dt dey konjungtivitis
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Topic Discussion
DEY SHIE(I11108083)
Konjungtivitis & Keratitis
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Defnisi dan Etiologi
• Konjungtivitis merupakan radangkonjungtiva atau radang selaputlendir yang menutupi belakang
kelopak dan bola mata, dalambentuk akut maupun kronis.
• Etiologi:
1. Ineksi: bakteri, virus, parasitdan jamur.
!. "on ineksi: alergi, iritasi yang
lama pada mata, #at$#at yangbersiat toksik kelainan
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PATOGENESIS DAN PATOFISIOLOGI KONJUNGTIVITIS
GANGGUAN PADA MEKANISME
PERTAHANAN HOST
NORMAL FLORA
KONTAMINASI
EKSTERNAL
GANGGUAN LAPISAN EPITEL
KONJUNGTIVA
MEKANISME IMUN
DARAH IMMUNOGLOBULIN DAN
LISOZIM PD PERMUKAAN
FILM AIR MATA
LAKRIMASI
FAGOSITOSIS OLEH
NEUTROFIL
MEDIATOR INFLAMASI
GATAL PERMEABILITAS
VASKULARPELEBARAN
VASKULAR
INJEKSI
KONJUNGTIVAL EKSUDAT HIPEREMIA
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%ambaran klinis
1. Injeksi knj!n"#i$%&. M%#% 'e(%s% se)e(#i %*%n+% ,en*% %sin"
-. Sens%si se)e(#i %*% #ek%n%n *%n (%s% )%n%s
. L%k(i'%si
/. Ke0)%k '%#% 0en"ke# %ki,%# )(*!ksi sek(e# +%n" 'enin"k%# #e(!#%'% )%*% )%"i %(i
2. P#3,i%
4. Pse!*)#sis
5. Ke'sis
6. Hi)e(#()i )%)i0
17. F0ike0
11. Me',(%ne
1&. Pse!*'e',(%n1-. G(%n!0%si
1. F0ik#en
1/. A*en)%#i )(e%!(ik!0%(
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Pe(,e*%%n "%',%(%n '%#% 'e(%
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)%nn!s
Injeksi knj!n"#i$%
)se!*'e',(%n
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Hi)e(#(3i )%)i0
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enis$jenis Konjungtivitis
TemuanKlinis danSitologi
Viral Bakteri Klamidia Alergika
G%#%0 Mini'%0 Mini'%0 Mini'%0 He,%#
Hi)e(e'i% Gene(%0is%#% Gene(%0is%#% Gene(%0is%#% Gene(%0is%#%
M%#% ,e(%i( B%n+%k Se*%n" Se*%n" Mini'%0
Eks!*%si Mini'%0 B%n+%k B%n+%k Minii'%0
A*en)%#i)(e%!(ik!0e(
Se(in" J%(%n" H%n+% se(in")%*%knj!n"#i$i#isink0!si
T%k %*%
P%*% ke(k%n*%n eks!*%#+%n" *i)!0%s
Mnsi# B%k#e(i8 PMN PMN8 se0)0%s'%8,%*%n ink0!si
Esin3i0
Dise(#%i s%ki##en""(k%n
*%n *e'%'
K%*%n"9k%*%n"
K%*%n"9k%*%n"
9 9
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Tanda Bakterial Viral Alergik Toksik TRIC
(Trakoma)
Injeksi
knj!n"#i$%
Men:0k Se*%n" Rin"%n9
se*%n"
Rin"%n9
se*%n"
Rin"%n9
se*%n"
Ke'sis ;; ;
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Konjungtivitis 'akteri
K%(%k#e(is#ik? i)e(e'i% knj!n"#i$% !ni0%#e(%0 *en"%n nse# +%n":e)%#8 e*e'% ke0)%k '%#%8 *%n sek(e# '!k)!(!0en8'en!0%( ke
'%#% se,e0%n+%
K0%si3ik%si *%n )en+e,%,?
Akut Hiperakut KronikStaphylococcusaureusStreptococcus
pneumoniae
Haemophilusinfluenzae
NeisseriagonorrhoeaeNeisseriameningitidis
StaphylococcusaureusMoraxella lacunataEnteric bacteria
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9Hi)e(e'i%8 sek(e#
'!k)!(!0en8 *%)%#
*ise(#%i8 ke(%#i#is.
9 Se03 0i'i#in" 4917%(i
9 Pen",%#%n? %n#i,i#ik
s)ek#(!' 0!%s=30!(@!in0ne
"ene(%si - %#%!
8s*i!' s!03%:e#%'i*e
178 %#%!
#(i'e#)(i'9
)0+'+i'> 4917 %(i
N. Gonorhoea.
Se(in" )%*%nen%#!s =3#%0'i%nen%#(!'> *%n
*eC%s% '!*% +%n"%k#i3 se:%(% seks!%0.
& j%' %C%0'e0i)!#i
i)e(e'i%8 n+e(i8sek(e# )!(!0en,e(C%(n% k!nin"9
ij%!8 ke'sis8 *%nn*!0 )(e%!(i:!0%(.
- 'in""!
B%k#e(i )en+e,%, #e(se(in"?
S. Aureus, Moraxella
lacunata, roteus mirabilis8
Escherichia coli 8 !lebsiella
pneumoniae.
S. Aureus *%)%#'en+e,%,k%n
,0e3%(knj!n"#i$i#is8
,e(k0ni *i '%(" ke0)%k
'%#% *%n 'en"e0!%(k%n
eks#ksin 'en+e,%( ke
knj!n"#i$%8 'e0!%s
'enj%*i !0k!s k(ne%.
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KONJUNGTIITIS O!EHI"US
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Kon#$ngti%itis %i&$s Pen+e,%,? %*en$i(!s8 e()es s#e(8 $i(!s neC :%s#0e8
)i:(n%$i(!ses8 en#e($i(!s 478
Jenis? knj!n"#i$i#is 30ik!0%(8 *e'%' 3%(in"knj!n"#i$%8
ke(%#knj!n"#i$i#is e)i*e'i8 knj!n"#i$i#is e()e#ik8 knj!n"#i$i#is
$%(i:e0%9s#e(8 knj!n#i$i#is ink0!si8 knj!n"#i$i#is neC :%s#0e8 *%n
knj!n"#i$i#is e'(%"ik e)i*e'ik %k!#. D%(i 1 se(#i)e %*en$i(!s8 #e(*%)%# 16 se(#i)e +%n" *%)%#
'en+e,%,k%n knj!n"#i$i#is.
In3eksi *%)%# 'en+e,%( 'e0%0!i *()0e# %#%! kn#%k 0%n"s!n" *%(i
j%(i #%n"%n ke ke0)%k '%#% *%n knj!n"#i$%.
M%s% ink!,%si /91& %(i8 *%n s%ki# se:%(% k0inis ,i%s%n+% /91/ %(i.
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Kon#$ngti%itis %i&$s '$t
1 De*a* +a&ingoon#$ngti%a Ineksi adenovirus tipe (, ), dan *
+ada anak$anak lebi- sering, penularan dari airkolam renang
Demam (/,(0
$)00
, aringitis, sekret berairserosa, kelopak bengkak, otopobia,
2imadenopati preaurikuler tidak nyeri k-as
3olikel pada konjungtiva, unilateral atau bilateral
Dapat sembu- sendiri, diberikan kompres, astringen,lubrikasi
4teroid dan antibiotik diberikan pada kasus beratdengan keratitis
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, Ke&atoon#$ngti%itis e-ide*ia Ineksi adenovirus /, 15, !5, dan (*
'ilateral +ada de6asa terbatas di bagian luar mata, anak$
anak: demam, sakit tenggorokan, otitis media, dandiare
76al: injeksi konjungtiva, mata berair, nyeri sedang,
perdara-an subkonjungtiva, olikel terutama padakonjungtiva ba6a-, pseudomembran
8$1) -ari: otoobia, keratitis epitel, dan kekeru-ansubepitel
2imadenopati preaurikular dengan nyeri tekan
Kompres dingin untuk mengurangi gejala
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F0ike0
In3i0#(%# )%*% k(ne%
P%*% in3eksi %*en$i(!s
k(nik
Pse!*'e',(%n
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3. Konjungtiitis Herpetik
HSV #i)e 1
&9- 'in""!
Injeksi knj!n"#i$% !ni0%#e(%08 i(i#%si8 sek(e# '!ki*8 n+e(i8 *%n
3#3,i% (in"%n Se(in" *ise(#%i ke(%#i#is e()es si')0eks? !0k!s #!n""%0 %#%! !0k!s
*en*(i#ik
Vesike0 e()es *i )%0)e,(% *%n #e)i%n )%0)e,(%8 e*e'% )%0)e,(%
e,%#
An%k *i %#%s 1 #%!n %#%! )%*% (%n" *eC%s%? se',! sen*i(i K(ne% #e(0i,%#? %n#i$i(!s #)ik%0? #(i30!(i*ine se#i%) & j%' seC%k#!
,%n"!n se0%'% 4917 %(i s%0e) %:+:0$i( 4 / se%(i %#%!
*en"%n %:+:0$i( 77 '" / se%(i se0%'% 4 %(i
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!. Konjungtiitis "en#akit $e%&astle
J%(%n" *i#e'!k%n
Pe(%s%%n #e(,%k%(8 "%#%08 n+e(i8 'e(%8 '%#%
,e(%i(8 )en"0i%#%n k%,!(
F0ik!0e( knj!n"#i$% *i #%(s!s s!)e(i( *%n
in3e(i(
P%*% )eke(j%%n )e#e(n%k%n !n""%s
D%)%# se',! sen*i(i
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'. Konjungtiitis Hemoragika Akut
In3eksi en#e($i(!s #i)e 47
Ink!,%si )en*ek =595 j%'> *%n ,e(0%n"s!n"
sin"k%# =/94 %(i>
N+e(i8 3#3,i%8 sens%si ,en*% %sin"8 sek(e#
,%n+%k8 i)e(e'i8 e*e'% )%0)e,(%8 )e(*%(%%n
s!,knj!n"#i$% *i3!s
F0ike0 *i knj!n"#i$%
Li'3%*en)%#i )(e%!(ik!0%(
D%)%# se',! sen*i(i
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,0e3(%knj!n"#i$i#is e()es si')0ek
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KONJUNGTIITIS'!E"GI
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Konjungtivitis alergi
Me(!)%k%n (e%ksi %n#i,*i !'(%0 #e(%*%) %0e("en)%*% ,%#8,%k#e(i8 #ksik8 *%)%# ,e(!)% (e%ksi :e)%#
*%n 0%',%#.
P%sien 'e'i0iki (iC%+%# %#)i
Gej%0%? (%*%n" ='e(%8 s%ki#8 ,en"k%k8 )%n%s>8 "%#%08si0%! ,e(!0%n" *%n 'en%!n8 )%)i0 ,es%( )%*%
knj!n"#i$%.
Pen",%#%n? %n#iis#%'in *%n s#e(i* sis#e'ik
Jenis9jenis? kj!n"#i$i#is $e(n%08 knj!n"#i$i#is 30ik#en8knj!n"#i$i#is i%#("enik8 sin*(' s#e$en jnsn
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1. Konjungtivitis vernal
Me(!)%k%n (e%ksi i)e(sensi#i$i#%s #i)e I +" 'en"en%i
ke*!% '%#% *%n ,e(si3%# (ek!(en.
Ti)e? )%0)e,(% *%n 0i',%0
Ti)e )%0)e,(%? *i#e'!k%n )%)i0 ,es%( *en"%n )e('!k%%n
(%#% )%*% knj!n"#i$% #%(s%08 *en"%n (%s% "%#%0 ,e(%#8sek(e# "e0%#in ,e(isi esin3i08 *%)%# *ise(#%i ke(%#i#is.
Ti)e 0i',%0? #e(0i%# ,enj0%n *i *%e(% 0i',!s8 *en"%n
,e(:%k H(ne( T(%n#%s.
Rek!(en8 ,i0%#e(%08 'en"en%i )%sien !si% '!*% -9&/ #%!n
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!. Konjungtivitis 9ikten
Me(!)%k%n knj!n"#i$i#is n*!0%( +" *ise,%,k%n %0e("i
i)e(sensi#i$i#%s #i)e IV8 se(in" *i#e'!k%n )%*% %n%k9%n%k *i
0in"k!n"%n )%*%# *en"%n "ii k!(%n" %#%! se(in" 'en"%0%'i
(%*%n" s%0!(%n n%)%s.
Gej%0%? '%#% ,e(%i(8 i(i#%si *en"%n (%s% s%ki#8 3#),i%8,0e3%(s)%s'e.
D%)%# se',! sen*i(i *%0%' & 'in""! *en"%n ke'!n"kin%n
kek%',!%n8 n%'!n *%)%# 0e,i ,e(%# jik% #e(ken% k(ne%
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(. Konjungtivitis 4teven o-nson
Sin*(' s#e$en jnsn 'e(!)%k%n )en+%ki# e(i#e''!0#i3(' +%n" ,e(%#8 se(in" #e(j%*i )%*% !si% seki#%( -/
#%!n
Pen+e,%, *i*!"% (e%ksi %0e("i )%*% (%n" *en"%n
)(e*is)sisi %0e("i ,%#9,%#%n
Gej%0% )%*% '%#%? '%#% 'e(%8 $%sk!0%(is%si k(ne%8
)%(!# knj!n"#i$%8 knj!n"#i$% ke(in"8 si',0e3%(n8 #!k%k
*%n )e(3(%si k(ne%8 en*3#%0'i#is.
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Trakoma
Me(!)%k%n knj!n"#i$i#is 30ik!0%( k(nik +%n"
*ise,%,k%n 0e ,%k#e(i "hlamydia trachomatis.
D%)%# 'en"en%i se"%0% !'!(8se(in" )%*% *eC%s% '!*%
*%n %n%k9%n%k.
%(% )en!0%(%n? kn#%k 0%n"s!n" *en"%n sek(e#8 %0%#ke,!#!%n se%(i9%(i =%n*!k8 %0%# ke:%n#ik%n8 *00>
M%s% ink!,%si /91 %(i.
Gej%0%? 3#),i%8 "%#%08 ,e(%i(8 eks!*%si8 e*e'%
)%0)e,(%8 ke'sis8 i)e(#(3i )%)i08 n*!0 )(e%!(ik!0%(
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KE7TITI4
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KE7TITI4 '7KTEI
''n O("%nis's? Staphylococcus aureus, Stap.Epidermidis, Strep. neumoniae, *00
Un:''n O("%nis's? Neisseria spp.,
Mycobacterium spp, *00
P%#"enesis? A*e(ensi ,%k#e(i
,e()(0i3e(%si )%*%s#('% k(ne%(es)n in30%'%si se(#% sek(esi
'e#%00)(#ein%se '%#(iksnek(sis k(ne%
GK? !0k!s k(ne% *en"%n nse# n+e(i %k!#8
)#),i%8 injeksi k(ne% *%n )en!(!n%n $is!s
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.UNG'!KE"'TITIS
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3ungal Keratitis
In3eksi k(ne% 0e j%'!(. Bi%s%n+% j%'!( Aspergillus F%k#( Resik ? T(%!'%8 (ni: ke(%#i#is =e()es si')0e8
e()es s#e(8 Ve(n%0 ( %00e("i: ke(%#:nj!n:#i$i#is>8 Di%,e#es8
AIDS.
Si"n? nj!n:#i$%0 %n* :i0i%(+ :n"es#in8 E)i#e0i%0 *e3e:#8
S#('%0 in3i0#(%#es8 D(+ %n* (!" #e#!(e S+')#'s ?
In:(e%sin" e+e )%in ( *is:'3(#
S!**en ,0!((+ $isin
Un!s!%0 (e*ness 3 #e e+e
E:essi$e #e%(in" %n* *is:%("e 3(' #e e+e
In:(e%se* 0i"# sensi#i$i#+
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3ungal Keratitis 6it- ;ypopyon
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Si"ns?
S%#e00i#e 0esins
B(Cn )i"'en#%#in *!e # *e'%#i%:e!s 3!n"!s=!($!0%(i% 0!n%#%>
In#%:# e)i#e0i!' Ci# s#('%0 in3i0#(%#es
An#e(i( :%',e( (e%:#in
ungal Keratitis "igmented *esion
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Treatment
N%#%'+:in /
%n*i*% s)e:ies (es)n* ,e##e( # A')#e(i:in B 7.1/ F0!:n%0e &
Mi:n%0e 1
S:(%))in" e$e(+ & # 5 !(s
T(e%#'en# is (e@!i(e* 3( 2 Ceeks
S+s#e'i:?
F0!:n%0e ( Ke#:n%0e is in*i:%#e* in se$e(e 3(' 3
ke(%#i#is8 s:0e(i#is %n* en*)#%0'i#is
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;erpes 4imple< Keratitis
P(i'%(+ ( 0%#en# = (e:!((en# > HSV in3e:#in
Gej%0% P(i'%(+? se$e(e 'n:!0%( )%in8 )#),i%8
)en"0i%#%n ,0!(
L%#en#? %s+')#'%#i:8 )#sensi#i$i#+8 ,0!((e* $isin
Si"ns P(i'%(+? $esi:!0%( ,0e)%(i#is8 300i:!0%( :nj!n:#i$i#is8
)(e%!(i:!0%( %*en)%#+8 s#%inin" e)i#e0i%0 *en*(i#e=s> L%#en#? $%(i%,0e :(ne%0 in$0$e'en#8 3(' )!n:#%#e
ke(%#i#is # 0%("e "e"(%)i: !0:e( =s#%inin">8
*e:(e%se* :(ne%0 sens%#in
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+I=7> ;4? I"3ETI@"
P(i'%(+ HSV :!0%( in3e:#in 's# :''n0+ '%ni3es#s %s
,0e)%(:nj!n:#i$i#is Te ke(%#i#is in #ese )%#ien#s '%+ ,ese$e(e %n* ,i0%#e(%0
,0e)%(:nj!n:#i$i#is F00i:!0%( nj!:#i$i#is
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Diagnosis
Di%"nsis?
I''!n30!(es:en:e #es#8
!0#!(e 3 e)i#e0i%0 s:(%))in" (
Tiss!e ,i)s+
HSV *en*(i#i: !0:e( s#%ine* Ci#
30!(es:ein
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;erpes Aoster @p-t-almicus ;A@
%!se* ,+ V%(i:e00% Zs#e( $i(!s Ci: ,e0n"s #e()es $i(!s "(!)
S+')#'s Gene(%0? 3e$e(8 '%0%ise8 ne!(%0"i: )%in.
Skin 3 %33e:#e* %(e% ,e:'es e*e'%#!s %n* (e*
Di33e(en#i%0 *i%"nsis e(+si)e0%s ,!# *is#(i,!#in%0n" in$0$e* ne($e ,(%n:es *i33e(en#i%#e
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He()es Zs#e( O)#%0'i:!s
0ini:%0 )#"(%)s sCin" *is#(i,!#in 3 (%ses
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Treatment
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Treatment
1. A:+:0$i(? 577 '" /917 %(i8 A0#e(n%#i$e0+
(%0 F%':i:0$i(8 &/7 '" -94 %(i
&. M%in#en%n:e 3 +"ieni: :n*i#in #
)(e$en# se:n*%(+ in3e:#in. T)i:%0%n#i$i(%0 =%:+:0$i(> %n* %n#i,i#i: in#'en#
n skin 0esins
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TE"I/' K'SIH
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