bluuebunny/crossref_metadata_2025_split huggingface dataset:
CORRELATION BETWEEN DEGREE OF PROPTOSIS WITH EYE BALL DIMENSION IN GRAVES OPHTHALMOPATHY PATIENT AT WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR
Authors: Stephanie Tanjung  
Published: February 2024

Abstract
Introduction & Objectives : Introduction Hyperthyroidism is one of the cause of Graves’ Ophthalmopathy (GO), which is an autoimmune orbital disease. Clinical manifestations of GO are orbital and periorbital edema, eyelid retraction, eyelid lag in down gaze, restrictive strabismus, compressive optic neuropathy, and keratopathy exposure. We can also find proptosis in GO patient. this happened because the expansion of adipose tissue and muscle at the edge of the orbital bones resulting in increased intraorbital pressure. Protrusion of eyeball can cause changes in the dimensions of the eyeball such as axial length, anterior chamber depth, and cornea curvature. Objective To assess the correlation of degree of proptosis with eyeball dimension in Patients Graves’ Ophthalmopathy.
Methods : This research was a cross sectional study. A total of seventeen eyes were proptotic from patient with Graves' ophthalmopathy. They underwent measurement with a Hertel exophthalmometer and optical biometry to record the degree of proptosis, axial length, anterior chamber depth, and cornea curvature.
Results : Patient with proptosis in Graves' Ophthalmopathy. This study analysed the degree of proptosis with axial length, anterior chamber depth, and cornea curvature. There is no statistically significant result.
Conclusion : There was no correlation between degree of proptosis with axial length, anerior chamber depth, and cornea curvature in patient with Graves’ Ophthalmopathy.
RELATIONSHIP BETWEEN DEGREE OF OPTICAL NERVE DAMAGE ON LEVEL OF DEPRESSION AND ANXIETY PATIENT WITH PRIMARY GLAUCOMA
Authors: SETIAWAN I KADEK AGUS , Rahayu Ni Kompyang , Ariani Ni Ketut Putri , Widiana I Gde Raka , Kusumadjaja I Made Agus , Juliari I Gusti Ayu Made 
Published: February 2024

Introduction & ObjectivesGlaucoma is one of the leading causes of irreversible global blindness and the second most commoncause of blindness in the world after cataracts. Depression and anxiety often occur in glaucomapatients when glaucoma is first diagnosed, the effect of decreased vision function in glaucoma, sideeffects of glaucoma therapy both medically and surgically and financial effects due to length oftreatment and loss of job due to limited vision. This study aims to determine the relationship of thedegree of optic nerve damage to the level of depression and anxiety in patients with primaryglaucoma.
MethodsThis research is an analytic, prospective observational research with a cross-sectional studyapproach. The relationship between independent variables and dependent variables was analyzed.
ResultsThe Man Whitney test found a significant difference in anxiety scores between the severe and mildto moderate groups with a p value of 0.020 . The ANCOVA test found that there was a relationshipbetween the degree of optic nerve damage in primary glaucoma and the level of anxiety aftercontrolling for control variables.
ConclusionThis study can be concluded that there is a difference in the level of anxiety between the degree ofsevere and mild to moderate optic nerve damage. The level of anxiety itself corresponds to thedegree of damage to the optic nerve. The more severe the damage to the optic nerve, increased ofthe patient's anxiety score.
A RARE CASE OF STERILE ENDOPHTHALMITIS FOLLOWING INTRAVITREAL TRIAMCINOLONE ACETONIDE INJECTION IN VITRECTOMIZED EYE
Authors: Pitanatri Nyoman Brahmani , Panjawati Ni Luh Diah 
Published: February 2024

Introduction : Intravitreal Triamcinolone Acetonide (IVTA) has been widely used to treat Diabetic Macular Edema (DME). Sterile endophthalmitis is one of the major related complications after IVTA which occurs between 0.20% and 6.73% of the injections. We present a case of sterile endophthalmitis following IVTA injection in a patient with a vitrectomized eye and DME.
Case Illustration : A 53?year?old female patient with a history of vitrectomy due to high-risk characteristic proliferative diabetic retinopathy on her right eye underwent IVTA for DME. One day after the injection, the visual acuity (VA) improved from 6/45 to 6/12 without any complication. Three days later, she complained of ocular discomfort and sudden diminution of vision. The VA had dropped to hand movement, with conjunctival injection, hypopyon, anterior chamber reaction, and an inaccessible fundus. The patient was treated with topical antibiotics, corticosteroids, and cycloplegic, followed by intravitreal antibiotics injection. Furthermore, vitrectomy and vitreous tap were performed. On one- week follow-up, the VA was improved to 6/60 with normal IOP. The anterior chamber and the vitreous cavity remained clear.
Discussion : The etiology of sterile endophthalmitis following IVTA injection remains unclear. Compared to infectious endophthalmitis, the patient is usually in less pain, and the eye is less injected. Although it generally has a benign course, some studies have shown serious complications such as vitreous hemorrhage and retinal detachment. Therefore, caution should be taken to prevent such complications from developing.
Conclusion : In presumed sterile endophthalmitis, a careful diagnosis and intervention must be reconsidered to avoid potential long-term visual loss due to its related complications.
Chiari I Malformation Presenting Vertical Gaze-Evoked Nystagmus : A Case Report
Authors: Mischka Scalvinni Suvero Suyar  , Nazhira Janani  , Ferdian Ramadhan  , Balgis Desy Sulistyowati  
Published: February 2024

Abstract
Introduction : Chiari malformation is characterized by herniation of posterior cerebellar vermis in which type 1 malformation has coexisting syringomyelia of cervicothoracic spinal cord. This malformation can be congenital or acquired, in which gaze-evoked nystagmus is the typical movement deficit. This case aimed to report a case of vertical gaze-evoked nystagmus as a primary symptom to detect Type I Chiari Malformation.
Case Illustration : A 44-year-old woman presented with involuntary movements of both eyes in the last 5 months with vision problems in which objects appear to jump or vibrate. Visual acuity was 20/50 in both eyes with 12 prism diopters BI exotropia. We recognized vertical and torsional nystagmus in upgaze without any movement in primary gaze. While performing supraduction, the oscillation was detected and increased. Brain MRI revealed Type I Chiari Malformation.
Discussion : Nystagmus was seen in many diseases of the central nervous system, in particular those affecting the brainstem and cerebellum. Vertical gaze evoked nystagmus was a disorder of the gaze holding function, purely vertical gaze-evoked nystagmus is observed in midbrain lesions involving the interstitial nucleus of Cajal (INC) as the neural integrator for vertical gaze-holding function. Based on this pathophysiology, the Brain MRI of this patient revealed some degrees of compression in midbrain, and cervico medullary junction due to her brain malformation.
Conclusion : A sustained gaze-evoked nystagmus is an important ocular finding that may indicate serious neurologic pathology. It is important for an eye care provider to thoroughly examine additional tests to determine the underlying cause of the nystagmus.
HUMAN RESOURCES DEVELOPMENT IN CHILDREN EYE HEALTH SERVICES IN SOUTH SULAWESI
Authors: Amalius Ahmad Ashraf , Muhiddin Habibah Setyawati , Ichsan Andi Muhammad , Faisal Andi Akhmad , Kamaruddin Muhammad Irfan , Akib Marlyanti N. , Kotha Satya Prabha 
Published: February 2024

Introduction: Children eye health are one of the most common problems in ophthalmology that are getting attention globally and nationally especially in South Sulawesi. To optimize its services quality and quantity of human resources are required. This study aims to report the human resources development in children eye health services in South Sulawesi.
Methods: Surveys were carried out in several districts to assess the availability of human resources in children eye health services. Creating collaborations with several institutes such as Faculty of Medicine, Hasanuddin University and related professional organizations. Conducting several trainings in provinces, districts, subdistricts, village, and urban village.
Results: Preparation and dissemination of materials and media on prevention of blindness in children, improvement of human resources in the form of District Trainer training in 24 districts that recruited 98 people who were ready to become trainers. For 2 years conducting tiered training at 24 districts, they produced human resources of 1,395 officers at the Puskesmas, 11,145 posyandu cadres, and 3,826 teachers. The results of this built system revealed that 3,248 paediatric patients were screened with vision problems, 3,528 toddlers in Integrated Health Centre were screened and referred to Health Centre as many as 426 toddlers, and at the School Health Unit it was recorded that 173,778 children were screened and there were 28,845 (17%) children who had visual disturbances.
Conclusion: Development of human resources in children eye health in Indonesia was not only the responsibility of the government and the health sector but also need cross-sectoral roles.
Full Thickness Skin Graft Procedure for Basal Cell Carcinoma : A Case Report
Authors: PETER SALMON  , Yuliana Hartono  
Published: February 2024

Introduction : To present a case of basal cell carcinoma (BCC) of the right upper eyelid using a full thickness skin graft (FTSG) procedure
Case Illustration : 69 year old woman with the main complaint of a lump on the upper right eye that has been getting bigger and bleeding more and more since 4 years ago. Examination revealed a tumor measuring 22mm x 12mm x 5mm, smooth surface of pearl-like nodules, talengectiasis, madarosis, palpebral retraction towards the medial canthus. The patient works as a farmer. Wide excision of the tumor and FTSG procedure was performed from the right infraclavicular area, histopathological results of basal cell carcinoma tumor.
Discussion : BCC accounts for 90% of malignant eyelid tumors. The biggest risk factor for BCC is UV exposure. BCC rarely metastasizes but orbital invasion occurs in approximately 2%. This patient underwent an FTSG procedure. The graft was taken from the infraclavicular area. One of the key factors for graft success is revascularization of the graft area.
Conclusion : FTSG procedure for BCC can give good results. The risk after the procedure is sometimes difficult to predict so that it can become difficult in graft attachment and even failure in attachment to the excision area can occur. This patient was under close observation due to a hematoma under the graft skin.
Penetrating Fishhook Ocular Injury: Challenging management in low- resource country
Authors: Nafisa Naaz Nisha  , Andronico Ly  
Published: February 2024

Introduction : Fishing is a common income source in rural areas, but fishhook eye injuries are rare. This report describes a case of a rare penetrating fishhook ocular injury, which resulted in endophthalmitis and eye evisceration, and highlights the challenges caused by delayed referral and limited options for intravitreal antibiotics due to inadequate consumable availability.
Case Illustration : A 13-year-old boy from Vanuatu had a fishhook in his right eye and was referred to an Ophthalmologist one day later due to unavailability of flights. Upon arrival, endophthalmitis signs were noted, with the left eye having a visual acuity of 6/7.5 and the right eye showing only hand movement. The right eye showed corneal edema and a blood stain around the fishhook, fresh keratic precipitates, discharge and conjunctival edema. The fishhook was removed, and the cornea repaired under local anesthesia. On Day 1 post-operation, Intravitreal vancomycin and moxifloxacin were administered after procuring privately from pharmacies outside the hospital. However, the patient's condition worsened, requiring evisceration of the right eye.
Discussion : Prompt management of penetrating eye injuries is crucial, with patients requiring broad spectrum antibiotics, tetanus shots, and an eye shield during referral. However, challenges such as lack of an eye shield and transportation delays worsened the patient's condition before arrival. This case also highlights the challenges faced in treating the patient effectively by the ophthalmologist due to limited options intravitreal antibiotics.
Conclusion Timely management and urgent referral are crucial in low-resource areas to prevent complications. Essential consumables are necessary for effective treatment by an ophthalmologist.
Changes in Ocular Surface Parameter After Intense Pulsed Light Therapy in Ocular Demodicosis: A Case Report
Authors: Rizki Adi Santosa  , Angga Fajriansyah  , Elfa Ali Idrus  , Patriotika Muslima  , Arief Akhdestira Mustaram  
Published: February 2024

Introduction : Demodex infestation may manifest as blepharitis and dry eye syndrome. Intense Pulsed Light (IPL) therapy is an emerging option for managing ocular demodicosis.
Case Illustration : A 77-years-old woman complained of itch and watery eyes since four years ago. Meibomian pouting, telangiectasias, foamy secretions, and sleeves were identified in both eyelids. Right eye examination showed 52% and 42% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 6 mm, lipid layer thickness (LLT) 43 nm, tear meniscus height (TMH) 0.36 mm, and non-invasive tear break-up time (NIBUT) 9.6 seconds. Left eye examination showed 65% and 56% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 5 mm, LLT 66 nm, TMH 0.16 mm, and NIBUT 5.8 seconds. Demodex mites were identified during eyelash wet mount examination. She underwent four sessions of IPL. At the two-month follow-up, complaints were alleviated. Signs of blepharitis were subsided. Right eye examination showed 36% and 34% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT 68 nm, TMH 0.49 mm, and NIBUT 10.7 seconds. Left eye examination showed 25% and 35% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT >100 nm, TMH 0.9 mm, and NIBUT 6.2 seconds.
Discussion : IPL has a role in managing ocular demodicosis by local inflammation control, meibum liquefaction, and meibomian glands photomodulation. IPL is also thought to directly eradicate Demodex mites.
Conclusion : Improvement of ocular surface parameters was observed after IPL therapy in ocular demodicosis.
LOW VISION IN RETINITIS PIGMENTOSA: HOW TO ENHANCE FUNCTIONAL VISION IN PSEUDOPHAKIC PATIENT
Authors: Siti Shalihah Ramadhani Novizar  , Ani Ismail  , Eva Kumalasari  
Published: February 2024

Introduction : Retinitis Pigmentosa (RP) could lead to various visual impairments, including decreased visual acuity, poor dark adaptation, decreased contrast sensitivity, poor color vision, visual field constriction, leading to low vision (LV). LV in RP decreases patient’s quality of life (QoL) and Independence. We aim to report a successful case of LV management in a bilateral pseudophakic patient with RP.
Case Illustration : A 33-year-old man came with progressively blurred vision in both eyes (BE) that worsen 6 months ago. Ophthalmologic examination revealed his uncorrected visual acuity for right eye (RE) and left Eye (LE) was 6/60 and 4/60. The patient had cataract surgeries and IOLs implantation on BE in 2021. Funduscopic examination revealed the bone spicule appearance, blood vessel attenuation, and waxy disc pallor on BE. Humphrey's examination showed a peripheral visual field defect. Decreased contrast sensitivity and poor color vision were also found.
Discussion : The patient was managed by LV aids and rehabilitation. Spectacle clarified distant and near vision with best corrected visual acuity (BCVA) 6/21 and 0.8 M on BE, photochromic lenses aided in adapting to various lighting levels and as a UV protection, and the addition of illumination and color contrast enhancement improved vision in dim light. A convex mirror to be used as a field- enhancement spotting tool. Rehabilitation enhances his head tracking, scanning, and habitual spotting skills. Improvement of QoL has been recorded using LVQoL questionnaires.
Conclusion : LV management are vary based on an individual’s level of functional vision and personal preferences. Optimal LV management could enhance patient QoL and Independence.
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.