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REFRACTIVE ERROR

dr. Nurfifi Arliani, SpM


Fakultas Kedokteran
Universitas Muhammadiyah Yogyakarta
INTRODUCTION

Hazy, foggy, blurred vision at particular distance


refractive error

The causes :
Diameter antero-posterior (axial length)
Refractive index (power)
The Lens

The most case of refractive error : Myopia.


Good vision :

No refractive error
Clear refraction medium
Healthy fundus oculi
Normal visual pathway
Good visual center
Good intelectual consciousness
Emmetropia
The object could be seen : reflecting light

The light from far distance : parallel will be


focused by refraction system

In emmetropia focused in retina

The parallel light focused not in retina


ametropia
Near-sight needs accommodation

Accommodative effort : lens

In old patient : weak of accommodation need


reading glasses Presbyopia
Myopia

The most common case

The cause : diameter antero-posterior too long


focus in front of the retina

Normal: 24 mm (approx. add 1 mm miop equally


with add 3 Dioptri)
Myopia
MATA NORMAL MATA MIOPIA
Sign and symptom:

Appearance of eyeball bigger

Far-sight (distance-vision): blurred

Clear near-sight

Children with high-myop : creep around &


examine things closely
Myopia needs correction : spherical glass negative

Degree of Myopia:
<3 D : mild
3-6 D : moderate
>6 D : high

The higher myop the blurrer vision the nearer


reading ( the nearer near-sight)

Complication of high myop :


Ablatio retina
Glaucoma
Can lead to blindness
HYPEROPIA
Diameter antero-posterior shorter than normal

Light focused behind the retina

Far-sight need acomodation, near-sight need


stronger acomodation

Need positif spherical Lens/glasses


MATA NORMAL MATA HIPERMETROP
HYPEROPIA
Sign and symptom:
Distance vision : blurred
Near-sight need accomcodasion
Unconfinient in reading a book
Fatigueness when reading a book
Headache, stiffness of the neck,
vomiting
Complication:
Strabismus (esotropi acomodativa)
Amblyopia
ASTIGMATISM

The light focused in two significantly different


meridians

The cause : surface of the cornea


ASTIGMATISM
Site of light focus:

One at retina, other one in front of retina,


astigmat myop simplex
One at retina, other one behind the retina,
astigmat hyperopia simplex
Both focuses in front of retina but in different
distance from retina astigmat myop
compositus
Both focuses behind the retina but in different
distance from retina astigmat hyperopia
compositus
one in front of retina and other one behind
the retina, -> astigmat mixtus

Astigmatism sight : the object seen shadowy


Correction of astigmatism : combined glasses
spherical and cylinder.
Conclusion

It need an awareness from the parents of the


condition of refractive error, since early detection
give more benefit result in correcting the
refractive error. It will prevent from the
occurance of further complication.