-Kelainanpada kelopak mata

dan sistem lakrimal-

BINTO AKTURUSIANO
 Benda asing pada kornea
LAKUKAN PENGANGKATAN BENDA ASING
EVERSI KELOPAK MATA UNTUK MEMASTIKAN TIDAK
ADA LAGI BENDA ASING
TERAPI ANTIBIOTIK TOPIKAL
REFERRAL TO OPHTHALMOLOGIST

Residual rust ring

EYELID DISEASES

• Infection
– Hordeolum
• Suppurative acute
infection at eyelids
gland caused by
Staphylococcus

– Hordeolum internum
: at meibom gland
 – Hordeolum eksternum :
at zeiss, mole gland

• Therapy :

– Systemic & local

antibiotics

– Incision :

» mostly common on
hordeolum externum

» Skin incision

» Conjuctival incision
• Complication : eyelids
abscess
• Chalazion
– Chronic lipogranulomatous inflammation of the meibom
gland
– red-purple painless nodule at the conjunctiva
– Therapy : incision
• eyelids abscess
– originates from hordeolum or severe eyebrow infections
– Therapy :
• Local and systemic antibiotics
• incision skin line
• Blepharitis
– bilateral
– chronic infection margin of the eye lid
– Squamous blepharitis (seborrhea) :

• signs : itching, burning, squamous seborrhoic at the lash

• Th/ : cleaning with wet cotton, corticosteroid ointment

– Ulcerated blepharitis :

• margo infection caused by

staphylococci at children with
bad general condition

• clinical signs : red palpebra,

squamous seborrhoic, ulceration
along margo covered by crust,

• loss of eye lashes, margo

distortion (if chronic and
severe)

• Th/ : improving general

condition, clean the crust with
wet cotton, antibiotic ointment
• Acute dacrioadenitis
– signs :
• red painfull swelling with redness of the outer of the upper
eye lid , pseudo ptosis (sometime)
– E/ :
• adult : gonorrhoica
• children : with another disease --> parotitis
• Chronic dacrioadenitis
– slightly edema
– not pain
– often at TB, leukemia, trachoma
– Th/ : depend on the etiological agent
• Chronic dacriosistitis
–more common
–attributed to the nasolacrimal obstruction
–children and adult
–symptom :
• epiphora
• swelling at the site of the sac (distended sac)
• on pressure over the sac --> muco-pus or pus regurgitates trough the puncta
–Th/ :
• topical and systemic antibiotic
• if obstruction --> dacriosistorinostomi
 Selulitis Orbita

Periorbital erythema and edema

Proptosis
Restriksi gerakan bolamata
Tajam penglihatan menurun
Kemosis
Demam

keluhan kelopak mata bengkak dan nyeri dan gerakan

bolamata terhambat
 Selulitis Orbita

Broad spectrum intravenous antibiotik

CT scan orbita
Referred Ophthalmologist

Subperiosteal abscess
Laserasi kelopak mata

Trauma tajam atau trauma tumpul

Pemeriksaan radiologi untuk melihat

adanya benda asing

Keluarkan benda asing disuperfisial

Curigai benda asing yang lebih dalam

Berikan profilaksis antitetanus

 Laserasi kelopak mata

RUJUK KE DOKTER SPESIALIS

MATA APABILA DITEMUKAN :

Ruptur globe
Ruptur saluran lakrimal
Levator aponeurosis
Medial canthal tendon
Hilangnya jaringan ( > 1/3 )
EYE LID MALPOSITION

• Entropion
– turning in of the eye lid margin --> the lashes
touch the cornea (Trichiasis) --> corneal irritation -
-> corneal ulcer
– unilateral or bilateral
• Congenital entropion
• Senile Entropion
• Th/ : blepharoplasty (reconstruction)

• Acute spastic
• ocular inflamation
• ocular irritation
• Cicatricial entropion
• caused by cicatrix/shortening of the tarsus
• E/ :
• trauma thermal, chemical burns and eye lid injury
• infections : trachoma, herpes zoster
• Th/
• eye lid reconstruction
• trachoma --> Sie Boen Lian technique (SBL)
• Ectropion
– turning out of the eye lid margin--> conjunctiva is not
well covering --> thick, red, chronic conjunctivitis
• Congenital ectropion
• Senile ectropion :
• caused by tissue relaxation--> loss of eye lid
tone-->evertion of margin
• often seen in the lower eye lid
• Paralytic ectropion :
• caused by N.VII palsy--> poor blinking &
lagophthalmos
• Cicatrical ectropion

• Th/ : blepharoplasty/reconstruction
 TRICHIASIS

• Trichiasis : Inturned eyelash may

lead to complication including
chronic conjunctivitis, corneal
abration and ulceration

• Caused by : scarr tissue of the

conjunctiva surface (common
complication of trachoma), senile
entropion, spastic entropion

• Therapy : Epilation, surgery

• Lagophthalmos
– the eyelids aperture can not close perfectly
– E/ : paralyze of N.VII, cicatrix, proptosis, tumor
– complication : xerosis (dry eye)
• Ptosis
– the upper eye lid can not
open perfectly
– unilateral/bilateral
– congenital ptosis
– acquired ptosis
• senile
• myogenic
• neurogenic (paralyze of N.III)
• trauma
• mechanic (tumor)
– Th/ :
• fasanela servat
– if some and the function of levator
still good
• levator shortening
– skin approach or conjunctival
approach
 EYELID RETRACTION

The usual cause is overactivity of the levator muscle from

hyperthyroidism. In severe cases, a recession of the levator
muscle may be done.
Control of hyperthyroidism may be helpful.
TERIMA KASIH