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10/6/2017
INTRODUCTION
The term myopia was introduced from the
habits :
Short sighted.
Half closing the eyelids, when looking at
distance
Myopia may be caused by :
Largeness of the eyeball.
An increase in the strength
of the refractive power of the media
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DEFINITION
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DEFINITION
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ETIOLOGY
. 1. The great majority of cases, myopia is axial
due to increase in the antero- posterior
diameter of the eye.
2. Curvature myopia may be associated with an
increase in the curvature of the cornea or 1
or both surface of the lens.
3. If the lens dislocated.
4. Index myopia , a change of refractive index
of the aqueous or vitreous.
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CLASIFICATION
BY THE CAUSE :
Axial myopia
Refractive myopia :
Curvatura myopia.
Index myopia.
BY THE CLINICAL APPEARANCE :
1. Simple myopia.
2. Degenerative myopia.
3. Nocturnal myopia.
4. Pseudomyopia.
5. Induced myopia.
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CLASIFICATION
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DEVELOPMENT OF MYOPIA.
Myopia increasing with increasing age.
In US :
Prevalence of myopia 3% (5 -7 years)
8% (8-10years)
14% (11-12 years).
25% (12-17 years).
Ethnic Chinese children highher rate of myopia at all
ages.
Taiwan,Singapore and Japan study :
12 % among 6 years.
84 % among 6 18 years.
In one of the elementary school at Surabaya : 23.4 %
among 7-12 years.(2011)
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DEVELOPMENT OF MYOPIA
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DEVELOPMENT OF MYOPIA
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DEVELOPMENT OF MYOPIA
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DEVELOPMENT OF MYOPIA
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MYOPIA PROGRESSION
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TREATMENT OF MYOPIA
The optical correction for Myopia is :
Spectacles.
Contact lenses.
Refractive surgery.
Principal correction with concave or minus lens to
diverge the rays of light so that they will focus on the
retina .
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VISUAL HYGIENE
1. Resting from reading or working in close distance
every 30 mins. During the rest, you should take a walk
around the room and looking far though the window.
2. Have a comfortable upright sitting during reading.
3. Using enough light during reading.
4. A good reading distance is an arm length to elbow.
5. Sitting from 6 feet distance during wacthing TV.
6. Limit the amount of time spent for watching TV
or playing game/gadget.
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PRESCRIBING IN CHILDREN
1. THE INFANT (the first 12 - ,18 months).
Total spatial world is at near.
Not correcting.
Under correcting as much as 4.00 D of Myopia..
Visual aquity must be monitored for amblyopia.
2. TOODLERS AND OLDER CHILDREN.
The child begins to walk and move around.
-3.00 D of Myopia as a threshold for correction.
If without correction, monitored visual aquity, refractive error
and emetropization every 3 -4 mothns.
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PRESCRIBING IN CHILDREN
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PSEUDOMYOPIA
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DEGENERATIVE MYOPIA
(MALIGNANT MYOPIA / PROGRESSIVE MYOPIA)
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DEGENERATIVE MYOPIA
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DEGENERATIVE MYOPIA
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DEGENERATIVE MYOPIA
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COMPLICATION OF MYOPIA
1. Retinal detachment.
2. Strabismus.
Exotropia.
Esotropia.
3. Amblyopia.
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ASTIGMATISM
Prillia Tri Suryani MD
Ophthalmology Department
Medical Faculty Airlangga University
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INTRODUCTION
Astigmatism is distorted vision caused by
a variation in refractive power along
different meridians of the eye.
Astigmatism :
Regular astigmatism.
Irregular astigmatism
Regular astigmatism :
With the rule.
Against the rule.
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DEFINITION
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DEFINITION
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DEFINITION
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PREVALENCE
2. IRREGULAR ASTIGMATISM.
Irregularities in the curvature of the meridians.
Caused :
Corneal irregularity.
Corneal cicatrix /Keratoconus.
Not lend it self adequate correction by
spectacles.
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TYPE OF ASTIGMATISM.
REGULAR ASTIGMATISM
Simple astigmatism.
Compound astigmatism.
Mixed astigmatism.
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TYPE OF ASTIGMATISM.
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SYMPTOMS OF ASTIGMATISM
Blurred or distorted vision at all distances.
Photophobia
Headaches especially after reading.
Squinting
Eye strain.
Constanly clossing eye.
In High astigmatism :
Tilting of the head ( obliq astigmatism ).
Turning of the head ( high astigmatism)
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DIAGNOSIS OF ASTIGMATISM
1. Patient history.
2. Refraction.
Subyective.
Trial & error.
Obyective.
Retinoscopy.
Fogging technique.
Autorefractometer.
Jackson Cross Cylinder.
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MANAGEMENT OF ASTIGMATISM
1. Spectacle.
2. Contact lens.
3. Refractive surgery.
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MANAGEMENT OF ASTIGMATISM
SPECTACLE.
1. Regular astigmat :
Correction : Cyl (-) /(+).
Combined Sphere (-) /(+)
2. Irregular astigmatism :
Mild : Hard contact lens.
Severe : Keratoplasty.
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MANAGEMENT OF ASTIGMATISM
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MANAGEMENT OF ASTIGMATISM
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MANAGEMENT OF ASTIGMATISM
CONTACT LENS.
If Cyl < 1.00 D : Sphere SCL.
If Cyl ( 1.00 3.00 ) D : Toric SCL/ RGP- CL.
If Cyl > 3.00 D : RGP CL.
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MANAGEMENT OF ASTIGMATISM
REFRACTIVE SURGERY.
LASIK
To decrease the curvature by relaxing incision
in the axis.
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