sensationIntestitial keratitis and anterior uveitis >


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Fungal Corneal ulcerRish Factor :Gardener : preplant or vegetableContact lens wearCorticosteroid treatment topical / systemic

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Clinical PresentationResemble with batecterial ulcerGray-white infiltrate, irreguler and filament

marginsSatelite infiltrateAnterior chamber reaction, hypopion

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Hypersensitivity reaction1. Atopic keratoconjunctivitis2. Steven Johnson syndrome3. Ocular cicatrical Pemphigoid4. Mooren Ulcer


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Treatment cornea ulcerEtiology / causePredisposing factorsPotentially sight threateming

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Local - cycloplegic : atropin 0.5% - Specific : antibiotic, anti viral, anti fungal, anti inflamation / immunosuppresive eye drop / ointment

• Systemic : oral : IV

Subconjunctiva, subtenon

- Surgical ( complication )

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Complications1. Corneal scar : nebula, macula, leucoma2. Iridocyclitis : Synechia, complited cataract,

secondary glaucoma3. Perforation4. Endofthalmitis5. Panophthalmitis6. Atrophia bulbi

Visual impairment – visual loss

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Perforasi kornea

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