bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECTIVENESS OF INTRAVITREAL ANTI-VEGF INJECTION IN EALES' DISEASE: A CASE REPORT
Authors: Khairani Azizah Ardityastiti  , Halida Wibawaty  
Published: February 2024

Introduction : Eales’ Disease (ED) is an idiopathic inflammatory retinal vasculitis, affecting retinal veins of small and large caliber that results in extraretinal neovascularization with vitreous hemorrhage. The etiopathogenesis of ED is poorly understood. However, many studies have attributed inflammation as a response to mycobacterium tuberculosis. Treatment of this disease can be done with corticosteroids, anti-VEGF therapy, laser photocoagulation, and vitreoretinal surgery.
Case Illustration : We reported a patient, a 31-year-old woman with complaints of blurred vision and floaters in both eyes. An initial examination showed the visual acuity of the RE was 0,1F1 and the LE was 0,1. Examination of the posterior segment found perivascular exudate and peripheral retinal neovascularization. We performed an OCT examination on both eyes and found that there was extensive macular edema, especially in the RE. Patient was diagnosed with ED and received steroidsas an initial treatment. But there was no improvement in both eyes. In addition, patient received two anti-VEGF injections in the RE and one injection in the LE and showed good improvement. After that injection, the posterior segment showed very minimal lesions on the macula and repeated OCT results showed normal central macular thickness.
Discussion : Anti-VEGF may also play a role in the treatment and management of ED. This is because, besides inflammation, there is an increased expression of VEGF in vitreous patients with ED. Several case reported there is significant improvement in anti-VEGF injection in the management of patients with ED.
Conclusion : Intravitreal anti-VEGF injection shows good results in ED that did not improve with steroid treatment.
THE DIFFERENCES OF MAXIMUM BLINK INTERVAL IN HYPERTENSION PATIENTS WITH AND WITHOUT DRY EYE DISEASE
Authors: I NYOMAN CAHYA SETIABUDI  , I Gusti Ayu Made Juliari  , Cokorda Intro Dewiyani Pemayun  
Published: February 2024

Abstract
Introduction & Objectives : Hypertension and the use of antihypertensive drugs are thought to be one of the risk factors for dry eye disease due to a decrease in tear production. Maximum blink interval (MBI), which is the time during which the eye can remain unblinking, can be an easy method for assessing dry eye disease because local conditions in the eye can affect blinking patterns. This study aims to determine the difference in the average MBI in hypertensive patients with dry eye disease and hypertensive patients without dry eye disease.
Methods : This study is a cross-sectional analytic study which was conducted in January 2022-June 2022. The sample of the study was hypertensive patients with dry eye disease and without dry eye disease who were treated at the Internal Medicine Polyclinic, Kidney-Hypertension Division at Sanglah Hospital (Prof I.G.N.G. Ngoerah Hospital). The sample selection technique was consecutive sampling and the total sample in the study was 81 people. Data were collected using the OSDI questionnaire and TBUT and Schirmer examinations to assess dry eye disease, blood pressure tests to assess hypertension, and MBI examination.
Results : The results showed that the average MBI in hypertensive patients with dry eye disease twice shorter than in hypertensive patients without dry eye disease (p<0.001).
Conclusion : This shows that MBI can be used as a modality for screening and screening for dry eye disease in hypertensive patients. MBI can be an alternative for practitioners to objectively assess dry eye disease in primary health care where there is no complete ophthalmological facility.
SUCCESSFUL DIFFERENT TREATMENT IN INTERMITTENT EXOTROPIA: CASE SERIES
Authors: NASIKA CELIA DENDY  , Sesy Caesarya  , Primawita O. Amiruddin  , Mayasari Wahyu Kuntorini  , Feti Karfiati  
Published: February 2024

Introduction : In intermittent exotropia, management's goals are to diminish deviation by improving fusion control.
Case Illustration : Case 1: A 19-year-old woman has complained of squinting and blurred vision since the age of 3 years. The visual acuity of both eyes (OU) was 0.05, with a BCVA of 0.63. Hirschberg's test was exotropia 15o . The exotropia after the cover test (Figure 1A) improved without blinking. The prism cover test was 35 D in near and distance. Patient was diagnosed with exotropia, an intermittent basic type with good control, astigmatism, and myopia compositus OU. Three months after, with refraction correction and occlusion, the Hirschberg test revealed orthotropia (Figure 1B). Case 2: A 7-year-old boy has suffered of squinting and blurred vision from the age of 6 years. The visual acuity of both eyes was 0.63 with a BCVA of 1.0. Hirschberg's test was exotropia 30° (Figure 2A). The prism cover test was 50 D in near and distance. Exotropia intermittent basic type, poor control, and bilateral astigmatism were diagnosed in the patients. The patient had surgery for bilateral lateral rectus recession. Hirschberg test 1 day Postoperatively, orthotropia was present (Figure 2B).
Discussion : In exodeviation, control mechanisms relate to therapy compliance and different deviation angles. Intermittent exotropia can be progressive due to loss of fusion control and cause persistent deviation.
Conclusion : For patients with exotropia with intermittent good control, non-surgical management can give good results. Surgical management is considered for large angle deviations in patients with poor control.
DIAGNOSING OCULAR MALINGERING IN CHILDREN WITH SIMPLE TEST: IS IT POSSIBLE?
Authors: KEVIN ANGGAKUSUMA HENDRAWAN  , NI MADE AYU SURASMIATI  , I WAYAN EKA SUTYAWAN  , ANAK AGUNG DEWI ADNYA SWARI  , MADE KUSUMA WARDANI  
Published: February 2024

Introduction : Malingering is a condition in children which need a thorough and meticulous examination to diagnose the condition. According to several publication, simple test can be done to diagnose this condition without necessarily performing imaging and electrophysiologic tests.
Case Illustration : An 8-year-old male patient, came to eye clinic with sudden visual loss on both eyes for the last 3 days, following pain on both eyes and headache which fluctuating over the last 3 weeks. Patient insisted on wearing black glasses during examinations. Preliminary examination revealed visual acuity no light perception on both eyes. Slit lamp examination and pupillary reflex were normal, fundus examination revealed normal fundus. We tried to do surprise test by suddenly swaying hand towards patient’s eyes and record a visual response. Afterwards we asked patient’s parent to wait outside while performing LEA test which revealed visual acuity 6/6 on both eyes. Further history taking revealed that patient got bullied on school that makes him try to avoid attending school.
Discussion : Patient with malingering usually come with decreased vision but seldomly come with blindness. Though it was quite challenging, doing some simple test available in daily practice such as surprise test can help us to diagnose the suspicion. Handling such patient needs a cautious analysis towards patient’s condition and gentle approach towards the patient. It is crucial to rule out organic condition before diagnosing patient with malingering.
Conclusion : Simple test such as surprise test can be done in assisting malingering diagnosis when carefully done with the support of thorough history taking and physical
Shave Excision Of Marginal Lower Eyelid Nevus
Authors: Rika Karim Chan  , Prof. Dr. dr. Rodiah Rahmawaty Lubis, M.Ked(Oph), SpM(K)  
Published: February 2024

Introduction : INTRODUCTION: Nevus is a common benign melanocytic lesion and may appear in palpebral region. It may appear congenitally or acquired. Such lesions contain melanocyte derived from neural crest. Palpebral nevus is a group of heterogenous lesion with varying clinical and histological presentation depending on age and nevus stage. PURPOSE: To report shave excision procedure of the left inferior palpebral nevus located in the palpebral margin using local anesthesia.
Case Illustration : CASE REPORT: A 43-years old woman came to the hospital with a solitary mass in the lower right eyelid. The mass was experienced since 2 year ago and slowly increasing in size and most notably 3 months prior. The mass was round, tender, painless, black-greyish colored, with a smooth surface, mobile, and measured 0,5 cm x 0,5 cm in size. The lesion was located in the middle portion of right lower palpebral margin without extension to the tarsal or bulbar conjunctiva. No bleeding or discharge was found. No history of trauma, use of medication, family history, previous ocular and systemic disease was found. Histopathological examination concluded the lesion was nevus pigmentosus. The nevus was excised entirely using shave excision technique with local anesthesia. Follow-up examination revealed an excellent result with no complications.
Discussion :
Conclusion : CONCLUSION: Palpebral nevus pigmentosus are common benign tumor with wide range of clinical and histological manifestation. Not all palpebral nevus required surgical intervention. The most effective treatment is complete excision of the nevus and recurrence rate is generally low.
The Importance of Initial Management in Ocular Chemical Burn: A Case Series
Authors: Dr. ANDREAS SURYA ANUGRAH, Sp.M  , Dr. Reny Setyowaty, Sp.M  
Published: February 2024

Introduction : Ocular chemical injuries are true emergency which requires immediate intervention. Delayed management may result in severe eye injuries. This report aims to describe the effectivity of initial management and medical treatment of ocular chemical burns.
Case Illustration : We reported four cases of ocular chemical injuries due to alkaline, acidic, and unspecified chemical compound. All subjects were men, aged 30 to 50 years old. They had injuries at work and none of them used eyewear protector. Each was brought to emergency unit in less than 2 hours. They were given initial timely irrigation until pH neutralized. Ocular damages were evaluated using Roper-Hall Classification, three cases were Roper-Hall 2 and other was Roper-Hall 3. After initial management, all cases were treated with medical treatment and showed significant improvement. After 6 months follow up, there weren’t any long-term sequelae in all subjects.
Discussion : Serious eye damage results from strongly alkaline or acidic compounds. Most critical factor is timely delivery of irrigating fluid. Irrigation should ideally be performed with isotonic saline or lactate ringer solution and continued until the pH neutralized to a physiological level. Any method of irrigating the eye is preferable than delay in elimination of the destructive chemical. Medical treatments in acute management of severe ocular chemical burns are anti-inflammatory therapy, halting epithelial and stromal breakdown, promoting re-epithelialization and promoting corneal stromal healing.
Conclusion : Timely irrigation of the eye effectively reduces severity of chemical burns, reduces need for surgical intervention, and improves final visual acuity if combined with medical treatment in golden period.
PENETRATING EYELID INJURY DUE TO FISHING HOOK : AN UNUSUAL
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.
What To Expect In An Unexpected Spontaneous Bilateral Ectopia Lentis
Authors: Yudakusuma Cheryll , Susyono Maria Larasati 
Published: February 2024

Introduction : Ectopia lentis is present in 50% to 80% of Marfan syndrome sufferers. In many people the position of lens is fixed, some individuals’ lens experience subluxation which took amount of time. This case presents a young patient with rare manifestation of spontaneous bilateral ectopia lentis, both lens luxated within two days after admission due to secondary glaucoma.
Case Illustration : A 14 years old patient came to the emergency department with acute glaucoma like symptoms: pain and redness in both eyes, along with headache and nausea. The patient appeared highly suspectedof Marfan syndrome appearance with tall stature, and arachnodactyly; both eyes shown visual acuityof 1/300, low digital palpation, ectopia lentis and anteriorly subluxated lens in both eyes, positive fundus reflex. Posterior segment USG B-scan is normal. Patient then prescribed with oral Acetazolamide, Timolol Maleate eye drop, and Prednisolone eye drop, then scheduled for lensectomy. Just within 2 days after admission, right eye shown lens anteriorly luxated with 20/100 visual acuity, while left eye appears aphakic with ectopia lentis at vitreous with 1/60 visual acuity. The physician immediately sent the patient to higher referral hospital then received secondary implant on right eye and secondary implant with vitrectomy procedure on left eye.
Discussion : Drastic measure took place given the presence of both lenses' dislocation, one into anterior chamber, another into vitreous cavity. Collaboration with cardiologist is necessary to perceived other potential comorbid.
Conclusion : Physician do need always to be prepared for even the uncommon complications to occur, hence have to be prepared for the unexpected.
CHOPPING METHODS IN APPROACHING HARD CATARACT: OPTIONS AND RECOMMENDATION
Authors: MUHAMMAD IQBAL  , Haikal Hamas Putra Iqra  
Published: February 2024

Abstract
Introduction & Objectives : Mature cataracts with hard-nuclear and soft-nuclear cataracts were different in their anatomical features and their management approach. Degeneration of zonules, loss of capsule and cortical liquefaction are often found in hard cataracts. Therefore, different approaches are required in this condition. Chopping methods have several advantages in managing the nucleus which plays a major part in cataract surgery. It lessened phaco power which minimized endothelial damage. The risk of intraoperative zonular dehiscence may also be lowered with chopping methods. Several chopping methods are widely accepted in approaching hard cataracts such as vertical chop, horizontal chop, crater and chop, drill and chop, stop and chop, and multilevel chop. Burst mode which requires high vacuum and power to chop and flow rates must be adequately comprehended by the surgeon in achieving the optimal result. This review discussed chopping methods in cataract surgery.
Methods : Several chopping methods are widely accepted in approaching hard cataracts such as vertical chop, horizontal chop, crater and chop, drill and chop, stop and chop, and multilevel chop.
Results : Burst mode which requires high vacuum and power to chop and flow rates must be adequately comprehended by the surgeon in achieving the optimal result.
Conclusion : This review discussed chopping methods in cataract surgery.
Axenfeld Rieger Syndrome: an unusual case report
Authors: RAHMADIANSYAH MUHAMMAD FADHIL , SAYUTI KEMALA 
Published: February 2024

Introduction : Axenfeld-Rieger Syndrome (ARS) is a rare autosomal dominant disorder that characterized by ocular manifestation, especially the cornea, iris, glaucoma, and systemic abnormalities in teeth, face, abdomen, heart and genitals.
Case Illustration : A 7-year-old boy patient presented to policlinic with complaint of blurry vision in both eyes. No other abnormalities in history. On examination, visual acuity of right eye 5/60 and left eye 4/60. Slit lamp examination revealed hypoplasia iris, corectopia, and polycoria. Intraocular pressure (IOP) on right eye 25 mmHg and left eye 24 mmHg. Non ocular manifestation were flat face and teeth deformity. This patient was diagnosed ARS with secondary glaucoma. We managed the patient together with the dental and pediatric department in order to confirm and treat any systemic abnormality. Patient underwent cycloplegic refractive correction to achieve best corrected visual acuity right eye 20/200 and left eye 20/150 (LEA chart). Timolol 0,25% eye drop was given twice a day with IOP right eye 19 mmHg and left eye 20 mmHg after 2 weeks.
Discussion : The diagnosis of patient was ARS with secondary glaucoma. The patients with ARS have a 50% lifetime risk of glaucoma. Comprehensive management to confirm and treat the systemic abnormalities from dental and pediatric departments was important. Management in our department includes correction of refractive errors and lowering of IOP.
Conclusion : Axenfeld Rieger Syndrome that manifest ocular and non-ocular need to investigated thoroughly. Multidisciplinary contribution of this case is necessary to maintain the ocular stabilization and prevent any harm from systemic abnormalities.
EFFECT OF CORTICOSTEROID ON OCULAR TUBERCULOSIS: A SYSTEMATIC REVIEW
Authors: Rahmah Amran  , Dr. Dicky Stevano Zukhri, Sp.M  
Published: February 2024

Introduction & Objectives : There are still some disagreements between experts regarding the use of corticosteroids as an adjunctive treatment for ocular tuberculosis. Even though corticosteroid is important for controlling the inflammation to reduce further damage to the eye, some evidence claim that corticosteroid may interfere with ATT and causes more damage. This study aims to summarize and assess the role of corticosteroids on ocular tuberculosis.
Methods : This study reviews papers from PubMed and Ophthalmologica Indonesiana database published in English or Indonesia between the years 2017 and 2022. The search terms used are a combination of treatment or therapy, corticosteroid, and ocular tuberculosis.
Results : A total of 8 studies are included in this review with a total of 992 patients. Ocular TB can be further differentiated into anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis, retinitis and retinal, vasculitis, neuroretinitis, and optic neuropathy. Corticosteroids are delivered through different routes depending on the site and severity of the inflammation. Generally, patients treated with ATT and corticosteroids have a positive response but improper timing, dosage, or route may actually worsen the infection and inflammation.
Conclusion : Corticosteroids are needed as adjunctive treatment to control the inflammation from further damaging the eye. However, further studies regarding the specificity of the usage should be done as there are still limited studies about the factors affecting the outcome
RE-TRABECULECTOMY + 5-FLUOROURACIL IN PRIMARY ANGLE CLOSURE GLAUCOMA PATIENTS AGGRAVATED BY CONSUMPTION OF SCHIZOAFFECTIVE DRUG
Authors: Syafridon M Fadhil , Fidalia  , Sari Prima Maya 
Published: February 2024

Introduction : PACG occurs when the anterior chamber angle is occluded by the iris thus reducing aqueous humor outflow. Most schizoaffective patients use anticholinergic drugs which may result in iridocorneal angle closure through deposition. This article reported a Re-Trabeculectomy + 5 FU surgery in PACG which was aggravated by the use of schizoaffective drugs
Case Illustration : A 43 year old woman, underwent Re-Trabeculectomy + 5 FU on LE after increasing IOP and regularly took schizoaffective drugs. Tapering of schizoaffective therapy was done 1 month preoperatively. Patient presented with LE UCVA of 3/60 and LE IOP is 30.9 mmHg with three anti- glaucoma medications. LE examinations revealed VH1 AC, bayonet sign and cupping on funduscope, closed angle on gonioscope, nasal step defect on humphrey and diffuse RNFL thinning on OCT. On the first postoperative day LE IOP is 18.5 mmHg. The schizoaffective therapy was re-initiated from psychiatric and evaluation was done weekly
Discussion : Re-trabeculectomy surgery have been done considering the failure of the first trabeculectomy and administration of 5-Fluorouracil as an anti-fibrosis. The benefits of reducing preoperative dose of schizoaffective drugs for a month due to having an anticholinergic effect and reduces IOP by 5 mmHg. Psychiatrists and ophthalmologists work together to try to administer basic schizoaffective drug doses and evaluate IOP to keep it under control.
Conclusion : The re-operative action was carried out by adding anti-fibrosis and cooperating with psychiatry for postoperative tapering of schizoaffective drugs. Long-term use of antidepressant drugs and benzodiazepines increases PACG.
Moxifloxacin Treatment for Contact Lens-Related Corneal Ulcer: A Case Report
Authors: Gek Ayu Krismayogi  , AA Sagung Mirah Prabandari  , Harumi Purwa Prahesthy  
Published: February 2024

Introduction : A corneal ulcer is an ophthalmological emergency that can threaten vision. It is characterized by inflammation or infection involving the corneal epithelium and stroma. Prolonged use of contact lenses is more likely to cause corneal ulcers. The purpose of this paper is to report on the management of corneal ulcers.
Case Illustration : A 30-year-old female complained of blurred vision, redness, pain, swelling, and sensitivity to light in both eyes for the last two days. She reported falling asleep in her contact lenses two nights before the visit. The patient had compound myopic astigmatism before and her visual acuity was decreased to 3/60 in the right eye and 5/60 in the left eye, examinations showed palpebral edema and conjunctival hyperemia in both eyes. The use of fluorescein in both eyes highlighted the area of the defect. The patient was diagnosed with corneal ulcers. Treatments were Moxifloxacin Eye Drop every hour and Ibuprofen 2x400 mg by intravenous infusion. On the last visit, the corneas were clear with visual acuity 6/15 in both eyes.
Discussion : According to the study by Kishor et al., ophthalmic eye drop is the most effective treatment and fourth-generation fluoroquinolones represent the most frequently used strategies in Corneal Ulcer.Conclusion : Antibiotics and analgesics are effective for the management of corneal ulcers in this patient. Education regarding contact lenses is important to prevent the occurrence of corneal ulcers.