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ANTERIOR UVEITIS
REVISION NUMBER: PAGE:

RSUP
PROF. Dr. R. D. KANDOU
MANADO
CLINICAL PRACTICE GUIDELINES PUBLISH ESTABLISH
DATE: HEAD OF DEPARTEMENT
DR. Dr. Vera Sumual, Sp.M (K)

NIP:
Anterior uveitis is an inflammation of the iris and ciliary

DEFINITION body.
Red eyes, glare and blurred vision

HISTORY TAKING
1. On examination of the eye will be found cilliary

injection, keratic precipitates (KPs), cells and flare in
PHYSICAL EXAMINATION
the anterior chamber, sometimes accompanied by
hipopion.
2. posterior synechia can also be found
1. Checking the visual aquity with Snelien card or

projector chart with the best correction and using
pinhole
2. Intraocular pressure examination (IOP) with non-
DIAGNOSTIC PROSEDURE contact tonomoter
3. slit-lamp to see the anterior segment
4. Conducted posterior segment examination using
indirect ophthalmoscopy (lens condensing or
binocular indirect ophthalmoscope)
5. If the posterior segment is difficult to assess, then do
ultrasound examination.
6. Diagnosis of anterior uveitis is established when
intermediate uveitis or Posterior uveitis is not found
DIFFERENTIAL DIAGNOSIS Intermediate uveitis and posterior uveitis

1. In the first attack of anterior uveitis, non-
granulomatous uveitis, unilateral as well as reactions,
inflammation of the anterior chmaber is not heavy,
then no additional examination is required
2. In cases other than those mentioned above, additional
checks are necessary to look for underlying systemic
SUPPORTING EXAMINATION diseases.
3. Check laboratory: complete blood, diff count, liver
function test, kidney function test, urinalysis, VDRL /
TPHA, chest X-ray, Mantoux test (as basic data).
4. If a particular systemic condition is suspected,
selective additional laboratory tests may be conduct.
1. Topical corticosteroid and cycloplegic therapy

2. In severe inflammatory conditions, oral
corticosteroids may be given with
immunosuppressive doses
3. Additional therapy such as antiglaukoma when IOP
THERAPY increases.
4. Surgical measures such as cataract extraction when
uveitis is remissioned for 3 months by giving
systemic corticosteroid 1 week before surgery and
continued after surgery with tapering
EDUCATION Chronic disease that need long term therapy
PROGNOSIS AND ONGOING

Dubia ada bonam
SUPERVISION
1. American Academy of Ophthalmology Staff. Clinical
Approach to Uveitis. In: Intraocular Inflammation
LITERATURE
and Uveitis. Basic and Clinical Science Course.
Section 9. California: American Academy of
Ophthalmology 2016; p.79, 84-89, 93416.
INTERMEDIATE UVEITIS

RSUP
MANADO

NIP:
Intermediate uveitis is an inflammation that affects the

DEFINITION posterior cilliary body or pars plana. Generally bilateral.
1. Patients will complain of floaters and occasionally

accompanied by a sharp decrease of vision
HISTORY TAKING 2. Not accompanied by pain, redness or photophobia.
1. There is vitreous opacity behind the lens and around

diffuse pars plana or snow-balls.
2. Sometimes cells can be seen in the anterior chamber
(spill over).
PHYSICAL EXAMINATION 3. posterior sinecia and posterior subcapsular cataract
can also be seen.
4. In severe cases cyclitic membrane or retinal
detachment can occur.
1. Check the visual aquity with Snellen card or projector

chart with the best correction and use pinhole.
2. Intraocular press examination (TIO) with non-contact
DIAGNOSTIC PROSEDURE
tonomoter.
3. Check with the slit-lamp to see the anterior segment.
indirect ophthalmoscope (lens condensing or
binocular indirect ophthalmoscope).
5. If the posterior segment difficult to assess, then do
ultrasound examination.
6. Diagnosis of intermediate uveitis is established when
no anterior uveitis or posterior uveitis is present.
1. Anterior uveitis
DIFFERENTIAL DIAGNOSIS
2. Posterior uveitis
1. Ultrasound
SUPPORTING EXAMINATION
2. Laboratory
Give topical and oral corticosteroids and in severe cases may

THERAPY be given by orbital floor or subtenon injection

Dubia ad bonam
SUPERVISION
American Academy of Ophthalmology Staff. Clinical
Approach to Uveitis. Intraocular Inflammation and
Uveitis. Basic and Clinical Science Course. Section 9.
California: American Academy of Ophthalmology 2016;
LITERATURE p.79-82, 84-5, 89, 93-116.
POSTERIOR UVEITIS

RSUP
MANADO

NIP:
Posterior uveitis is an intraocular inflammation involving the
choroid, also can affect the optic nerve, retina
(chorioretinitis), neuroretinitis. Can be caused by infections
such as tuberculosis, syphilis, toxoplasmosis and
DEFINITION cytomegalovirus infection. Can also be caused by
autoimmune diseases such as Vogt-Koyanagi-Harada,
Behcet, sympathetic ophthalmia or other systemic
autoimmune diseases.
1. Blurred vision can occur suddenly which then progressive,

HISTORY TAKING without red eye, painless.
2. Floater
1. In uveitis associated with systemic conditions,

identify related conditions such as skin lesions,
genitalia, neuroauditory and central nervous system.
2. Examine the visual aquity with Snellen card or
projector chart with the best correction and use
pinhole
PHYSICAL EXAMINATION 3. Examination of intraocular pressure (IOP) with non-
contact tonomoter
4. Slit-lamp to see the anterior segment
6. Fundus photo as documentation and for treatment
evaluation (follow-up)
7. Selectively conducting fundus fluorosceint
angiography
8. Check blood pressure
Check laboratory: complete blood, diff count , liver

function test, kidney function, urinalysis, VDRL /
DIAGNOSTIC PROSEDURE TPHA, chest X-ray, Mantoux test and blood sugar (as
baseline data and guidelines for systemic therapy)
1. Anterior uveitis
2. Posterior uveitis
1. Selectively perform serological tests of IgG and IgM
toxoplasma, cytomegalovirus, herpes simplex and
HIV filter
2. Ultrasound examination when the posterior segment
can not be assessed directly
SUPPORTING EXAMINATION 3. In circumstances where the cause is difficult to
determine based on anamnesis, physical examination
and investigation, it may be considered to do
polymerase chain reaction (PCR) by taking specimens
of humorous or vitreous
1. If it is believed that the cause is an infection, give

specific treatment for the infection and when needed
can be added with corticosteroids per oral at
immunospuresive dose 48-72 hours later (except
CMV retinitis in HIV patients)
2. Administration of IV metylprednisolone for uveitis
associated with VKH, Behcet and sympathetic
ophthalmia, and in this disease may be given second-
THERAPY line immunosuppressive.
3. Oral corticosteroids with high doses at baseline, given
for 2 weeks and decreased based on individual
responses
4. If the cause is CMV retinitis, it is given oral
valganciclovir, unless the patient is incapacitated,
consideration may be given to intravitreal ganciclovir
5. Second-line immunospuresive administration may be
considered when corticosteroid administration is
found to be cause side effect, with high doses of
corticosteroids not responding or recurring at doses
above maintenance doses.
6. Local corticosteroids, such as orbital floor, subtenon
or intravitreal injections may be considered when
considered necessary.
7. Treatment of complications arising related to the
illness or treatment, such as antiglaukoma and when
necessary can be done filtration surgery.
8. Surgical measures such as cataract extraction when
uveitis is remissioned for 3 months by administering
systemic corticosteroids 1 week before surgery and
continued after surgery with tapering.
EDUCATION Chronic disease with high recurrence

Dubia ad malam
SUPERVISION
American Academy of Ophthalmology Staff. Clinical
Approach to Uveitis. In: lntraocular inflammation and
LITERATURE California: American Academy of Ophthalmology 2016;
p.82, 84-5, 89-90, 93-116
ENDOPHTHALMITIS

RSUP
MANADO

NIP:
Endophthalmitis is a severe infection of intraocular tissue.

DEFINITION
Visual aquity very decreased, eyes look red, pain

HISTORY TAKING
1. Intraocular pressure can be high, and can also be low

2. On examination there will be severe inflammation in
the anterior segment with edema of the cornea, fibrin
PHYSICAL EXAMINATION to hypopion.

chart with the best correction and use pinhole
2. Intraocular press examination (IOP) with non-contact
tonomoter
3. Check with the slit-lamp to see the anterior segment
4. Conducted examination of the posterior segment by
using indatek oftatmoskopi (lens condensing or
5. Ultrasound examination to see the posterior segment
DIFFERENTIAL DIAGNOSIS Panophthalmitis

Perform a complete blood test, liver function tests and
SUPPORTING EXAMINATION urinalysis if the patient is planned for vitrectomy or other
surgery
1. Patients are treated inward in the hospital
2. Prepare the patient for vitrectomy surgery
3. Consult to Vitreoretina Division
4. If it is not possible for immediate vitrectomy surgery,
an intravitreal antibiotic injection is performed.
Preferably vancomycin and ceftazidime antibiotics,
but if not obtained then it can be replaced with
cefazolin and tobramycin
5. Prior to intravitreal injection, take specimens for
THERAPY microbiological culture
6. Systemic antibiotics are given, with the first choice
being the fluoroquinolone class antibiotic and may be
continued or replaced in accordance with culture
results and sensitivity tests.
7. Other additional therapies according to other tests
found, such as antiglaukoma when IOP is high.
8. When the visual aquity is ZERO, then planned for the
eviceration and reconstruction of the eyeball.
The purpose of treatment is to treat the infection, not to treat the

EDUCATION
visual aquity, and to retain the eyeball and to avoid complication.

Dubia ad Malam
SUPERVISION
American Academy of Ophthalmology Staff.
Enclophthalmitis. In: Intraocular Inflammation and
LITERATURE
p.269-80.
PANOPHTHALMITIS

RSUP
MANADO

NIP:
Panophthalmitis is a severe inflammation of the entire

DEFINITION eyeball tissue, both intraocular and extraocular tissue.
Same with ENDOPHTHALMITIS

HISTORY TAKING
1. eye movement disorders

2. Usually accompanied by proptosis
PHYSICAL EXAMINATION 3. May be accompanied by fever
4. Generally visual aquity is ZERO

tonomoter
DIAGNOSTIC PROSEDURE 3. Check with the slit-lamp to see the anterior segment
5. Ultarsonographic examination to assess the posterior
segment
DIFFERENTIAL DIAGNOSIS Endophthalmitis

Perform complete blood tests, liver function tests and
SUPPORTING EXAMINATION urinalysis if the patient is planned for vitrectomy or other
surgery
1. Patients are treated inward in the hospital
2. Prepare the patient for surgical evaluation and
reconstruction of the eyeball
3. Systemic antibiotics are given, with the first choice
being the fluoroquinolone class antibiotic and may be
THERAPY continued or replaced in accordance with culture
results and sensitivity tests.
4. Perform specimens at the time of evisceration for
microbiological culture examination
EDUCATION Severe infection that need evisceration to avoid complication

Malam
SUPERVISION
1. American Academy of Ophthalmology Staff.
Endophthalmitis. In: Intraocular Inflammation and
California: American Academy of Ophthalmology
2016; p.269-80.
2. American Academy of Ophthalmology Staff. Orbital
Inflammatory and Infectious Disorders. In: Orbit,
LITERATURE Eyelids and Lacrimal system. Basic and Clinical
Science Course. Section 7. California: American
Academy of Ophthalmology 2016; p.40-4.
ORBITAL SELULITIS

RSUP
MANADO

NIP:
Inflammation of the tissue around the eyeball in the orbital

DEFINITION cavity
HISTORY TAKING visual impairment, occasionally with fever
Orbital cellulitis in children often occurs with clinical

symptoms of proptosis, inhibited eye movement, palpebra
edema, khemosis, hyperemia. If there is a complication to the
PHYSICAL EXAMINATION sinus cavernosus, then both eyes will be proptosis and N, III,
IV, V and VI disorders occur.

tonomoter
segment
6. Performed radiological examination and CT scan
7. Consultation to ENT, Pediatrics and Neurology to
look for possible complications.
DIFFERENTIAL DIAGNOSIS Preseptal selulitis

1. If there is sinus cavernosus thrombosis, the patient is
referred to Neurology.
SUPPORTING EXAMINATION 2. CT scan orbita or MRI.
3. Laboratory
1. Just as endophthalmitis but does not need

evisceration, and antiobiotics are given systemicly in
high doses (IV, IM or oral)
2. Drainage may be necessary
3. If necessary can be given analgetic and sedative
4. If there is a pre-orbital abscess, do incision and
drainage
THERAPY 5. Ophthalmology department treat systematic and
topical antibiotics, as well as follow-up the visual
aquity.
6. Give systemic corticosteroids cautiously or give
NSAIDs
7. Because there is a proptosis, to prevent corneal
damage due to exposure, do tarsorraphy.
EDUCATION Routine treatment

Dubia ad bonam
SUPERVISION
American Academy of Ophthalmology Staff. Orbital
Inflammatory and Infectious Disorders. In: Orbit, Eyelids
and Lacrimal system. Basic and Clinical Science Course.
LITERATURE
Ophthalmology 2016; p.40-4.
DRY EYE SYNDROME

RSUP
MANADO

NIP:
Group of abnormalities due to reduced tear production or
excessive tear evaporation associated with eye discomfort
with or without symptoms of visual impairment and can
DEFINITION cause abnormalities on the surface of the eyeball. This group
of abnormalities is called dry eye.
Possible symptoms are irritation, aqueous, hot, sore, foreign

body sensation, mild itching, photophobia, blurred vision,
contact lens intolerance, red eyes, mucous secretions,
increased blinking frequency, diurnal fluctuations in which
symptoms get heavier at the end of the day.
Anamnesis that need to be asked:
Previous medical history and its effects on
symptoms
Historical use of medications that may cause
HISTORY TAKING
dry eye
Use of contact lenses
Allergic conjunctivitis
History of previous eye surgery
History of eyeball surface disorder
History of punctum surgery
Eyelid operation history
Bell's palsy
History of cigarette smoke exposure
Skin disease
Cleanliness of face and petals
Atopy
Menopause
Systemic inflammatory disease
Other systemic treatments
Trauma
Chronic viral infection
Non-ocular surgery
Radiation orbit
Neurological disorders
Dry mouth, cavities, sores
Slit lamp:
tear meniscus, debris, increased viscosity,
mucus strands, and foamy tears
Eyelid; Trikiasis
Edge of the anterior and posterior eyelids;
Meibom gland abnormalities, meibom gland
secretion character, vascularization, scarring.
Punctum, position and position of plug
Conjunctiva;
Inferior fornic and conjunctival tarsal;
PHYSICAL EXAMINATION Mucous thread, scar tissue, erythema, papil
reaction, follicle enlargement, keratinization,
shortening, symbopharyngeal
Bulbar conjunctiva; Staining, hepermia,
keratinization
Cornea; Drought between the petals, punctate
epithelial erosion, staining, filaments,
epithelial defects, mucous plaques,
keratinization, pannus formation, thinning,
infiltrates, ulcers, scarring, neovascularization,
corneal or refractive postoperative signs.

tonomoter.
3. Slit-lamp examination to view anterior segments,
assess dry eye signs, menft: presence of aqueous tear
production deficiency and / or increase in
evaporation, see other causes of ocular irritation
DIFFERENTIAL DIAGNOSIS Conjunctivitis

1. Perform diagnostic tests, tear break up time, ocular
surface dye staining, Schirmer test, Ferning test,
corneal sensibility test.
2. Clinical and laboratory examination for patients
SUPPORTING EXAMINATION suspected of autoimmune disease. Consultations with
relevant departments such as the Department of
Internal Medicine and Dentistry and Mouth may be
required.
1. Determine th dry eye classification; Mild, moderate

and severe as well as trying to see whether dry eye is
due to aqueous deficiency or evaporative effect.
2. Identify the causal factors and factors that exacerbate
the dry eye.
3. Patient education regarding the course of the disease
and the chronicity of dry eye disease. Realistic
expectations of therapeutic goals should be discussed.
4. Recommended therapy on mild dry eye
Education and environmental modification
Eliminating causes such as topical or systemic
drugs
Increased aqueous components using artificial
THERAPY
tear substitution or gel / ointment.
Eyelid therapy (warm compress and eyelid
hygiene)
Therapy of contributing factors such as
blepharitis or meibomianitis,
5. Treatment of moderate dry eye
The above therapy is supplemented by the
following therapy
Anti-inflammatory drugs such as topical
cyclosporin and topical corticosteroids, systemic
omega-3 supplements
Punctal plug
Spectacle side shileds and moisture chambers
6. Therapy of severe dry eye
The above therapy is supplemented by the
following therapy
Systemic cholinergic agonists
Systemic antiinflammatory drugs
Mucolytic drugs
Autologous serum
Contact lens
Correction of eyelidabnormalities
Punctal permanent occlusion
Tarsorraphy

Dubia ad bonam
SUPERVISION
1. American Academy of Ophthalmology Cornea/External
Disease Panel. Preferred Practice Pattern Guidelines.
Dry Eye Syndrome. San Fransisco, CA: American
Academy of Ophtalmology;2008. Available at
http://www.aao.orgippo
LITERATURE
2. A me ri c an Ac ad e m y o f O p h th a lm o lo g y S t a ff. O c ul a r
Su rf a ce D i se a se : D i ag no s t i c Approach. In: External
Disease and Cornea. Basic and Clinical Science Course.
Ophthalmology 2016;p.55-63.
OPHTHALMOLOGIC COMPLICATIONS OF HIV / AIDS
INFECTION

RSUP
MANADO
CLINICAL PRACTICE PUBLISH ESTABLISH
GUIDELINES DATE: HEAD OF DEPARTEMENT

NIP:
The ophthalmological complication of HIV / AIDS infection is an
ophthalmological disorder occurring in HIV-positive patients. All
HIV-positive patients regardless of CD4 cell count, with
DEFINITION ophthalmological symptoms should be examined by an
ophthalmologist. Patients with CD4 cell counts below 50 cells /
mm3 should be checked by an ophthalmologist every 6 months.
1. General early history
Age
Ocular symptoms
Systemic symptoms
History of eye diseases, other diseases and surgical
history
History of other sexually transmitted diseases
History of illness or complication ----: the other AIDS
Methods of HIV transmission
HISTORY TAKING Duration of HIV infection
Current and past risk factors (history of sexual behavior,
use of intra venous drugs, transfusion history)
Current HIV regimen (duration and compliance)
Drugs used today
CD4 current
Viral load at this time
Allergy treatment
1. General physical appearance
PHYSICAL EXAMINATION
2. External examination, face and eye adnexa.
3. Lymphatic glands
1. Check the visual aquity with Snellen card or projector chart

with the best correction and use pinhole
tonomoter
3. Extraocular motility
4. Inspection of a confrontational field
6. Conducted posterior segment examination using indirect
ophthalmoscopy (lens condensing or binocular indirect
ophthalmoscope).
segment when not seen using indirect ophthalmoscopy.
1. CD4 count
2. Viral Load
SUPPORTING EXAMINATION 3. If newly suspected HIV positive, check anti-HIV ELISA
then followed Western Blot confirmation.
General management
1. Management of HIV / AIDS patients should involve a
multidisciplinary team (POKDISUS and Eye Health
Department)
2. Anti-Retroviral Therapy (ART) or Highly Active Anti-
Retroviral Therapy (HAART)
THERAPY 3. Emphasis on prevention of disease transmission.
4. Identification and treatment of HIV / AIDS-related diseases
or infections
Here is the management of some of the ophthalmological

complications of HIV / AIDS
HIV Retinopathy: If there is a macular edema consider
corticosteroids or focal lasers.
CMV retinitis
1. The main purpose is to provide anti-CMV treatment and
improve the immune status with HAART.
2. Choice of anti-CMV therapy:
a. Ganciclovir
i. Intravenous - 5 mg / kg every
12 hours for 2 to 3 weeks,
then 5 mg / kg / day 5 to 7
times per week
ii. Intraocular - 2 to 2.5 mg / 0.1
ml intravitreal injection twice
a week until inactivity then
2. Intravitreal sustained-release implant (Vitrasert)
a. Foscarnet
i. Intravenous - 60 mg / kg every 8 hours
or 90 mg / kg every 12 hours for 14
days, then 90 to 120 mg / kg / day.
ii. Intraocular --1.2 mg / 0.05 ml (or 2.4
mg / 0.1 ml)
b. Valganciclovir
iii. Oral - 900 mg twice daily for 2 weeks
then 900 mg a day
3. Anti-CMV is discontinued when the patient is in HAART
therapy and there is no sign of active CMV retinitis in
patients with CD4 cell counts above 100 to 150 cells for at
least three to six months.
Tuberculosis
1. Systemic treatment with rifampin (500 mg / day for weight>
50 kg and 600 mg / day for weight <50 kg), isoniazid (5 mg
/ kg / day), pyrimethamine (25 to mg / kg / day, and Eta
mbutol (15 mg / kg / day) for 2 months then rifarnpisin and
isoniazid for 4 to 7 months
2. Oral prednisone (1 mg / kg / day), decreased according to
clinical response
3. Starting HAART
4. Coordinate with POKDISUS
Toxoplasmosis
1. Initial therapy is administered antitoksoplasma for 4 to 6
weeks, the choice of therapy is as follows
Trimethoprim / sufamethoxazole (80/160) per or
two times daily
Pyrimethamine (100 mg starting dose for 24 hours
is continued 25-50 mg daily) and sulfadiazine (1 g
given four times daily) for 4 to 6 weeks. Given
along with folinic acid (3 to 5 mg twice a week) to
prevent leucopenia and thrombocytopenia.
Clindamycin (300 mg orally every 6 hours) for
three weeks or more
Atovaquone (750 mg orally four times daily) for 3
months
Consider giving Azithromycin to patients with
sulfa allergy
2. Continued therapy for patients with ocular toxoplasmosis
who continue to experience severe immunofeficiency
3. Oral corticosteroids are considered when severe
inflammation (vitritis, vasculitis, serous retinal detachment,
lesions involving papil or macula) of 0.5 mg / kg / day are
lowered, initiated and terminated along with
antitoxoplasmic drugs.
4. Topical steroids are given when there is significant
inflammation of the front chamber.
Syphilis
1. Therapy as neurosyphilis
2. Coordinate with other departments for the management of
systemic abnormalities
3. First line therapy is penicillin G IV 18 to 24 million units
for 14 days.
4. Increased ocular inflammation after penicillin therapy may
be a Jarish-Herxheimer reaction.
EDUCATION Chronic disease that need to be treated in long term

Dubia ad malam
SUPERVISION
1. International council of Ophthalmology. Ocular HIV /
AIDS related diseases: Initial and follow up evaluation.
2. American Academy of Ophthalmology Staff. Ocular
Involvement in AIDS. In: Intraocular Inflammation and
LITERATURE
Uveitis. BASIC and Clinical Science Course. Section 9.
p.305-14.

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ANTERIOR UVEITIS

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Anterior uveitis is an inflammation of the iris and ciliary

Red eyes, glare and blurred vision

1. On examination of the eye will be found cilliary

1. Checking the visual aquity with Snelien card or

DIFFERENTIAL DIAGNOSIS Intermediate uveitis and posterior uveitis

1. Topical corticosteroid and cycloplegic therapy

EDUCATION Chronic disease that need long term therapy

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Intermediate uveitis is an inflammation that affects the

1. Patients will complain of floaters and occasionally

1. There is vitreous opacity behind the lens and around

1. Check the visual aquity with Snellen card or projector

Give topical and oral corticosteroids and in severe cases may

EDUCATION Chronic disease that need long term therapy

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

1. Blurred vision can occur suddenly which then progressive,

1. In uveitis associated with systemic conditions,

Check laboratory: complete blood, diff count , liver

1. If it is believed that the cause is an infection, give

EDUCATION Chronic disease with high recurrence

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Endophthalmitis is a severe infection of intraocular tissue.

Visual aquity very decreased, eyes look red, pain

1. Intraocular pressure can be high, and can also be low

1. Check the visual aquity with Snellen card or projector

DIFFERENTIAL DIAGNOSIS Panophthalmitis

The purpose of treatment is to treat the infection, not to treat the

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Panophthalmitis is a severe inflammation of the entire

Same with ENDOPHTHALMITIS

1. eye movement disorders

1. Check the visual aquity with Snellen card or projector

DIFFERENTIAL DIAGNOSIS Endophthalmitis

EDUCATION Severe infection that need evisceration to avoid complication

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Inflammation of the tissue around the eyeball in the orbital

HISTORY TAKING visual impairment, occasionally with fever

Orbital cellulitis in children often occurs with clinical

1. Check the visual aquity with Snellen card or projector

DIFFERENTIAL DIAGNOSIS Preseptal selulitis

1. Just as endophthalmitis but does not need

EDUCATION Routine treatment

PROGNOSIS AND ONGOING

REVISION NUMBER: PAGE:

DR. Dr. Vera Sumual, Sp.M (K)

Possible symptoms are irritation, aqueous, hot, sore, foreign

1. Check the visual aquity with Snellen card or projector

DIFFERENTIAL DIAGNOSIS Conjunctivitis

1. Determine th dry eye classification; Mild, moderate

EDUCATION Chronic disease that need long term therapy