bluuebunny/crossref_metadata_2025_split huggingface dataset:
When do Ophthalmology Residents Study to Prepare for The National Exam?
Authors: WIDYANA  , FELICIA WIDYAPUTRI  , SUPANJI  , MUHAMMAD BAYU SASONGKO  
Published: February 2024

Abstract
Introduction & Objectives : Ophthalmology residents are occupied with clinical services in the hospital. They only have limited time to study. Since 2022, we established a progress test for residents to facilitate their study especially during the national examination preparation that is obligated to be completed once per year. To report the allocated time for completing the progress test by ophthalmology residents to inform educational centres about the recommended study time for residents.
Methods : Data from the online progress test that was available from the Gadjah Mada eLearning (GAMEL) platform was extracted and analysed. The test was consisted of 60 multiple questions and opened for two weeks with a 24-hour access time. In this study, the scores, the time of the test, and time spent to complete the test were descriptively and quantitatively analysed.
Results : Overall, 42 out of 55 (76.4%) and 42 out of 56 (75.0%) residents completed the progress test with a total test attempt of 60 and 51 times in 2022 and 2023, respectively. The mean score achieved was 43.3 (min-max 3.3-70.0). Majority of residents (65.8%) accessed the test at between 16.00 - 23.00 Western Indonesian Time (WIT), while 19.8% and 14.4% at between 09.00 - 16.00 and 03.00 - 9.00 WIT. The mean time spent to complete the test was 55.2  20.9 minutes.
Conclusion : Most ophthalmology residents spent their time for completing the progress test after working hours with an average duration of less than an hour. Any national exam preparation programs can be scheduled in this time for better resident’s engagements.
Ocular Manifestations Of Hiv Patients At Ophthalmology Polyclinic Of Prof.Dr.I.G.N.G.Ngoerah Hospital January 2019 - December 2021
Authors: NI MADE AYU WULANDARI  
Published: February 2024

Abstract
Introduction & Objectives : Human Immunodeficiency Virus (HIV) is a disorder that affects many organs including the eyes. It is highly recommended that HIV patients be referred to an ophthalmologist before experiencing symptoms.To determine the ocular manifestations in HIV patients
Methods : This was an observational study with anayltic cross-sectional approach. Data was collected retrospectively from medical records of HIV patients who visited Ophthalmology Polyclinic at Prof.Dr.I.G.N.G. Ngoerah Hospital Denpasar for the period 1 January 2019 – 31 December 2021. Data analysis was performed using chi-square test in SPSS version 22
Results : There were 52 patients included, mostly were male (61.5%), aged 30-39 years (40.4%), WHO stage IV (63.5%) taking 1st Highly Active Antiretroviral Theraphy (HAART) (75%), have been diagnosed with HIV and consume (HAART) for 1-5 years, CD4 100-249 (42.3%), BCVA <3/60 (46.2%), and had not ckecked their HIV RNA (77.2%). There were 71 occurrences of HIV ocular manifestations with dry eye as the most common type (31%), followed by ocular CMV (26.8%). In patients with CD4 < 250, the most ocular manifestations were dry eye, in CD4 250-500 were dry eye and ocular syphilis, whereas in CD4 > 500 were ocular toxoplasmosis and ocular syphilis. There is no relationship between the use of HAART and dry eye syndrome
Conclusion : The most common ocular manifestations of HIV patients at the Ophthalmology Polyclinic of Prof.Dr.I.G.N.G.Ngoerah Hospital was dry eyes. Ocular manifestations in patients with CD4 <500 was dry eye whereas those with CD4>500 was ocular toxoplasmosis and syphilis.
Orbital Apex Syndrome in a diabetic patient, Is It Tolosa Hunt?
Authors: MADE PARAMITA WIJAYATI  , AA Mas Putrawati  
Published: February 2024

Abstract
Introduction : The presence of that specific sign in neuro ophthalmology cases can easily determine the differential diagnosis. But the challenge is how do we found the cause. We describe a case of visual loss with ophthalmoplegia in a diabetic patient suspected of having Tolosa Hunt syndrome.
Case Illustration : Woman, 63 years old with acute visual loss and feel a "heavy eyelid" in the left eye for 2 weeks. The Visual Acuity is no light perception on the left and ophthalmoplegia with mild proptosis. We do the laboratory test and MRI. No specific result of infection was found but the patient was diagnosed with diabetes mellitus (DM) type 2. MRI shows a lesion in the left cavernous sinus. Diagnosis of Orbital Apex syndrome was made. We give the patient a high dose of steroid and then continue with prednisone orally. In 24 hours after treatment the "heavy eyelid" decreased. One month after therapy there are improvements in eye movement but still no light perception.
Discussion : In cases of orbital apex syndrome with DM, we need to consider mucormycosis as the cause. In this case, the symptoms and signs as well as the MRI led to a Tolosa Hunt. Steroid administration was able to reduce heavy eyelids and cranial nerve palsy even though visual acuity had not improved after 1 month of therapy.
Conclusion : Laboratory test and Neuroimaging plays an important role to find out the cause. High-dose steroid therapy in a diabetic patient with Tolosa Hunt Syndrome can be given with tight hyperglycemic control.
A Case of Pediatric Eyelid Laceration ec Unusual Foreign Body
Authors: Olivia Mokolensang Gabriella , Umboh Roy , Umboh Anne 
Published: February 2024

Introduction : Eyelid lacerations refer to partial or full-thickness defects in the eyelid and constitute a significant subset of facial trauma which is often accompanied by other injuries including foreign bodies.
Case Illustration : A 16-year-old boy was brought to the emergency department with a laceration and penetrating orbital injury in his right upper eyelid. On examination, there was a 4 cm x 0,5 cm upper eyelid laceration caused by tooth penetrating, CT scan revealed a high density foreign body measuring 1,5 cm x 0,5 cm in the right upper eyelid as deep as levator muscle and no globe injury. The patient underwent an emergency operation under general anesthesia, the foreign body was removed completely and the size of the foreign body was 2,6cm x 0,5cm. After the removal of the foreign body, debridement was performed and then sutured layer by layer. After surgery, he was treated with Tetanus prophylaxis, antibiotic, and analgetic.
Discussion : Eyelid laceration is one of the most encountered ocular trauma, but needed to be evaluated and treated carefully. Although the rate of ocular foreign bodies found was low, it can lead to devastating ocular morbidities. After surgery and treatment, there is no other complaint from the patient. Visual acuity and ophthalmology examination are all in normal condition.
ConclusionEyelid trauma with foreign bodies must undergo a complete examination. A good prognosis and outcomes can be achieved when appropriate medical and surgical treatment is performed.
HISTOLOGICAL FEATURES OF ETHAMBUTOL INDUCED MICE EYES: A PRE- EXPERIMENTAL STUDY ON TOXIC OPTIC NEUROPATHY CASE
Authors: BATARI TODJA UMAR  , Itzar Chaidir Islam  
Published: February 2024

Abstract
Introduction & Objectives : Toxic Optic Neuropathy (TON) is a visual disease caused by toxic substances damaging the optic nerve. It can be caused by inflammation, infection, or long-term drug use. Over 10% of ethambutol- treated optic neuropathy patients developed major complications. Cellular changes should be observed histologically. This study examines ethambutol-induced mice's eye histology in the fibrous, vasculous, nervous tunica, optical media, and optic nerve tissue.
Methods : This pre-experimental study used 20 eyes of 10 white mice aged 1-2 weeks weighing 50-65 grams. Group 1 consisted of healthy mice without therapy and group 2 received 35 mg/kgBW/day of ethambutol for 60 days. (group 2). Hematoxylin eosin staining was used to observe binocular experimental animal eyes after enucleation. All measurements used Olympus® CX-20 microscope with 40x objective resolution.
Results : The average thickness of the cornea was 72.238 ± 10.542 and 60.572 ± 10.25, while the sclera was 336.533±40.851 μm and 331.339±34.219 μm. In groups 1 and 2, no significant changes were foundin the cell layer morphology of both tissues (p > 0.05). Iris, ciliary body, and choroid were observedin the tunica vasculosa. Groups 1 and 2 had eye and ciliary body lengths of 595.148±137.805 μm and 497.705±213.866 μm, respectively, and choroid thicknesses of 161.369±37.925 and 162.605±25.160 (p>0.05). Group 1 had 402.268±55.666 μm retinal thickness in the tunica nervosa, while group 2 had 399.854±27.585 (p>0.05).
Conclusion : Ethambutol-induced and normal experimental animals had substantial histological differences in optic nerve thickness, but no significant difference in the other ocular structures.
How Childhood Obesity May Be Harming Your Child’s Vision: A Systematic Review of High Myopia in Obese Children and Adolescents
Authors: Ajeng Kartika  , Seruni Hanna Ardhia  , Marcelius Patria Prabaniswara  , Sarah Shabrina  , Rona Ali Badjrai  
Published: February 2024

Abstract
Introduction & Objectives : High myopia is a severe and progressive form of myopia that can result in blindness. The prevalenceof high myopia is rising globally, and obesity has been identified as a potential risk factor, particularly in children and adolescents. This review aims to evaluate complex interplay between obesity and myopia in the young population.
Methods : A systematic literature review was conducted through PubMed, Embase, and Cochrane databases using relevant keywords. Abstract-only papers, case reports/series, and review studies were excluded, and only studies published in English between 2019 - 2023 were considered. The study selection process will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
Results : This review analyzed four studies that involved 1.326.898 participants aged between 5 to 19 years. The majority of the studies found a significant association between obesity and high myopia (p<0.05). One of the studies reported that individuals with a normal BMI have a 40% lower risk of developing high myopia compared to those who are obese. Additionally, one study found that even a slightly higher BMI value, which is not yet categorized as obesity, was significantly linked to high myopia (OR 1.19; p=0.009).
Conclusion : Most of the studies showed a significant association between high myopia and higher BMI, especially in cases of obesity. However, to establish a deeper understanding of the potential link between high myopia and obesity, further studies are necessary to consolidate data from a larger population and investigate the underlying pathological pathway.
An Uneventful Case of Unresolved Suprachoroidal Hemorrhage After Cataract Surgery: When to Operate?
Authors: Dearaini  , Ivanovna Regina , Lumintang Agnesstacia Vania , Augiani Amani Sakinah , Mawarasti Burhana , Djatikusumo Ari 
Published: February 2024

Introduction : Suprachoroidal hemorrhage (SCH) is a rare, but potentially vision-threatening condition. The management options for SCH varied and still debatable.
Case Illustration : Female 54 years old with chief complaint blurry vision of right eye (RE) since four days after she underwent cataract surgery. She also experienced radiating pain from RE with nausea and vomiting. No history of elevated intraocular pressure (IOP) before the surgery. Her left eye was blind for 20 years prior due to an unknown cause. Visual acuity (VA) on presentation was light perception good projection and IOP was 34mmHg. There was 2.5mm hyphema and fibrin on the anterior chamber. Lens appeared to be aphakic and there was lens material at pupillary margin. Ultrasonography (USG) of RE showed choroidal elevation with medium to high spike and positive after movement indicating SCH. She was hospitalised for IOP monitoring and serial USG was performed to monitor the hemorrhage. Six days after admission, IOP remain elevated despite medications and SCH didn’t resolve, then vitrectomy and scleral drainage was performed. Postoperative exam showed improved VA to 0.5/60, IOP to 16mmHg without medication, and reduced suprachoroidal hemorrhage on USG.
Discussion : It’s imperative to perform complete evaluation of ocular and systemic conditions in preoperative period to prevent SCH. Ultrasonography is crucial during the close follow-up after developing SCH, it also aids in the timing of surgical intervention.
Conclusion : Vitrectomy with scleral drainage is a valuable approach in managing extensive SCH, a condition generally associated with poor prognosis.
Validation of Indonesian Graves’ Ophthalmopathy Quality of Life Questionnaire and Its Association with Clinical Activity and Severity of Graves’ Ophthalmopathy
Authors: CECILIA ANGGRAINI  , Syntia Nusanti  , Muhammad Sidik  , Dicky L Tahapary  , Levina Chandra Khoe  
Published: February 2024

Abstract
Introduction & Objectives : Graves' ophthalmopathy (GO) ocular abnormalities persisted even after treatment, negatively impacting the patient's psychological and social health. The Indonesian Graves' Ophthalmopathy Quality of Life (GO-QoL) Questionnaire has not been validated; hence it cannot measure patient quality of life in Indonesia, which is crucial to GO treatment. This objective of this study is providinga reliable Indonesian GO-QoL questionnaire and identifying an association between patient quality of life and clinical activity and severity of GO.
Methods : The cross-sectional study ran from May through October 2022. Graves' ophthalmopathy and thyroid disease management were the inclusion criteria. Those who could not be reached by video call or controlled for two weeks for test-retest data collection were excluded. The process of questionnaire validation involves transcultural adaptation and cross-sectional design. The content validity index (CVI) and Cronbach's alpha assessed validity and reliability, respectively.
Results : Content validity index (CVI) was 1.00 for the Indonesian GO-QoL questionnaire. Cronbach's alpha visual function subscale value was 0.971, while the appearance subscale value was 0.993, and the total score was 0.986. The appearance subscale and total score of GO patients' quality of life had a significant association with the clinical activity score (p<0.05) and disease severity (p<0.001).
Conclusion : The Indonesian version of the GO-QoL questionnaire has high validity and reliability values. Patients' appearance and overall quality of life decreases with active Graves' ophthalmopathy. Graves' ophthalmopathy severity decreases quality of life on the appearance and overall subscales.
Comparison of Pain and Anxiety Scales in The First and Second Cataract Surgeries in Patient with Bilateral Cataract
Authors: SARAH EISYA PUTRI  , Ahmad Ashraf Amalius  , Andi Akhmad Faisal  , M. Irfan Kamaruddin  
Published: February 2024

Abstract : Introduction & ObjectivesPain and anxiety in cataract surgery can be investigated as subjective experiences and satisfaction. This study was to evaluate and compare pain and anxiety scale reported by patients with bilateral cataract in the first and second surgery.
Methods : This prospective study was based on patients in Jakarta Eye Centre Orbita Makassar between August-October 2022. Consecutive patients undergoing bilateral cataract surgery with the first and second surgery separated by minimum of two weeks with phacoemulsification method and used topical anaesthesia, by three surgeons. Patients with traumatic cataract, secondary cataract, and other ocular abnormality, also patients with intraoperative complications were excluded. Patients completed questionnaires of Numerical Rating Scale to evaluate pain and Amsterdam Preoperative Anxiety and Information Scale (APAIS) to evaluate anxiety divided into no, mild, moderate, severe, and very severe anxiety.
Results : A total of 42 patients with an average of 64,5 years old were included. There were 2 (4.7%) patients reported more pain in the first surgery, 30 (71%) patients reported more pain in the second surgery, and 10 (23%) patients reported same pain between the first and second surgeries (p=0,000). Most patients reported mild anxiety in the first surgery and no anxiety in second surgery.
Conclusion : Patients with bilateral cataracts reported more pain on the second surgery than the first surgery. The anxiety was reported more severe before and during the first surgery than the second surgery. This report can be used in giving informed concern and in the management of bilateral cataract surgeries consecutively.
Perforating Ocular Sickle Knife Trauma: a Case report
Authors: DEWI KANIA MAEMUNAH  
Published: February 2024

Introduction : Perforating ocular injury can lead to disability or even mortality. Most individuals sustaining eye injuries are male in young age. This is a report of an extreme case when a sickle knife stabbed in the right eye of a young male cause perforating of the eyeball.
Case Illustration : Seventeen years old young male presented to Emergency Room of Sukabumi Regional Public Hospital with pain and bleeding in his right eye an hour before. He had been hacked during a brawls. There was a wound in the right supraorbita area and a big sickle knife stuck in the head and tear the eye ball. Visual acuity was no light perception in his right eye. Anterior segment examination of the right eye revealed perforated sclera and cornea. X-ray examination showed fracture of the roof of the right orbit and a metal object had stuck into the Orbits. The sickle knife extraction, enucleation and superior orbit reconstruction of the right eye was done.
Discussion : Identification of wounds caused by sharp metal foreign body is very important for the subsequent treatment of injuries. If the eyeball cannot be preserved, then enucleation can't be avoided. In this case, hard impact of sharp object around of the eye are also cause fracture of superior orbital rim. Reconstruction of the orbital roof using titanium and micro screws given the most stable and effective results.
Conclusion : Removing a metal foreign body and anatomical defect management is important for a good outcome.
A snake venom ophthalmia: A case – report
Authors: Aljufri Nabila , Sadikin Irma Suwandi , Petra Dany , Susantono Diannisa , Oktariani Virna Dwi , Widyawati Syska 
Published: February 2024

Introduction : Snake venom ophthalmia is caused by venoms of spitting snakes. Delayed treatment may result in corneal ulcer, corneal perforation and blindness. We aim to report a fortunate snake venom ophthalmia case.
Case Illustration : A-54-year-old male complained of burning eye pain, watery, and redness of the right eye (RE) after being spat by a snake 3 hours before admission. The snake was identified as a cobra-snake, spitted at a distance of 1 meter without body bite. He rinsed his eyes with tap water and irrigated at a nearby hospital before referred. During the admission, the pH of both eyes (BE) was 8. The patient was irrigated with normal-saline. The visual acuity (VA) of the right eye was 6/12 and left eye 6/6. There was RE conjunctival and ciliary injection. Other examinations were unremarkable. The patient was discharged and treated with levofloxacin eye-drop, sulfas-atropine 1%, EDTA 1%, artificial tears, and vitamin C. He did self-eye irrigation. Two days later, he presented with VA of 6/6 for BE with normal ocular examinations and pH of 7 for BE.
Discussion : The general principle is prompt and copious irrigation of the eyes in chemical contact. The snake venom mixture of chemicals was washed out, which local necrosis can be prevented. Managing snake venom as a chemical splash injury with considerable irrigation, lubricants, and topical antibiotics, resulted a good outcome and prevented sequelae in this patient.
Conclusion : Urgent irrigation of the affected eyes and other mucous membranes is the key in treating snake venom ophthalmia
Non-Surgery Management of Globe Rupture in Rural Area
Authors: Diajeng Rindang Galih Annisa  , Dr Dedeh Kurniasih SpM  
Published: February 2024

Introduction : Globe rupture is a vision-threatening emergency. The management of globe rupture must arrange immediate.
Case Illustration : A 59-year-old woman presented with painful and sudden vision loss on her left eye after hit by wood an hour prior. From the examination, the palpebra was oedema, and spasm, the conjunctiva was chemosis and bleeding, the sclera was laceration. Visual acuity of the left eye was 1/~. We diagnosed as globe rupture of the left eye. We gave levofloxacin injection, methylprednisolone injection, tranexamic acid injection, prednisolone eyedrop every 3 hours, levofloxacin topical every hour, and oxytetracycline eye ointment once a day in night. After 10 days, clinical manifestation was improved, but the visual acuity. From the examination, we found retinal detachment on her left eye. Patient was referred to the primary health care.
Discussion : In globe rupture, infection risk is high and requires immediate systemic empiric antibiotics and surgical management. The conservative treatment was administered since the patient rejected for the globe exploration and scleral suture surgery. The aim treatment for this case is to prevent the infection. We used combination systemic and topical levofloxacin antibiotics and corticosteroid. Systemic tranexamic acid was to control the bleeding. No improvement of visual acuity after 10 days, we suspected because of retinal detachment and need surgery management.
Conclusion : Surgical exploration and infection prevention are needed for globe injury. The sooner management, the better prognosis it could be.
Periocular Capillary Hemangioma Treated With Low Dose Oral Propranolol - Presentation and Outcome of 2 patients
Authors: TEGUH ANAMANI  , PRIMA SUGESTY NURLAILA  
Published: February 2024

Introduction : Infantile hemangioma (IH) is the most common benign vascular tumor of infancy. IH arises in the first few weeks of life, then displays a period of active growth followed by spontaneous involution.[1,2] Most IHs are uncomplicated, do not require intervention, and regress spontaneously.[3] Infantile hemangioma (IH) having an incidence of 4%–5%.[4-6]
Case Illustration : First patient is 6 -month-old girl weighing 6.2 kg, with Periocular lesions on the superior palpebra since 2 weeks after birth. Second patient is 6-month-old girl weighing 6.3 kg, with Periocular lesions on the superior palpebra since 1 weeks after birth. The lesions rapidly increased in size within 1 months. The lesions made it difficult to open superior palpebra. Both patient was diagnosed with periocular infantile hemangioma. The diagnosis was established by clinical examination, and was given oral propranolol therapy. Initially, a dose of propranolol was 1 mg/kg body weight in divided doses for 2 weeks then increased to 2 mg/kg body weight. Patients have followed up at 4-week intervals until the final follow-up was reached according to the response of treatment. The lesions were significantly decreased and bith pastients could open their right eye normally after 3 months of propranolol therapy
Discussion : Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects.
Conclusion : Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes