DT Dey Konjungtivitis

8/17/2019 DT Dey Konjungtivitis

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Topic Discussion

DEY SHIE(I11108083)

Konjungtivitis & Keratitis


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Defnisi dan Etiologi

• Konjungtivitis merupakan radangkonjungtiva atau radang selaputlendir yang menutupi belakang

kelopak dan bola mata, dalambentuk akut maupun kronis.

• Etiologi:

1. Ineksi: bakteri, virus, parasitdan jamur.

!. "on ineksi: alergi, iritasi yang

lama pada mata, #at$#at yangbersiat toksik kelainan


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PATOGENESIS DAN PATOFISIOLOGI KONJUNGTIVITIS

GANGGUAN PADA MEKANISME

PERTAHANAN HOST

NORMAL FLORA

KONTAMINASI

EKSTERNAL

GANGGUAN LAPISAN EPITEL

KONJUNGTIVA

MEKANISME IMUN

DARAH IMMUNOGLOBULIN DAN

LISOZIM PD PERMUKAAN

FILM AIR MATA

LAKRIMASI

FAGOSITOSIS OLEH

NEUTROFIL

MEDIATOR INFLAMASI

GATAL PERMEABILITAS

VASKULARPELEBARAN

VASKULAR

INJEKSI

KONJUNGTIVAL EKSUDAT HIPEREMIA


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%ambaran klinis

1. Injeksi knj!n"#i$%&. M%#% 'e(%s% se)e(#i %*%n+% ,en*% %sin"

-. Sens%si se)e(#i %*% #ek%n%n *%n (%s% )%n%s

. L%k(i'%si

/. Ke0)%k '%#% 0en"ke# %ki,%# )(*!ksi sek(e# +%n" 'enin"k%# #e(!#%'% )%*% )%"i %(i

2. P#3,i%

4. Pse!*)#sis

5. Ke'sis

6. Hi)e(#()i )%)i0

17. F0ike0

11. Me',(%ne

1&. Pse!*'e',(%n1-. G(%n!0%si

1. F0ik#en

1/. A*en)%#i )(e%!(ik!0%(


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Pe(,e*%%n "%',%(%n '%#% 'e(%


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)%nn!s

Injeksi knj!n"#i$%

)se!*'e',(%n


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Hi)e(#(3i )%)i0


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enis$jenis Konjungtivitis

TemuanKlinis danSitologi

Viral Bakteri Klamidia Alergika

G%#%0 Mini'%0 Mini'%0 Mini'%0 He,%#

Hi)e(e'i% Gene(%0is%#% Gene(%0is%#% Gene(%0is%#% Gene(%0is%#%

M%#% ,e(%i( B%n+%k Se*%n" Se*%n" Mini'%0

Eks!*%si Mini'%0 B%n+%k B%n+%k Minii'%0

A*en)%#i)(e%!(ik!0e(

Se(in" J%(%n" H%n+% se(in")%*%knj!n"#i$i#isink0!si

T%k %*%

P%*% ke(k%n*%n eks!*%#+%n" *i)!0%s

Mnsi# B%k#e(i8 PMN PMN8 se0)0%s'%8,%*%n ink0!si

Esin3i0

Dise(#%i s%ki##en""(k%n

*%n *e'%'

K%*%n"9k%*%n"

K%*%n"9k%*%n"

9 9


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Tanda Bakterial Viral Alergik Toksik TRIC

(Trakoma)

Injeksi

knj!n"#i$%

Men:0k Se*%n" Rin"%n9

se*%n"

Rin"%n9

se*%n"

Rin"%n9

se*%n"

Ke'sis ;; ;


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Konjungtivitis 'akteri

K%(%k#e(is#ik? i)e(e'i% knj!n"#i$% !ni0%#e(%0 *en"%n nse# +%n":e)%#8 e*e'% ke0)%k '%#%8 *%n sek(e# '!k)!(!0en8'en!0%( ke

'%#% se,e0%n+%

K0%si3ik%si *%n )en+e,%,?

Akut Hiperakut KronikStaphylococcusaureusStreptococcus

pneumoniae

Haemophilusinfluenzae

NeisseriagonorrhoeaeNeisseriameningitidis

StaphylococcusaureusMoraxella lacunataEnteric bacteria


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9Hi)e(e'i%8 sek(e#

'!k)!(!0en8 *%)%#

*ise(#%i8 ke(%#i#is.

9 Se03 0i'i#in" 4917%(i

9 Pen",%#%n? %n#i,i#ik

s)ek#(!' 0!%s=30!(@!in0ne

"ene(%si - %#%!

8s*i!' s!03%:e#%'i*e

178 %#%!

#(i'e#)(i'9

)0+'+i'> 4917 %(i

N. Gonorhoea.

Se(in" )%*%nen%#!s =3#%0'i%nen%#(!'> *%n

*eC%s% '!*% +%n"%k#i3 se:%(% seks!%0.

& j%' %C%0'e0i)!#i

i)e(e'i%8 n+e(i8sek(e# )!(!0en,e(C%(n% k!nin"9

ij%!8 ke'sis8 *%nn*!0 )(e%!(i:!0%(.

- 'in""!

B%k#e(i )en+e,%, #e(se(in"?

S. Aureus, Moraxella

lacunata, roteus mirabilis8

Escherichia coli 8 !lebsiella

pneumoniae.

S. Aureus *%)%#'en+e,%,k%n

,0e3%(knj!n"#i$i#is8

,e(k0ni *i '%(" ke0)%k

'%#% *%n 'en"e0!%(k%n

eks#ksin 'en+e,%( ke

knj!n"#i$%8 'e0!%s

'enj%*i !0k!s k(ne%.


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KONJUNGTIITIS O!EHI"US


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Kon#$ngti%itis %i&$s Pen+e,%,? %*en$i(!s8 e()es s#e(8 $i(!s neC :%s#0e8

)i:(n%$i(!ses8 en#e($i(!s 478

Jenis? knj!n"#i$i#is 30ik!0%(8 *e'%' 3%(in"knj!n"#i$%8

ke(%#knj!n"#i$i#is e)i*e'i8 knj!n"#i$i#is e()e#ik8 knj!n"#i$i#is

$%(i:e0%9s#e(8 knj!n#i$i#is ink0!si8 knj!n"#i$i#is neC :%s#0e8 *%n

knj!n"#i$i#is e'(%"ik e)i*e'ik %k!#. D%(i 1 se(#i)e %*en$i(!s8 #e(*%)%# 16 se(#i)e +%n" *%)%#

'en+e,%,k%n knj!n"#i$i#is.

In3eksi *%)%# 'en+e,%( 'e0%0!i *()0e# %#%! kn#%k 0%n"s!n" *%(i

j%(i #%n"%n ke ke0)%k '%#% *%n knj!n"#i$%.

M%s% ink!,%si /91& %(i8 *%n s%ki# se:%(% k0inis ,i%s%n+% /91/ %(i.


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Kon#$ngti%itis %i&$s '$t

1 De*a* +a&ingoon#$ngti%a Ineksi adenovirus tipe (, ), dan *

+ada anak$anak lebi- sering, penularan dari airkolam renang

Demam (/,(0

$)00

, aringitis, sekret berairserosa, kelopak bengkak, otopobia,

2imadenopati preaurikuler tidak nyeri k-as

3olikel pada konjungtiva, unilateral atau bilateral

Dapat sembu- sendiri, diberikan kompres, astringen,lubrikasi

4teroid dan antibiotik diberikan pada kasus beratdengan keratitis


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, Ke&atoon#$ngti%itis e-ide*ia Ineksi adenovirus /, 15, !5, dan (*

'ilateral +ada de6asa terbatas di bagian luar mata, anak$

anak: demam, sakit tenggorokan, otitis media, dandiare

76al: injeksi konjungtiva, mata berair, nyeri sedang,

perdara-an subkonjungtiva, olikel terutama padakonjungtiva ba6a-, pseudomembran

8$1) -ari: otoobia, keratitis epitel, dan kekeru-ansubepitel

2imadenopati preaurikular dengan nyeri tekan

Kompres dingin untuk mengurangi gejala


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F0ike0

In3i0#(%# )%*% k(ne%

P%*% in3eksi %*en$i(!s

k(nik

Pse!*'e',(%n


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3. Konjungtiitis Herpetik

HSV #i)e 1

&9- 'in""!

Injeksi knj!n"#i$% !ni0%#e(%08 i(i#%si8 sek(e# '!ki*8 n+e(i8 *%n

3#3,i% (in"%n Se(in" *ise(#%i ke(%#i#is e()es si')0eks? !0k!s #!n""%0 %#%! !0k!s

*en*(i#ik

Vesike0 e()es *i )%0)e,(% *%n #e)i%n )%0)e,(%8 e*e'% )%0)e,(%

e,%#

An%k *i %#%s 1 #%!n %#%! )%*% (%n" *eC%s%? se',! sen*i(i K(ne% #e(0i,%#? %n#i$i(!s #)ik%0? #(i30!(i*ine se#i%) & j%' seC%k#!

,%n"!n se0%'% 4917 %(i s%0e) %:+:0$i( 4 / se%(i %#%!

*en"%n %:+:0$i( 77 '" / se%(i se0%'% 4 %(i


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!. Konjungtiitis "en#akit $e%&astle

J%(%n" *i#e'!k%n

Pe(%s%%n #e(,%k%(8 "%#%08 n+e(i8 'e(%8 '%#%

,e(%i(8 )en"0i%#%n k%,!(

F0ik!0e( knj!n"#i$% *i #%(s!s s!)e(i( *%n

in3e(i(

P%*% )eke(j%%n )e#e(n%k%n !n""%s

D%)%# se',! sen*i(i


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'. Konjungtiitis Hemoragika Akut

In3eksi en#e($i(!s #i)e 47

Ink!,%si )en*ek =595 j%'> *%n ,e(0%n"s!n"

sin"k%# =/94 %(i>

N+e(i8 3#3,i%8 sens%si ,en*% %sin"8 sek(e#

,%n+%k8 i)e(e'i8 e*e'% )%0)e,(%8 )e(*%(%%n

s!,knj!n"#i$% *i3!s

F0ike0 *i knj!n"#i$%

Li'3%*en)%#i )(e%!(ik!0%(

D%)%# se',! sen*i(i


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,0e3(%knj!n"#i$i#is e()es si')0ek


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KONJUNGTIITIS'!E"GI


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Konjungtivitis alergi

Me(!)%k%n (e%ksi %n#i,*i !'(%0 #e(%*%) %0e("en)%*% ,%#8,%k#e(i8 #ksik8 *%)%# ,e(!)% (e%ksi :e)%#

*%n 0%',%#.

P%sien 'e'i0iki (iC%+%# %#)i

Gej%0%? (%*%n" ='e(%8 s%ki#8 ,en"k%k8 )%n%s>8 "%#%08si0%! ,e(!0%n" *%n 'en%!n8 )%)i0 ,es%( )%*%

knj!n"#i$%.

Pen",%#%n? %n#iis#%'in *%n s#e(i* sis#e'ik

Jenis9jenis? kj!n"#i$i#is $e(n%08 knj!n"#i$i#is 30ik#en8knj!n"#i$i#is i%#("enik8 sin*(' s#e$en jnsn


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1. Konjungtivitis vernal

Me(!)%k%n (e%ksi i)e(sensi#i$i#%s #i)e I +" 'en"en%i

ke*!% '%#% *%n ,e(si3%# (ek!(en.

Ti)e? )%0)e,(% *%n 0i',%0

Ti)e )%0)e,(%? *i#e'!k%n )%)i0 ,es%( *en"%n )e('!k%%n

(%#% )%*% knj!n"#i$% #%(s%08 *en"%n (%s% "%#%0 ,e(%#8sek(e# "e0%#in ,e(isi esin3i08 *%)%# *ise(#%i ke(%#i#is.

Ti)e 0i',%0? #e(0i%# ,enj0%n *i *%e(% 0i',!s8 *en"%n

,e(:%k H(ne( T(%n#%s.

Rek!(en8 ,i0%#e(%08 'en"en%i )%sien !si% '!*% -9&/ #%!n


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!. Konjungtivitis 9ikten

Me(!)%k%n knj!n"#i$i#is n*!0%( +" *ise,%,k%n %0e("i

i)e(sensi#i$i#%s #i)e IV8 se(in" *i#e'!k%n )%*% %n%k9%n%k *i

0in"k!n"%n )%*%# *en"%n "ii k!(%n" %#%! se(in" 'en"%0%'i

(%*%n" s%0!(%n n%)%s.

Gej%0%? '%#% ,e(%i(8 i(i#%si *en"%n (%s% s%ki#8 3#),i%8,0e3%(s)%s'e.

D%)%# se',! sen*i(i *%0%' & 'in""! *en"%n ke'!n"kin%n

kek%',!%n8 n%'!n *%)%# 0e,i ,e(%# jik% #e(ken% k(ne%


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(. Konjungtivitis 4teven o-nson

Sin*(' s#e$en jnsn 'e(!)%k%n )en+%ki# e(i#e''!0#i3(' +%n" ,e(%#8 se(in" #e(j%*i )%*% !si% seki#%( -/

#%!n

Pen+e,%, *i*!"% (e%ksi %0e("i )%*% (%n" *en"%n

)(e*is)sisi %0e("i ,%#9,%#%n

Gej%0% )%*% '%#%? '%#% 'e(%8 $%sk!0%(is%si k(ne%8

)%(!# knj!n"#i$%8 knj!n"#i$% ke(in"8 si',0e3%(n8 #!k%k

*%n )e(3(%si k(ne%8 en*3#%0'i#is.


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Trakoma

Me(!)%k%n knj!n"#i$i#is 30ik!0%( k(nik +%n"

*ise,%,k%n 0e ,%k#e(i "hlamydia trachomatis.

D%)%# 'en"en%i se"%0% !'!(8se(in" )%*% *eC%s% '!*%

*%n %n%k9%n%k.

%(% )en!0%(%n? kn#%k 0%n"s!n" *en"%n sek(e#8 %0%#ke,!#!%n se%(i9%(i =%n*!k8 %0%# ke:%n#ik%n8 *00>

M%s% ink!,%si /91 %(i.

Gej%0%? 3#),i%8 "%#%08 ,e(%i(8 eks!*%si8 e*e'%

)%0)e,(%8 ke'sis8 i)e(#(3i )%)i08 n*!0 )(e%!(ik!0%(


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KE7TITI4


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KE7TITI4 '7KTEI

''n O("%nis's? Staphylococcus aureus, Stap.Epidermidis, Strep. neumoniae, *00

Un:''n O("%nis's? Neisseria spp.,

Mycobacterium spp, *00

P%#"enesis? A*e(ensi ,%k#e(i

,e()(0i3e(%si )%*%s#('% k(ne%(es)n in30%'%si se(#% sek(esi

'e#%00)(#ein%se '%#(iksnek(sis k(ne%

GK? !0k!s k(ne% *en"%n nse# n+e(i %k!#8

)#),i%8 injeksi k(ne% *%n )en!(!n%n $is!s


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.UNG'!KE"'TITIS


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3ungal Keratitis

In3eksi k(ne% 0e j%'!(. Bi%s%n+% j%'!( Aspergillus F%k#( Resik ? T(%!'%8 (ni: ke(%#i#is =e()es si')0e8

e()es s#e(8 Ve(n%0 ( %00e("i: ke(%#:nj!n:#i$i#is>8 Di%,e#es8

AIDS.

Si"n? nj!n:#i$%0 %n* :i0i%(+ :n"es#in8 E)i#e0i%0 *e3e:#8

S#('%0 in3i0#(%#es8 D(+ %n* (!" #e#!(e S+')#'s ?

In:(e%sin" e+e )%in ( *is:'3(#

S!**en ,0!((+ $isin

Un!s!%0 (e*ness 3 #e e+e

E:essi$e #e%(in" %n* *is:%("e 3(' #e e+e

In:(e%se* 0i"# sensi#i$i#+


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3ungal Keratitis 6it- ;ypopyon


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Si"ns?

S%#e00i#e 0esins

B(Cn )i"'en#%#in *!e # *e'%#i%:e!s 3!n"!s=!($!0%(i% 0!n%#%>

In#%:# e)i#e0i!' Ci# s#('%0 in3i0#(%#es

An#e(i( :%',e( (e%:#in

ungal Keratitis "igmented *esion


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Treatment

N%#%'+:in /

%n*i*% s)e:ies (es)n* ,e##e( # A')#e(i:in B 7.1/ F0!:n%0e &

Mi:n%0e 1

S:(%))in" e$e(+ & # 5 !(s

T(e%#'en# is (e@!i(e* 3( 2 Ceeks

S+s#e'i:?

F0!:n%0e ( Ke#:n%0e is in*i:%#e* in se$e(e 3(' 3

ke(%#i#is8 s:0e(i#is %n* en*)#%0'i#is


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;erpes 4imple< Keratitis

P(i'%(+ ( 0%#en# = (e:!((en# > HSV in3e:#in

Gej%0% P(i'%(+? se$e(e 'n:!0%( )%in8 )#),i%8

)en"0i%#%n ,0!(

L%#en#? %s+')#'%#i:8 )#sensi#i$i#+8 ,0!((e* $isin

Si"ns P(i'%(+? $esi:!0%( ,0e)%(i#is8 300i:!0%( :nj!n:#i$i#is8

)(e%!(i:!0%( %*en)%#+8 s#%inin" e)i#e0i%0 *en*(i#e=s> L%#en#? $%(i%,0e :(ne%0 in$0$e'en#8 3(' )!n:#%#e

ke(%#i#is # 0%("e "e"(%)i: !0:e( =s#%inin">8

*e:(e%se* :(ne%0 sens%#in


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+I=7> ;4? I"3ETI@"

P(i'%(+ HSV :!0%( in3e:#in 's# :''n0+ '%ni3es#s %s

,0e)%(:nj!n:#i$i#is Te ke(%#i#is in #ese )%#ien#s '%+ ,ese$e(e %n* ,i0%#e(%0

,0e)%(:nj!n:#i$i#is F00i:!0%( nj!:#i$i#is


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Diagnosis

Di%"nsis?

I''!n30!(es:en:e #es#8

!0#!(e 3 e)i#e0i%0 s:(%))in" (

Tiss!e ,i)s+

HSV *en*(i#i: !0:e( s#%ine* Ci#

30!(es:ein


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;erpes Aoster @p-t-almicus ;A@

%!se* ,+ V%(i:e00% Zs#e( $i(!s Ci: ,e0n"s #e()es $i(!s "(!)

S+')#'s Gene(%0? 3e$e(8 '%0%ise8 ne!(%0"i: )%in.

Skin 3 %33e:#e* %(e% ,e:'es e*e'%#!s %n* (e*

Di33e(en#i%0 *i%"nsis e(+si)e0%s ,!# *is#(i,!#in%0n" in$0$e* ne($e ,(%n:es *i33e(en#i%#e


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He()es Zs#e( O)#%0'i:!s

0ini:%0 )#"(%)s sCin" *is#(i,!#in 3 (%ses


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Treatment


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Treatment

1. A:+:0$i(? 577 '" /917 %(i8 A0#e(n%#i$e0+

(%0 F%':i:0$i(8 &/7 '" -94 %(i

&. M%in#en%n:e 3 +"ieni: :n*i#in #

)(e$en# se:n*%(+ in3e:#in. T)i:%0%n#i$i(%0 =%:+:0$i(> %n* %n#i,i#i: in#'en#

n skin 0esins


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TE"I/' K'SIH

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DT Dey Konjungtivitis