bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Anterior and Posterior Lens Dislocation in Marfan Syndrome in Teenager : A Case Report
Authors: Daeli Pasti Rahmat , Ferdiansyah Muhammad , Agustiawan Referano , Ihsan Nasheul
Published: February 2024

Introduction : The zonular defect leads to ectopia lentis, which is a hallmark of Marfan ocular abnormalities. Bilateral dislocation of lens in marfan’s syndrome occurs frequently in same location. In this case the lens of RE dislocated in the anterior chamber and the lens of LE was found in vitreous cavity. Iris fixation IOL and Yamane’s scleral fixation technique are prompt treatment for crystalline lens displacement.

Case Illustration : A 14 year-old male patient came with chief complaint a painless blurred vision on LE since 2 weeks before visit Ophthalmologist. The BCVA in both eyes was 6/30 RE and 1/60 LE. There was no history of ocular injury nor development disorder. Lens dislocation in anterior chamber was found in RE and aphakic lens was found in LE during slit lamp examination. The IOP ODS were 9.7 mmHg and 3.0 mmHg. Further examination from funduscopy showed the lens of LE was seen in vitreous cavity.

Discussion : Bilateral dislocation of lens in opposite position are quite rare. To avoid many of the potential complications, Iris Fixation IOL placement is preferred choice to improve visual impairment on the right eye. Yamane’s Scleral Fixation technique has been performed on left eye however challenging and time consuming it is, to achieve excellent improvement with minimal or no intra- and postoperative complications.

Conclusion : This case shows that manifest of crystalline lens in marfan syndrome could happen differently to each eye. Different surgical approach especially IOL placement technique is crucial and must be considered carefully depends on the condition during surgery.
Management of Iatrogenic Iridodialysis with Single-pass Four-Throw (SFT) Pupilloplasty : A Case Report
Authors: Setiabekti Nisia Pratama , Kristianto Bobby
Published: February 2024

Introduction : Iridodialysis is a localized separation or tearing away of the iris from its attachment to the ciliary body. It occurs most commonly secondary to trauma, and it is more frequently associated with blunt traumas compared to penetrating eye injuries. Iridodialysis can also occur due to intraocular surgeries. The prevalence of iridodialysis secondary to blunt trauma was reported to be 9.3-14% as compared to 0.2% caused by cataract surgeries. Small and superiorly located iridodialysis may be left untreated. However, a more inferiorly placed, larger, or symptomatic iridodialysis warrants surgical repair.

Case Illustration : A Male 62 years old came with chief complaint Glare on right eye after complicated cataract surgery 2 months before.Patient also complained blurry vison without redness. Examination found visual acuity 6/60 UCVA RE, iridodialysis at superior region from 10 o’clock until 1 o’clock, IOL (+) with good central, Normal Posterior Segment. Patient was treated with Single-pass Four-Throw (SFT) Pupilloplasty with local anesthesia and 1-month after Pupilloplasty we found visual acuity 6/30 UCVA RE and without any glare complaint anymore.

Discussion : Management of this patient is a challenging case. The treatment og Single-pass Four-Throw (SFT) Pupilloplasty can give great outcome for visual acuity and glare symptom. SFT Pupilloplasty is also great and easy technique for beginner eye surgeon but for anesthesia, general anesthesia is more convenience than local ones.

Conclusion : SFT Pupilloplasty is also great and easy techinique for iatrogenic iridodialysis.
Management Strategies of Ocular Alkaline Chemical Injury
Authors: Nadia Ayu Destiani  , Patriotika Muslima  , Elfa Ali Idrus  , Arief Akhdestira Mustaram  , Angga Fajriansyah
Published: February 2024

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done.

Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2).

Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane.

Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.
Management of Subluxated cataract : A case report
Authors: Ufadila Lulu Hasna , Hitam Hilman
Published: February 2024

Introduction : Surgical management of ectopia lentis is one of the major challenges faced by cataract surgeons. A cataract is a clouding of the natural crystalline lens inside your eye. Symptoms may include loss of vision, blurry vision or distortion.

Case Illustration : A 70 year old man comes of misty eyes in his right eye. History of trauma is unknown to the patient, there is no recurrent red eye, no pain in the eye. Physical examination revealed vital signs within normal limits. Vision right eye 6/12 left eye 1/60 (pseudophakia). Eyeball pressure OD 19 OS 11, good eyeball movement in all directions. The anterior segment of the superior and inferior lids ODS is calm, ODS bulbi conjunctiva is calm, ODS cornea is clear, ODS pupils are round RC +/+ RAPD (-) pupil diameter OD 5.5 mm OS 6 mm, OD lens is subluxated inferonasal.

Discussion : The change in the position of the lens with different head positions helps to indicate the severity of subluxation. In eyes with ectopia lentis, the phacoemulsification technique used depends on the degree of zonulopathy and its underlying pathophysiologic origin. Hoffman et al classified the degree of subluxation into three broad groups mild, moderate, severe which the lens edge uncovers more than 50% of the pupil.

Conclusion : The natural crystalline lens is held in place by tiny fibres called zonules. When these zonules are disrupted or weakened, the crystalline lens or more commonly the artificial intraocular lens may sublux (dislocated) into the back of the eye.
Bilateral Ocular Ischaemic Syndrome due to Carotid Artery and Cardiovascular Disease: A Case Report
Authors: FIBRIAN KARTIKA CINDY
Published: February 2024

Introduction : Ocular ischemic syndrome (OIS) is a rare but potentially blinding and fatal condition caused by carotid artery disease or other systemic condition results in ocular hypoperfusion.

Case Illustration : A 62-year-old male with sudden bilateral vision loss, swelling, redness and pain of both eye for 7 days. There were dilated conjunctival and episcleral vessels, visual acuity of the right eye was hand movement and 0.05 for left eye, intraocular pressure (IOP) was 33 mmHg in right eye and 37 mmHgfor left eye. Anterior segment evaluation revealed rubeosis iris, mild anterior chamber reaction, and temporal angle neovascularization on gonioscopy. Both direct and consensual light reflexes were sluggish. Fundus examination showed normal optic disc, minimal hemorrhages at mid-periphery, narrowed arterioles, and minimal cotton wool spot. Macular OCT demonstrated discrete hyperreflectivity of inner retinal layers. From Macular Angiography OCT, ETDRS Central vessel density were 11.2% and 17.6% for the right eye and left eye, respectively. In both eyes, paracentesisof anterior chamber, intravitreal and intracameral injections of anti-VEGF were performed. Brain Magnetic Resonance Angiography Imaging revealed moderate stenosis of both distal carotid artery circulation. Percutaneous Coronary Angiography showed extensive stenosis in coronary artery, with low Ejection Fraction.

Discussion : For the cardiovascular management, a pacemaker was implanted. One week after procedure, BCVA were 1/60 and 0.15, and IOPs of 17 and 18 mmHg, for the right and left eye, respectively. The patient was scheduled to have laser retinal photocoagulation.

Conclusion : Quick clinical diagnosis, targeted workup for systemic associations, and prompt treatment might preserve life and sight in OIS.
WHAT WE SHOULD DO FOR CROUZON SYNDROME ?
Authors: RYAN AQUARI  , Linda Trisna  , Riani Erna
Published: February 2024

Introduction : Crouzon syndrome is a rare genetically disease characterized by craniosynostosis resulting in skull and facial deformities. Fortunately, not all patient requires surgery so we will review the workup of Crouzon syndrome and describes the collaboration of health professionals needed to manage this condition.

Case Illustration : A 10 years old boy came to hospital with exophthalmos since birth. There is decreasing of visual acuity on RE caused by atrophy papil and leads to sensoric exotropia. There is also lagophthalmos 1 mm on the both eyes. Brain CT shown there are craniosynostosis and thickening of the rectus muscles. This patient also do a bone Survey with the result are asymmetrical calvarial thickening, cooper beaten skull, shallow orbits, depressed nasal bridge and hypoplasia maxilla. This case is managed by multidisciplinary to correct the maldevelopment of the midface and orbits to prevent blindness, airways obstruction and intellectual disability related.

Discussion : The combination of detailed family history, the use of various imaging modalities and genetic testing help differentiate the spectrum of craniosynostosis syndromes. The management is complex and requires a team of subspecialists including pediatricians, oral maxillofacial surgeons, plastic surgeons, neurosurgeons, otorhinolaryngology, and ophthalmologists (pediatric and oculoplastics). Long-term follow up needed to monitor ocular development due to the propensity strabismic amblyopia and atrophy optic.

Conclusion : An interprofessional team approach will provide the best outcomes and recognizing possible complications for crouzon syndrome.
Tuberculosis-related episcleritis: a case report
Authors: RINA WULANDARI  , Erdina Hana Jelita
Published: February 2024

Introduction : Tuberculosis (TB) is a leading cause of infectious disease in developing and highly endemic countries. Primarily affects the lungs, but also invariably involves ocular tissue. Association of TB and episcleritis is very rarely documented and no such case has been reported in Indonesia.

Case Illustration : A 39-year-old female presented with unilateral mild pain and redness of right eye two weeks before admission. It was her fourth episode in one year. Previous steroid and non- steroidal anti- inflammatory drug (NSAID) treatment partially ended her symptoms before reappeared. Rheumatoid disease also TB history of her and her family were denied. There was nodular episcleritis in the inferior part of the right eye. Systemic investigation showed leukocyte and erythrocyte sedimentation rate (ESR) elevation, positive Mantoux test, with normal chest radiograph. Later symptoms and lesion resolved after anti tubercular therapy (ATT).

Discussion : Episcleritis is mostly idiopathic, only one third of cases are found to be related with systemic condition. Association of tuberculosis with episcleritis is very rare, only a few cases have been reported worldwide. We encountered a case of tubercular episcleritis by the history of recurrent episode which not responding with regular medication, positive Mantoux test and Indonesia’s TB endemic status. Additionally, improvement after ATT also confirmed the diagnosis.

Conclusion : This case suggests that TB can cause episcleritis, especially in TB endemic countries. TB should be considered in facing recurrent episcleritis cases to avoid unnecessary complications.
Chemical Eye Burn Injury Due to Polyester in Industrial Worker: A case report
Authors: Zahira Rikiandraswida  , Ayu Anggraini Kusumaningrum
Published: February 2024

Introduction : Chemical eye burns are common causes of work-related eye injuries. Prompt and appropriate emergency management may be the most important factor in determining the visual outcome.

Case Illustration : A 50-year-old man who works in a plastic factory immediately went to the emergency room after being exposed to melted polyester in his right eye. He complained of hurt and hotness in his eye. The emergency primary survey was stable. Triage of ophthalmology was an emergency. Initial Uncorrected Visual Acuity (UCVA) was light perception with correct projections. Physical examination revealed 2nd-degree combutio on the forehead and left cheek. Anterior right eye examination revealed palpebral edema, polyester debris on the eyelid, conjunctival mixed injection, ischemia of less than 1/3 of the limbus, corneal edema, corneal opacity, and polyester sticking to the cornea. The damage was determined as Roper-Hall grade II. In the Emergency room, Eye was immediately irrigated with 1 L of normal saline. A referral was made to the ophthalmologist and Immediate debridement was carried out. Wide corneal erosion was found after the procedure. Treatment was continued with antibiotic eye drops, lubricant eye drops, oral vitamin, and oral analgetic. The patient had improved visual acuity to 20/20 f2 with corneal scar and opacity 1 month after surgery.

Discussion : The combined management of this case consisted of ocular lavage, surgery, and medication. A Chemical Eye Burn requires immediate management to prevent extensive damage leading to visual impairment.

Conclusion : Initial treatment in the emergency department and referral to the ophthalmologist can improve patient outcomes.
Sympathetic ophthalmia following corneal patch graft for corneal perforation
Authors: RENI ANGRAINI  , Havriza Vitresia
Published: February 2024

Introduction : Sympathetic ophthalmia (SO) is a rare, bilateral, diffuse granulomatous uveitis that usually occurs after open globe injury or intraocular surgery. We report a rare case of SO after the closure of corneal perforation using a corneal patch graft.

Case Illustration : A 12 year old boy diagnosed as corneal perforation in the right eye, with visual acuity (VA) 20/100, underwent a corneal patch graft. He presented with redness and decreased vision in both eyes 2 weeks after surgery. The patient had VA of hand movements in the RE and 20/200 in the LE. Anterior segment examination showed a corneal patch graft with iris adherent to the graft posteriorly in RE, endothelial dusting, 2+ cells in both eye. Fundus examination showed optic disc oedema in both eye and inferior retinal detachment with macular involvement in RE. The patient was managed with pulse steroids for three days followed by oral steroids in tapering doses along with continued topical steroids. Three months follow-up showed improvement of VA to 20/60 in RE and 20/25 in LE

Discussion : SO is thought to be an autoimmune response to uveal injury. The incarceration of uveal tissue in the wound is a major risk factor. SO has been reported 5 days to 66 years after penetrating insult to the eye. In this case, incarceration of uvea in corneal pacth resulted in SO 2 weeks after surgery.

Conclusion : In a case of a perforated cornea, the possibility of iris incarceration in the wound is high and hence SO can develop
PENETRATING EYELID INJURY DUE TO FISHING HOOK : AN UNUSUAL CASE
Authors: BIMA RYANDRA PUTRA  , RIANI ERNA
Published: February 2024

Introduction : Ocular penetrating injury due to fishing hook is rarely reported. Identifying organ structures involved and determining appropriate approach will affect the outcome. This special case explained penetrating eyelid injury due to fishing hook without ocular involvement.

Case Illustration : R, boy, 12y.o, came to M.Hoesin ED in January 2023 with complaint of left eye was exposed to fishing hook one hour before admission. Patient was experiencing mild pain with pain scale of three, no blurry vision, excessive tears nor blood. History of immunization was uncomplete.There was no significant visual disturbance. On left superior palpebra, there was a fishing hook penetrated into the medial superior palpebra (partial thickness) without any marginal involvement, no active bleeding, and corneal abrasion in central-paracentral nasal 6-9 o’clock direction. Patient was diagnosed with penetrating eyelid injury due to fishing hook. Intraoperatively back-out technique were performed to extract the fishing hook. Patient was prescribed with 250IU Tetagam injection, chloramphenicol eye ointment, and oral analgetic.

Discussion : Ocular penetrating fishing hook injury could cause severe complications. In this patient, it only penetrates the eyelid until the dermis layer without marginal involvement. Complications occurred were only corneal erosion with minimal pain. After the operative procedure, topical antibiotic and analgetic were administered. There was no decreased levator palpebra function and corneal erosion was resolved in three days after topical antibiotics were administered.

Conclusion : Management of ocular penetrating fishing hook injury is challenging. Determining the best technique to extract the fishing hook depends on the depth and type of fishing hook.
Adherent leukoma with iris prolapse and cataract in old farmer patient : a case report
Authors: Lulu Hasna Ulfadila  , Hilman Hitam
Published: February 2024

Introduction : Adherent leukoma is a condition of the formation of white scars with the involvement of iris incarceration on the cornea, scar which has fibrous tissue adherent to its deeper surface.

Case Illustration : a 70 year old grandfather with complaints of blurry right and left eyes, especially in the left eye there are white spots that increasingly interfere with discomfort vision in 5 months ago. The patient works as a rice farmer every day and is likely due to frequent trauma from being exposed to rice seeds since he was young. There is no history of disease and he likely to used insto eye drops. General physical examination is normal. VODS 6/15. IOP OD 11 and OS 7. There is adherens leukoma at 11 o'clock and iris prolapse and there are cataracts as well as the right and left eyes which are still thin. fundoscopy within normal limits.

Discussion : Corneal opacity such as adherent leukoma generally results from incidental or iatrogenic trauma. In this case, the patient was traumatized showed post-traumatic cases to be the most common cause of corneal opacity (47.2%), followed by post-ulceration cases (37.7%), glaucoma (7.5%), and other unknown causes (4%). A few rare cases of non-traumatic bilateral adherent leukoma have been described to occur in association with protein energy malnutrition, vitamin A deficiency, herpetic infections and measles. Corneal tattoos and corneal transplantation have been used in treating corneal opacities with varying results.

Conclusion : White corneal scar on leucoma represents fibrosis secondary to a previous corneal insult, most frequently trauma or infection.
Effects of Dark Chocolate and Milk Chocolate consumption on Sub foveal Choroidal Thickness in healthy young subject: A Randomized double-blind Cross over Study
Authors: LA ODE HAMZAH  , YUNITA, MD  , BATARI TODJA UMAR, MD
Published: February 2024

Abstract

Introduction & Objectives : Dark Chocolate consumption was known to effect blood flow and to date there is little information about this effect to human eye. We aim to compare the effect of consuming dark chocolate (DC) and milk chocolate (MC) on sub foveal choroidal thickness (SFCT) and blood pressure (BP) in healthy young subject

Methods : A randomized double blind cross over study was used. We randomly assigned subjects into two group. First group consumed DC and then MC at least 72 hours later and the second group consumed MC and then DC. BP and SFCT was measured at baseline, 30 minutes and 2 hours after consumption for each group

Results : Data from two group (Group A; 40 eye/20 subject, age 26 -36 years and group B; 40 eye/20 subject, age 27 -34 years) were collected. There was an increase on SFCT at 30 minutes (DC 11.05 ± 13.720 μm, p>0.01; MC 4.40 ± 8.040 μm, p>0.01) and 2 hours (DC 23.45 ± 11.581 μm, p>0.01; MC 9.92 ± 11.288 μm, p>0.01) after consumption compare to baseline. There were no changes found on BP and there was no correlation found between BP and SFCT changes

Conclusion : This study found that there was a significant increase in SFCT especially in DC consumption in 30 minute and 2 hours after consumption. There were no changes in BP and No correlation was found between BP and SFCT changes
TRABECULECTOMY IN CLOSED ANGLE UVEITIS GLAUCOMA A CASE REPORT
Authors: SAMOSIR ALEXANDER THEODORE , NATAN PRISCILLA CHRISTINA
Published: February 2024

Introduction : Glaucoma uveitis is caused by increased outflow resistance, which distorts the balance between water production and outflow. Trabeculectomy is better than LPI in controlling IOP in glaucoma uveitis

Case Illustration : Male patient aged 45 years, came to the Eye Polyclinic at Serui Hospital with complaints of very painful right eye since 2 weeks ago, the patient also complained of being unable to see at all, red eyes, headache, stiff neck, nausea and vomiting. Ophthalmological examination reveal right eye vision no light perception (NLP), palpebral edema, spasm, conjunctival hyperemia, corneal edema, shallow anterior chamber angle, iris-corneal contact, negative pupillary reflex, total pupillary block, negative fundus reflex, schiotz IOP 81 mmHg.

Discussion : The patient diagnosed as right eye acute glaucoma and treated with acetazolamide, timolol maleate eye drops, potassium aspar tablets, prednisolone acetate drops, diclofenac sodium drops in the right eye, paracetamol tablets, re-evaluate in 2 hours. The patient chose to be referred to a hospital in Surabaya. The patient came back with the same complaint and was treated the same as before, right eye surgery trabeculectomy + peripheral iridectomy with releaseable suture flap limbal base with controlled IOP results, releaseable suture sutures were removed in 2 weeks. Trabeculectomy of the uveitic eye is generally less successful because of accelerated wound healing by the postoperative fibrinous and cellular response. Antimetabolites such as 5FU and Mitomycin C are used to enhance the success of trabeculectomy in uveitis eyes (5FU, MMC). 95% success (IOP less than 21 mm Hg with 1 or no treatment) was achieved with MMC augmented trabeculectomy.

Conclusion : Increased IOP due to pupillary block causes acute glaucoma with signs of high IOP, middilated pupils, decreased pupillary reflexes, and irregular shape, corneal epithelial edema, episcleral and conjunctival vascular congestion, shallow anterior chamber, small number of flares and cells.
Hybrid Contact Lenses in Children: a Case Series
Authors: ADISTI LUKMAN
Published: February 2024

Introduction : Refractive errors in children have experienced a significant increase in recent years. Contact lenses are a therapeutic option when spectacles can no longer provide maximum results. One of the most advanced design than suitable for children is Hybrid Contact Lenses (HCL). HCL feature a Rigid Gas Permeable (RGP) center surrounded by a soft ridge or skirt. This design enable the hard center to provide clear vision while the soft skirt offers the comfort and ease of a soft lens. However, this type of contact lens has not been widely used in Indonesia.

Case Illustration : Three patients were prescribed HCL to correct their high refractive errors and amblyopia; 1. 5 years old female: OD: S-14.50 C-3.25x180 6/24 OS: S-12.5 C-3.50x10 6/24; 2. 5 years old female with anisometropia: OD: S-6.00 C-2.50x180 6/12 OS: S-0.75 C-2.000x170 6/6; 3. 8 years old male with pseudophakic eyes: OD: S-9.00 C-2.00x180 6/30 OS: S-8.00 C-2.00x175 6/30. Visual Acuity after 1 month of HCL average from 6/9 to 6/6 both eyes (BE).

Discussion : In this study, we can notice several advantages of using HCL. The main outcome are significantly increased visual acuity and reduced amblyopia. HCL also has a higher comfort level compare to RGP Lenses, the soft hydrogel skirt really help the neophyte patient to ease their initial adaptation.

Conclusion : Contact lenses are a mainstay of optical correction options for children with special refractive needs. Due to it's design and comfort, HCL is one of the most suitable contact lenses for children. Therefore, socialization and further introduction about this contact lens is needed.
DISTRIBUTION OF HEALTH FACILITY SERVING CATARACT SURGERY IN SOUTH SULAWESI
Authors: ARIFFIN ANNISA IKHSANIAH , Amalius Ahmad ashraf , Faisal Andi Akhmad , Kamaruddin Muhammad Irfan
Published: February 2024

Introduction & ObjectivesOne of the elements in Vision 2020: the right to sight is the fulfillment of resources to reduceavoidable blindness. According to the Indonesian’s prevention of blindness roadmap about sources,we need to collect the data about health facilities serving cataract surgery. The aim of this study isto provide the data about health facilities serving cataract surgery in South Sulawesi Province.

MethodsA descriptive study using a questionnaire which is distributed to hospitals/clinics in South SulawesiProvince. In addition, secondary data was also used from previous research conducted by one of theresidents of Ophthalmology at Hasanuddin University. All the data were collected from Januari toJune 2022.

ResultsThe distribution of health facilities in all districts/cities in South Sulawesi has at least one healthfacility serving cataract surgery, with the most distribution in Makassar. Twelve of 62 hospitals andfive of 27 eye clinics have not provided cataract surgery services..There are 6 districts (25%) thathave not fullfil the minimum number standard of ophthalmologist according to WHO. Alldistrict/cities in the Province have all the instrument required for cataract surgery.

ConclusionEvery district/city in South Sulawesi has at least one health facility serving cataract surgery.Information on the distribution of health facilities serving cataract surgery needs to be routinelyconducted twice a year according to Indonesian’s prevention of blindness roadmap.
Virna Glaucoma Drainage Device Implantation On Pediatric Patient With Steroid Induced Glaucoma
Authors: CHRISTIAN ANDREW DARIAN SIANIPAR  , Fidalia  , Sari Prima Maya
Published: February 2024

Introduction : Steroid-induced Glaucoma (SIG) in pediatric patient is reported to have a more progressive and severe manifestations often unresponsive to glaucoma filtration surgery. We aim to report a successful management of SIG using Virna implant on pediatric patient.

Case Illustration : A 10 years old boy underwent bilateral Virna GDD implantation following uncontrollable IOP after multiple trabeculectomies. The patient presented with a UCVA of 4/60 on both eyes. IOP of RE and LE is 31.8 mmHg and 29.7 mmHg respectively with four anti-glaucoma medications. Both eyes revealed conjunctival hyperemia with no bleb formation, VH3 AC, 12 o’clock iridectomy, C/D ratio of 0.9 with bayonet sign and nasalization on indirect funduscope, open angle on gonioscope, annular scotoma on Humphrey, and diffuse thinning of RNFL on OCT. Six months postoperatively, BCVA of RE and LE is 6/60 and 6/30 respectively with minimal progression on both ocular visual field defects. As for IOP, RE IOP is 18.7 mmHg with two anti-glaucoma medications and LE IOP is 14.3 mmHg without anti-glaucoma medications.

Discussion : Multiple failed trabeculectomies is an indication for GDD. Virna implants are meant for adult subsequently making plate and tube placement crucial in pediatric patient because the globe is still growing and relatively thin. It is necessary to evaluate IOP periodically after implantation as IOP will enter hypertensive phase and stabilize in 3-6 months.

Conclusion : GDD implantation, including Virna Implant, is a viable alternative to children with refractory SIG to prevent further glaucomatous damage.
MANAGEMENT OF CONJUNCTIVAL MELANOMA ARISING FROM PRIMARY ACQUIRED MELANOMA (PAM) : A CASE REPORT
Authors: DYAH TJINTYA SARIKA  , Hernawita Suharko
Published: February 2024

Introduction : Conjunctival melanoma (CMM) is a rare but potentially a life threatening ocular malignancy. It is an aggressive pigmented tumor and the recurrence rate may be as high as 51% over 10 years.1,2 Surgical wide local excision of the tumour and cryotherapy are current standard treatment of CMM.3,4 The purpose of this case is to report our successful management of conjunctival melanoma using wide excision and cryotherapy.

Case Illustration : A 67-year-old man who presented to our hospital with a large, pigmented lesion arising from inferior and superior fornix conjunctiva in his left eye since 6 months ago. On examination, a massive pigmented tumor sized 25 x 10 x 15 mm, protruding from inferior fornix conjunctiva and sized 7 x 5x 3 mm arising from superior fornix conjunctiva of left eye. The mass was excised with 3 mm free margin from the tumour border confirmed with negative frozen section and followed by cryotherapy and conjunctival reconstruction using oral mucous graft. Histopathology confirmed with invasive conjunctival melanoma arising in PAM with severe atypia and no lymphovascular and perineural metastasis

Discussion : Two months after we performed wide excision, cryotherapy and oral mucous graft, no recurrence and conjunctival necrosis at primary site were reported.

Conclusion : A local wide excision with ‘no touch technique’, cryotherapy and oral mucous graft confirmed with negative frozen section are the mainstay treatment of CMM and has achieved satisfying functional outcomes. Since the high recurrence rate of CMM, we have to close follow up for the next 3 years
Survival Analysis Of Dry Eye Disease Related To The Bleb Morphology In Primary Glaucoma Patient Post Trabeculectomy
Authors: MELISA ESTER LETARENI
Published: February 2024

Abstract

Introduction & Objectives : Dry eye disease (DED) has a prevalence of approximately 40-59% of all glaucoma patients. Changes in cellular structure after trabeculectomy underlie the instability of the tear film. This study aims to determine the relationship between DED and post-trabeculectomy bleb morphology.

Methods : An observational study with survival analysis design to evaluate the time to DED in primary glaucoma patients with post- trabeculectomy blebs was undertaken at the Eye Health Polyclinic of Mohammad Hoesin Hospital Palembang from January to March 2022. There were 30 primary glaucoma patients who met the inclusion criteria. Bivariate analysis to determine the relationship between bleb morphology and DED was analyzed using the Fisher Exact test. DED survival analysis was conducted using Kaplan Meier analysis.

Results : Three months after trabeculectomy, 11 of 30 (36.7%) patients suffered from DED. There was a significant relationship between bleb height and DED three months after trabeculectomy [PR = 14.222 (Cl 95% 2.324- 87.028; p = 0.004)]. In addition, the results showed that there was a significant difference in the survival time of DED in glaucoma patients based on bleb height (p = 0.001).

Conclusion : Bleb height is a predictor of DED in glaucoma patients after trabeculectomy.
Sympathetic Ophthalmia in Paediatric Post-Surgical Repair, A Case Report
Authors: Muhammad Akbar Wicaksana  , Irawati Irfani  , Mayasari Wahyu Kuntorini  , Sesy Caesarya  , Feti Karfiati  , Amiruddin Primawita O.
Published: February 2024

Introduction : Sympathetic Ophthalmia (SO) is a rare and devastating complication of ocular trauma. Incidence reached 0.26% among cohort in paediatric open globe injury. We present a case report of pediatric Sympathetic Ophthalmia.

Case Illustration : An 8-year-old boy is present in an outpatient clinic with a history of corneal lacerating injury on LE 1 month ago and had surgical repair 7 days after the injury. The patient complained of redness and blurry vision in both eyes. VA RE 0.5 and LE 0.05. RE revealed ciliary injection, flare/cell (f/s) +2/+2, and vitreous cell +1. LE revealed ciliary injection, corneal scars, f/s +2/+2, and vitreous cell +2 (Fig. 1). Fundus and OCT revealed macular oedema with exudative retinal detachment RE and bilateral optic nerve head swelling (Fig. 2). Patient was diagnosed with sympathetic ophthalmia and treated with prednisolone acetate 8x per day for RLE with high-dose oral steroid methylprednisolone 1 mg/kg body weight (32 mg). One week after treatment, clinical findings were improved, and the steroid was tapered. After 2 months f/s, macular oedema, exudative retinal detachment and optic nerve head swelling were resolved with VA RE 1.0 and LE 0.4.

Discussion : Although the etiology of SO is currently unknown, it is believed that hypersensitivity following trauma to the fellow eye may be the trigger. The severity of SO's clinical presentation might range from mild to severe.

Conclusion : Sympathetic ophthalmia is a serious complication that rarely occurs after trauma, especially in the pediatric population. Prompt treatment of oral and topical corticosteroids may lower the inflammatory response.
Intravitreous aflibercept or vitrectomy for initial treatment of diabetic vitreous hemorrhage? A Systematic Review of Current Evidence
Authors: Ningrum Indra Utami Mutiara , Primarhyani Marchia
Published: February 2024

Introduction & Objectives : To assess the efficacy and safety of intravitreous aflibercept versus vitrectomy in patients with diabetic vitreous hemorrhage (VH)

Methods : Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE database were searched. No constraints based on language or publication date were applied. Only randomized controlled trials (RCTs) comparing intravitreal aflibercept injection with vitrectomy procedure were included. Search results were screened independently by two authors. Data extraction and synthesis were performed according to The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome measures were best-corrected visual acuity obtained at least 6 months following interventions, rate of recurrent hemorrhage, and periprocedural ocular adverse events. The quality of evidence was assessed using the GRADE tools.

Results : Two clinical trials that randomized 239 eyes were included in this review. There was no evidence ofa difference in primary outcome of mean visual acuity at six months between randomized groups. However, patients receiving intravitreous aflibercept were more likely to experience recurrent VH than those undergoing vitrectomy (RR 3.12 95% CI 1.95 - 4.99, absolute effect of 32 more people with recurrent VH per 100 people treated with aflibercept). Rates of periprocedural ocular complications were similar in both groups.

Conclusion : Intravitreous aflibercept safety and efficacy appear to be non-inferior compared to vitrectomy for initial management of diabetic VH. Further well-designed studies are needed to investigate the long- term effects of treatments.
Low Prevalence of and Related Factors for Myopia in Primary School Children in North Maluku
Authors: Sayyidati Rokhimah
Published: February 2024

Introduction & Objectives : Myopia is a refractive error that commonly occurs in children, and its onset usually begins during school age. Factors associated with myopia development include genetic and environmental factors. This study aims to investigate the prevalence of myopia and related factors associated with its development in primary school children in the North Wasile District, one of the most remote areas in North Maluku Province, Indonesia.

Methods : A cross-sectional study was conducted from May to September 2022 in 8 primary schools in North Wasile. Children's visual acuity was examined using a Snellen or E chart, and an anterior segment examination was also performed. A questionnaire was completed by the parents of the children.

Results : A total of 431 primary school children with an age range of 6–13 years and a mean age of 9.4 years participated in the study. Myopia was found in only four children (0.9%), and it was categorized as mild myopia. Among the school children, the majority had non-myopic parents (84.7%), had never watched television (54.1%), had never used mobile phones (37.6%), and spent more than 3 hours per day engaged in outdoor activities (97.7%).

Conclusion : The prevalence of myopia is relatively low in primary school children in North Wasile, North Maluku. Having non-myopic parents, spending less time on near work, and spending more time engaged in outdoor activities appear to have a protective effect against myopia.
SCREENING FOR DIABETIC RETINOPATHY AND PROPTOSIS TO PREVENT BLIND IN JERO MANGKU CULTURE INTARAN VILLAGE, WEST SANUR
Authors: Noviantari I Gusti Agung Ratna , Suryathi Ni Made Ari , Suryanadi Ni Made
Published: February 2024

Introduction and Objective: The social service of diabetic retinopathy (DR) and proptosis screening by going directly to the community is one of the efforts to reduce blindness. The aim of this study is reporting the result of DR and proptosis screening toward priests in Intaran Village, Sanur Kauh, Bali.

Method: This is an observational study with cross-sectional approach conducted in April 2022.We performed DR screening using portable funduscopy and proptosis screening using Herthel exophthalmometry. Collected data were analyzed descriptively.

Results: In the diabetic retinopathy screening, a total of 8 participants had their eyes examined. Based on the results of the examination, 3 people and 5 eyes were found to have diabetic retinopathy. Of the 3 participants who had RD, two participants had bilateral RD, while 1 had unilateral RD. Of the 5 eyes that had RD, four eyes had a mild degree, while 1 eye had a moderate degree. None of the eyes had severe degrees. Participants with RD were given referrals for further treatment. The average Hertel exophthalmometry examination result in the right eye was 14.30 ± 2.14 mm while in the left eye was 14.46 ± 2.11 mm. This data can be used as a reference for normal values in the population.

Conclusion: DR screening is important because it can detect the disease before the appearance of complaints. DR screening by going directly to the community can also reach people who have difficulty in accessing health care facilities.
Persepsi Masyarakat Terhadap Buruh Tani Perempuan Di Desa Wuwuk Kecamatan Tareran Kabupaten Minahasa Selatan
Authors: Lengkong Gabriela Melisa , Pangemanan Paulus Adrian , Kaunang Rine
Published: February 2024

This study aims to describe people's perceptions of female farm laborers in Wuwuk Village, Tareran District, South Minahasa Regency. The research was conducted from May to July 2023. The data used in this study were primary data and secondary data. Primary data was obtained from direct interviews with 25 respondents who are the general public of Wuwuk Village. Secondary data obtained from literature studies, libraries, and journals. The sampling technique in this study is purposive sampling technique. The data analysis method used is descriptive analysis. The results of the study show that the people of Wuwuk Village on average agree with women's work as farm laborers because according to the community work as farm laborers is work that not only men but also women can do. The Wuwuk Village community considers that the women farm workers in Wuwuk Village are tough women whose energy and performance are not inferior to men, and there are even women whose energy and performance are better than men. However, there are also people who disagree with women's work as farm laborers because according to the community work as farm laborers is not suitable for women, they argue that women should focus on household activities.
Effects of Using Digital Magazines "Sobat Busui" Against Mother's Knowledge and Attitudes About Breastfeeding
Authors: Islamiyah Alfin Nihayatul , Dina Isfentiani  , Dwi Purwanti  , Kharisma Kusumaningtyas
Published: February 2024

Breast milk is best food babies. In this era information technology is developing very rapidly, this brings changes in society. It is possible that breastfeeding mothers also use Android-based media to access information on the internet about breastfeeding. The purpose to analyze the effect of using the digital magazine “Sobat Busui” on mothers’ knowledge and attitudes about breastfeeding. Research method is quantitative research with a Quasi Experiment Design study with one group pre post test design. The independent variable is the use of digital magazines about breastfeeding, the dependent variable is the mother's knowledge and attitudes about breastfeeding. To analyze the effect using the Wilcoxon test. The results showed good knowledge (56.4%) before using the digital magazine “Sobat Busui” after using the digital magazine “Sobat Busui” showing a good increase in knowledge (70.9%) then for a positive attitude (50.9%) before using digital magazine “Sobat Busui” and after using digital magazine “Sobat Busui” showed an increase in positive attitude (67.3%). Wilcoxon test knowledge variable p = 0.006 (< 0.05) and attitude variable p = 0.000 (< 0.05). This means that there is an effect of using the digital magazine “Sobat Busui” on mothers’ knowledge and attitudes. The conclusion is an increase in mothers’ knowledge and attitudes after using the digital magazine “Sobat Busui”. The suggestion is health workers are expected to use the digital magazine “Sobat Busui” as a support in providing health education about breastfeeding and for researchers to add cultural factor variables in future research.
Validating Collatz Conjecture through Binary Representation and Probabilistic Path Analysis
Authors: Zaman Budee U
Published: February 2024

The Collatz conjecture, a longstanding mathematical puzzle, posits that, regardless of the starting integer, iteratively applying a specific formula will eventually lead to the value 1. This paper introduces a novel approach to validate the Collatz conjecture by leveraging the binary representation of generated numbers. Each transition in the sequence is predetermined using the Collatz conjecture formula, yet the path of transitions is revealed to be intricate, involving alternating increases and decreases for each initial value. The study delves into the global flow of the sequence, investigating the behavior of the generated numbers as they progress toward the termination value of 1. The analysis utilizes the concept of probability to shed light on the complex dynamics of the Collatz conjecture. By incorporating probabilistic methods, this research aims to unravel the underlying patterns and tendencies that govern the convergence of the sequence. The findings contribute to a deeper understanding of the Collatz conjecture, offering insights into the inherent complexities of its trajectories. This work not only validates the conjecture through binary representation but also provides a probabilistic framework to elucidate the global flow of the sequence, enriching our comprehension of this enduring mathematical mystery.
A Rare Localization of Solitary Neurofibroma: A Case Report
Authors: Azzouzi Rajaa El , Hassene Zein Abidine Babah , Dani Bouchra , Boulaadas Malik
Published: February 2024

Neurofibromas are benign connective tissue tumors that develop mainly at the expense of the endoneurium of peripheral nerves. The head and neck region is one of the sites of neurogenic tumors such as neurofibromas. Usually part of a neurofibromatosis, solitary localization in the naso-sinus cavities is rare, estimated at 4% of head and neck localizations. We report the case of an 8-year-old child hospitalized in our department for a nasal tumor, radiographic Images revealed a nasoethmoidal tumor with right orbital extension and bilateral temporoparietal schizencephaly with open cleft. Despite its rarity, solitary neurofibroma must be taken into account in the differential diagnosis of a unilateral benign tumour of the naso-sinus cavities.
Acute Intestinal Obstruction Due to a Foreign Body Migrated into the Abdomen after a Clandestine Abortion Almost 20 Years Ago
Authors: Yély Dianessy , Moussa Samaké , Souleymane Dembelé B. , S Yede, D. L. , Nadio Thierno , Oumar Sacko , Sekou Koumaré , Yusimi Ramos R.
Published: February 2024

Acute intestinal obstruction caused by a foreign body is no longer a rare phenomenon, especially if the latter is found in the digestive tract. However, the migration of an extradigestive foreign body as a cause of obstruction is extremely rare. We report the case of a 60-year-old female patient seen urgently on September 5, 2023 at 3:00 p.m. at the District Hospital of Commune IV of Bamako with the diagnosis of acute intestinal obstruction. Intraoperatively we noted grélo-uterine, grélo-sigmoid adhesions and bands tying the terminal ileum with significant intestinal dilatation upstream without signs of necrosis. Also a foreign body (tubing of a serum infuser) rigid curved of approximately 40 cm was located between the loop. The procedures performed were: adhesiolysis, sectioning of the flanges, extraction of the foreign body, toileting and installation of a Redon drain in the Douglas cul de sac. The in-depth postoperative questioning revealed a notion clandestine abortion in 2003 by a nurse in a country in the sub-region, leaving an infusion tube in place for a few hours. And she was supposed to go in the next day for a check-up, but she didn't show up. Our medical team reviewed the ASP image where we noted in addition to the central hydroaeric levels, an inverted U-shaped image of a foreign body (infuser tubing) going from the left hypochondrium to the left iliac fossa. confirming the diagnosis intraoperatively. The postoperative course was simple. The patient returned home on postoperative day 5.
Laparoscopic Port Site Infection: A Review of Its Management of 100 Cases Studies
Authors: Iqbal Kazi Sohel , Shohan Tanvir Ahmed , Hasan A M Kamrul , Parveen Ruksana , Md. Alfazzaman Md. Alfazzaman , Md. Jamaluddin Md. Jamaluddin , Mustika Riditta , Hossain Sourov
Published: February 2024

Introduction: The advent of laparoscopic surgery has transformed the landscape of surgical interventions, providing patients with the benefits of reduced trauma, shorter recovery times, and improved cosmetic outcomes. As this minimally invasive approach continues to gain popularity across various surgical disciplines, it is essential to address the associated challenges and complications that may arise. Aim of the Study: The aim of this study was to analyze the microbial distribution and antibiotic sensitivity patterns in laparoscopic port site infections. Methods: A prospective observational study was conducted on a cohort of 100 patients who underwent laparoscopic procedures at MH Samorita Medical College & Hospital, Hi Tech Surgicare Hospital & piles Centre, Savar Specialized Hospital, Lab Zone Hospital Savar, Dhaka, Bangladesh from Jan 2016 to Dec 2023. The study focused on identifying cases with culture-positive laparoscopic port site infections. Result: The Laparoscopic cholecystectomy being analyzed by Cholelithiasis, Acute cholecystitis, Ch. Cal. Cholecystitis, Empyema GB, and GB polyp. For Cholelithiasis, 33.3% of males and 40.5% of females had this condition. Regarding Acute cholecystitis, it was found in 20.0% of males and 16.7% of females. Majority 36.7% were 40 – 50 years in age group for male and 30.9% were in 40 – 50 years in age group for female respectively. Out of the total 100 patients in the study, 71% patients tested positive for port site infection. Conclusion: In conclusion, the insights gained from our study provide a foundation for advancing the management of laparoscopic port site infections.