bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower Eyelid Laceration in Children: A Case Report
Authors: FRANCISCUS ASSISI TIMMY BUDI YUDHANTARA  , FADIMA FITRI LARASATI  
Published: February 2024

Introduction : Eyelid lacerations may be associated with serious ocular injury and are often accompanied by other ocular injuries. Most injuries occur in children. Eyelids have an important role in protecting the globe. Effective management of eyelid lacerations requires an understanding of the basic anatomical features of the eyelids.
Case Illustration : A two-year-old boy was brought to our emergency department after getting scratched in the eyelid by the family dog. The patient has received first aid and a tetanus shot at another hospital. Eye examination shows a lower eyelid laceration on the right eye, extending from the medial downwards around 3 cm. Visual examination was central+, steady+, maintenance+, and eye movement was within normal limits. The patient was admitted to undergo eyelid repair in the operating room.
Discussion : The first step in eyelid repair is wound irrigation and removal of foreign particles to avoid infection and inflammation, and primary repair of eyelids should be performed within 12 to 24 hours of the injury to reduce subsequent complications. The recommended method for best wound closure and healing is gently handling tissue edges, slight eversion, and using the smallest diameter sutures. A proper pre-operative assessment and surgical planning include evaluation of the thickness of the defect, the size, the location, and the involvement of canthus and lacrimal drainage. The goals are to provide adequate eye closure, preservation of tear film, maintenance of visual field, and aesthetics.
Conclusion : A thorough knowledge of the eyelid anatomy and suture technique is important to successfully repair the defect while maintaining eyelid function.
Persistent Fetal Vasculature with Pediatric Cataract, Microcornea, Sensory Exotropia and Mental Retardation: A Case Report
Authors: MADE KUSUMA WARDANI  , Dr. dr. Ni Made Ayu Surasmiati, M.Biomed, Sp.M(K)  , Dr. dr. I Wayan Eka Sutyawan, Sp.M(K)  , Kevin Anggakusuma Hendrawan  , A. A. Dewi Adnya Swari  
Published: February 2024

Introduction : Persistent Fetal Vasculature (PFV) is a congenital, nonhereditary ocular malformation that frequently involves the lens. PFV is most frequently unilateral. The classical presentation is leukocoria, microphthalmia, and cataract.
Case Illustration : A 16-year-old boy patient with mental retardation, came with chief complaint blurred vision and white appearance on the RE, noticed for 1 month ago. Visual acuity of the RE was LPBP and the LE was 6/120. There was microcornea on both eyes with diameter 8 mm. Lens opacity and exotropia with XT 30 0 on the RE. IOP on both eyes was normal. Funduscopic on the RE was negative and LE there was tigroid retina. Ultrasonography of the RE was echogenic with minimal after movement and low to moderate spikes. Planning for this patient were RE lens extraction with IOL. After that evaluate for the posterior segment.
Discussion : Progressive cataract formation often occurs, sometimes leading to a complete cataract. Strabismus associated with a unilateral cataract. The most important was differentiating PFV from retinoblastoma. In patients with poor view of the fundus, ultrasonography should be performed. Retinal or optic nerve abnormalities cannot be definitively ruled out, however, until the posterior pole can be visualized directly. The opacity in the affected eye should be cleared to allow visual development and to save the eye from complications of untreated PFV.
Conclusion : It is important to obtain a detailed history of the child’s growth, development, systemic disorders, family history, and need further comprehensive examination and multidiscipline consultation to establish the diagnose.
Low Vision Management in Chronic Glaucoma
Authors: Muhammad Fahmi  , Ani Ismail  , Eva Kumalasari  
Published: February 2024

Introduction : Glaucoma is a group of progressive optic neuropathy corresponding to peripheral vision loss, causing severe visual impairment to blindness. Low vision is a person who has the best visual acuity in the best eye of 6/18 to light perception or with a visual field of <10 degrees from the fixation point, after medical, surgical, and/or optical intervention. Low vision will affect every aspect of patient’s life, hence precise management of low vision is important.
Case Illustration : RY, a woman, 64 years old, works as a housewife. Complained of blurred vision slowly since 3 years ago, especially when reading. The patient then went for treatment to get glasses and was said to have glaucoma. Glaucoma surgery was performed on both patient's eyes and cataract surgery on the right eye. Now the patient’s visual acuity is 6/21 with peripheral vision loss on the right eye and NLP on the left eye.
Discussion : The patient was diagnosed with Low Vision et causa Glaucoma. Treatment includes pharmacological treatment, optical and non-optical treatment to carry out daily activities so that the patient remains independent. Education must be explained to patients that there is no therapy to eliminate visual field disturbances but that the use of the remaining visual fields can be maximized.
Conclusion : The goal of low vision management in this patient is to maximize central vision and provide visual aids to maximize the patient’s quality of life.
ADVANCED ADIPOSE PROTEIN EXTRACT PROMOTES LIMBAL STEM CELLS REGENERATION THROUGH STEM CELL NICHE MODULATION
Authors: YUYUN RINDIASTUTI  
Published: February 2024

Abstract
Introduction & Objectives : Limbal stem cells (LSCs) play important role in maintaining corneal clarity. Disruption of LSCs or its niche may lead to LSCs deficiency that result in blindness. This study aimed to investigate therapeutic effect of advanced adipose protein extract (AAPE) in LSCs regeneration.
Methods : AAPE was derived from adipose derived mesenchymal stem cell secretome purifed by ultrafiltration technique. 2D culture of LSCs were exposed by 0.25 NaOH, then treated with serum-free media as control group, media supplemented with 20% and 50% AAPE as treatment group I and II, respectively. MTT assay was conducted to measure cell proliferation and in vitro scratch assay to assess cell migration at 48 hours after treatment. EGF, FGF, HGF, and KGF from supernatant were measured by ELISA. Data was analyzed using One way ANOVA and post-hoc Tukey.
Results : A 50% AAPE successfully promoted the highest proliferation and migration rate of LSCs compared to control group (94.38±2.51%, P 0.001; 68.52±3.51%, P 0.001). EGF (1216.67pg/mL), FGF (988.25pg/mL), HGF (119.33pg/mL), and KGF (793.25pg/mL) from 50% AAPE supernatant group were highest among other groups.
Conclusion : A 50% AAPE demonstrated optimal beneficial effect on LSCs regeneration through upregulation of EGF, FGF, HGF, and KGF associated with niche modulation.
BOTULINUM TOXIN A FOR BLEPHAROSPASM WITH DRY EYE: A SYSTEMATIC REVIEW
Authors: Dr. Muthia Despi Utami  , Yulia Aziza  , Lukman Edwar  , Made Susiyanti  , Rina La Distia Nora  , Ratna Sitompul  
Published: February 2024

Introduction & Objectives : Essential blepharospasm is a neurological condition that is defined by uncontrolled and abnormal eyelid closure from a central cerebral disorder. Between 40%-85% of blepharospasm occurs in conjunction with dry eye symptoms. Botulinum neurotoxin (BoNT) injections are commonly used treatment for reducing spasms in blepharospasm. Furthermore, it is often suggested for dry eye therapy due to their ability to reduce lacrimal drainage. The purpose of this review is to assess the effectiveness of BoNT treatment for blepharospasm with dry eye symptoms.
Methods : A literature research was conducted on online databases such as PubMed, Cochrane library and Google scholar. All studies of BoNT and dry eye with full-text journals published in English within the last 10 years were included. We assessed Tear Breakup Time (TBUT), Schirmer Test, and Blepharospasm Disability Index (BSDI).
Results : 204 patients from 6 publications were analyzed. In five trials, the BoNT treatment statistically significant increased TBUT (p<0,5), with mean final TBUT 5,7 ±1.1 s. Furthermore, the Schirmer test also increased with the mean final score 6,29 ± 4,6 mm. The mean BSDI score dropped by 6,05 ± 3,7 in two studies.
Conclusion : It is confirmed that BoNT injection is an effective treatment for essential blepharospasm with dry eye symptoms. Clinicians should be screened for dry eye in all blepharospasm patients prior to BoNT treatment.
CENTRAL CORNEAL THICKNESS IN METABOLIC SYNDROME POPULATION, NON-METABOLIC SYNDROME POPULATION, AND DIFFERENT BODY MASS INDEX POPULATION
Authors: KHULUQI ROFA HUSNUL , Handayani Nina , Anandita Nanda Wahyu 
Published: February 2024

Introduction & ObjectivesCentral corneal Thickness (CCT) is associated with many factors including systemic disease. Thisstudy aims to evaluate and compare the CCT values in Metabolic Syndrome (MS) population, Non-Metabolic Syndrome (non-MS) population, and all different Body Mass Index (BMI) population.
MethodsThis population-based & community service-based cross sectional study, conducted on September-November 2019 in 3 rural areas of Malang. Written informed consent was obtained from all subjects.CCT was measured with ultrasound pachymeter. The diagnosis of MS was based on InternationalDiabetes Foundation 2006 criteria. Subjects were classified into 2 groups by MS and non-MS, alsostratifed by BMI, gender, and age. Differences in CCT value between groups based on MS & non-MS, BMI, age, and gender were analyzed.
ResultsA total of 890 subjects aged ? 40 years old were included in this study, whereas 400 subjects werediagnosed as MS (44.9%) and 490 (55.1%) others as non-MS. Mean CCT of MS were significantlygreater than that of non-MS (549.743±43.22 ?m, P<0.05). Mean CCT of obese subjects weresignificantly greatest among other BMI groups (549.036±48.31 ?m, P<0.05). Mean CCT in womenwere significantly greater than that in men (546.268±39, P<0.05). Mean CCT of subjects aged 40–49years were significantly greatest among other age groups (551.278±33,33, P<0.05).
ConclusionMS population had greater CCT value as compare to non-MS population. Obese population hadgreatest CCT value than overweight, normal, and underweight population. These findings may haveimplications for understanding the relationship between CCT changes and metabolic syndrome, aswell as BMI.
MANAGEMENT OF CORNEAL ULCER PRESENTED WITH RARE PATHOGEN : STREPTOCOCCUS MITIS
Authors: Ibnu Gilang Syawali  , Marina Yusnita Albar  
Published: February 2024

Introduction : Corneal ulcers can arise from various corneal diseases, including infections, inflammation, and autoimmune disease. Staphylococcus aureus is the most common bacterial pathogen, but lesser- known bacteria like Streptococcus mitis can also cause corneal ulcers. Accurate diagnosis and treatment are essential to prevent vision loss and complications.
Case Illustration : A 19-year-old female patient presented with a chief complaint of white spots on her right eye for three months. Previously, her right eye was hit by a foreign object and subsequently, the patient experienced redness and pain in the affected eye. One week later, white spot appeared in the patient's eye and reported to enlarge in the last month. The patient also complained of pain, blurry vision with visual acuity of 1/300, redness, glare, and a foreign body sensation. Corneal swab culture discovered Streptococcus mitis to be the causative agent. The patients was given hourly drop of topical levofloxacin. One month after initial treatment, patient’s symptoms was improving with visual acuity of 6/60 on her affected eye and the ulcer was healed.
Discussion : Streptococcus mitis is a commensal pathogen in oral cavity and not normally cause infection of ocular tissue. It may cause ulcer due to prolonged use of topical steroid and previous ocular trauma, since Streptococcus mitis had low virulence rate.
Conclusion : Corneal scraping culture should be carried out before treatment of infectious corneal ulcer. Streptococcus mitis is considered rare for corneal ulcer pathogen. Topical quinolones are the first- line drug for bacterial corneal ulcer and worked exceptional for wide range of bacteria.
Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy With and Without Internal Limiting Membrane Peeling: A Case Series
Authors: WISESAPUTRA TJOK AGUNG PURNAMA , Panjawati, Sp.M(K) Dr. Ni Luh Diah 
Published: February 2024

Introduction : Proliferative Diabetic Retinopathy (PDR) is a potentially blinding complication of diabetes mellitus, one of them because of tractional retinal detachment. Pars Plana Vitrectomy (PPV) is performed to treat it and in recent years internal limiting membrane (ILM) peeling has been employed as an additional treatment for patient with PDR.
Case Illustration : Two patient, patient 1 (male, 64 years old) was diagnosed with right eye vitreous hemorrhage due to high-risk PDR and left eye vitreous hemorrhage due to early PDR + DME, and patient 2 (female, 58 years old) was diagnosed with right and left eye PDR + ERM + senile immature cataract. Both patients underwent PPV + membrane peeling + endolaser for both eyes, and additional ILM peeling on their left eye. The visual acuity 1 month after surgery without ILM peeling on right eye was improved to 6/30 and 6/18, and with ILM peeling on left eye was improved to 6/30 for both patients.
Discussion : Removal of the ERM either with or without ILM peeling can significantly improve vision. However, many other comparison studies found no functional difference between both groups. In addition, one study found ILM removal was correlated with worse visual outcome. In this study, visual acuity 1 month after surgery in both with and without ILM peeling was improved compared with pre- operative.
Conclusion : Although there are still pros and cons, PPV with additional ILM peeling gives results as good as PPV without ILM peeling for patient with PDR.
Oral Vitamins for Lowering the Risk of Cataracts: Is It Needed?
Authors: Badruddin Gabriella Hafidha , Nathania Stella , Safira Nadya , Jutamulia Jovita , Utami Muthia Despi 
Published: February 2024

Introduction & Objectives : Cataracts are a common age-related ocular disorder leading to blindness. As the role of oral vitamins in the prevention of cataracts remains controversial, various studies have investigated the potential association between oral vitamin supplementation and risk of cataracts. This review aims to find association between oral vitamins and the risk of cataracts.
Methods : A thorough literature research was conducted on online databases (PubMed, ProQuest, and Cochrane) and hand-searching. This review incorporates human studies in the past decade (2013-2023), conducted concerning the correlation between various kinds of oral vitamins and cataracts. All studies shall be published in English and be available in full-text journals.
Results : The majority of studies indicated that vitamin C, vitamin E, and multivitamin supplementations were associated with lower risks of cataract incidence. Two articles had similar relative risks (RR) for vitamin C (RR = 0.80-0.81), one article had RR of 0.90 for vitamin E, while two others had RR of 0.66 and hazard risk (HR) of 0.91 for multivitamin. However, one cohort stated otherwise as both vitamin C and vitamin E increased the risk of developing cataracts (HR = 1.21 and 1.59, respectively), while multivitamin had no association (HR = 0.96).
Conclusion : Oral multivitamin, vitamin C, and E have a significant association with cataracts. Further research is needed to specify the efficacy of each vitamin.
Kearns–Sayre Syndrome with Bilateral Ptosis and External Ophthalmoplegia: A Rare Case Report
Authors: Philipus Putra Raharjo  , Yunia Mansyur  , Batari Todja Umar  
Published: February 2024

Abstract
Introduction : Kearns-Sayre syndrome (KSS) is a rare genetic disorder caused by a deletion of mitochondrial DNA (mtDNA) segment, typically characterized by a triad of symptoms includes external ophthalmoplegia, pigmentary retinopathy and appeared before the age of 20. The prevalence rate is about 1–3 per 100.000 individuals. It was diagnosed based on clinical features and supported by biochemical, radiological, histologic, and molecular genetic tests.
Case Illustration : 26-year-old male with bilateral ptosis, chronic progressive external ophthalmoplegia, pigmentary retinopathy was shown from ophthalmology examination and associated with hearing loss. Physical examination showed short stature, wasting, and weakness of limb muscles. MRI examination revealed focal brain atrophy on bilateral parietal regions.
Discussion : Mitochondrial DNA defect led to dysfunction of the central nervous system, endocrine system, extraocular muscle, myocardium, skeletal muscle, and other multiple systems. The clinical findings in this patient are appropriate for classical signs and symptoms of KSS. Central nervous involvementis shown by the neuroimaging result. There is no cardiac involvement suggested by normal cardiology examination. Although muscle pathology and molecular genetic analysis can play a great role to diagnose KSS, the classical triad of clinical signs plus one of the other symptoms could establish KSS diagnosis.
Conclusion : KSS is a rare genetic disorder and challenging to diagnose. However, if a patient presents with the classic triad of symptoms, clinicians should have a high level of suspicion for the disorder. Additionally, It is important to perform a thorough evaluation to rule out other conditions that can cause similar symptoms.
Amnion Membrane Transplantation: A Therapy for Persistent Epithelial Defect as A Result of Neurotrophic Keratitis
Authors: Nathasya Maharani Susilo  , Nathasya Maharani Susilo  , Patriotika Muslima  , Elfa Ali Idrus  , Arief Akhdestira Mustaram  , Angga Fajriansyah  
Published: February 2024

Introduction : A persistent epithelial defect (PED) is a failure of re-epithelialization and complete healing of the cornea. The primary goal of PED treatment is to create a favorable environment for corneal wound healing. Amniotic membrane transplants (AMT) become one of the refractory cases treated for PED. This study aims to report AMT as therapy for a PED.
Case Illustration : A fifty-six-year-old male presents with a chief complaint of redness and pain in the left eye in the last2 weeks. The patient complained of blurred vision, tearing, and foreign body sensations. An ophthalmology examination of the left eye revealed that it was close to face finger counting in visual acuity and had a persistent epithelial defect, corneal edema, descemet fold, and a decrease in corneal sensation. The patient was diagnosed with PED and received autologous serum eye drops, levofloxacin eye drops, vitamin A palmitate eye gel, and acyclovir 400mg twice a day, but did not respond adequately. AMT was planned for the patient. The patient's pain level improved one week after surgery.
Discussion : The most common symptom of PED is pain. There are various etiological factors for PED. Neurotropic keratitis has emerged as one of the causes of PED. Management for PED is carried out sequentially according to the protocol.
Conclusion : Amniotic membrane transplantation has become an alternative therapy for PED. The amniotic membrane provides re-epithelialization of the cornea and anti-inflammatory properties. The prognosis for AMT as a therapy for PED is quite good.
Appropriateness of Antibiotics Prescription for Conjunctivitis in Primary Health Care: A Literature Review
Authors: Belinda Liliana  , Atrika Fitri Nur Cahyani  , Azura Nabila Putri  , Oriana  , Mohammad Eko Prayogo  
Published: February 2024

Abstract
Introduction & Objectives : Conjunctivitis is one of the most common diseases present in primary health care (PHC) settings. The most common causes of conjunctivitis are viral infections and allergies. Despite this, patients diagnosed with conjunctivitis are often given antibiotics as therapy. Therefore, this literature review will assess the appropriateness of antibiotics prescription for patients with conjunctivitis in PHC settings.
Methods : The authors performed an electronic literature search on databases PubMed and Scopus for eligible articles, which showed antibiotic prescription for patients with conjunctivitis in PHC settings and published between 2012 and 2022, then further sorted based on the inclusion and exclusion criteria.
Results : A total of 8 studies met the inclusion criteria. Five studies showed high rates of inappropriate antibiotic prescriptions for patients with conjunctivitis in PHC. Several factors that might cause inappropriate prescription include the difficulty in determining the exact etiology, the need to fulfill patients’ satisfaction, the amount of experience and training doctors have received, consultation’s duration, stigma, the socio-demographic factors of the patient, the availability of treatment guidelines, and the availability of drugs. Some of the consequences that are concerned include the rise of antimicrobial resistance, stigma revolving around the usage of antibiotics for every infectious disease, and economic burden. Delays in prescribing antibiotics and proper training for general practitioners can be a solution to reduce inappropriate prescribing of antibiotics.
Conclusion : Prescribing antibiotics for patients with conjunctivitis in PHC settings is mostly inappropriate
Nocturnal Lagophthalmos in Pediatric Patient with Hydrocephalus
Authors: IZZA ZUKHRUFIA  , Yunia Irawati  , Julie Dewi Barliana  
Published: February 2024

Introduction : Nocturnal lagophthalmos is a physiologic and asymptomatic condition observed in 1.4-5% of the population. In unconscious patients, using mechanical ventilation and neuromuscular blocker medication can worsen the lagophthalmos, causing the patient to have exposure keratopathy. This report aims to emphasize the importance of eye care in unconscious patients.
Case Illustration : A 5-year-old girl came with a chief complaint of a whitish lesion on the right eye. She got the lesion when hospitalized in Pediatric Intensive Care Unit for two weeks due to seizure attacks. A red and watery eye accompanied the whitish lesion. The patient had history of nocturnal lagophthalmos and Dandy-Walker syndrome, a complex malformation characterized by agenesis or hypoplasia of the vermis and cystic enlargement of the fourth ventricle. The corneal ulcer was treated with antibiotic treatment. After several visits, her infection had subsided but left a corneal cicatrix on her right eye.
Discussion : In unconscious patients, it’s important to pay attention to the eyelid. Lagophthalmos can be divided into three groups; where grade 1 has complete eyelid closure; grade 2 has conjunctival exposure; and grade 3 has corneal exposure. It’s important to lubricate the eye in each grade and keep it closed using eyelid tape or cover in grades 2 and 3 to prevent exposure keratopathy. Surgical intervention can be considered when there is a risk of corneal ulcer.
Conclusion : Prevention is always better than cure. Establishing standardized eye care in the intensive care unit is crucial to prevent ocular complications and preserve visual acuity.