Scenario 5 Block Indera

Khusus
Leader : David Lionardi
Secretary : Tri Lidya Anggraini
Notulen : Juli Sari G
Members : Cendy Juliana
Roni Dwindra Wardiansyah
Tridia Putra G Eninta Sitepu
Nadia Khariza Alfiany Sahr
Anastasia K Rudi Aprianto
Megawati
Een Gustinaz
Rizky Zulbakri Mrp
 Scenario
Zeky 22 years of coming to the poly eye RS.
Royal Prima with headaches accompanied
by nausea and vomiting sudden. It is
accompanied by blurred vision and like
seeing a rainbow when view lamp. Intraokuli
pressure of 42 mmHg. What do you do to find
out the diagnosis and handling?
 DISCUSSION SCENARIO
I. CLARIFICATION OF TERMS
Intraocular pressure: the pressure against the walls of
the contents of the eyeball eyeball.

II. PROBLEMS IDENTIFICATIONS

Why the headache with nausea and vomiting
suddenly tib?
Why did occur such as blurred vision and see a
rainbow when looking at the lights?
What causes an increase in pressure of 42 mmHg
intraokuli?
III. PROBLEM ANALYSIS
There may be an obstruction in the canal sclhemm
so that aqueous humor produced little, ciliary
processes can not be transmitted to the anterior
chumber buildup increased ocular fluid.
IV. CONCLUSIONS
Zeky 22 years the possibility of having glaucoma.
V. LEARNING OBJECTIVE
1. Definition, Etiology, Epidemiology Glaucoma
2. Classification of Glaucoma
3. Diagnosis and Glaucoma Diagnosis
4. Prevention and Management of Glaucoma
5. Complications and Prognosis Glaucoma
Definition Glaucoma
Chronic neuropathy ophtic that mark with
ophtic discuss concaftion.

Etiology Glaucoma
1. Congenital
2. Infections
3. Trauma
4. Pre Surgery
5. Steroid
6. Episclera Venous
Epidemiology
CLASSIFICATION OF GLAUCOMA
1. Primary Glaucoma
Opening angle
Closed-angle
2. Secondary Glaucoma
Trauma
Uveitis
3. Congenital Glaucoma
PATHOPHYSIOLOGY OF GLAUCOMA
CLINICAL SYMPTOMS OF GLAUCOMA
1. closed-angle glaucoma
Severe periorbital pain and ipsilateral frontal
headache
Blurred vision
Halo around light colored
Nauseous vomit
2. open-angle Glaucoma
Early stage: asymptomatic
Step Further: visual field disturbance
3. Congenital Glaucoma
epistrophe
Photophobia
Increased corneal diameter
A torn Descemet membrane
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS GLAUCOMA
Diagnosis:
I. History
1. Identity of the patient
2. The main complaint
3. Additional Complaints
4. Previous medical history
5. Employment history
6. History of nutrients
7. History of drug consumption
8. Family history

II. PHYSICAL EXAMINATION

1. Inspection
2. Palpation
III. SUPPORTING INVESTIGATION
1. Slit lamp
2. Ganioskopi
3. tonometry
4. Assessment of the optic disc
5. perimetry

Differential diagnosis:
1. Conjunctivitis
2. Iritis
3. diabetic retinopathy
4. hypertensive retinopathy
Management and prevention of Glaucoma
1. Eyedrops
a. Prostaglandin analog
Latanoprost (xalatan) 1 x daily before
bedtime
b. Beta-blocker
Timolol 0,25 % 2 x daily ( do not
recommend at night)
c. Agonis Alfa-2
Brimonidin 0,2 % 2 x daily
d. parasimpatomimetik
e. Simpatomimetik
adrenalin 1 % 2 x daily
Drugs that can combine :
Timolol + latanoprost 1 x daily
Timolol + pilocarpine 2 x daily
Timolol +brimonidin 2 x daily

2. Oral drug
a. Carbonic Anydrase inhibitor
Asetozolamid 250 mg 3 x 1
b. Osmotic agents
Mannitol 1g/kgBW IV for 30 minutes
3. Trabeculoplasty
4. Trabeculectomy
PREVENTION :
1. Often examining the eyes to ophtalmologist
2. There are genetic factors
3. Wear eye protection when working
COMPLICATION AND PROGNOSE OF GLAUCOMA

A. COMPLICATION
1. Chronic glaukoma
2. Sinekia anterior
3. Cataract glaukoma
4. Opticus nerve damage
5. Blindness

B. PROGNOSE
1. Primary glaucoma
2. Secondary glaucoma
3. Congenital glaucoma
4. Absolut glaucoma
 CONCLUSION
Zeky who was 22 years old came to the poly
eye Prima Royal Hospital with complaints of
headaches accompanied by nausea, vomiting,
blurred vision and like seeing a rainbow when viewed
lamp. Pressure oculi increase of 42 mmHg. Patients
diagnosed with glaucoma, as a general practitioner
competent to diagnose and in referred to the
ophthalmologist. If necessary give symptomatic
treatment.