tips and pitfall in ophthalmologic cases...palpebra ptosis (parese n. 3 atau sebab lain) pemeriksaan...
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TIPS AND PITFALL IN OPHTHALMOLOGIC CASESHow to detect BRAIN TUMOR
Delfitri Lutfi
BRAIN TUMOR IN DAILY PRACTICE
1
Divisi Orbita Onkologi Dept./SMF Ilmu Kesehatan MataFK Unair/RSUD dr. Soetomo Surabaya – Indonesia
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4/26/2018
TUMOR OTAK
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TANDA & GEJALA3
Penglihatan tergangguPosisi mata tampak
asimetris
Gangguan gerakan
bola mata (melihat
dobel)
Mata tampak menonjol
Kelopak mataturun/tidak bisatertutup sempurna
Nyeri
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GANGGUAN PENGLIHATAN
Penglihatan Central (Tajam Penglihatan/Visus)
4/26/2018
- Transient visual
loss
- Visus naturalis
- Pin hole atau
koreksi terbaik
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PEEK ACUITY
4/26/2018
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Penglihatan Warna
4/26/2018
GANGGUAN PENGLIHATAN
Dyschromatopsia
Terutama gangguan penglihatan
merah (tanda awal)
Dibandingkan mata yang sehat
dengan yang tidak
14 atau 38 Ishihara plate
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LAPANG PANDANGAN
- Tergantung lokasi lesi : pre chiasma – chiasma – post chiasma
- Pemeriksaan : tes konfrontasi, Humphrey Perimetri, Goldman Perimetri
- Lesi intra kranial yang menekan jaras penglihatan
4/26/2018
GANGGUAN PENGLIHATAN
Confrontation Test
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PERIMETRI
4/26/2018
Humphrey Perimetry
Goldmann Perimetry
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4/26/2018
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GANGGUAN GERAKAN BOLA MATA
4/26/2018
- Diplopia binokular
- Parese n. 3, 4, 6
- N. 4 : m. obliquus
superior (basal)
- N. 6 : m. rektus
lateralis
- N. 3 : others
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MATA MENONJOL (PROPTOSIS)
4/26/2018
Dokumentasi POSA Mata
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SEGMEN ANTERIOR
Palpebra Ptosis (parese n. 3 atau sebab lain)
Pemeriksaan Pupil
- Isokor atau anisokor
- Normal 3 – 4 mm
- RAPD (relative afferent pupillary defect)
4/26/2018Swinging flash light
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FUNDUSKOPI
Papilledema VS Compressive Optic Neuropathy
• Papilledema peningkatan TIK
• Progresif tergantung berat dan perubahan TIK
• CON penekanan langsung pada nervus optikus
• Infeksi, inflamasi, trauma, dan massa
4/26/2018
Direct
Ophthalmoscopy
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PAPILLEDEMA
4/26/2018
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PEMERIKSAAN PENUNJANG
Ophthalmic imaging :
Optical Coherence Tomography (OCT)
Fundal Fluorescein Angiography (FFA)
Neuroimaging (CT scan, MRI, Angiography)
4/26/2018
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TUMOR TERSERING
•Retinoblastoma
•Sphenoid wing meningioma
4/26/2018
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4/26/2018
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RETINOBLASTOMA
• Deteksi dini leukokoria
• Kenali binarnya
4/26/2018
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19
Save life
Save eye
Save vision
TO FIND THE ETIOLOGY DIAGNOSIS
THE EARLIER THE BETTER
FOR LIFE SAVING & VISUAL SAVING
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