Selulitis orbital merupakan penyakit serius yang mengancam jiwa, ditandai dengan infeksi jaringan lunak di bagian posterior septum orbital. melibatkan jaringan lunak orbita. Trombosis sinus kavernosa merupakan tahapan akhir infeksi orbita yang meluas ke intra cranium, ditandai dengan penurunan kesadaran dan gejala rangsangan meningeal. Dipresentasikan tiga kasus selulitis orbital dengan klinis khas yang sangat berbeda. Pilihan terapi diberikan diberikan berdasarkan gejala klinis. Tidak ada kesepakatan tentang antibiotik terbaik untuk digunakan, golongan antibiotik β-laktam selama 4-6 minggu masih direkomendasikan sebagai agen lini pertama, dan untuk kasus thrombosis sinus kavernosus, antibiotik meropenem dan vankomisin selama 6-8 minggu merupakan terapi utama. Observasi lanjutan dan pemeriksaan radiografi dapat dilakukan sesuai indikasi. Manajemen yang tepat dari pasien selulitis orbita memerlukan multidisiplin tim. Diagnosis cepat dan terapi yang tepat diharapkan bermanfaat untuk perbaikan visual dan klinis yang baik, meskipun kadang masih terdapat gejala residual seperti sikatrik kornea dan trichiasis. Selulitis orbital merupakan kasus yang mengancam jiwa, karena penyebaran infeksi yang dapat mencapai intrakranial. Diharapkan dengan diagnosis cepat dan pemberian antibiotik agresif berdasarkan gejala klinis dapat menyelamatkan nyawa pasien.

<p><em>Chronic inhalation of organic solvents causes retinal toxicity such as decreased color vision and contrast sensitivity because organic solvents cause damage to photoreceptor function, changes in cortical or retinal neurotransmitter systems such as glutamate, dopamine and acetylcholine and changes in function in parvo, magno and coniocellular cells.</em><em> </em><strong><em>Method</em></strong><em>: The sample of this study consisted of 45 gas station operators who were divided into 3 groups, namely those who worked 1 year</em><em>-</em><em>5 years, 5 years</em><em>-</em><em>10 years and </em><em>&gt;</em><em>10 years. All subjects underwent </em><em>q</em><em>uantitative color vision examination by calculating the value of the color confusion index (CCI) using Fansworth D15. Contrast sensitivity examination is by determining the log contrast sensitivity value using the Pelli-Robson test.</em><em> </em><strong><em>Results</em></strong><em>: CCI values&gt; 1.00 and log contrast sensitivity values &lt;1.65 were found in officers who worked for </em><em>&gt;</em><em>10 years by 12 subjects (80%). Statistically there is a significant relationship between the duration of work with the decrease in color vision and contrast sensitivity (P Value 0,000).</em><em> </em><strong><em>Conclusion</em></strong><em>: There is a significant relationship between the duration of exposure to organic solvents with a decrease in color vision and contrast sensitivity in operator officers who work </em><em>&gt;</em><em>10 years.</em></p>

Background: To report the surgical management for perforated Mooren's ulcer by performing conjunctival resection with situational corneal suture and Amniotic Membrane Transplantation. Case Illustration: There were six patients diagnosed with Mooren's ulcer between 2011-2013. Three of them were perforated Mooren's ulcer with iris prolaps, and the size of perforation was 2-4 mm. The sex distribution of the patient were 3 male and 3 female patients. The age of presentation of were varied from 11-48 yo. Three patients underwent surgery, one patient refused. The other 2 patients only got medical therapy. For perforated cases with iris prolaps, we performed conjunctival resection with situational corneal suture, overlying the perforation. The suture were made like a net or bridge, depend on cases, and then amniotic membrane were put over the suture. The corneal suture should not be tight because it can disrupt the corneal contour. Amniotic membrane were put on the net layer by layer, and then fixed by interrupted suture to the episclera and cornea, at least in 8 position. The eyes were patching about 4 days and give topical and systemic antibiotic, and corticosteroid systemic. All of patient have complete epithelization after surgery between day 7-10 and have visual acuity improvement. Some of the patient still followed up until now. Conclusion: Conjunctival Resection with situational corneal suture and Amniotic Membrane Transplantation appeared to be an effective procedure for perforated Mooren's ulcer and iris prolaps, even more than 2 mm size of perforation.

Background: Infectious corneal ulcer (CU) occurs due to an agent, which may be a bacterial, fungal, or viral microorganism. A detailed examination of the ulcer was needed to determine the severity grading of the ulcer. Based on the size, depth of ulcer, density of infiltrate, and scleral involvement, it's divided into mild, moderate, and severe grades and may be used to objectively monitor the progress of the ulcer and as a parameter for management. Medical management includes topical, systemic antibiotic, and periocular injection, while amniotic membrane transplantation (AMT), conjunctiva flap, fascia lata, and evisceration as surgical. This study aimed to assess the clinical grading associated with the management of CU in Dr. M. Djamil General Hospital, Padang, Indonesia. Methods: Observational analytics based on the medical record of corneal ulcer patients in Dr. M. Djamil General Hospital, Padang, Indonesia, in 2016-2017. A total of 191 research subjects participated in this study. Data analysis was carried out using SPSS univariately. Results: The fungal, bacterial, and viral CU was diagnosed clinically. The severity grading that we found is moderate (60,73%), mild (25,14%), and severe (14,13%). All of the cases used medical treatment. Surgical was performed in moderate (36,59%) and all severe cases. AMT was performed in severe cases with perforation ≤ 4 mm and perforation > 4 mm conjunctival flap (3.7%), fascia lata (3,7%), and evisceration (61,53%), preferably. Conclusion: The clinical grading of corneal ulcers in our hospital is moderate, and it may be associated with our hospital as a referral hospital. Surgery was performed in all severe and moderate cases that don't respond well to medicine.

Fluconazole, salah satu anti jamur golongan azole, memiliki kemampuan penetrasi okular yang cukup efektif, dapat mencapai konsentrasi akuos sama dengan konsentrasi plasma. Fluconazole dapat diberikan berupa tetes mata, subkonyungtiva, atau intrakamera. Pemberian intrakamera lebih menguntungkan karena tidak melalui reaksi corneal esterase dan konsentrasi akurat langsung di KOA. Dilaporkan empat pasien dengan ulkus kornea ec.jamur, endoftalmitis eksogen ec susp. jamur dan ulkus ateromatosus ec. jamur diberikan injeksi intrakamera fluconazole dengan dosis 0,025/0,1 ml di kamar operasi. Swab kornea (+). Terdapat perbaikan pada kasus infeksi jamur dengan rata-rata 1 hari sampai 7 minggu post op. Kasus pertama, visus membaik signifikan, ukuran infiltrat dan endothelial plaque berkurang, serta hipopion menghilang pada follow up post op hari pertama. Pada kasus kedua visus membaik serta ukuran infiltrat dan edem berkurang pada minggu kedua post op. Kasus ketiga juga terdapat perbaikan, tetapi hasil yang didapatkan tidak terlalu signifikan dimana visus sedikit membaik dengan ukuran endothelial plaque dan edem kornea sedikit berkurang pada follow up minggu keempat post op. Kasus keempat perbaikan didapatkan pada minggu ketujuh post op, dimana ukuran endothelial plaque dan edem kornea berkurang serta hipopion (-). Kultur: candida (+) (kasus 1 dan 2). Pemberian fluconazole intrakamera cukup efektif pada kasus ulkus jamur refrakter.