CORNE

DR. YULIA FITRIANI, SPM

LAPISAN CORNEA

KORNEA
FISIOLOGI
- Sebagi media referakta (+ 45
D)
- Pelindung / dinding bola mata.
- Kejernihan kornea
dipertahankan oleh :
* Kondisi dehidrasi relatif
* Susunan sel / serat kolagen
yang teratur
* Tidak adanya pembuluh
darah (Avaskuler)

Standard shape
o

o

o

o

Central zone of 1-3 mm closely fits a
spherical surface
Paracentral zone, 3-4 mm ring, with an
outer diameter of 7-8 mm, area of
progressive flattening (prolate)
Peripheral zone, outer diameter of 11
mm, greatest flattening and asphericity
Limbus, outer diameter that averages 12
mm, the cornea steepens before joining
the sclera

LIMBUS .

NEOVASKULARISASI KORNEA .

SENSIBILITAS KORNEA .

PLACIDO DISK .

KERATOCONUS .

KERATOGLOBUS .

.

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ERROSIO KORNEA  DEFEK EPITEL KORNEA .

TRIKIASIS .

CORPUS ALIENUM CORNEA .

KERATITIS  PERADANGAN PADA KORNEA YANG DITANDAI DENGAN :  DEFEK EPITEL KORNEA  INFILTRAT DI SEKELILING DEFEK  OEDEMA DI SEKITAR INFILTRAT .

multifokal Kedalaman : epitel. fokal. jamur . stroma.KERATITIS       Radang pada kornea Distribusi : difus. geografika. sub epitel. pungtata Causa : virus. perifer Bentuk : dendritik. numular. bakteri. disciform. endotel Lokasi : sentral.

CORNEAL DRAWING .

GEJALA  NYERI   FOTOFOBIA    Iris meradang  kontraksi  nyeri BERAIR   memburuk dengan pergerakan palpebra Refleks karena syaraf mata di kornea yg meradang Penurunan visus Sensasi benda asing .

TANDA      Penurunan visus Injeksi silier Kornea edem Infiltrat : Superfisial. Profunda Sel radang di bilik mata depan : Tyndall effect. Hypopion .

PEMERIKSAAN SPESIFIK     SLIT LAMP BIOMICROSCOPY FLUORESCEIN TEST SENSITIVITAS KORNEA PEMERIKSAAN MIKROBIOLOGI .

Injeksi silier .

OEDEMA KORNEA .

Tyndal effect .

SLIT LAMP BIOMICROSCOPY  Infiltrat pungtata superfisial Infiltrat numularis (stromal) Infiltrat dendritik  Infiltrat disciformis (stromal) Infiltrat geografika .

FLUORESCEIN TEST .

PEMERIKSAAN MIKROBIOLOGI .

ARCUS SENILIS  TIMBUNAN LIPID .

Band Shaped keratopathy Horizonal opacity ( in the interpalpebral area ) Old degenerated eyes Hyaline degeneration + Ca deposition .

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Haemophilus .MICROBIAL KERATITIS (Bacterial) Pathogens which can produce corneal infection in intact epithelium.Listeria  4.Neisseria gonorrhoeae  2.  1.Corynebacterium diphtheriae  3.

aureus and strep. yellowwhite.Staph. pneumoniae  Oval. densely opaque stromal suppuration surrounded by relatively clear cornea .

FUNGAL KERATITIS  Filamentous fungal keratitis        Aspergillus Fusarium Greyish-white ulcer with indistinct margins Surrounded by feathery infilterates Ring infilterate Endothelial plaque Hypopyon .

Candida keratitis     Usually develops in pre-existing corneal disease or immunocompromised patient Satelite lession Yellow-white ulcer Dense suppuration .

ACANTHAMOEBA KERATITIS        Protozoan  active (trophozoite)  dormant (cystic) Common in swimmers and CL wearers Blurred vision and disproportionate pain Patchy anterior stromal infilterates Perineural infilterates (radial keratoneuritis) Infilterates coalesce –ring abcess. ulceration and hypopyon White satellite lesions .

HERPES SIMPLEX KERATITIS  Primary ocular herpes:    Blepharoconjunctivitis Keratitis (punctate epithelial) Dendritic ulcer .

Mooren’s Ulcer ( chronic serpeginous ulcer ) 1ry non infective corneal ulcer Rare Common in old age Aetiology ( unknown ) Limbal vasculitis Autoimmune disease Symptoms Signs Proteolytic enzymes necrosis of sup. Excision // to the ulcer Lamellar keratoplasty Systemic Steroids & Immunosuppressive drugs . layers 12345 Marginal grey infiltration Crescentic Ulcer Advanced edge ( undermined and creeps toward the center ) Healed edge ( Peripheral and vascularised ) Thin cornea Extension is slow and perforation is rare Treatment Usual ttt + Topical Steroids Topical Cyclosporine Conj.

Keratitis profunda .

ULKUS KORNEA     DEFEK EPITEL KORNEA INFILTRAT DI SEKELILING DEFEK OEDEMA KORNEA JARINGAN NEKROTIK .

PERFORASI KORNEA .

Seidel test .

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STAPHYLOMA KORNEA .

KERATOPLASTY    MEMBUANG SEBAGIAN KORNEA YANG RUSAK MENGGANTI DENGAN KORNEA DONOR MEMBERIKAN JALAN CAHAYA MASUK KE DALAM BOLA MATA .

SIKATRIKS KORNEA NEBUL A MAKUL A LEKOM A .

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Keratic precipitate  granulomatous  Non granulomatous .