bluuebunny/crossref_metadata_2025_split huggingface dataset:
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