2. Trauma Mata - Dr. Christina Indrajati

7/24/2019 2. Trauma Mata - Dr. Christina Indrajati

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TRAUMAdr. CH.INDRAJATI SpM

Bag.Ilmu Kesh Mata

FK UNISULA/RISA


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TRAUMA MATA

MKANISTAJAM

TUM!UL FISIS

KIMIA !SIKIS


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!MRIKSAANANAMNSA "

!r#ses ter$ad%&'a Trauma (Kapa&/Je&%s

!e&a&ga&a& ) pertama

!ra*%raa& ) +%susHu,u&ga& ) Trauma - +%susSTATUS FTALMLI "

+%sus

Segme& ) Depa& - ,ela*a&g

Keadaa& ) B#la ) Mata "

Be&tu*/era*/Kedudu*a&0 dll


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!MRIKSAAN ANAMNSA

Pemeriksaan :

LOUPE

OBLIG ILLUMINASI / SLIT LAMP

OFTALMOSKOP

R O

USG

CT SCAN


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TRAUMA TAJAM "

!e&etra&N#& ) pe&etra&

TRAUMA TUMPUL

Perforasi

Non perforasi

Melibatkan

Dinding orbita

TRAUMA MEKANIS


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TRAUMA ) TAJAM& pe&etra&

Laseras%!alpe,ra

K#&$u&gt%1a

Luka lamelar

Kornea

Sklera

Putusnya Otot-otot ekstra okuler dll


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NN(!RFRASI

2.

!alpe,ra(hemat#m / dll3. K#&$u&gt%1a(Khem#s%s / dll

4. K#r&ea )r#s%/dll

5. KA(H%6ema

7. Ir%s(Re*s%s/D%al%s%s8. Le&sa(Lu*sas%/dll

9. K#rpus +%treum(!erdaraha& .

:. Ret%&a(A,las%#

;. B#la Mata(*s./talm#s

2


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TRAUMA TAJAMpenetranRuptur

Kornea / Sklera

Sering disertai :

Penurunan VISUS

Kemosis / ekhimosis

Prolap Iris / Khoroid dll.

KOA :

Dangkal / HifemaLensa : Katarak, Ruptur Lensa

PROLAP CV

Dll.


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d%dalamKamera(*ul%(

A&ter%#r!e&'e,a,"

TRAUMA

2.!RIMR"

Segera )Setelah(trauma

3.SKUNDR

7/9(Hr(setelah(trauma

S!NTAN M%s"Ru,e#s%s(%r%d%s


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!NANANAN(HIFMA

2. Ra>at/Ist%rahat(t#tal

3. !#s%s%(*epala(8as%"

TI/!erdaraha&(se*u&der

7. !arase&tes%s


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!DMAN !NANANAN!RTAMA

2. LASRASI !AL!BRA? Amat% ada&'a a*%,at la%& d%

mata? Be,at mata? ATS

3. LASRASI KNJUNTI+A KCIL@@..KNSR+ATIF

BSAR/LUAS@@@@JAHIT


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4. LASRASI

KRNAKATRI

2. LAMLAR3. LUKA TMBUS

Dapat me&utup se&d%r%

CA dalamHA t%da* *eluar searaa*t%6

4.LUKA TMBUS

HA merem,es0CAda&g*al

T%da* mel%,at*a&U1ea/le&sa

5. LUKA TMBUS


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4.LASRASI KRNA!NANANAN

2.KATRI 2 - 3 K#&ser1at%6 "A&t% B%#t%*a

Be,at mata @.F#ll#>

Up2.KA!"OR# $ % & 'A("A( )A(#P*LA+#

'A("A( eri +#KLOPL!"#K

-keuali terpaksa menuna ru0ukan 1 !A )AA -kasa steril1

A+ % Antii3tika parenteral

R*'*K


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5.BNDA ASIN d%KRNA

Tetes a&estes% t#p%*al *stra*s% C#rpus Al%e&um

La*u*a& seara hat%(hat% de&ga&

me&ggu&a*a& apl%*at#r*apas

C#tt#& ,ad atau d% %r%gas%

BILA AAL@@. RUJUK FLL= U! setelah 35 $am RUJUK B%la ada *#mpl%*as%


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BNDA ASIN !ADA

MATA MACAM " JNIS "

LAM NN LAM

RAKSI "

BNDA INRTBNDA RAKTIF


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AKIBAT " SU!RFISIAL TMBUS "

!RDARAHAN

PENANGANAN :

BENDA ASING

DIPERMUAAN

BENDA ASING

INTRA !ULER : INRT BIARKAN RAKTIF DIAMBIL

Ru$u* *e RS dg

Fas%l%tas


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TRAUMA(ALKALI THOFT

Dera$at 2 " H%perem% ) K#&$u&gt%1a

Kerat%t%s ( !u&gtata

Derajat 2 !"#erem" $ Konjun%t"&a!"lan%nya $ E#"tel $ Kornea

Derajat ' !"#erem"(Nekros"s $ Konjun%t"&a

!"lan%nya $ E#"tel $ Kornea

Derajat ) Konjun%t"&a $ Per"l"m*al

Nekros"s +,


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TRAUMA KIMIAKasus *ega>ata& #6talm%*

D%,ag% 3 " Trauma Asam

Trauma BasaTra"#a Basa $ #er"sak dibanding Tra"#a Asa#

Basa bereaksi dengan le#ak %pen&ab"nan '

#er"sak sel #e#bran

.erat r"n%an ter%antun% /ol

Konsentras"

Ke0e#atan d"1us"

aO! $ r"n%an

KO!

NaO!

Amon"um !ydro3"de


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CMMN ACIDS AND ALKALIPRODUK !EMIAL P4

Alkalies

D"s45as4er deter%entSod"um tr"#oly#4os#4ate 627,O&en 0leaners Sod"um 4ydro3"de 6)

Ammon"a Ammon"um 4"dro3"de 627+Dra"n 0leaner Sod"um or #otas"um 4ydro3"de 6)

AcidsTo"let 0leaner Sul1ur"0 a0"d 8 9, : 67,

Pool 0leaners Sod"um or 0al0"um 4y#o04lor"te 67,

.attery 1lu"d Sul1ur"0 a0"d 8 ', : 67,

.lea04es Sod"um 4y#o04lor"te 67,


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CLASSIFICATION OF

ALKALI BURNS

Grade 1C#r&eal ep%thel%al

damage

N# #&$u&t1%shem%a

##d pr#gs%s

Grade 3Total epit(elial loss )it( stro#al (a*e+ iris detail

seen!ne , t(ird to one-(alf of li#b"s is.(e#i.

/ision red".ed+ perforation rare

"rae 2

!a;y 0ornea7 "r"s deta"l seenLess t4an one $ t4"rd o1 l"m*us "s04em"0


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KOMPLIKASI AKIBAT TRAUMA KIMIA

S'm,le6ar#& "

!erle&g*eta& a&tara *#&$u&gt%1a ,ul,% dg *#&$palpe,ra

A&*'l#,le6ar#& "

!erle&g*eta& a&tara palpe,ra super%#r da&%&6er%#r

Ir%d#s%*l%t%s


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!NBATANTRAUMA (

ALKALI

01 Netralisasi , Irigasi

dengan air 23 451 Uk"r P6 Air-#ata

21 Debride#ent+ Antibiotika

71 Diberikan , Sikloplegik81 6ati-(ati dengan Steroid

91 Lensa ontak

NaO!


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TRAUMA ) ASAM!e&etras% at ) Asam

*e$ar%&ga&

berlangsung lambat0

*are&a ter$ad% *#agulas%pr#te%&

sa#a dengan penangananTra"#a-Alkali

PENAN


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TRAUMA(ALKALIHUGHS2. RINAN !r#gsa ) ,a%*

r#s% ) ep%tel ) *#r&ea

K#r&ea ( *eruh51 SEDANG Prognosa baik

Kornea keruh

Iskemia ringanNekrosis - ringan

'> .ERATPro%nosa $ *uruk

Konjun%t"&a $ Sklera - #u0at


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TRAUMA ! FISIS

PA"AS !#I"GI"

SINA

H!R)#+

#(4RA 5 )!RAH*LRA V#OL!

+#(AR 6


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SINAR E Katara*

I"FRA MRAH Ret$n$pat%$

Solar$& Katarak

U!"A VI#!$" eratitis -S"perfisial

Las 5 Listrik


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TRAUMA !SIKIS

STRS


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'entral Serou& '%or$oRet$nopat$/'S'R

Udem pada ma*ula lutea "nd"skopi : (alo di daera( #ak"la

!ada #ra&g(#ra&g 'a&g ,era*t%tas ,erat

Terap% " NSAID t#p%*al da& s%stem%*


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FTALMIA SIM!ATIKAU+ITIS BILATRAL RANULMATSA

DIFUSAE;ITING E


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FTALMIA SIM!ATIKA

U/EITIS #ada sala4 satu

mata 7 yan% d"se*a*kanole4 karena traumatem*us yan% men%ena"

u&ea mata kontra lateral


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HAL !NTIN GAN !RLUDI!RHATIKAN

2. ANAMNSA 'a&g me&garah

3. !er%*sa +ISUS se,elum terap% /

se,elum d%ru$u* *eual% trauma*%m%a

4. RUJUK ,%la 1%susu *ura&g dar% 8 / 2:

5. MANI!ULASI MINIMAL


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25

Ad. 2. Fa%al ,#&e 6rature

Midfacial fracturesLe F#rt Fratures LFF I " l#> tra&s1erse ma%llar' 6r.0

a,#1e the teeth0 #r,%tal

I&1#l1eme&t LFF II " !'ram%dal #&gurat%#&.

I&1#l1e the &asal0 lar%mal a&d

ma%llar' ,#&es0 med%al #r,%tal >all LFF III " Cra&%#6a%al d%s$u&t%#&0

#r,%tal ##r a&d med%al a&d lateral

>alls are %&1#l1ed


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22

Orbital Fractures

()*o+at$, -ra,ture& #r,%tal ape 6ratures

r,%tal R##6 6ratures Med%al #r,%tal 6ratures Or.$tal oor -ra,ture&


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27

Le Fort -ra,ture


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28

r,%tal ##r 6ratures "

2. D%ret 6ratures U&pure Bl#>#ut

6ratur

3. I&d%ret 6ratures !ure Bl#>#ut

6ratur


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29

Pure .lo0out -ra,ture


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2>

Unpure .lo0out

-ra,ture


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2?

Mechanism blowout fracture

I.

Blu&t 6#re tha& the #r,%tal r%m

I&tra#r,%tal pressure %s sudde&l'ele1ated

r,%tal t%ssue are #mpressed

Frat #6 the >ea*est part #6 the #r,.

3Te#r%es "


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2@

II. Ree&t Te#r'

Blu&t 6#re tha& the #r,%tal R%m

I&6er%#r #r,%tal r%m #mpresses

Bu*l%&g #6 the #r,%tal ##r


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73

Bl#>#ut 6rature #6 the #r,%tal ##rare suggested ,' "

!at%e&ts h%st#r' !h's%al eam%&at%#& ) ra's CT Sa& C#r#&al - sag%tal 1%e>s


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70

T'p%al &d%&g #6 the ph's%aleam%&at%#& "

'el%d s%g& eh'm#s%s a&dedema #6 the e'el%d

D%pl#p%a >%th l%m%tat%#& #& upgaOea&d / #r d#>&gaOe

phthalm#s a&d pt#s%s #6 thegl#,e

H'p#esthes%a %& the d%str%,ut%#& #6the %&6ra #r,%tal &er1e

mph'sema #6 the #r,%t a&d

e'el%ds


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75

Ma&ageme&t 6#r ,l#>#ut 6rature "

Bl#>#ut 6rature edema P0 #r,%talhem#rrhage P

ral ster#%ds 2 mg/*g/da' 6#r 9 da's

dema (

F#re dut%#& test P

Surger'


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F#re dut%#& test


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u%del%&e t# determ%&e >he&surger' %s ad1%sa,le "

D%pl#p%a PQ p#s%t%1e 6#re dut%#&

test 9 ) 2< da's a6ter %&$ur'Q R#.6rature P phthalm#s #1er 3 mm

Large 6rature %&1#l1%&g #&e hal6 #6the #r,%tal ##r #r m#re

2. Trauma Mata - Dr. Christina Indrajati

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